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Rajakumar HK, Coimbatore Sathyabal V, Palaniyandi A, Balakrishnan D. Exploring mean platelet volume and neutrophil-to-albumin ratio as surrogate markers for monitoring tuberculosis treatment: a prospective longitudinal study. BMC Pulm Med 2024; 24:406. [PMID: 39180021 PMCID: PMC11344401 DOI: 10.1186/s12890-024-03236-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 08/19/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND Tuberculosis (TB) remains a global health challenge, with India bearing a significant burden. Despite advancements in TB diagnosis and treatment, monitoring TB treatment is challenging, particularly in resource-limited settings. This study aimed to explore the mean platelet volume (MPV) as a potential surrogate marker for monitoring TB treatment and assessing if the neutrophil-to-albumin ratio (NAR) enhances treatment monitoring. METHODS Patients diagnosed with TB following NTEP guidelines were recruited. Participants underwent routine blood tests during the six-month Anti-Tubercular therapy course at the start, end of the intensive phase, and end of the continuous phase. Statistical analyses included Spearman correlation, Friedman test, linear mixed effects (LME) models, and multiple linear regression. RESULTS 150 individuals were included for analysis. Deviations from normality were noted. Significant associations were found between CRP and sputum grade. MPV mediated between CRP and sputum grade. Significant differences were observed across the three-time points. LME models showed changes in MPV and CRP levels over time. Including NAR enhanced predictive capability. CONCLUSIONS MPV may serve as a promising surrogate marker for monitoring ATT. Personalized approaches are crucial in TB treatment monitoring. LME models revealed MPV and CRP level trends. Future research should explore MPV's treatment response mechanisms and cost-effectiveness.
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Affiliation(s)
| | | | - Arulkumaran Palaniyandi
- Department of Respiratory Medicine, Government Medical College, Omandurar Government Estate, Chennai, India
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Djibougou DA, Mensah GI, Kaboré A, Toé I, Sawadogo LT, Lompo PF, Kone AMM, Hien H, Meda CZ, Combary A, Bonfoh B, Addo KK, Belem AMG, Dabiré RK, Hoffmann J, Perreau M, Diagbouga PS. Immunological and Haematological Relevance of Helminths and Mycobacterium tuberculosis Complex Coinfection among Newly Diagnosed Pulmonary Tuberculosis Patients from Bobo-Dioulasso, Burkina Faso. Biomedicines 2024; 12:1472. [PMID: 39062045 PMCID: PMC11274831 DOI: 10.3390/biomedicines12071472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/08/2024] [Accepted: 06/14/2024] [Indexed: 07/28/2024] Open
Abstract
The effect of helminthiasis on host immunity is a neglected area of research, particularly in tuberculosis (TB) infection. This study aimed to evaluate the effect of helminthiasis on immunological and haematological parameters in newly diagnosed TB patients in Bobo-Dioulasso. After all biological analyses, we formed three subpopulations: group 1 (n = 82), as control, were participants without helminthic or Mycobacterium tuberculosis complex infection (Mtb-/Helm-), group 2 (n = 73) were TB patients without helminthic infection (Mtb+/Helm-), and group 3 (n = 22) were TB patients with helminthic infection (Mtb+/Helm+). The proportion of helminth coinfection was 23.16% (22/95) in TB patients, and Schistosoma mansoni infection was found in 77.3% (17/22) cases of helminthiasis observed in this study. A low CD4 T cell count and a low CD4:CD8 ratio were significantly associated with concomitant infection with helminths and the Mtb complex (Mtb+/Helm+) compared to the other groups (p < 0.05). However, there was no statistically significant difference in the CD8 median among the three participating groups (p > 0.05). Lymphopenia, monocytosis, thrombocytosis, and hypochromic microcytic anaemia were the haematological defects observed in the Mtb+/Helm+ and Mtb+/Helm- patients. Exploring these types of immune-haematological biomarkers would be a valuable aid in diagnosing and a better follow-up and monitoring of the tuberculosis-helminthiasis coinfection.
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Affiliation(s)
- Diakourga Arthur Djibougou
- Doctoral School of Natural Sciences and Agronomy, Université Nazi BONI, Bobo-Dioulasso 1091, Burkina Faso; (I.T.); (L.T.S.); (C.Z.M.); (A.M.-G.B.)
- Infectious Diseases Program, Centre MURAZ, Institut National de Santé Publique, Bobo-Dioulasso 1091, Burkina Faso; (A.M.M.K.); (H.H.); (R.K.D.)
- Institut de Recherche en Sciences de la Santé, CNRST, Bobo-Dioulasso 545, Burkina Faso
| | - Gloria Ivy Mensah
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra 00233, Ghana; (G.I.M.); (K.K.A.)
| | - Achille Kaboré
- Infectious Disease and Health Systems (IDHS), FHI 360, Washington, DC 20037, USA;
| | - Inoussa Toé
- Doctoral School of Natural Sciences and Agronomy, Université Nazi BONI, Bobo-Dioulasso 1091, Burkina Faso; (I.T.); (L.T.S.); (C.Z.M.); (A.M.-G.B.)
- Institut de Recherche en Sciences de la Santé, CNRST, Bobo-Dioulasso 545, Burkina Faso
| | - Leon Tinnoga Sawadogo
- Doctoral School of Natural Sciences and Agronomy, Université Nazi BONI, Bobo-Dioulasso 1091, Burkina Faso; (I.T.); (L.T.S.); (C.Z.M.); (A.M.-G.B.)
- National Tuberculosis Programme, Ministry of Health and Public Hygiene, Ouagadougou 01 P.O. Box 690, Burkina Faso;
| | - Palpouguini Felix Lompo
- Etudes Formation et Recherches Développement en Santé (EFORDS), Ouagadougou 10 P.O. Box 13064, Burkina Faso;
| | - Amariane M. M. Kone
- Infectious Diseases Program, Centre MURAZ, Institut National de Santé Publique, Bobo-Dioulasso 1091, Burkina Faso; (A.M.M.K.); (H.H.); (R.K.D.)
| | - Hervé Hien
- Infectious Diseases Program, Centre MURAZ, Institut National de Santé Publique, Bobo-Dioulasso 1091, Burkina Faso; (A.M.M.K.); (H.H.); (R.K.D.)
- Institut de Recherche en Sciences de la Santé, CNRST, Bobo-Dioulasso 545, Burkina Faso
| | - Clement Ziemlé Meda
- Doctoral School of Natural Sciences and Agronomy, Université Nazi BONI, Bobo-Dioulasso 1091, Burkina Faso; (I.T.); (L.T.S.); (C.Z.M.); (A.M.-G.B.)
- Infectious Diseases Program, Centre MURAZ, Institut National de Santé Publique, Bobo-Dioulasso 1091, Burkina Faso; (A.M.M.K.); (H.H.); (R.K.D.)
| | - Adjima Combary
- National Tuberculosis Programme, Ministry of Health and Public Hygiene, Ouagadougou 01 P.O. Box 690, Burkina Faso;
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifique de Côte d’Ivoire, Adiopodoumé 01 P.O. Box 1303, Côte d’Ivoire;
| | - Kennedy Kwasi Addo
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra 00233, Ghana; (G.I.M.); (K.K.A.)
| | - Adrien Marie-Gaston Belem
- Doctoral School of Natural Sciences and Agronomy, Université Nazi BONI, Bobo-Dioulasso 1091, Burkina Faso; (I.T.); (L.T.S.); (C.Z.M.); (A.M.-G.B.)
| | - Roch Konbobr Dabiré
- Infectious Diseases Program, Centre MURAZ, Institut National de Santé Publique, Bobo-Dioulasso 1091, Burkina Faso; (A.M.M.K.); (H.H.); (R.K.D.)
