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IL-18 and related function proteins associated with tuberculosis severity and screening for active TB among patients
Sebastian Wawrocki1, Michal Seweryn2, Grzegorz Kielnierowski3
1Department of Immunology and Infectious Biology, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237 Lodz, Poland.
Background:
Differentiation of active pulmonary tuberculosis (TB) from non-mycobacterial community-acquired pneumonia (CAP) still remains a diagnostic challenge.
Objective:
The study aimed to quantify the IL-18, IFN-γ, IL-18BP, IL-37, and IP-10 levels in serum and Mycobacterium tuberculosis (M.tb) antigens-stimulated blood cultures from TB or CAP patients and explore if the proteins can be a useful basis for discriminating these diseases.
Methods:
In total, 124 Polish adults, including mild/moderate (M/MTB) or advanced (ATB) TB patients, and CAP patients, were enrolled in the study. The concentrations of IL-18, IL-18BP, IFN-γ, IL-37, and IP-10 in sera and M.tb-stimulated cultures were measured by ELISA.
Results:
The most specific and sensitive serum proteins discriminating TB from CAP were IP-10 and IL-18BP; however, IP-10 had the highest AUC in the ROC curve for the diagnosis. Serum IP-10 and IL-18BP levels increased significantly in M/MTB or ATB groups. The IL-18BP elevation in ATB group was accompanied by an increase in IL-18. No single protein measured in M.tb-stimulated cultures differed TB from CAP patients.
Conclusions:
The combined analysis of serum IL-18BP and IP-10 might be considered as an auxiliary tool in the differentiation of TB from CAP.
Insights
Distinguishing active pulmonary tuberculosis (TB) from community-acquired pneumonia (CAP) is challenging. Serum IP-10 and IL-18BP show promise as biomarkers for differentiating these respiratory conditions.
Area of Science:
- Immunology
- Infectious Diseases
- Respiratory Medicine
Background:
- Differentiating active pulmonary tuberculosis (TB) from community-acquired pneumonia (CAP) presents a significant diagnostic hurdle.
- Accurate diagnosis is crucial for effective treatment and patient outcomes.
Purpose of the Study:
- To evaluate serum and stimulated blood culture levels of IL-18, IFN-γ, IL-18BP, IL-37, and IP-10.
- To determine the utility of these proteins in distinguishing between TB and CAP.
Main Methods:
- Serum and Mycobacterium tuberculosis (M.tb) antigen-stimulated blood cultures were analyzed from 124 Polish adults.
- Participants included patients with mild/moderate TB (M/MTB), advanced TB (ATB), and CAP.
- Cytokine concentrations were quantified using enzyme-linked immunosorbent assay (ELISA).
Main Results:
- Serum IP-10 and IL-18BP were the most specific and sensitive biomarkers for differentiating TB from CAP.
- IP-10 demonstrated the highest area under the receiver operating characteristic curve (AUC).
- Elevated serum IP-10 and IL-18BP levels were observed in both M/MTB and ATB groups, with IL-18BP elevation correlating with increased IL-18 in ATB patients. No significant differences were found in stimulated cultures.
Conclusions:
- Combined analysis of serum IL-18BP and IP-10 may serve as an auxiliary diagnostic tool.
- These biomarkers can aid in the differentiation of TB from CAP.
- Further research may refine their role in clinical practice.
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