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The Assessment of Serum Fibronectin Levels as a Potential Biomarker for the Severity of Drug-Sensitive Pulmonary
Shreedhar Kulkarni1, Sumalatha Arunachala1,2,3, Sindaghatta Krishnarao Chaya1
1Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India.
Background:
Tuberculosis (TB) is a global health burden caused by Mycobacterium tuberculosis (Mtb) infection. Fibronectin (Fn) facilitates Mtb attachment to host cells. We studied the Fn levels in smear-positive TB patients to assess its correlation with disease severity based on sputum smears and chest X-rays.
Methods:
Newly detected consecutive sputum AFB-positive pulmonary TB patients (n = 78) and healthy control subjects (n = 11) were included. The mycobacterial load in the sputum smear was assessed by IUATLD classification, ranging from 0 to 3. The severity of pulmonary involvement was assessed radiologically in terms of both the number of zones involved (0-6) and as localized (up to 2 zones), moderate (3-4 zones), or extensive (5-6 zones). The serum human fibronectin levels were measured by using a commercially available enzyme-linked immunosorbent assay (ELISA) kit (Catalogue No: CK-bio-11486, Shanghai Coon Koon Biotech Co., Ltd., Shanghai, China).
Results:
The PTB patients showed lower Fn levels (102.4 ± 26.7) compared with the controls (108.8 ± 6.8), but they were not statistically significant. Higher AFB smear grades had lower Fn levels. The chest X-ray zones involved were inversely correlated with Fn levels. The Fn levels, adjusted for age and gender, decreased with increased mycobacterial load and the number of chest radiograph zones affected. A Fn level <109.39 g/mL predicted greater TB severity (sensitivity of 67.57% and specificity of 90.38%), while a level <99.32 pg/mL predicted severity based on the chest radiology (sensitivity of 84.21% and specificity of 100%).
Conclusions:
The Fn levels are lower in tuberculosis patients and are negatively correlated with severity based on sputum mycobacterial load and chest radiographs. The Fn levels may serve as a potential biomarker for assessing TB severity, which could have implications for early diagnosis and treatment monitoring.
Insights
Tuberculosis patients have lower fibronectin (Fn) levels, which correlate with increased disease severity. Lower Fn may indicate higher mycobacterial load and more extensive lung damage on chest X-rays.
Area of Science:
- Infectious Diseases
- Biochemistry
- Pulmonology
Background:
- Tuberculosis (TB) remains a significant global health challenge caused by *Mycobacterium tuberculosis* (Mtb).
- Fibronectin (Fn) is implicated in the attachment of Mtb to host cells.
- Understanding host factors like Fn levels can provide insights into TB pathogenesis and severity.
Purpose of the Study:
- To investigate the correlation between serum fibronectin (Fn) levels and disease severity in patients with smear-positive pulmonary tuberculosis (TB).
- To assess the relationship between Fn levels, mycobacterial load in sputum, and radiological findings on chest X-rays.
Main Methods:
- Serum Fn levels were measured in 78 newly diagnosed sputum AFB-positive pulmonary TB patients and 11 healthy controls using ELISA.
- Mycobacterial load was quantified using AFB smear grading (IUATLD classification 0-3).
- Pulmonary involvement severity was assessed radiologically by the number of chest X-ray zones affected (0-6).
Main Results:
- Pulmonary TB patients exhibited lower mean Fn levels compared to controls, though not statistically significant.
- A significant inverse correlation was observed between Fn levels and both AFB smear grade and the number of chest X-ray zones affected.
- Adjusted Fn levels decreased with increased mycobacterial load and radiological severity, with specific thresholds predicting greater TB severity.
Conclusions:
- Serum fibronectin (Fn) levels are reduced in tuberculosis patients and correlate negatively with disease severity.
- Fn levels show potential as a biomarker for assessing TB severity, aiding in early diagnosis and treatment monitoring.
- These findings highlight the role of fibronectin in TB pathogenesis and its utility in clinical assessment.
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