Diagnostic performance of serum interferon gamma, matrix metalloproteinases, and periostin measurements for pulmonary tuberculosis in Japanese patients with pneumonia
Momoko Yamauchi aff001; Takeshi Kinjo aff001; Gretchen Parrott aff001; Kazuya Miyagi aff001; Shusaku Haranaga aff001; Yuko Nakayama aff003; Kenji Chibana aff003; Kaori Fujita aff003; Atsushi Nakamoto aff003; Futoshi Higa aff003; Isoko Owan aff003; Koji Yonemoto aff004; Jiro Fujita aff001
Působiště autorů: Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan aff001; Center for General Clinical Training and Education, University of the Ryukyus Hospital, Okinawa, Japan aff002; Department of Respiratory Medicine, National Hospital Organization Okinawa Hospital, Okinawa, Japan aff003; Division of Biostatistics, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan aff004; Division of Biostatistics, Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan aff005
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
Serum markers that differentiate between tuberculous and non-tuberculous pneumonia would be clinically useful. However, few serum markers have been investigated for their association with either disease. In this study, serum levels of interferon gamma (IFN-γ), matrix metalloproteinases 1 and 9 (MMP-1 and MMP-9, respectively), and periostin were compared between 40 pulmonary tuberculosis (PTB) and 28 non-tuberculous pneumonia (non-PTB) patients. Diagnostic performance was assessed by analysis of receiver-operating characteristic (ROC) curves and classification trees. Serum IFN-γ and MMP-1 levels were significantly higher and serum MMP-9 levels significantly lower in PTB than in non-PTB patients (p < 0.001, p = 0.002, p < 0.001, respectively). No significant difference was observed in serum periostin levels between groups. ROC curve analysis could not determine the appropriate cut-off value with high sensitivity and specificity; therefore, a classification tree method was applied. This method identified patients with limited infiltration into three groups with statistical significance (p = 0.01), and those with MMP-1 levels < 0.01 ng/mL and periostin levels ≥ 118.8 ng/mL included only non-PTB patients (95% confidence interval 0.0–41.0). Patients with extensive infiltration were also divided into three groups with statistical significance (p < 0.001), and those with MMP-9 levels < 3.009 ng/mL included only PTB patients (95% confidence interval 76.8–100.0). In conclusion, the novel classification tree developed using MMP-1, MMP-9, and periostin data distinguished PTB from non-PTB patients. Further studies are needed to validate our cut-off values and the overall clinical usefulness of these markers.
Decision trees – Diagnostic medicine – Extracellular matrix – Interferons – Mycobacterium tuberculosis – Pneumonia – Tuberculosis – Tuberculosis diagnosis and management
1. World Health Organization. Global tuberculosis report 2018. Geneva: World Health Organization; 2018.
2. Peto L, Nadjm B, Horby P, Ngan TT, van Doorn R, Van Kinh N, et al. The bacterial aetiology of adult community-acquired pneumonia in Asia: a systematic review. Trans R Soc Trop Med Hyg. 2014;108: 326–337. doi: 10.1093/trstmh/tru058 24781376
3. Chon SB, Kim TS, Oh WS, Lee SJ, Han SS, Kim WJ. Pulmonary tuberculosis among patients hospitalised with community-acquired pneumonia in a tuberculosis-prevalent area. Int J Tuberc Lung Dis. 2013;17: 1626–1631. doi: 10.5588/ijtld.13.0183 24200280