- Institut de Recherche en Sciences de la Santé, CNRST, Bobo-Dioulasso 545, Burkina Faso
| | - Jonathan Hoffmann
- Département Médical et Scientifique, Fondation Mérieux, 17 rue Bourgelat, 69002 Lyon, France;
| | - Matthieu Perreau
- Faculty of Biology and Medicine, Université de Lausanne, 1010 Lausanne, Switzerland;
| | - Potiandi Serge Diagbouga
- Institut de Recherche en Sciences de la Santé, CNRST, Bobo-Dioulasso 545, Burkina Faso
- Etudes Formation et Recherches Développement en Santé (EFORDS), Ouagadougou 10 P.O. Box 13064, Burkina Faso;
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J NH, Venkataraman A, Thiruvengadam K, B B, M K, S S, Balaji S, S E, Smuk M, Hanna LE, Prendergast AJ. Evaluation of platelet indices as markers of tuberculosis among children in India. ERJ Open Res 2024; 10:00734-2023. [PMID: 38410718 PMCID: PMC10895425 DOI: 10.1183/23120541.00734-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/15/2023] [Indexed: 02/28/2024] Open
Abstract
Children with tuberculosis have increased platelet count and platelet/lymphocyte ratio along with decreased mean platelet volume, suggesting that these indices may be useful as adjunct tools in diagnosis of paediatric tuberculosis https://bit.ly/3Ga4AWT.
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Affiliation(s)
- Nancy Hilda J
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
- Joint first authors
| | - Aishwarya Venkataraman
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
- Blizard Institute, Queen Mary University of London, London, UK
- Joint first authors
| | | | - Brindha B
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | - Karthick M
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | - Subha S
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | - Sarath Balaji
- Institute of Child Health, Madras Medical College, Chennai, India
| | - Elilarasi S
- Institute of Child Health, Madras Medical College, Chennai, India
| | - Melanie Smuk
- Blizard Institute, Queen Mary University of London, London, UK
| | - Luke Elizabeth Hanna
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
- Joint senior authors
| | - Andrew J Prendergast
- Blizard Institute, Queen Mary University of London, London, UK
- Joint senior authors
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Okeke CO, Amilo GI, Manafa PO, Ibeh NC. Inflammation-mediated changes in haemostatic variables of pulmonary tuberculosis patients during treatment. Tuberculosis (Edinb) 2023; 138:102285. [PMID: 36436460 DOI: 10.1016/j.tube.2022.102285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022]
Abstract
Tuberculosis (TB) disease is usually marked by inflammation which is closely linked to haemostasis both in health and disease. Close monitoring of haemostatic response to inflammatory changes during treatment is important to improve TB management. Here we studied associations between haemostatic markers and inflammatory cytokines in 60 TB-infected individuals, aged 18-65 years who received anti-TB therapy. They were recruited before commencement of therapy and followed up till completion of therapy after 6-months. The TNF-α, IL-6, IL-2 (pro-inflammatory cytokines) and P-selectin, GP IIb/IIIa, thrombopoietin (haemostatic variables) were significantly increased at 2 month into therapy compared to pre-treatment values and decreased at 6 month into therapy. Also at 6 month into therapy in comparison to 2-month into therapy, there were significant increase in IL-10 and TGF-β (anti-inflammatory cytokines) as well as a significant decline in PF-4. There were significant positive correlations between GP IIb/IIIa and TNF-α, IL-6 and PSEL, IL-6 and TPO, PF4 and TGF-β. Conclusively, the changes in the TNF-α, IL-6, IL-2 aligned with changes in the levels of P-selectin, GP IIb/IIIa, and TPO in the course of TB therapy. This may suggest that the levels of inflammatory cytokines are linked to the levels of these haemostatic variables in TB individuals.
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Affiliation(s)
- C O Okeke
- Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus P.M.B. 5001, Anambra State, Nigeria.
| | - G I Amilo
- Department of Haematology, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus P.M.B. 5001, Anambra State, Nigeria
| | - P O Manafa
- Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus P.M.B. 5001, Anambra State, Nigeria
| | - N C Ibeh
- Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus P.M.B. 5001, Anambra State, Nigeria
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Wei Y, Tang S, Xie Z, He Y, Zhang Y, Xie Y, Chen S, Liu L, Liu Y, Liang Z. Pulmonary Tuberculosis-Related Ischemic Stroke: A Retrospective Case Control Study. J Inflamm Res 2022; 15:4239-4249. [PMID: 35923909 PMCID: PMC9341260 DOI: 10.2147/jir.s368183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/01/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Yunfei Wei
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Precision Medicine in Cardio-cerebrovascular Diseases Control and Prevention & Guangxi Clinical Research Center for Cardio-cerebrovascular Diseases, Nanning, People’s Republic of China
- Department of Neurology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
| | - Shiting Tang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Precision Medicine in Cardio-cerebrovascular Diseases Control and Prevention & Guangxi Clinical Research Center for Cardio-cerebrovascular Diseases, Nanning, People’s Republic of China
| | - Zhouhua Xie
- Department of Tuberculosis, The Fourth People’s Hospital of Nanning City, Nanning, People’s Republic of China
| | - Yaoqin He
- Department of Tuberculosis, The Fourth People’s Hospital of Nanning City, Nanning, People’s Republic of China
| | - Yunli Zhang
- Department of Neurology, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, People’s Republic of China
| | - Yiju Xie
- Department of Neurology, Wuming hospital of Guangxi Medical University, Nanning, People’s Republic of China
| | - Shijian Chen
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Precision Medicine in Cardio-cerebrovascular Diseases Control and Prevention & Guangxi Clinical Research Center for Cardio-cerebrovascular Diseases, Nanning, People’s Republic of China
| | - Liuyu Liu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Precision Medicine in Cardio-cerebrovascular Diseases Control and Prevention & Guangxi Clinical Research Center for Cardio-cerebrovascular Diseases, Nanning, People’s Republic of China
| | - Yayuan Liu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Precision Medicine in Cardio-cerebrovascular Diseases Control and Prevention & Guangxi Clinical Research Center for Cardio-cerebrovascular Diseases, Nanning, People’s Republic of China
| | - Zhijian Liang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Precision Medicine in Cardio-cerebrovascular Diseases Control and Prevention & Guangxi Clinical Research Center for Cardio-cerebrovascular Diseases, Nanning, People’s Republic of China
- Correspondence: Zhijian Liang, Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Precision Medicine in Cardio-cerebrovascular Diseases Control and Prevention & Guangxi Clinical Research Center for Cardio-cerebrovascular Diseases, Nanning, People’s Republic of China, Tel +86-771-5330705, Fax +86-771-5352627, Email
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KOÇ İ, GULLU YT. C-reactive protein Lymphocyte Ratio in the Diagnosis of Pulmonary Tuberculosis. TURKISH JOURNAL OF INTERNAL MEDICINE 2022. [DOI: 10.46310/tjim.1072714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Tuberculosis (TB) is still a severe problem in underdeveloped and developing countries. Diagnostic tests are unavailable in every health institution, and TB culture can take up to 45 days. Therefore, there is a need for cheaper, faster, and easily accessible diagnostic methods that can guide the diagnosis. This study aimed to determine whether red blood cell distribution width (RDW), C-reactive protein (CRP)-lymphocyte ratio (CLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) can be used as biomarkers in the diagnosis of pulmonary TB in patients with no comorbidities.
Material and Methods: Files of microbiologically confirmed 122 patients with pulmonary TB and 153 patients in whom pulmonary TB was excluded were retrospectively reviewed. Out of them, patients with comorbidities were excluded from the study. Eighty-one patients with TB and 100 controls were included in the study.
