背景:结核病(TB)是由结核分枝杆菌(Mtb)感染引起的全球健康负担。纤连蛋白(Fn)促进Mtb附着于宿主细胞。我们研究了涂片阳性结核病患者的Fn水平,以根据痰涂片和胸部X光检查评估其与疾病严重程度的相关性。
方法:纳入新检测的连续痰AFB阳性肺结核患者(n=78)和健康对照受试者(n=11)。通过IUATLD分类评估痰涂片中的分枝杆菌负荷,范围从0到3。根据所涉及的区域数量(0-6个)和局部(最多2个区域)在放射学上评估肺部受累的严重程度。中等(3-4个区域),或广泛(5-6区)。通过使用市售的酶联免疫吸附测定(ELISA)试剂盒(目录编号:CK-bio-11486,上海CoonKoonBiotechCo.,Ltd.,上海,中国)。
结果:PTB患者的Fn水平(102.4±26.7)低于对照组(108.8±6.8),但没有统计学意义。较高的AFB涂片等级具有较低的Fn水平。所涉及的胸部X射线区与Fn水平成反比。Fn级别,根据年龄和性别进行调整,随着分枝杆菌负荷的增加和受影响的胸部X光片区域的数量而减少。Fn水平<109.39g/mL可预测更严重的TB(敏感性为67.57%,特异性为90.38%),而<99.32pg/mL的水平根据胸部放射学预测严重程度(敏感性为84.21%,特异性为100%)。
结论:根据痰分枝杆菌载量和胸片,肺结核患者的Fn水平较低,与严重程度呈负相关。Fn水平可以作为评估TB严重程度的潜在生物标志物。这可能对早期诊断和治疗监测有影响。
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.