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Published on: February 24, 2023
Calprotectin as a Biomarker for Melioidosis Disease Progression and Management
Mohan Natesan1, Enoka Corea2, Shivankari Krishnananthasivam3
1Division of Molecular and Translational Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA mohan.natesan.ctr@mail.mil robert.g.ulrich.civ@mail.mil.
Abstract:
Melioidosis is a neglected tropical disease that is caused by the bacterium Burkholderia pseudomallei and is underreported in many countries where the disease is endemic. A long and costly administration of antibiotics is needed to clear infections, and there is an unmet need for biomarkers to guide antibiotic treatment and increase the number of patients that complete therapy. We identified calprotectin as a lead biomarker of B. pseudomallei infections and examined correlations between this serum protein and the antibiotic treatment outcomes of patients with melioidosis. Serum levels of calprotectin and C-reactive protein were significantly higher in patients with melioidosis and nonmelioidosis sepsis than in healthy controls. Median calprotectin levels were higher in patients with melioidosis than in those with nonmelioidosis sepsis, whereas C-reactive protein levels were similar in both groups. Notably, intensive intravenous antibiotic treatment of patients with melioidosis resulted in lower levels of calprotectin and C-reactive protein (P < 0.0001), coinciding with recovery. The median percent reduction of calprotectin and C-reactive protein was 71% for both biomarkers after antibacterial therapy. In contrast, we found no significant differences in calreticulin levels between the two melioidosis treatment phases. Thus, reductions in serum calprotectin levels were linked to therapeutic responses to antibiotics. Our results suggest that calprotectin may be a sensitive indicator of melioidosis disease activity and illustrate the potential utility of this biomarker in guiding the duration of antibiotic therapy.
Insights
Calprotectin shows promise as a biomarker for melioidosis, a serious infection caused by Burkholderia pseudomallei. Lowering calprotectin levels during antibiotic treatment indicates a positive response, potentially guiding therapy duration.
Area of Science:
- Infectious Diseases
- Biomarkers
- Tropical Medicine
Background:
- Melioidosis, caused by *Burkholderia pseudomallei*, is a neglected tropical disease with prolonged antibiotic treatment requirements.
- Current treatment lacks reliable biomarkers to guide therapy duration and ensure patient adherence.
- There is a critical need for effective biomarkers to monitor melioidosis treatment outcomes.
Purpose of the Study:
- To identify and validate calprotectin as a biomarker for *Burkholderia pseudomallei* infections.
- To investigate the correlation between serum calprotectin levels and antibiotic treatment response in melioidosis patients.
- To assess the potential utility of calprotectin in guiding antibiotic therapy duration.
Main Methods:
- Serum samples were analyzed for calprotectin and C-reactive protein levels in patients with melioidosis, non-melioidosis sepsis, and healthy controls.
- Correlations between biomarker levels and response to intensive intravenous antibiotic treatment were examined.
- Calreticulin levels were also assessed during different treatment phases.
Main Results:
- Serum calprotectin and C-reactive protein were elevated in melioidosis and sepsis patients compared to controls.
- Calprotectin levels were higher in melioidosis patients than in non-melioidosis sepsis patients.
- Antibiotic treatment significantly reduced calprotectin and C-reactive protein levels (median 71% reduction), correlating with recovery. Calreticulin levels did not change significantly.
Conclusions:
- Serum calprotectin is a promising biomarker for indicating melioidosis disease activity.
- Reductions in serum calprotectin levels are linked to successful antibiotic therapy response.
- Calprotectin may serve as a valuable tool to guide the duration of antibiotic treatment for melioidosis.