Results: The lymphocyte, eosinophil, and LMR levels remained significantly lower in the TB group, while neutrophil, monocyte, RDW, platelet, and PLR levels were higher in the same group.
Conclusion: In those patients suspicious of pulmonary TB, higher levels of RDW, PLR, and CLR, whereas lower levels of eosinophil, PDW, and LMR may predict the diagnosis of pulmonary TB in previously healthy individuals.
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Use of Platelet Parameters in the Differential Diagnosis of Lung Adenocarcinoma-Associated Malignant Pleural Effusion and Tuberculous Pleural Effusion. DISEASE MARKERS 2022; 2022:5653033. [PMID: 35531478 PMCID: PMC9068346 DOI: 10.1155/2022/5653033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 04/07/2022] [Indexed: 12/01/2022]
Abstract
Background Both malignant pleural effusion (MPE) and tuberculous pleural effusion (TPE) are common etiologies of pleural effusion; the present study was conducted to establish the diagnostic value of platelet parameters in the differential diagnosis of MPE and TPE. Methods This retrospective study enrolled patients with lung adenocarcinoma-associated MPE and TPE. Platelet parameter data, including platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW), and platelet-larger cell ratio (P-LCR), were collected. Principal component analysis and multiple logistic regression modelling were carried out to assess the diagnostic value of these platelet parameters. Results The MPE group and the TPE group enrolled 270 and 433 patients, respectively. Demographic characteristics of patients were more female and higher age in the MPE group. MPV, PDW, and P-LCR were significantly higher in MPE patients, while PLT and PCT were significantly higher in TPE patients. Principal component analysis generated two principal components (PCs) based on above platelet parameters. After adjusting for confounding factors including gender and age, multiple logistic regression showed positive association between PC1 and MPE. Conclusion Platelet parameters were potential biomarkers in distinguishing lung adenocarcinoma-associated MPE from TPE. A patient with lower PLT and PCT and higher MPV, PDW, and P-LCR was more likely to be diagnosed as the former. Principal component analysis and multiple logistic regression performed well in improving multicollinearity, adjusting confounding factors, and identifying important risk factors for MPE.
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Meier S, Seddon JA, Maasdorp E, Kleynhans L, du Plessis N, Loxton AG, Malherbe ST, Zak DE, Thompson E, Duffy FJ, Kaufmann SHE, Ottenhoff THM, Scriba TJ, Suliman S, Sutherland JS, Winter J, Kuivaniemi H, Walzl G, Tromp G. Neutrophil degranulation, NETosis and platelet degranulation pathway genes are co-induced in whole blood up to six months before tuberculosis diagnosis. PLoS One 2022; 17:e0278295. [PMID: 36454773 PMCID: PMC9714760 DOI: 10.1371/journal.pone.0278295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
Mycobacterium tuberculosis (M.tb) causes tuberculosis (TB) and remains one of the leading causes of mortality due to an infectious pathogen. Host immune responses have been implicated in driving the progression from infection to severe lung disease. We analyzed longitudinal RNA sequencing (RNAseq) data from the whole blood of 74 TB progressors whose samples were grouped into four six-month intervals preceding diagnosis (the GC6-74 study). We additionally analyzed RNAseq data from an independent cohort of 90 TB patients with positron emission tomography-computed tomography (PET-CT) scan results which were used to categorize them into groups with high and low levels of lung damage (the Catalysis TB Biomarker study). These groups were compared to non-TB controls to obtain a complete whole blood transcriptional profile for individuals spanning from early stages of M.tb infection to TB diagnosis. The results revealed a steady increase in the number of genes that were differentially expressed in progressors at time points closer to diagnosis with 278 genes at 13-18 months, 742 at 7-12 months and 5,131 detected 1-6 months before diagnosis and 9,205 detected in TB patients. A total of 2,144 differentially expressed genes were detected when comparing TB patients with high and low levels of lung damage. There was a large overlap in the genes upregulated in progressors 1-6 months before diagnosis (86%) with those in TB patients. A comprehensive pathway analysis revealed a potent activation of neutrophil and platelet mediated defenses including neutrophil and platelet degranulation, and NET formation at both time points. These pathways were also enriched in TB patients with high levels of lung damage compared to those with low. These findings suggest that neutrophils and platelets play a critical role in TB pathogenesis, and provide details of the timing of specific effector mechanisms that may contribute to TB lung pathology.
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Affiliation(s)
- Stuart Meier
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Stellenbosch University, Cape Town, South Africa
- DSI–NRF Centre of Excellence for Biomedical Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Tuberculosis Bioinformatics Initiative, Stellenbosch University, Cape Town, South Africa
| | - James A. Seddon
- South African Tuberculosis Bioinformatics Initiative, Stellenbosch University, Cape Town, South Africa
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
- Department of Infectious Diseases, Imperial College London, London, United Kingdom
| | - Elizna Maasdorp
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Stellenbosch University, Cape Town, South Africa
- DSI–NRF Centre of Excellence for Biomedical Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Tuberculosis Bioinformatics Initiative, Stellenbosch University, Cape Town, South Africa
- Centre for Bioinformatics and Computational Biology, Stellenbosch University, Cape Town, South Africa
| | - Léanie Kleynhans
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Stellenbosch University, Cape Town, South Africa
- DSI–NRF Centre of Excellence for Biomedical Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
| | - Nelita du Plessis
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Stellenbosch University, Cape Town, South Africa
- DSI–NRF Centre of Excellence for Biomedical Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
| | - Andre G. Loxton
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Stellenbosch University, Cape Town, South Africa
- DSI–NRF Centre of Excellence for Biomedical Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
| | - Stephanus T. Malherbe
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Stellenbosch University, Cape Town, South Africa
- DSI–NRF Centre of Excellence for Biomedical Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
| | - Daniel E. Zak
- Seattle Children’s Research Institute, Center for Global Infectious Disease Research, Seattle, WA, United States of America
| | - Ethan Thompson
- Seattle Children’s Research Institute, Center for Global Infectious Disease Research, Seattle, WA, United States of America
| | - Fergal J. Duffy
- Seattle Children’s Research Institute, Center for Global Infectious Disease Research, Seattle, WA, United States of America
| | - Stefan H. E. Kaufmann
- Max Planck Institute for Infection Biology, Berlin, Germany
- Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany
- Hagler Institute for Advanced Study, Texas A&M University, College Station, TX, United States of America
| | - Tom H. M. Ottenhoff
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Thomas J. Scriba
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Sara Suliman
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Jayne S. Sutherland
- Vaccines & Immunity Theme, Medical Research Council Unit, The Gambia, at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Jill Winter
- Catalysis Foundation for Health, San Ramon, CA, United States of America
| | - Helena Kuivaniemi
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Stellenbosch University, Cape Town, South Africa
- DSI–NRF Centre of Excellence for Biomedical Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
| | - Gerhard Walzl
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Stellenbosch University, Cape Town, South Africa
- DSI–NRF Centre of Excellence for Biomedical Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Tuberculosis Bioinformatics Initiative, Stellenbosch University, Cape Town, South Africa
| | - Gerard Tromp
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Stellenbosch University, Cape Town, South Africa
- DSI–NRF Centre of Excellence for Biomedical Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Tuberculosis Bioinformatics Initiative, Stellenbosch University, Cape Town, South Africa
- Centre for Bioinformatics and Computational Biology, Stellenbosch University, Cape Town, South Africa
- * E-mail:
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Stefanescu S, Cocoș R, Turcu-Stiolica A, Shelby ES, Matei M, Subtirelu MS, Meca AD, Stanciulescu EC, Popescu SO, Biciusca V, Pisoschi CG. Prediction of Treatment Outcome with Inflammatory Biomarkers after 2 Months of Therapy in Pulmonary Tuberculosis Patients: Preliminary Results. Pathogens 2021; 10:pathogens10070789. [PMID: 34206598 PMCID: PMC8308673 DOI: 10.3390/pathogens10070789] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022] Open
Abstract
Pro-inflammatory mediators play an important role in the pathogenesis of pulmonary tuberculosis. Consecutively, 26 pulmonary tuberculosis patients were enrolled in our study based on the exclusion criteria. We have used Spearman’s correlation analysis, hierarchical clustering and regression modelling to evaluate the association of 11 biomarkers with culture status after antituberculosis treatment. The results of our study demonstrated that six inflammatory biomarkers of 11, C-reactive protein (CRP), white blood cells (WBC), neutrophils, interferon gamma inducible protein 10, C-reactive protein (CRP) to albumin ratio (CAR) and neutrophil to albumin ratio (NAR), were significantly associated with culture negativity. The predictive ability of a composite model of seven biomarkers was superior to that of any single biomarker based on area under the receiver operating characteristic curve (AUC) analysis, indicating an excellent prediction efficacy (AUC:0.892; 95% CI:0.732-1.0). We also found that the highest significant trends and lower levels of CRP and IP-10 were observed in the two-month treated tuberculosis (TB) patients. We believe that our study may be valuable in providing preliminary results for an additional strategy in monitoring and management of the clinical outcome of pulmonary tuberculosis. Using a panel of predictors added a superior value in predicting culture status after anti-TB therapy.
