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SUSTAINED ELEVATED LEVELS OF C-REACTIVE PROTEIN AND FERRITIN IN PULMONARY TUBERCULOSIS PATIENTS REMAINING CULTURE POSITIVE UPON TREATMENT INITIATION
Miranda, Pryscila et al. | Date Issued: 2017
Author
Miranda, Pryscila
Santana, Leonardo Gil
Oliveira, Marina G.
Mesquita, Eliene Denites Duarte
Silva, Elisangela Costa da
Rauwerdink, Anneloek
Cobelens, Frank
Oliveira, Martha Maria de
Andrade, Bruno de Bezerril
Kritski, Afrânio Lineu
Affilliation
Federal University of Rio de Janeiro. Medical School. Tuberculosis Academic Program. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Fundação Jose Silveira. Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil / Faculdade de Tecnologia e Ciências. Curso de Medicina. Salvador, BA, Brazil.
Federal University of Rio de Janeiro. Medical School. Tuberculosis Academic Program. Rio de Janeiro, RJ, Brazil.
Ary Parreira Institute. State Secretary of Health of Rio de Janeiro. Rio de Janeiro, RJ, Brazil.
State University of North Fluminense Darcy Ribeiro. Recognize the Biology Laboratory, Center of Bioscience and Biotechnology. Rio de Janeiro, RJ, Brazil / Rede Brasileira de Pesquisas em Tuberculose. Rio de Janeiro, RJ, Brazil.
Amsterdam Institute for Global Health and Development. Academic Medical Centre. Amsterdam, The Netherlands.
Amsterdam Institute for Global Health and Development. Academic Medical Centre. Amsterdam, The Netherlands.
Rede Brasileira de Pesquisas em Tuberculose. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Centro de Desenvolvimento Tecnológico em Saúde. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Fundação Jose Silveira. Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brasil / Faculdade de Tecnologia e Ciências. Curso de Medicina. Salvador, BA, Brasil / Rede Brasileira de Pesquisas em Tuberculose. Rio de Janeiro, RJ, Brazil / Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil / Universidade Salvador. Laureate International Universities. Salvador, BA, Brazil.
Federal University of Rio de Janeiro. Medical School. Tuberculosis Academic Program. Rio de Janeiro, RJ, Brazil / Rede Brasileira de Pesquisas em Tuberculose. Rio de Janeiro, RJ, Brazil.
Abstract
Clinical trials that evaluate new anti-tubercular drugs and treatment regimens take years to complete due to the slow clearance of Mycobacterium tuberculosis infection and the lack of early biomarkers that predict treatment outcomes. Host Inflammation markers have been associated with tuberculosis (TB) pathogenesis. In the present study, we tested if circulating levels of C-reactive protein (CRP) and ferritin reflect mycobacterial loads and inflammation in pulmonary TB (PTB) patients undergoing anti-tuberculous therapy (ATT). Methods Prospective measurements of CRP and ferritin, used as readouts of systemic inflammation, were performed in cryopreserved serum samples from 165 Brazilian patients with active PTB initiating ATT. Associations between levels of these laboratory parameters with mycobacterial loads in sputum as well as with sputum conversion at day 60 of ATT were tested. Results: Circulating levels of both ferritin and CRP gradually decreased over time on ATT. At pretreatment, concentrations of these parameters were unable to distinguish patients with positive from those with negative acid-fast bacilli (AFB) in sputum cultures. However, patients who remained with positive cultures at day 60 of ATT exhibited heightened levels of these inflammatory markers compared to those with negative cultures at that time point. Conclusions: CRP and Ferritin levels in serum may be useful to identify patients with positive cultures at day 60 of ATT.
Keywords in Portuguese
Tuberculose Pulmonar
Proteína C-reativa
Ferritinas
Humanos
Agentes antituberculosos
 
Keywords
Tuberculosis Pulmonary
C-Reactive Protein
Ferritins
Humans
Antitubercular Agents
 
Publisher
Public Library of Science
Citation
MIRANDA, P. et al. Sustained elevated levels of C-reactive protein and ferritin in pulmonary tuberculosis patients remaining culture positive upon treatment initiation. Plos One, v. 12, n. 4, p. 1-12, 2017.
DOI
10.1371/journal.pone.0175278
ISSN
1932-6203