Monitoring Anti-tuberculosis Treatment Response Using Analysis of Whole BloodMycobacterium tuberculosisSpecific T Cell Activation and Functional Markers

Vickers, Molly A.; Darboe, Fatoumatta; Muefong, Caleb N.; Mbayo, Georgetta; Barry, Amadou; Gindeh, Awa; Njie, Sainabou; Riley, Abi-Janet; Sarr, Binta; Sambou, Basil; Dockrell, Hazel M.; Charalambous, Salome; Rachow, Andrea; Owolabi, Olumuyiwa; Jayasooriya, Shamanthi und Sutherland, Jayne S. (9. September 2020): Monitoring Anti-tuberculosis Treatment Response Using Analysis of Whole BloodMycobacterium tuberculosisSpecific T Cell Activation and Functional Markers. In: Frontiers in Immunology, Bd. 11, 572620: S. 1-13

Abstract

Background: Blood-based biomarkers have been proposed as an alternative to current sputum-based treatment monitoring methods in active tuberculosis (ATB). The aim of this study was to validate previously described phenotypic, activation, and cytokine markers of treatment response in a West African cohort.

Methods: Whole blood immune responses to Mycobacterium tuberculosis ESAT-6/CFP-10 (EC) and purified protein derivative (PPD) were measured in twenty adults at baseline and after 2 months of standard TB treatment. Patients were classified as fast or slow responders based on a negative or positive sputum culture result at 2 months, respectively. Cellular expression of activation markers (CD38, HLA-DR), memory markers (CD27), and functional intracellular cytokine and proliferation (IFN-γ, Ki-67, TNF-α) markers were measured using multi-color flow cytometry.

Results: There was a significant increase in the proportion of CD4+CD27+ cells expressing CD38 and HLA-DR following EC stimulation at 2 months compared to baseline (p = 0.0328 and p = 0.0400, respectively). Following PPD stimulation, slow treatment responders had a significantly higher proportion of CD8+CD27–IFN-γ+ (p = 0.0105) and CD4+CD27+HLA-DR+CD38+ (p = 0.0077) T cells than fast responders at baseline. Receiver operating curve analysis of these subsets resulted in 80% sensitivity and 70 and 100% specificity, respectively (AUC of 0.82, p = 0.0156 and 0.84, p = 0.0102).

Conclusion: Our pilot data show reductions in expression of T cell activation markers were seen with treatment, but this was not associated with fast or slow sputum conversion at 2 months. However, baseline proportions of activated T cell subsets are potentially predictive of the subsequent speed of response to treatment.

• Dokumententyp: Zeitschriftenartikel
• Publikationsform: Publisher's Version
• Keywords: Tuberculosis; treatment; activation markers; cytokines; immunity
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1664-3224
• Sprache: Englisch