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Affiliation(s)
- Simona Stefanescu
- Clinical Analysis Laboratory, Clinical Emergency County Hospital Craiova, 200642 Craiova, Romania;
| | - Relu Cocoș
- Department of Medical Genetics, University of Medicine and Pharmacy “Carol Davila”, 020032 Bucharest, Romania
- Institute of Pneumophtisiology “Marius Nasta”, 050159 Bucharest, Romania
- Correspondence:
| | - Adina Turcu-Stiolica
- Department of Pharmacoeconomics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.T.-S.); (M.-S.S.)
| | - Elena-Silvia Shelby
- Scientific Research Nucleus, Dr. Nicolae Robanescu National Clinical Centre for Children’s Neurorecovery, 041408 Bucharest, Romania;
| | - Marius Matei
- Department of Histology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Mihaela-Simona Subtirelu
- Department of Pharmacoeconomics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.T.-S.); (M.-S.S.)
| | - Andreea-Daniela Meca
- Department of Pharmacology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Elena Camelia Stanciulescu
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (E.C.S.); (S.O.P.); (C.-G.P.)
| | - Stefana Oana Popescu
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (E.C.S.); (S.O.P.); (C.-G.P.)
| | - Viorel Biciusca
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Catalina-Gabriela Pisoschi
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (E.C.S.); (S.O.P.); (C.-G.P.)
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10
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Gao SH, Chen CG, Zhuang CB, Zeng YL, Zeng ZZ, Wen PH, Yu YM, Ming L, Zhao JW. Integrating serum microRNAs and electronic health records improved the diagnosis of tuberculosis. J Clin Lab Anal 2021; 35:e23871. [PMID: 34106501 PMCID: PMC8373357 DOI: 10.1002/jcla.23871] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 04/29/2021] [Accepted: 05/25/2021] [Indexed: 12/14/2022] Open
Abstract
Background To verify the differential expression of miR‐30c and miR‐142‐3p between tuberculosis patients and healthy controls and to investigate the performance of microRNA (miRNA) and subsequently models for the diagnosis of tuberculosis (TB). Methods We followed up 460 subjects suspected of TB, and finally enrolled 132 patients, including 60 TB patients, 24 non‐TB disease controls (TB‐DCs), and 48 healthy controls (HCs). The differential expression of miR‐30c and miR‐142‐3p in serum samples of the TB patients, TB‐DCs, and HCs were identified by reverse transcription–quantitative real‐time PCR. Diagnostic models were developed by analyzing the characteristics of miRNA and electronic health records (EHRs). These models evaluated by the area under the curves (AUC) and calibration curves were presented as nomograms. Results There were differential expression of miR‐30c and miR‐142‐3p between TB patients and HCs (p < 0.05). Individual miRNA has a limited diagnostic value for TB. However, diagnostic performance has been both significantly improved when we integrated miR‐142‐3p and ordinary EHRs to develop two models for the diagnosis of tuberculosis. The AUC of the model for distinguishing tuberculosis patients from healthy controls has increased from 0.75 (95% CI: 0.66–0.84) to 0.96 (95% CI: 0.92–0.99) and the model for distinguishing tuberculosis patients from non‐TB disease controls has increased from 0.67 (95% CI: 0.55–0.79) to 0.94 (95% CI: 0.89–0.99). Conclusions Integrating serum miR‐142‐3p and EHRs is a good strategy for improving TB diagnosis.
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Affiliation(s)
- Shu-Hui Gao
- Department of Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Chun-Guang Chen
- Department of Clinical Laboratory, Henan Provincial Infectious Disease Hospital, Zhengzhou, 450000, China
| | - Chun-Bo Zhuang
- Department of Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yu-Ling Zeng
- Department of Clinical Laboratory, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Zhen-Zhen Zeng
- Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Pei-Hao Wen
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yong-Min Yu
- Department of Clinical Laboratory, Henan Provincial Infectious Disease Hospital, Zhengzhou, 450000, China
| | - Liang Ming
- Department of Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Jun-Wei Zhao
- Department of Clinical Laboratory, Key Clinical Laboratory of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
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11
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Xu F, Qu S, Wang L, Qin Y. Mean platelet volume (MPV): new diagnostic indices for co-morbidity of tuberculosis and diabetes mellitus. BMC Infect Dis 2021; 21:461. [PMID: 34016046 PMCID: PMC8139153 DOI: 10.1186/s12879-021-06152-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 05/06/2021] [Indexed: 12/18/2022] Open
Abstract
Background Tuberculosis (TB) and type 2 diabetes mellitus (DM) are global health diseases with high morbidity and mortality. Few studies have focused on platelet indices in TB-DM coinfection patients. The objective of this work was to analyze the platelet indices in TB, DM and TB-DM patients to assess the predictive value of the platelet index for the risk of these diseases. Methods In total, 246 patients admitted to our hospital were distributed into three groups (113TB, 59 DM and 74TB+DM). A total of 133 individuals were also recruited as healthy controls (HC). Platelet indices, namely, platelet count (PC), mean platelet volume (MPV), plateletcrit (PCT) and platelet distribution width (PDW), were compared among the four groups, and the relationship with inflammatory markers was explored by using statistical software. Results Our study discovered that MPV and PCT were significantly downregulated in TB+DM patients (9.951.25fL, 0.200.05%, P<0.0001, P=0.0121, separately) compared with DM individuals (10.921.17fL, 0.220.04%). Moreover, the changes in MPV were significantly higher in TB+DM patients (9.951.25fL, P=0.0041) than in TB patients (9.421.01fL). No differences were found in PLT and PDW among the four groups (P>0.05). The sensitivity and specificity of MPV in the differential diagnosis of DM patients vs TB+DM patients were 64.9 and 66.1% (P<0.0001), respectively, and the sensitivity and specificity of MPV between TB patients and TB+DM patients was 60.8 and 66.4%, respectively (P=0.003). MPV improved the diagnosis sensitivity when it was combined with clinical parameters, such as fasting blood glucose in DM and Mycobacterium tuberculosis culture result in TB (76.3% vs 64.9, 72.6% vs 60.8%, P<0.0001, P=0.001, respectively). In addition, the sensitivity and specificity of PCT in the differential diagnosis of DM patients vs TB+DM patients were 69.5 and 59.4%, respectively (P=0.008). PCT improved the diagnosis sensitivity when combined with fasting blood glucose in DM (72.9% vs 64.9%, P=0.004). In addition, MPV was linked to CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate) in the TB+DM patients (r=0.3203, P=0.0054, r=0.2504, P=0.0307) but PCT was not (r=0.1905, r=0.008675, P>0.05, respectively). Conclusions Our research shows that MPV and PCT might be good clinical laboratory markers to distinguish TB+DM patients from TB or DM individuals, thus providing support for earlier clinical diagnosis, prevention, and therapy.
