Dynamics of inflammation biomarkers in drug sensitive tuberculosis and pneumonia

Abstract

Introduction: Tuberculosis (TB) biomarker discovery could aid the routine clinical practice and in shortening of clinical trials of new anti-TB drugs. Aims and Objectives: To evaluate the changes of selected host biomarkers (soluble intercellular adhesion molecule type 1 (sICAM-1), soluble urokinase-type plasminogen activator receptor (suPAR), C-reactive protein (CRP)) during the treatment of pulmonary TB and pneumonia. To evaluate, if the changes of T lymphocyte subpopulations correlate with treatment outcomes. Methods: A prospective study was carried out in university hospital. 62 patients with drug-susceptible pulmonary TB and 19 with pneumonia were included. Before starting the treatment blood was drawn for flow cytometry and inflammation marker testing. 1 month later inflammation marker testing was repeated in both groups; 5 months later blood tests (including flow cytometry) were repeated in TB group. Results: At baseline CRP and sICAM-1 were significantly higher in TB group with no culture conversion after 1 month of treatment. After the first month CRP was the only inflammation marker that significantly decreased in both pneumonia and TB groups. Higher baseline CRP and suPAR values were observed in the unfavorable TB outcome group. Differences of lymphocyte subpopulations were observed between conversion and non-conversion and between favorable and unfavorable outcome groups (p Conclusions: Selected markers can have a role in evaluating treatment response and predicting TB outcomes. Best markers in TB treatment outcome and culture conversion prediction were observed to be suPAR and CRP. T cell depletion can have an impact on the unfavorable prognosis.