4. Jhun BW, Sim YS, Shin TR, Kim DG. The utility of delta neutrophil index in differentiation of pulmonary tuberculosis from community acquired pneumonia. Sci Rep. 2018;8: 12343. doi: 10.1038/s41598-018-30967-9 30120386
5. Cooper AM, Dalton DK, Stewart TA, Griffin JP, Russell DG, Orme IM. Disseminated tuberculosis in interferon gamma gene-disrupted mice. J Exp Med. 1993;178: 2243–2247. doi: 10.1084/jem.178.6.2243 8245795
6. Flynn JL, Chan J, Triebold KJ, Dalton DK, Stewart TA, Bloom BR. An essential role for interferon gamma in resistance to Mycobacterium tuberculosis infection. J Exp Med. 1993;178: 2249–2254. doi: 10.1084/jem.178.6.2249 7504064
7. Somerville RP, Oblander SA, Apte SS. Matrix metalloproteinases: old dogs with new tricks. Genome Biol. 2003;4: 216. doi: 10.1186/gb-2003-4-6-216 12801404
8. Ong CW, Elkington PT, Friedland JS. Tuberculosis, pulmonary cavitation, and matrix metalloproteinases. Am J Respir Crit Care Med. 2014;190: 9–18. doi: 10.1164/rccm.201311-2106PP 24713029
9. Elkington PT, Ugarte-Gil CA, Friedland JS. Matrix metalloproteinases in tuberculosis. Eur Respir J. 2011;38: 456–464. doi: 10.1183/09031936.00015411 21659415
10. Dorhoi A, Kaufmann SH. Pathology and immune reactivity: understanding multidimensionality in pulmonary tuberculosis. Semin Immunopathol. 2016;38: 153–166. doi: 10.1007/s00281-015-0531-3 26438324
11. Yamada G, Shijubo N, Shigehara K, Okamura H, Kurimoto M, Abe S. Increased levels of circulating interleukin-18 in patients with advanced tuberculosis. Am J Respir Crit Care Med. 2000;161: 1786–1789. doi: 10.1164/ajrccm.161.6.9911054 10852745
12. Andrade BB, Pavan Kumar N, Amaral EP, Riteau N, Mayer-Barber KD, Tosh KW, et al. Heme oxygenase-1 regulation of matrix metalloproteinase-1 expression underlies distinct disease profiles in tuberculosis. J Immunol. 2015;195: 2763–2773. doi: 10.4049/jimmunol.1500942 26268658
13. Xu D, Li Y, Li X, Wei LL, Pan Z, Jiang TT, et al. Serum protein S100A9, SOD3, and MMP9 as new diagnostic biomarkers for pulmonary tuberculosis by iTRAQ-coupled two-dimensional LC-MS/MS. Proteomics. 2015;15: 58–67. doi: 10.1002/pmic.201400366 25332062
14. Koguchi Y, Kawakami K, Uezu K, Fukushima K, Kon S, Maeda M, et al. High plasma osteopontin level and its relationship with interleukin-12-mediated type 1 T helper cell response in tuberculosis. Am J Respir Crit Care Med. 2003;167: 1355–1359. doi: 10.1164/rccm.200209-1113OC 12574077
15. Okamoto M, Hoshino T, Kitasato Y, Sakazaki Y, Kawayama T, Fujimoto K, et al. Periostin, a matrix protein, is a novel biomarker for idiopathic interstitial pneumonias. Eur Respir J. 2011;37: 1119–1127. doi: 10.1183/09031936.00059810 21177844
16. Matsumoto H. Serum periostin: a novel biomarker for asthma management. Allergol Int. 2014;63: 153–160. doi: 10.2332/allergolint.13-RAI-0678 24759559
17. Li W, Gao P, Zhi Y, Xu W, Wu Y, Yin J, et al. Periostin: its role in asthma and its potential as a diagnostic or therapeutic target. Respir Res 2015;16: 57. doi: 10.1186/s12931-015-0218-2 25981515
18. Verma SC, Agarwal P, Krishnan MY. Primary mouse lung fibroblasts help macrophages to tackle Mycobacterium tuberculosis more efficiently and differentiate into myofibroblasts up on bacterial stimulation. Tuberculosis (Edinb). 2016;97: 172–180.