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Affiliation(s)
- Feifan Xu
- Department of Pathogen Biology, School of Medicine, Nantong University, 19 Qixiu Road, Nantong, 226001, Jiangsu, P.R. China.,Department of Clinical Laboratory, The Sixth People's Hospital of Nantong, 500 Yonghe Road, Nantong, 226011, Jiangsu, P.R. China
| | - Shengyan Qu
- Department of Clinical Laboratory, The Sixth People's Hospital of Nantong, 500 Yonghe Road, Nantong, 226011, Jiangsu, P.R. China
| | - Lin Wang
- Department of Clinical Laboratory, The Sixth People's Hospital of Nantong, 500 Yonghe Road, Nantong, 226011, Jiangsu, P.R. China
| | - Yongwei Qin
- Department of Pathogen Biology, School of Medicine, Nantong University, 19 Qixiu Road, Nantong, 226001, Jiangsu, P.R. China. .,Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, P.R. China.
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12
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Kirwan DE, Chong DLW, Friedland JS. Platelet Activation and the Immune Response to Tuberculosis. Front Immunol 2021; 12:631696. [PMID: 34093524 PMCID: PMC8170316 DOI: 10.3389/fimmu.2021.631696] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/04/2021] [Indexed: 12/24/2022] Open
Abstract
In 2019 10 million people developed symptomatic tuberculosis (TB) disease and 1.2 million died. In active TB the inflammatory response causes tissue destruction, which leads to both acute morbidity and mortality. Tissue destruction in TB is driven by host innate immunity and mediated via enzymes, chiefly matrix metalloproteinases (MMPs) which are secreted by leukocytes and stromal cells and degrade the extracellular matrix. Here we review the growing evidence implicating platelets in TB immunopathology. TB patients typically have high platelet counts, which correlate with disease severity, and a hypercoagulable profile. Platelets are present in human TB granulomas and platelet-associated gene transcripts are increased in TB patients versus healthy controls. Platelets most likely drive TB immunopathology through their effect on other immune cells, particularly monocytes, to lead to upregulation of activation markers, increased MMP secretion, and enhanced phagocytosis. Finally, we consider current evidence supporting use of targeted anti-platelet agents in the treatment of TB due to growing interest in developing host-directed therapies to limit tissue damage and improve treatment outcomes. In summary, platelets are implicated in TB disease and contribute to MMP-mediated tissue damage via their cellular interactions with other leukocytes, and are potential targets for novel host-directed therapies.
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Affiliation(s)
- Daniela E Kirwan
- Institute for Infection & Immunity, St. George's, University of London, London, United Kingdom
| | - Deborah L W Chong
- Institute for Infection & Immunity, St. George's, University of London, London, United Kingdom
| | - Jon S Friedland
- Institute for Infection & Immunity, St. George's, University of London, London, United Kingdom
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13
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Li B, Ren Q, Ling J, Tao Z, Yang X, Li Y. Clinical relevance of neutrophil-to-lymphocyte ratio and mean platelet volume in pediatric Henoch-Schonlein Purpura: a meta-analysis. Bioengineered 2021; 12:286-295. [PMID: 33412982 PMCID: PMC8291875 DOI: 10.1080/21655979.2020.1865607] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The association of neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV) with the severe gastrointestinal (GI) involvement in pediatric Henoch–Schonlein Purpura (HSP) has been reported in many studies. However, the conclusions from the previous studies were controversial. Therefore, for the first time, we performed a meta-analysis to systematically evaluate the relationship of NLR and MPV to the severe GI involvements. We retrieved PubMed, EMBASE, Web of Science, and Chinese National Knowledge Infrastructure (CNKI) (up to October 2020) thoroughly to acquire eligible studies. The pooled standard mean difference (SMD) with 95% confidence interval (CI) was used to describe the correlation of NLR and MPV with the severe GI involvement. A total of 12 studies comprising 2168 patients with HSP were included in this meta-analysis. Our combined analysis showed that NLR in HSP patients with the severe GI involvement was significantly higher than that in those without the severe GI involvement (SMD = 1.37; 95% CI: 0.70–2.05; p < 0.01). In addition, a lower MPV was observed in children with severe GI involvement (SMD = −0.29; 95% CI: −0.56 – −0.01, p = 0.042). Our sensitivity analysis and publication bias evaluation indicated that our combined results were reliable. Taken together, our study suggested NLR and MPV may be used as biomarkers for predicting or diagnosing the severe GI involvement in children with HSP. Nevertheless, more homogeneous studies with a larger sample size are required to validate these findings.
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Affiliation(s)
- Bowen Li
- Department of Pediatrics, The First Hospital of Lanzhou University , Lanzhou, China
| | - Qian Ren
- Department of Gastroenterology, The First Hospital of Lanzhou University , Lanzhou, China
| | - Jizu Ling
- Department of Pediatrics, The First Hospital of Lanzhou University , Lanzhou, China
| | - Zhongbin Tao
- Department of Pediatrics, The First Hospital of Lanzhou University , Lanzhou, China
| | - Xuemei Yang
- Department of Pediatrics, The First Hospital of Lanzhou University , Lanzhou, China
| | - Yuning Li
- Department of Pediatrics, The First Hospital of Lanzhou University , Lanzhou, China
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14
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Zahid M, Naushad VA, Purayil NK, Jamshaid MB, Parambil J, Rashid F, Ismail S, Saddique M, Chalihadan S. Profile of Patients With Tuberculous Pleural Effusion in Qatar: A Retrospective Study. Cureus 2020; 12:e12391. [PMID: 33532154 PMCID: PMC7845742 DOI: 10.7759/cureus.12391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction Tuberculosis (TB) remains one of the top 10 causes of death globally. Around 1.7 billion people are infected with mycobacterium TB worldwide, and almost 90% of cases each year are found in 30 high TB burden countries. Due to the influx of a large expatriate population mainly from the high TB burden countries, there is an increased number of pulmonary TB as well as tuberculous pleural effusion cases reported in Qatar. Objectives The demographic, clinical, laboratory, and histopathological parameters of patients with tuberculous pleural effusion were assessed. Methods A single-center study was conducted at Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. Adults diagnosed to have tuberculous pleural effusion were included, and those with clinical suspicion of tuberculous pleural effusion with positive sputum acid-fast bacillus (AFB) but negative AFB in pleural samples were excluded. Results A total of 106 patients were reviewed, of whom 100 were included for the final analysis, with 86% being men. Majority were from the Asian subcontinent, and the mean age was 33.8 years (SD ± 10.3). Main symptoms in decreasing order were cough (77%), fever (56%), and chest pain (54%). Of the patients, 72% had normal BMI, and rest were above the normal range. Anemia and hypoalbuminemia were found in 36.7% and 89.8% of the patients, respectively. Positive AFB culture was observed in pleural biopsy (79%), pleural fluid (13%), and sputum (16%). Positive AFB by polymerase chain reaction (PCR) was observed in pleural biopsy (57%), pleural fluid (3%), and sputum (2.2%), whereas AFB smear was positive in 2% of pleural biopsy samples. Caseating granuloma was seen in 80% of patients. All the three Light's criteria were met by 30% of the patients whereas 52% had two criteria fulfilled. No association between the number of Light's criteria and AFB yield was observed. Conclusions TPE was more common in healthy young adults. The AFB yield on pleural biopsy, PCR, and culture was significantly higher than that on all other samples. The number of positive Light's criteria did not have any association with positive AFB yield.
