Molecular evidence for the role of mycobacteria in sarcoidosis: a meta-analysis
Molecular evidence for the role of mycobacteria in sarcoidosis: a meta-analysis
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DOI：
10.1183/09031936.00002607
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发表时间：
2007-09-01
影响因子：
24.3
通讯作者：
Jindal, S. K.
中科院分区：
文献类型：
--
作者：
Gupta, D.;Agarwal, R.;Jindal, S. K.
结节病的病因目前尚不清楚。由于结节病和结核病在临床和组织学上的相似性，分支杆菌作为结节病的病原学致病因子已被反复研究。目前的荟萃分析旨在评估分枝杆菌在结节病发生中可能扮演的角色的现有分子证据。检索MEDLINE、EMBASE、CINAHL、DARE和中央数据库，检索1980-2006年间发表的相关研究，利用分子技术评估分枝杆菌在结节病患者生物样本中的存在的研究纳入本次分析。计算(个别研究的)预期比例的95%可信区间(CI)；然后将数据汇集在一起，获得95%可信区间的总体成功率。还计算了优势比(95%CI)，以评估结节病患者样本中分支杆菌的存在与非结节病对照样本中分支杆菌的存在。数据库搜索得到31项研究。所有研究都使用聚合酶链式反应进行核酸扩增，然后鉴定不同类型分枝杆菌特有的核酸序列。总体而言，874名患者中有231名分枝杆菌阳性，阳性信号率为26.4(23.6-29.5%)，使用随机效应模型在结节病患者样本中发现分枝杆菌的几率为9.67(4.56-20.5%)，使用确切的MET异质性和发表偏倚证据在结节病患者样本中发现分枝杆菌的几率为19.49(11.21-35.54%)。在结节病的病变中有方法学和统计学上可证明的分枝杆菌的存在，这表明分枝杆菌与一些结节病病例之间存在联系。为了避免方法的多样性，应该设计更大的多中心试验，并设立一个中心实验室进行样品检测。
The aetiology of sarcoidosis is currently unknown. Due to the clinical and histological similarities between sarcoidosis and tuberculosis, the role of mycobacteria has been repeatedly investigated as an aetiologicall agent for sarcoidosis. The current meta-analysis aimed to evaluate the available molecular evidence on the possible role of mycobacteria in the development of sarcoidosis.The MEDLINE, EMBASE, CINAHL, DARE and CENTRAL databases were searched for relevant studies published from 1980 to 2006, and studies evaluating the presence of mycobacteria using molecular techniques in biological samples of patients with sarcoidosis were included in the current analysis. The 95% confidence intervals (Cl) were calculated for the expected proportion (of individual studies); the data was then pooled to obtain a summary success rate with 95% CI. The odds ratio (95% Cl) was also calculated in order to assess the presence of mycobacteria in samples of patients with sarcoidosis versus those from nonsarcoldosis control samples.The database search yielded 31 studies. All studies used polymerase chain reaction for nucleic acid amplification followed by identification of nucleic acid sequences specific for different types of mycobacteria. Overall, 231 out of the 874 patients were positive for mycobacteria with a positive signal rate of 26.4 (23.6-29.5%), and the odds of finding mycobacteria in samples of patients with sarcoidosis versus controls were 9.67 (4.56-20.5%) using the random effects model and 19.49 (11.21-35.54%) using the exact met heterogeneity and evidence of publication bias.The results of the current study illustrate hod. There was methodological and statistical a demonstrable mycobacterial presence in sarcoidosis lesions suggesting an association between mycobacteria and some cases of sarcoidosis. To avoid methodological diversity, larger multicentre trials with a central laboratory for sample testing should be designed.