Abstract
Design: Biochemical characteristics of the 42 newly diagnosed patients with PT. Blood levels of acute phases reactants-ARP: ceruloplasmin-CP, haptoglobin-Hg, C-reactive protein-CRP, orosomucoid-AGP, albumin-A, neopterin-Np, elastase-El, alpha1-protease inhibitor- alpha1-IP, adenosine deaminase activities-ADA; were tested before the start of treatment. Test results were analyzed considering clinical, radiologic and bacteriologic examination data after three months of adequate anti-TB therapy. Sputum negativation and closing of cavities were classified as an outcome significant improvement (SI) while sputum negativation - as improvement (I).
Mycobacterium tuberculosis (MBT) isolate (the Pathogen) from sputum collected before the to treatment start had been studied as: MBT genotype (by spoligotyping), drug resistance patterns (DR), cytotoxicity (CT; MBT ability to stimulate THP-1 cells death). The data were analyzed according to MBT genotype Beijing (Bj) or another families and the therapy effect.
Results. Both SI and I outcomes were observed regardless MBT genotypes. Nevertheless Bj-genotype (MBT-B) was associated with I (41% and 70%; p=0,05) and high levels of ARPs, CT and DR. Low levels of ARPs were associated with SI while their high levels with I. Discriminative analysis revealed the constellation of four ARPs (CP, Hg, El, ADA) as the complex with the highest predictive value of the 3 month chemotherapy outcome with a prognostic accuracy in 95,2% for MBT-B patients and in 100% for those with MBT of other genotypes families.
Conclusion: In H-PS tuberculosis development is mainly determined by the host properties expressed as ARP levels. Complex of CP, Hg, El, ADA blood levels proved to be of the most prognostic value.
- © 2014 ERS