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Affiliation(s)
| | - Vamanjore A Naushad
- Internal Medicine, Hamad General Hospital/Hamad Medical Corporation, Doha, QAT.,Internal Medicine, Weill Cornell Medical College, Doha, QAT.,Internal Medicine, College of Medicine, Qatar University, Doha, QAT
| | - Nishan K Purayil
- Internal Medicine, Hamad Medical Corporation, Doha, QAT.,Internal Medicine, Weill Cornell Medical College, Doha, QAT.,Internal Medicine, College of Medicine, Qatar University, Doha, QAT
| | | | | | - Farah Rashid
- Internal Medicine, Hamad Medical Corporation, Doha, QAT
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15
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The Utility of Platelet Indices in Predicting Multiorgan Dysfunction in Scrub Typhus. Interdiscip Perspect Infect Dis 2020; 2020:3870354. [PMID: 32802052 PMCID: PMC7415085 DOI: 10.1155/2020/3870354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/25/2020] [Accepted: 07/02/2020] [Indexed: 11/18/2022] Open
Abstract
Platelet indices have been used to diagnose and prognosticate infections such as tuberculosis, malaria, dengue, and septic shock. Platelet indices have previously not been used in the prediction of multiorgan dysfunction (MODS) in patients with scrub typhus. A three-year retrospective review of patient charts was performed. Patients with and without MODS were compared. Platelet indices and other clinical and laboratory variables were used in logistic regression analysis to determine significant predictors. A ROC curve was generated with the platelet indices to predict MODS. Of 189 patients, 106 were male. Respiratory rate, serum creatinine, liver function tests, platelet count, thrombocytopenia <150 × 109/L, mean platelet volume (MPV) > 7.3 fL, and plateletcrit ≤0.19% varied significantly between patients with MODS and those without. Platelet indices are inexpensive and easily available. Only thrombocytopenia along with creatinine, alanine transaminase, and abnormal chest radiograph could significantly predict MODS in patients with scrub typhus.
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16
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Wang W, Du Z, Ni M, Wang Z, Liang M, Sheng H, Zhang A, Yang J. Aspirin enhances the clinical efficacy of anti-tuberculosis therapy in pulmonary tuberculosis in patients with type 2 diabetes mellitus. Infect Dis (Lond) 2020; 52:721-729. [PMID: 32552387 DOI: 10.1080/23744235.2020.1778177] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Tuberculosis in patients with diabetes mellitus is characterised by rapid disease progression, poor treatment efficacy, poor prognosis and poses a new challenge in tuberculosis treatment and control.Methods: Patients with pulmonary TB and type 2 DM were recruited at Yijishan Hospital of Wannan Medical College. A total of 348 patients were randomly assigned to two groups. The aspirin group (aspirin + TB/DM) included 174 patients who received anti-TB therapy and enteric-coated aspirin tablets (100 mg/tablet). The control group (placebo + TB/DM) included 174 patients who received anti-TB therapy and enteric-coated placebo tablets (an identical tablet containing no drug). Eighty-two patients in the aspirin group and 86 in the control group completed the trial and were included in the analysis. Clinical characteristics, laboratory test results, imaging data and side effects of aspirin were monitored.Results: Aspirin treatment affect certain signs and symptoms. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were lower in the aspirin group than in the control group after treatment (Both p = .000). The sputum-negative conversion rate was 86.7% in the aspirin group, significantly higher than in the control group (53.8%) (p = .031). After two months of treatment, the differences in the number of cases with cavities, the number of cavities, and maximum diameter of cavities in the aspirin group were statistically significant (p = .003, p = .023 and p = .015 respectively).Conclusion: Our findings suggest that aspirin may improve treatment in patients with pulmonary TB and type 2 DM.
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Affiliation(s)
- Wenjie Wang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, P. R. China
| | - Zhixiang Du
- Department of Infectious Diseases, The People's Hospital of Taizhou, Taizhou, P. R. China
| | - Mingyue Ni
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, P. R. China
| | - Zijian Wang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, P. R. China
| | - Manman Liang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, P. R. China
| | - Haoyu Sheng
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, P. R. China
| | - Aiping Zhang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, P. R. China
| | - Jianghua Yang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, P. R. China
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17
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Akya A, Bozorgomid A, Ghadiri K, Ahmadi M, Elahi A, Mozafari H, Almasi A, Namadi P, Chegenelorestani R. Usefulness of Blood Parameters for Preliminary Diagnosis of Brucellosis. J Blood Med 2020; 11:107-113. [PMID: 32280292 PMCID: PMC7125307 DOI: 10.2147/jbm.s245513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/17/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Human brucellosis is a multisystem disease with a wide range of clinical signs which often leads to misdiagnosis and treatment delay. Early diagnosis of this disease can prevent the serious complications and mismanagements. This study aimed to evaluate the hematological parameters with predictive value for the diagnosis of brucellosis. METHODS In this prospective case-control study which was done during 2015-2017 in Imam Reza Hospital, Kermanshah Province, west Iran, 100 patients with a confirmed diagnosis of brucellosis (brucellosis group) and 100 healthy individuals (control group) were studied. The hematological parameters, including hemoglobin (Hb), red blood cell (RBC), white blood cell (WBC) count, lymphocyte count, neutrophil count, platelet count (PLTs), mean platelet volume (MPV), platelet distribution width (PDW), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) of both groups were recorded. The data were statistically compared between the brucellosis and the control groups. RESULTS The mean age of patients and healthy groups was 44.04 ± 23.11 and 37.92 ± 24.80, respectively (P = 0.062). The WBC, CRP and neutrophil counts were significantly higher in the brucellosis group (P < 0.05). Based on the receiver operating characteristic (ROC) analysis, the sensitivity and specificity were 54% and 66% for the WBC, 45% and 71% for the neutrophil and 65% and 72% for the CRP, respectively. There was no statistically significant difference between the two groups in terms of Hb, RBC, WBC, lymphocyte and platelet count, MPV, PDW and ESR (P > 0.05). CONCLUSION The results of this study indicate that WBC, CRP and neutrophil count can be used as valuable markers in the preliminary diagnosis of brucellosis. However, further researches are required to standardize these parameters for various forms of brucellosis.
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Affiliation(s)
- Alisha Akya
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arezoo Bozorgomid
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kayghobad Ghadiri
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahnaz Ahmadi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Azam Elahi
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hadi Mozafari
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Afshin Almasi
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parvin Namadi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roya Chegenelorestani
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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18
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Hortle E, Oehlers SH. Host-directed therapies targeting the tuberculosis granuloma stroma. Pathog Dis 2020; 78:5800987. [DOI: 10.1093/femspd/ftaa015] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/03/2020] [Indexed: 12/12/2022] Open
Abstract
ABSTRACT
Mycobacteria have co-evolved with their hosts resulting in pathogens adept at intracellular survival. Pathogenic mycobacteria actively manipulate infected macrophages to drive granuloma formation while subverting host cell processes to create a permissive niche. Granuloma residency confers phenotypic antimicrobial resistance by physically excluding or neutralising antibiotics. Host-directed therapies (HDTs) combat infection by restoring protective immunity and reducing immunopathology independent of pathogen antimicrobial resistance status. This review covers innovative research that has discovered ‘secondary’ symptoms of infection in the granuloma stroma are actually primary drivers of infection and that relieving these stromal pathologies with HDTs benefits the host. Advances in our understanding of the relationship between tuberculosis and the host vasculature, haemostatic system and extracellular matrix reorganisation are discussed. Preclinical and clinical use of HDTs against these stromal targets are summarised.
