1. Mycobacterium tuberculosis-stimulated whole blood culture to detect host biosignatures for tuberculosis treatment response
- Author
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Katharina Ronacher, Gerhard Walzl, Karen Cilliers, Andre G. Loxton, Martin Kidd, Tariq Webber, Hazel M. Dockrell, Léanie Kleynhans, Angela Menezes, Novel N. Chegou, Jacqueline M. Cliff, Joel Fleury Djoba Siawaya, and Nelita du Plessis
- Subjects
Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Treatment response ,Tuberculosis ,Adolescent ,030106 microbiology ,Immunology ,Treatment outcome ,Sensitivity and Specificity ,Microbiology ,Gastroenterology ,Article ,Mycobacterium tuberculosis ,Young Adult ,03 medical and health sciences ,Recurrence ,Antigen specific ,Internal medicine ,medicine ,Humans ,Whole blood ,biology ,business.industry ,Middle Aged ,biology.organism_classification ,medicine.disease ,Treatment Outcome ,030104 developmental biology ,Infectious Diseases ,Blood Culture ,Cytokines ,Female ,Cell culture supernatant ,Chemokines ,business ,Biomarkers ,After treatment - Abstract
Host markers to monitor the response to tuberculosis (TB) therapy hold some promise. We evaluated the changes in concentration of Mycobacterium tuberculosis (M.tb)-induced soluble biomarkers during early treatment for predicting short- and long-term treatment outcomes. Whole blood samples from 30 cured and 12 relapsed TB patients from diagnosis, week 1, 2, and 4 of treatment were cultured in the presence of live M.tb for seven days and patients followed up for 24 weeks after the end of treatment. 57 markers were measured in unstimulated and antigen-stimulated culture supernatants using Luminex assays. Top performing multi-variable models at diagnosis using unstimulated values predicted outcome at 24 months after treatment completion with a sensitivity of 75.0% (95% CI, 42.8 – 94.5%) and specificity of 72.4% (95% CI, 52.8 – 87.3%) in leave-one-out cross validation. Month two treatment responder classification was correctly predicted with a sensitivity of 79.2% (95% CI, 57.8 – 92.9) and specificity of 93.3% (95% CI, 64– 99.8%). This study provides evidence of the early M.tb-specific treatment response in TB patients but shows that the observed unstimulated marker models are not outperformed by stimulated marker models. Performance of unstimulated predictive host marker signatures is promising and requires validation in larger studies.
- Published
- 2021
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