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Stevanovic G,,Pelemis M,,Pavlovic M,,Lavadinovic L
Journal of IMAB : Annual Proceeding (Scientific Papers) , 2011,
Abstract: Extra pulmonary tuberculosis (EPTB) is a growing problem worldwide. Due to the nature of the disease, the diversity of clinical pictures as well as its minor epidemiological importance, the diagnosis is difficult and often late.In addition to standard TB diagnostic techniques use of new biochemical (surrogate markers) are increased. With this work we wanted to examine the usefulness of serum adenosine deaminase levels as a diagnostic parameter for EPTB.The work included 116 patients with fever of unknown origin in which tuberculosis or infectious mononucleosis was not proven and 51 person who had proven EPTB. Correlated adenosine deaminase levels between these two groups we obtained significantly higher values in patients with EPTB. The calculated sensitivity was 0.56, specificity 0.89, positive predictive value 0.80 and negative predictive value 0.72. Certain reducing of the values observed during anti TB therapy. In previous studies the diagnostic importance of adenosine deaminase in the diagnosis of tuberculosis serosityes was demonstrated. The significance of serum levels in diagnosis is rarely evaluated during EPTB. Our findings are similar to the results of authors who have conducted such testing in the pediatric population.Increased concentrations of serum adenosine deaminase have shown the potential of usable screening test and can be used as an indicative EPTB parameter. To fully assess its diagnostic significance require future clinical research.
Neopterin in Diagnosis and Monitoring of Infectious Diseases  [PDF]
Michael Eisenhut
Journal of Biomarkers , 2013, DOI: 10.1155/2013/196432
Abstract: Neopterin is produced by activated monocytes, macrophages, and dendritic cells upon stimulation by interferon gamma produced by T-lymphocytes. Quantification of neopterin in body fluids has been achieved by standard high-performance liquid chromatography, radioimmunoassays, and enzyme-linked immunosorbent assays. Neopterin levels predict HIV-related mortality more efficiently than clinical manifestations. Successful highly active antiretroviral therapy is associated with a decrease in neopterin levels. Elevated neopterin levels were associated with hepatitis by hepatitis A, B, and C viruses. Serum neopterin levels were found to be a predictor of response to treatment of chronic HCV infection with pegylated interferon combined with ribavirin. Neopterin levels of patients with pulmonary tuberculosis were found to be higher in patients with more extensive radiological changes. Elimination of blood donors with elevated neopterin levels to reduce risk of transmission of infections with known and unknown viral pathogens has been undertaken. Neopterin measurement is hereby more cost effective but less sensitive than screening using polymerase chain reaction based assays. In conclusion neopterin is a nonspecific marker of activated T-helper cell 1 dominated immune response. It may be a useful marker for monitoring of infectious disease activity during treatment and for more accurate estimation of extent of disease and prognosis. 1. Introduction Neopterin was first isolated from larvae of bees, in worker bees and in royal jelly in 1963, and subsequently from human urine by Sakurai and Goto in 1967 [1]. Neopterin or 2-amino-4-hydroxy-6-(D-erythro-1′,2′,3′-trihydroxypropyl)-pteridine is produced from guanosine triphosphate via guanosine triphosphate cyclohydrolase I (GTPCH I) by activated monocytes, macrophages, dendritic cells, and endothelial cells and to a lesser extent in renal epithelial cells, fibroblasts, and vascular smooth muscle cells upon stimulation mainly by interferon gamma and to a lesser extent by interferon alpha and beta with its release being enhanced by tumor necrosis factor [2, 3]. GTPCH I mRNA expression is synergistically and independently induced by interferon gamma through the Jak2/Stat pathway of nuclear transcription regulation and through TNF by the NF-kappaB pathway (see Figure 1) [4]. Release in response to cytokines released by T-lymphocytes and natural killer cells make neopterin an indicator of activation of cell mediated immunity including release by infections associated with activation of T-lymphocytes and natural killer cells,
Serum Lipase in Pulmonary Tuberculosis Patients in Kinshasa—A Hospital Based Study  [PDF]
M. K. Mbelu, J. J. Malemba, B. Kabengele, J. M. Kayembe, D. N. Kayembe
Journal of Tuberculosis Research (JTR) , 2018, DOI: 10.4236/jtr.2018.62015