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Affiliation(s)
- Elinor Hortle
- Tuberculosis Research Program at the Centenary Institute, The University of Sydney, Camperdown, NSW 2050, Australia
- The University of Sydney, Faculty of Medicine and Health & Marie Bashir Institute, Camperdown, NSW 2050, Australia
| | - Stefan H Oehlers
- Tuberculosis Research Program at the Centenary Institute, The University of Sydney, Camperdown, NSW 2050, Australia
- The University of Sydney, Faculty of Medicine and Health & Marie Bashir Institute, Camperdown, NSW 2050, Australia
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19
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Fox KA, Kirwan DE, Whittington AM, Krishnan N, Robertson BD, Gilman RH, López JW, Singh S, Porter JC, Friedland JS. Platelets Regulate Pulmonary Inflammation and Tissue Destruction in Tuberculosis. Am J Respir Crit Care Med 2019; 198:245-255. [PMID: 29420060 DOI: 10.1164/rccm.201710-2102oc] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
RATIONALE Platelets may interact with the immune system in tuberculosis (TB) to regulate human inflammatory responses that lead to morbidity and spread of infection. OBJECTIVES To identify a functional role of platelets in the innate inflammatory and matrix-degrading response in TB. METHODS Markers of platelet activation were examined in plasma from 50 patients with TB before treatment and 50 control subjects. Twenty-five patients were followed longitudinally. Platelet-monocyte interactions were studied in a coculture model infected with live, virulent Mycobacterium tuberculosis (M.tb) and dissected using qRT-PCR, Luminex multiplex arrays, matrix degradation assays, and colony counts. Immunohistochemistry detected CD41 (cluster of differentiation 41) expression in a pulmonary TB murine model, and secreted platelet factors were measured in BAL fluid from 15 patients with TB and matched control subjects. MEASUREMENTS AND MAIN RESULTS Five of six platelet-associated mediators were upregulated in plasma of patients with TB compared with control subjects, with concentrations returning to baseline by Day 60 of treatment. Gene expression of the monocyte collagenase MMP-1 (matrix metalloproteinase-1) was upregulated by platelets in M.tb infection. Platelets also enhanced M.tb-induced MMP-1 and -10 secretion, which drove type I collagen degradation. Platelets increased monocyte IL-1 and IL-10 and decreased IL-12 and MDC (monocyte-derived chemokine; also known as CCL-22) secretion, as consistent with an M2 monocyte phenotype. Monocyte killing of intracellular M.tb was decreased. In the lung, platelets were detected in a TB mouse model, and secreted platelet mediators were upregulated in human BAL fluid and correlated with MMP and IL-1β concentrations. CONCLUSIONS Platelets drive a proinflammatory, tissue-degrading phenotype in TB.
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Affiliation(s)
- Katharine A Fox
- 1 Infectious Diseases and Immunity, Wellcome Trust Centre for Global Health Research, and
| | - Daniela E Kirwan
- 1 Infectious Diseases and Immunity, Wellcome Trust Centre for Global Health Research, and
| | - Ashley M Whittington
- 1 Infectious Diseases and Immunity, Wellcome Trust Centre for Global Health Research, and
| | - Nitya Krishnan
- 2 Medical Research Council Centre for Molecular Bacteriology and Infection, Department of Medicine, Imperial College London, United Kingdom
| | - Brian D Robertson
- 2 Medical Research Council Centre for Molecular Bacteriology and Infection, Department of Medicine, Imperial College London, United Kingdom
| | - Robert H Gilman
- 3 Department of International Health, Johns Hopkins University, Baltimore Maryland.,4 Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - José W López
- 5 Laboratorio de Bioinformática y Biología Molecular, Universidad Peruana Cayetano Heredia, Lima, Peru.,6 Instituto Nacional de Salud del Niño, Lima, Peru; and
| | - Shivani Singh
- 1 Infectious Diseases and Immunity, Wellcome Trust Centre for Global Health Research, and
| | - Joanna C Porter
- 7 Centre for Inflammation and Tissue Repair, Respiratory Medicine, University College London, United Kingdom
| | - Jon S Friedland
- 1 Infectious Diseases and Immunity, Wellcome Trust Centre for Global Health Research, and
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20
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Use of Antiplatelet Agents and Survival of Tuberculosis Patients: A Population-Based Cohort Study. J Clin Med 2019; 8:jcm8070923. [PMID: 31252593 PMCID: PMC6678265 DOI: 10.3390/jcm8070923] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/19/2019] [Accepted: 06/24/2019] [Indexed: 12/12/2022] Open
Abstract
While evidence is accumulating that platelets contribute to tissue destruction in tuberculosis (TB) disease, it is still not known whether antiplatelet agents are beneficial to TB patients. We performed this retrospective cohort study and identified incident TB cases in the Taiwan National Tuberculosis Registry from 2008 to 2014. These cases were further classified into antiplatelet users and non-users according to the use of antiplatelet agents prior to the TB diagnosis, and the cohorts were matched using propensity scores (PSs). The primary outcome was survival after a TB diagnosis. In total, 74,753 incident TB cases were recruited; 9497 (12.7%) were antiplatelet users, and 7764 (10.4%) were aspirin (ASA) users. A 1:1 PS-matched cohort with 8864 antiplatelet agent users and 8864 non-users was created. After PS matching, antiplatelet use remained associated with a longer survival (adjusted hazard ratio (HR): 0.91, 95% confidence interval (CI): 0.88–0.95, p < 0.0001). The risk of major bleeding was not elevated in antiplatelet users compared to non-users (p = 0.604). This study shows that use of antiplatelet agents has been associated with improved survival in TB patients. The immunomodulatory and anti-inflammatory effects of antiplatelet agents in TB disease warrant further investigation. Antiplatelets are promising as an adjunct anti-TB therapy.
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21
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Li K, Liu SX, Yang CY, Jiang ZC, Liu J, Fan CQ, Li T, Dong XM, Wang J, Ran RY. A routine blood test-associated predictive model and application for tuberculosis diagnosis: a retrospective cohort study from northwest China. J Int Med Res 2019; 47:2993-3007. [PMID: 31154881 PMCID: PMC6683917 DOI: 10.1177/0300060519851673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objectives This study aimed to use the results of routine blood tests and relevant parameters to construct models for the prediction of active tuberculosis (ATB) and drug-resistant tuberculosis (DRTB) and to assess the diagnostic values of these models. Methods We performed logistic regression analysis to generate models of plateletcrit-albumin scoring (PAS) and platelet distribution width-treatment-sputum scoring (PTS). Area under the curve (AUC) analysis was used to analyze the diagnostic values of these curves. Finally, we performed model validation and application assessment. Results In the training cohort, for the PAS model, the AUC for diagnosing ATB was 0.902, sensitivity was 82.75%, specificity was 82.20%, accuracy rate was 81.00%, and optimal threshold value was 0.199. For the PTS model, the AUC for diagnosing DRTB was 0.700, sensitivity was 63.64%, specificity was 73.53%, accuracy rate was 89.00%, and optimal threshold value was −2.202. These two models showed significant differences in the AUC analysis, compared with single-factor models. Results in the validation cohort were similar. Conclusions The PAS model had high sensitivity and specificity for the diagnosis of ATB, and the PTS model had strong predictive potential for the diagnosis of DRTB.