19. Kaarteenaho-Wiik R, Sademies O, Paakko P, Risteli J, Soini Y. Extracellular matrix proteins and myofibroblasts in granulomas of sarcoidosis, atypical mycobacteriosis, and tuberculosis of the lung. Hum Pathol. 2007;38: 147–153. doi: 10.1016/j.humpath.2006.07.001 16996565
20. The report of the Committee for the Respiratory System, the Committee of Clinical Evaluation Methods for Antibiotics, Japanese Society of Chemotherapy. Clinical evaluation method for new antimicrobial agents to treat respiratory infections. Jpn J Chemother. 1997;45: 762–778 [In Japanese].
21. Tamayose M, Fujita J, Parrott G, Miyagi K, Maeshiro T, Hirata T, et al. Correlations between extent of X-ray infiltration and levels of serum C-reactive protein in adult non-severe community-acquired pneumonia. J Infect Chemother. 2015;21: 456–463. doi: 10.1016/j.jiac.2015.02.009 25817351
22. Ootaki A, Horie Y, Steinberg D. Applied Tree-Based Method by CART. Tokyo, Japan: Nikkagiren Publishing; 1998.
23. Chandrashekara S, Anupama KR, Sambarey A, Chandra N. High IL-6 and low IL-15 levels mark the presence of TB infection: A preliminary study. Cytokine. 2016;81: 57–62. doi: 10.1016/j.cyto.2016.02.003 26878649
24. Namuganga AR, Chegou NN, Mubiri P, Walzl G, Mayanja-Kizza H. Suitability of saliva for tuberculosis diagnosis: comparing with serum. BMC Infect Dis. 2017;17: 600. doi: 10.1186/s12879-017-2687-z 28859607
25. Min F, Wu R, Pan J, Huang S, Luo Y, Zhang Y. Positive correlation between IP-10 and IFN-gamma levels in Rhesus monkeys (Macaca mulatta) with either naturally acquired or experimental infection of Mycobacterium tuberculosis. Biomed Res Int. 2017;2017: 5089752. doi: 10.1155/2017/5089752 28512637
26. Elkington P, Shiomi T, Breen R, Nuttall RK, Ugarte-Gil CA, Walker NF, et al. MMP-1 drives immunopathology in human tuberculosis and transgenic mice. J. Clin. Invest. 2011; 121: 1827–33. doi: 10.1172/JCI45666 21519144
27. Al Shammari B, Shiomi T, Tezera L, Bielecka MK, Workman V, Sathyamoorthy T, et al. The extracellular matrix regulates granuloma necrosis in tuberculosis. J. Infect. Dis. 2015; 212: 463–73. doi: 10.1093/infdis/jiv076 25676469
28. Sathyamoorthy T, Sandhu G, Tezera LB, Thomas R, Singhania A, Woelk CH, et al. Gender-dependent differences in plasma matrix metalloproteinase-8 elevated in pulmonary tuberculosis. PLoS One. 2015; 10: e0117605. doi: 10.1371/journal.pone.0117605 25635689
29. Li YT, Wang YC, Lee HL, Lu MC, Yang SF. Elevated plasma matrix metalloproteinase-9 and its correlations with severity of disease in patients with ventilator-associated pneumonia. Int. J. Med. Sci. 2016; 13: 638–45. doi: 10.7150/ijms.16187 27499696
30. Yang SF, Chu SC, Chiang IC, Kuo WF, Chiou HL, Chou FP, et al. Excessive matrix metalloproteinase-9 in the plasma of community-acquired pneumonia. Clin. Chim. Acta. 2005; 352: 209–15. doi: 10.1016/j.cccn.2004.09.025 15653116
31. Bircan HA, Cakir M, Yilmazer Kapulu I, Sutcu R, Kaya S. Elevated serum matrix metalloproteinase-2 and -9 and their correlations with severity of disease in patients with community-acquired pneumonia. Turk. J Med. Sci. 2015; 45: 593–9. doi: 10.3906/sag-1402-51 26281325
32. Hrabec E, Strek M, Zieba M, Kwiatkowska S, Hrabec Z. Circulation level of matrix metalloproteinase-9 is correlated with disease severity in tuberculosis patients. Int. J. Tuberc. Lung Dis. 2002; 6: 713–9. 12150484
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