Abstract: Context: The increase of serum lipase is established for pancreatic and bile duct disorders. However, the production of this enzyme by other organs, including the lungs, leads to the question of its potential role in the diagnosis of other conditions including lung diseases. Objective: The aim of the present study was to describe the profile of serum lipase in patients who suffered from the pulmonary tuberculosis and to identify its determinants. Patients and methods: A cross-sectional study was performed from July to October 2013 in four hospitals of Kinshasa (The University Hospital of Kinshasa, Lisanga medical Center and 2 medical centers of Save Army). Patients who suffered from tuberculosis were included. The levels of serum lipase, triglyceridemia, cholesterolemia, c-reactive protein were noted, as so as the hemogram profile and the prescribed treatment (category and phase). Results: One hundred and twenty-eight patients suffering from pulmonary tuberculosis were included. Forty three women (33.6%) and 85 men (66.4%). The sex ratio M/F was 1:9. Hyperlipasemia was observed in 44.5% of patients. The average level of serum lipase was 36.6 ± 5.0 IU/L (normal value: ≤ 38 IU/L) in tuberculosis patients and 30 ± 2.3 IU/L in controls The lipid profile of the patients was normal. Conclusion: L Hyperlipasemia can be encountered, in varying proportions, during pulmonary tuberculosis. It would be an indication of inflammation of the pulmonary parenchyma.
Altered serum microRNAs as biomarkers for the early diagnosis of pulmonary tuberculosis infection  [cached]
Qi Yuhua,Cui Lunbiao,Ge Yiyue,Shi Zhiyang
BMC Infectious Diseases , 2012, DOI: 10.1186/1471-2334-12-384
Abstract: Background Pulmonary tuberculosis (TB) is a highly lethal infectious disease and early diagnosis of TB is critical for the control of disease progression. The objective of this study was to profile a panel of serum microRNAs (miRNAs) as potential biomarkers for the early diagnosis of pulmonary TB infection. Methods Using TaqMan Low-Density Array (TLDA) analysis followed by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) validation, expression levels of miRNAs in serum samples from 30 patients with active tuberculosis and 60 patients with Bordetella pertussis (BP), varicella-zoster virus (VZV) and enterovirus (EV) were analyzed. Results The Low-Density Array data showed that 97 miRNAs were differentially expressed in pulmonary TB patient sera compared with healthy controls (90 up-regulated and 7 down-regulated). Following qRT-PCR confirmation and receiver operational curve (ROC) analysis, three miRNAs (miR-361-5p, miR-889 and miR-576-3p) were shown to distinguish TB infected patients from healthy controls and other microbial infections with moderate sensitivity and specificity (area under curve (AUC) value range, 0.711-0.848). Multiple logistic regression analysis of a combination of these three miRNAs showed an enhanced ability to discriminate between these two groups with an AUC value of 0.863. Conclusions Our study suggests that altered levels of serum miRNAs have great potential to serve as non-invasive biomarkers for early detection of pulmonary TB infection.
Role of Serum Procalcitonin Level in Differentiating between Pulmonary Tuberculosis and Community-Acquired Pneumonia  [PDF]
Mohammad Shameem, Mazhar Alam, Shagufta Moin, Rakesh Bhargava, Zuber Ahmad, Jamal Akhtar
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.515121

Pulmonary Tuberculosis (PTB) and Community-Acquired Pneumonia (CAP) are common causes of consolidation patch in chest radiograph. Sputum Z-N staining is positive in 30% to 60% cases only and sputum examination has poor yield in CAP. This study aimed to assess the value of serum Procalcitonin (PCT) levels in patients with Pulmonary Tuberculosis (PTB) and Community-Acquired Pneumonia (CAP). Patients with new opacity in chest radiograph were included in the study. Serum sample were taken at admission and stored. Patient’s diagnosis were confirmed and categorized into pulmonary TB group (32) and community-acquired pneumonia group (23). Their mean PCT level was compared with mean PCT level of 25 controls. Serum procalcitonin levels were found to be significantly elevated in patients of community-acquired pneumonia as compared to patients of pulmonary tuberculosis. In presence of consolidation in x-ray chest, increased level of serum procalcitonin might be used to differentiate pulmonary tuberculosis from community-acquired pneumonia. High level of serum procalcitonin was associated with high mortality rate in community-acquired pneumonia patients.