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Affiliation(s)
- Kui Li
- 1 Department of Infectious Diseases, Ankang Central Hospital, Shaanxi, China.,2 The Sixth Clinical Medical School of Hubei University of Medicine, Hubei, China
| | - Sheng-Xi Liu
- 1 Department of Infectious Diseases, Ankang Central Hospital, Shaanxi, China.,2 The Sixth Clinical Medical School of Hubei University of Medicine, Hubei, China
| | - Cai-Yong Yang
- 1 Department of Infectious Diseases, Ankang Central Hospital, Shaanxi, China.,2 The Sixth Clinical Medical School of Hubei University of Medicine, Hubei, China
| | - Zi-Cheng Jiang
- 1 Department of Infectious Diseases, Ankang Central Hospital, Shaanxi, China.,2 The Sixth Clinical Medical School of Hubei University of Medicine, Hubei, China
| | - Jun Liu
- 3 Laboratory of Molecular Pathology and Tuberculosis Diseases, Ankang Central Hospital, Shaanxi, China
| | - Chuan-Qi Fan
- 1 Department of Infectious Diseases, Ankang Central Hospital, Shaanxi, China
| | - Tao Li
- 1 Department of Infectious Diseases, Ankang Central Hospital, Shaanxi, China
| | - Xue-Min Dong
- 3 Laboratory of Molecular Pathology and Tuberculosis Diseases, Ankang Central Hospital, Shaanxi, China
| | - Jing Wang
- 4 Nanmen Primary School, Hanbin District, Shaanxi, China
| | - Ren-Yu Ran
- 1 Department of Infectious Diseases, Ankang Central Hospital, Shaanxi, China
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22
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Jiang TT, Shi LY, Chen J, Wei LL, Li M, Hu YT, Gan L, Liu CM, Tu HH, Li ZB, Yi WJ, Li JC. Screening and identification of potential protein biomarkers for evaluating the efficacy of intensive therapy in pulmonary tuberculosis. Biochem Biophys Res Commun 2018; 503:2263-2270. [PMID: 29959917 DOI: 10.1016/j.bbrc.2018.06.147] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 06/26/2018] [Indexed: 11/16/2022]
Abstract
This research aimed to discover potential biomarkers for evaluating the therapeutic efficacy of intensive therapy in pulmonary tuberculosis (TB). Protein profiles in 2-months intensively treated TB patients, untreated TB patients, and healthy controls were investigated with iTRAQ-2DLC-MS/MS technique. 71 differential proteins were identified in 2-months intensively treated TB patients. Significant differences in complement component C7 (CO7), apolipoprotein A-IV (APOA4), apolipoprotein C-II (APOC2), and angiotensinogen (ANGT) were found by ELISA validation. CO7 and ANGT were also found significantly different in sputum negative patients, compared with sputum positive patients after intensive treatment. Clinical analysis showed that after 2-months intensive treatment several indicators were significantly changed, and the one-year cure rate of sputum negative patients were significantly higher than sputum positive patients. Diagnostic models consisting of APOC2, CO7 and APOA4 were established to distinguish intensively treated TB patients from untreated TB patients and healthy controls with the AUC value of 0.910 and 0.935. Meanwhile, ANGT and CO7 were combined to identify sputum negative and sputum positive TB patients after intensive treatment with 89.36% sensitivity, 71.43% specificity, and the AUC value of 0.853. The results showed that APOC2, CO7, APOA4, and ANGT may be potential biomarkers for evaluating the efficacy of intensive anti-TB therapy.
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Affiliation(s)
- Ting-Ting Jiang
- South China University of Technology School of Medicine, Guangzhou, 510006, China
| | - Li-Ying Shi
- Department of Clinical Laboratory, Zhejiang Hospital, Hangzhou, 310013, China
| | - Jing Chen
- Institute of Cell Biology, Zhejiang University, Hangzhou, 310058, China
| | - Li-Liang Wei
- Department of Pneumology, Shaoxing Municipal Hospital, Shaoxing, 312000, China
| | - Meng Li
- Department of Clinical Laboratory, Zhejiang Hospital, Hangzhou, 310013, China
| | - Yu-Ting Hu
- South China University of Technology School of Medicine, Guangzhou, 510006, China
| | - Lin Gan
- South China University of Technology School of Medicine, Guangzhou, 510006, China
| | - Chang-Ming Liu
- Institute of Cell Biology, Zhejiang University, Hangzhou, 310058, China
| | - Hui-Hui Tu
- Institute of Cell Biology, Zhejiang University, Hangzhou, 310058, China
| | - Zhi-Bin Li
- Institute of Cell Biology, Zhejiang University, Hangzhou, 310058, China
| | - Wen-Jing Yi
- Institute of Cell Biology, Zhejiang University, Hangzhou, 310058, China
| | - Ji-Cheng Li
- South China University of Technology School of Medicine, Guangzhou, 510006, China; Institute of Cell Biology, Zhejiang University, Hangzhou, 310058, China.
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23
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Shi X, Li WC, Mo LJ, Li XH, Luo YZ, Qin LQ, Yang Z, Mo WN. Altered mean platelet volume in children with Henoch-Schonlein purpura and its association with disease activity. Ann Clin Biochem 2017; 55:368-372. [PMID: 28774183 DOI: 10.1177/0004563217727015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Henoch-Schonlein purpura is a systemic small-vessel vasculitis that occurs mainly in children. A review of the literature has suggested a correlation between mean platelet volume and several inflammatory disorders. However, to the best of our knowledge, any potential correlation between mean platelet volume and Henoch-Schonlein purpura has not been reported in the literature. Therefore, our study aimed to evaluate the role of mean platelet volume concentrations in patients with Henoch-Schonlein purpura. Methods This study included 97 children with Henoch-Schonlein purpura and 120 healthy individuals as controls. Results Mean platelet volume concentrations were found to be significantly lower in Henoch-Schonlein purpura patients compared with healthy controls (8.1 ± 0.86 vs. 9.4 ± 0.81, P < 0.001). Similarly, significant negative correlations were observed between mean platelet volume and neutrophil count, platelet count and erythrocyte sedimentation rate in patients with Henoch-Schonlein purpura (r=−0.327, P = 0.001; r=−0.419, P < 0.001; r=−0.255, P = 0.012). Interestingly, mean platelet volume was significantly lower in the acute phase compared with the convalescent phase of Henoch-Schonlein purpura patients (7.8 ± 0.86 vs. 8.3 ± 0.77, P = 0.002). A cut-off value for mean platelet volume was 7.85 with area under the curve of 0.726 to identify acute phase vs. convalescent phase in patients with Henoch-Schonlein purpura. Mean platelet volume was independently associated with Henoch-Schonlein purpura in logistic regression analysis (odds ratio = 0.114, 95% confidence interval = 0.053–0.243, P < 0.001). Conclusions Our results suggest that mean platelet volume is inversely associated with disease in patients with Henoch-Schonlein purpura, and mean platelet volume may be a useful marker to identify active disease in Henoch-Schonlein purpura patients.
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Affiliation(s)
- Xiang Shi
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Wen-Chao Li
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Li-Jun Mo
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Xiao-Hong Li
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Yu-Zhen Luo
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Liu-Qun Qin
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Zheng Yang
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Wu-Ning Mo
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
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24
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Mulenga CM, Kayembe JMN, Kabengele BO, Bakebe A. Anemia and Hematologic Characteristics in Newly Diagnosed Pulmonary Tuberculosis Patients at Diagnosis in Kinshasa. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/jtr.2017.54026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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