Clinical and genomic responses to ultra-short course chemotherapy in spinal tuberculosis.
Clinical and genomic responses to ultra-short course chemotherapy in spinal tuberculosis.
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DOI：
10.3892/etm.2017.4170
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发表时间：
2017-05
影响因子：
2.7
通讯作者：
Wang Z
中科院分区：
文献类型：
--
作者：
Niu N;Wang Q;Shi J;Zhang X;Geng G;Zhou S;Thach C;Cheng F;Wang Z
脊柱结核（TB）的传统治疗包括化疗和手术。在本研究中，已经确定持续<6个月的化疗[超短疗程化疗（UCCT）]，而不是传统方案的6-18个月，在完全手术清创后维持TB清除是有效的。本研究旨在比较脊柱结核病灶完全清创后，UCCT前后外周血基因表达的变化。该研究包括5名非TB患者和27名脊柱患者，分为三组：第1组（未治疗组，n=8）;第2组（UCCT治疗组，n=9）;第3组（UCCT治疗1年随访组，n=10）。采用DNA微阵列分析检测基因变化，通过逆转录-定量聚合酶链反应（RT-qPCR）进行确认，并使用大卫知识库对结果进行检查，以确定差异表达基因的途径和功能。第1组的结核病灶呈活动性，而第2组和第3组的临床表现和影像学检查显示无活动性结核迹象。对照组和研究组转录谱的比较表明，脊髓结核的治疗导致与免疫应答途径相关的基因上调; RT-qPCR产生了类似的结果。总之，这些结果表明，UCCT是一种有效的治疗结核病后，完全手术清创。此外，DNA微阵列分析被证明是一个有用的工具，以评估脊柱结核治疗对免疫反应途径相关基因表达的影响。
Traditional treatments for spinal tuberculosis (TB) involve chemotherapy and surgery. In the present study, it has been identified that chemotherapy lasting <6 months [ultra-short course chemotherapy (UCCT)], rather than the 6–18 months of the traditional regimen, is effective in sustaining TB clearance following complete surgical debridement. This current study aims to compare the changes in peripheral blood gene expression prior to and following UCCT, subsequent to complete debridement of spinal TB lesions. The study includes 5 patients without TB and 27 patients with spinal, divided into three groups: Group 1 (untreated group, n=8); group 2 (UCCT treatment group, n=9); and group 3 (UCCT treatment 1 year follow-up group, n=10). Gene changes were detected using DNA microarray analysis, confirmed through reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and the results were examined using the DAVID Knowledgebase to identify the pathways and functions of differentially expressed genes. TB lesions were active in group 1, while groups 2 and 3 showed no signs of active TB, as indicated by clinical manifestations and imaging. Comparison of the transcription profiles of the control and study groups showed that treatment of spinal TB resulted in upregulation of genes that are associated with immune response pathways; RT-qPCR produced similar findings. In conclusion, these results indicate that UCCT is an effective treatment against TB following complete surgical debridement. Furthermore, DNA microarray analysis proved a useful tool to evaluate the effects of spinal TB treatment on the expression of genes associated with immune response pathways.