Effect of Antituberculosis Regimen Containing Ethambutol on Serum magnesium Level in Pulmonary Tuberculosis Patients
Mohammad Abbasi Nazari,Farzad Kobarfard,Payam Tabarsi,Maryam Azimi
Iranian Journal of Pharmaceutical Research , 2009,
Abstract: Magnesium is an essential metal that has important roles in physiological function of the body organs. Ethambutol is an oral antitubercular agent with chelating effects owing to its chemical structure. The aim of present study is to determine whether ethambutol usage can alter serum magnesium concentration in patients with pulmonary tuberculosis. Sixty patients with diagnosis of pulmonary tuberculosis were enrolled in the study. Blood samples were obtained before treatment from patients. Ten days after starting anti tuberculosis therapy, second blood samples were obtained. The amounts of serum magnesium were determined in all samples by spectrophotometric method. Statistical analysis showed that serum magnesium concentrations at baseline (0.61±0.08 mmol/l) and at day 10 (0.62±0.11 mmol/l) were not different. It is possible that ethambotol does not affect magnesium concentration in tuberculosis patients, however further studies about the other cationic trace elements are recommended.
Immunoprofile of pulmonary tuberculosis-comparison with normal healthy controls.  [cached]
Bhave G,Pathare A,Dagha C,Chabria L
Journal of Postgraduate Medicine , 1989,
Abstract: The immunoprofile of 60 adult patients of pulmonary tuberculosis was studied and compared with 22 normal controls. The immunological parameters studied were serum protein electrophoresis, serum immunoglobulins (IgG, IgA and IgM), delayed hypersensitivity by Mantoux test, and T-cell % estimation. The mean total serum proteins and serum albumin were significantly lower, whereas mean beta and gamma globulins were elevated. Mean serum IgG and serum IgA showed a significant rise, whereas the T-cell % was significantly reduced when compared to controls. The significance of these findings is discussed.
Serum Neopterin Is Not Increased in Obese Juveniles  [PDF]
Harald Mangge,Florian Freytag,Gunter Almer,Daniel Weghuber,Carmen Bauer-Denk,Dietmar Fuchs
Journal of Obesity , 2011, DOI: 10.1155/2011/946795
Abstract: Objective. Cardiovascular disease is associated with inflammation and immune activation, concentrations of immune activation markers like neopterin predict outcome in adults. Methods. Serum neopterin concentrations and early metabolic and pre-atherosclerotic symptoms were analyzed in 295 obese juveniles and 101 normal weight controls of similar age. Additionally, the influence of a 12 months weight reduction program on neopterin levels was investigated in 31 obese juveniles. Results. Intima-media thickness of common carotid arteries (IMT) and the concentrations of C-reactive protein (CRP) were increased in the obese juveniles ( ). Also triglycerides, oxidized LDL, fasted insulin levels, HOMA-index, leptin, liver transaminases and uric acid were increased compared to the controls. However, serum neopterin was decreased in the obese versus non-obese juveniles ( ). The intervention consisting of regular sports, nutritional devices, and a psychologic attendance led after 12 months to an increase of neopterin concentration ( ; paired test). Conclusions. Neopterin concentrations in juvenile obesity behaved considerably different from what was demonstrated in adults, levels did not correlate with metabolic and pre-atherosclerotic symptoms found in early phases although early vascular burden and chronic low grade inflammation was indicated by increased IMT and CRP. Neopterin concentrations increased after a 12 months intervention program. 