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首页> 外文期刊>AIDS >Circulating inflammatory biomarkers can predict and characterize tuberculosis-associated immune reconstitution inflammatory syndrome.
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Circulating inflammatory biomarkers can predict and characterize tuberculosis-associated immune reconstitution inflammatory syndrome.

机译：循环的炎症生物标记物可以预测和表征结核相关的免疫重建炎症综合症。

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OBJECTIVE: To identify inflammatory biomarker profiles during paradoxical and unmasking tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS), and determine whether differences in biomarkers prior to antiretroviral therapy (ART) predict subsequent development of TB-IRIS. DESIGN: Case-control study within a cohort of patients initiating ART in South Africa (n = 498). METHODS: Participants were followed up for 24 weeks for development of TB-IRIS. Plasma samples were collected at baseline and presentation with symptoms. Groups of cases and controls were as follows: pre-ART TB and developed paradoxical TB-IRIS (n = 9); pre-ART TB but no IRIS (n = 12); no pre-ART TB but developed unmasking TB-IRIS (n = 13); no pre-ART TB and no TB or IRIS during treatment (n = 12). Concentrations of 18 cytokines and chemokines, and C-reactive protein (CRP), were measured and compared. RESULTS: Event samples were drawn a median of 28 days after ART initiation [interquartile range (IQR) 14-56 days]. During paradoxical TB-IRIS events, there were lower median concentrations of interleukin-10 [IL-10; 22.1 (IQR 15.3-34.9) vs. 82.2 (29.4-128.4) pg/ml, P = 0.047] and monocyte chemotactic protein-1 [MCP-1; 27.6 (20.0-29.7) vs. 71.4 (40.6-77.8) pg/ml, P = 0.005], and higher CRP: IL-10 ratio [2.2 x 10(3) (1.8-3.4) vs. 0.3 x 10(3) (0.2-0.5), P = 0.003] than in controls. Patients who developed unmasking TB-IRIS had higher median pre-ART levels of CRP [25 (8-47) vs. 6 (lower limit of detection, LLD-12) mg/l, P = 0.046] and interferon gamma (IFN-gamma) [9.1 (4.4-24.7) vs. 0.9 (LLD-8.7) pg/ml, P = 0.032] than controls. CONCLUSION: Patients with unmasking TB-IRIS had higher pre-ART levels of plasma IFN-gamma and CRP, consistent with preexisting subclinical TB. Paradoxical TB-IRIS was associated with lower levels of biomarkers of monocyte and regulatory T-cell activity, and higher CRP.
机译：目的：确定在自相矛盾的和与肺结核相关的免疫重建炎症综合症（TB-IRIS）中的炎症生物标志物谱，并确定抗逆转录病毒治疗（ART）之前生物标志物的差异是否可预测TB-IRIS的后续发展。设计：在南非发起抗逆转录病毒治疗的一组患者中进行病例对照研究（n = 498）。方法：对参与者进行了为期24周的随访，以开发TB-IRIS。在基线和出现症状时收集血浆样品。病例和对照的分组如下：ART前结核病和已发展的自相矛盾的TB-IRIS（n = 9）; ART之前的结核病但没有IRIS（n = 12）;无ART前结核病，但已开发出可掩盖的TB-IRIS（n = 13）;治疗期间无ART前结核，无TB或IRIS（n = 12）。测量并比较了18种细胞因子和趋化因子以及C反应蛋白（CRP）的浓度。结果：事件样本是在ART开始后28天的中位数[四分位间距（IQR）14-56天]抽取的。在反常的TB-IRIS事件期间，白介素10 [IL-10]的中位浓度较低。 22.1（IQR 15.3-34.9）与82.2（29.4-128.4）pg / ml，P = 0.047]和单核细胞趋化蛋白1 [MCP-1; 27.6（20.0-29.7）与71.4（40.6-77.8）pg / ml，P = 0.005]和更高的CRP：IL-10比[2.2 x 10（3）（1.8-3.4）与0.3 x 10（3） ）（0.2-0.5），P = 0.003]。出现未掩盖的TB-IRIS的患者具有较高的CART前中位CRP水平[25（8-47）比6（检测下限，LLD-12）mg / l，P = 0.046]和干扰素（IFN- γ[9.1（4.4-24.7）vs. 0.9（LLD-8.7）pg / ml，P = 0.032]。结论：具有掩盖性TB-IRIS的患者的ART前血浆IFN-γ和CRP水平较高，与先前存在的亚临床TB一致。矛盾的TB-IRIS与单核细胞和调节性T细胞活性的生物标志物水平降低以及CRP升高有关。

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