1. Introduction Nowadays, the role of inflammation and immune activation in atherogenesis is well established [1], and the activation of macrophages appears to be of critical relevance within this process [1, 2]. Cardiovascular disease (CVD) is also associated with increased neopterin concentrations [3–10], and predictive information is provided by neopterin in patients at risk of myocardial infarction [11–16]. A recent study in 2312 patients undergoing angiography demonstrated that neopterin is an independent predictor of total and cardiovascular mortality [17]. Likewise, in patients with diabetes, both neopterin and C-reactive protein (CRP) were independent predictors of fatal ischemic heart disease [18]. Neopterin is produced by human monocyte-derived macrophages and dendritic cells preferentially upon stimulation with Th1-type cytokine interferon-γ (IFN-γ) [19, 20]. Thus, neopterin concentrations reflect activation of the Th1-type immune response [21]. In humans, increased neopterin concentrations are detected in patients with virus infections including human immunodeficiency virus, infections by intracellular bacteria and
Elucidating Novel Serum Biomarkers Associated with Pulmonary Tuberculosis Treatment  [PDF]
Mary A. De Groote, Payam Nahid, Leah Jarlsberg, John L. Johnson, Marc Weiner, Grace Muzanyi, Nebojsa Janjic, David G. Sterling, Urs A. Ochsner
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0061002
Abstract: In an unbiased approach to biomarker discovery, we applied a highly multiplexed proteomic technology (SOMAscan, SomaLogic, Inc, Boulder, CO) to understand changes in proteins from paired serum samples at enrollment and after 8 weeks of TB treatment from 39 patients with pulmonary TB from Kampala, Uganda enrolled in the Center for Disease Control and Prevention’s Tuberculosis Trials Consortium (TBTC) Study 29. This work represents the first large-scale proteomic analysis employing modified DNA aptamers in a study of active tuberculosis (TB). We identified multiple proteins that exhibit significant expression differences during the intensive phase of TB therapy. There was enrichment for proteins in conserved networks of biological processes and function including antimicrobial defense, tissue healing and remodeling, acute phase response, pattern recognition, protease/anti-proteases, complement and coagulation cascade, apoptosis, immunity and inflammation pathways. Members of cytokine pathways such as interferon-gamma, while present, were not as highly represented as might have been predicted. The top proteins that changed between baseline and 8 weeks of therapy were TSP4, TIMP-2, SEPR, MRC-2, Antithrombin III, SAA, CRP, NPS-PLA2, LEAP-1, and LBP. The novel proteins elucidated in this work may provide new insights for understanding TB disease, its treatment and subsequent healing processes that occur in response to effective therapy.
Evaluation of Serum Levels of Essential Trace Elements in Patients with Pulmonary Tuberculosis Before and After Treatment by Age and Gender
F. Pourfallah,S. Javadian,Z. Zamani,R. Saghiri
Pakistan Journal of Biological Sciences , 2011,
Abstract: The purpose of this study was to evaluate the levels of Zinc, Copper, Iron and Copper/Zinc ratio in the serum of adult patients with pulmonary tuberculosis in Iran. Serum levels of Zinc and Copper were determined by flame atomic absorption spectrophotometer and serum iron concentration was measured by using an Auto Analyzer. The study group consisted of 50 pulmonary tuberculosis patients before treatment and after 6 months of anti-tubercular therapy. Levels of serum Zn (p<0.001) and Fe (p<0.001) in TB patients were significantly increased after 6 months of anti-tubercular therapy. However, serum Cu concentration (p<0.01) and Cu/Zn ratio (p<0.05) were decreased after 6 months of anti-tubercular therapy. Some studies indicated a strong association of Zn, Cu, Fe and the Cu/Zn ratio with TB. In this study, we found remarkable change in Cu/Zn ratio. Some researchers mentioned that serum Cu/Zn ratio could be used as an important laboratory marker for diagnosis and treatment of tuberculosis. They also mentioned that trace element levels must be closely monitored during the process of disease.
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