Serum GPL core antibody levels are associated with disease activity and treatment outcomes in Mycobacterium avium complex lung disease following first line antibiotic treatment
Serum GPL core antibody levels are associated with disease activity and treatment outcomes in Mycobacterium avium complex lung disease following first line antibiotic treatment
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DOI：
10.1016/j.rmed.2021.106585
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发表时间：
2021-10-01
影响因子：
4.3
通讯作者：
Kida, Hiroshi
中科院分区：
文献类型：
--
作者：
Fukushima, Kiyoharu;Kitada, Seigo;Kida, Hiroshi
背景：目前还没有客观的血清生物标志物的疾病过程或治疗结果的鸟分枝杆菌复杂的肺疾病（MAC-LD）。抗糖肽脂（GPL）核心的血清伊加抗体水平对MAC-LD具有良好的诊断准确性。然而，他们的有用性监测和预测疾病的进程和结果MAC-LD以下一线抗生素treatment.Methods：我们进行了一项单中心回顾性队列研究，以调查的效用系列测量的GPL核心伊加抗体监测疾病的进程在133例MAC-LD以下一线抗生素治疗。根据化疗后的细菌学结果，将患者分为治疗失败[n = 46（34.6%）]、复发[n = 19（14.3%）]或治疗成功[n = 68（51.1%）]组。治疗成功组治疗前血清抗GPL核心伊加水平与治疗失败组和复发组相似（分别为P = 0.6431和P = 0.9045）。在治疗成功组中，血清抗GPL核心伊加水平在开始抗生素治疗后显著且持续降低。在治疗失败或复发组中均未观察到抗GPL核心伊加水平的显著降低。抗生素治疗后GPL核心抗体水平的降低与治疗结果相关（P = 0.0045）。结论：在本研究中，通过进行系列测量，我们发现GPL核心抗体水平与MAC-LD患者的疾病活动性和治疗结果相关。抗GPL核心伊加水平的时程分析明确区分了治疗成功的患者和经历治疗失败或疾病复发的患者。
Background: No objective serum biomarkers of disease course or treatment outcome of Mycobacterium avium complex lung disease (MAC-LD) presently exist. Serum IgA antibody levels against the glycopeptidolipid (GPL) core have good diagnostic accuracy for MAC-LD. However, their usefulness for monitoring and predicting disease course and outcome of MAC-LD following first-line antibiotic treatment remains unclear.Methods: We conducted a single-center retrospective cohort study to investigate the utility of serial measurements of GPL core IgA antibodies for monitoring disease course in 133 patients with MAC-LD following first-line antibiotic treatment.Results: Patients were classified into treatment failure [n = 46 (34.6%)], recurrence [n = 19 (14.3%)], or treatment success [n = 68 (51.1%)] groups according to bacteriological outcomes after chemotherapy. Pre-treatment serum anti-GPL core IgA levels in the treatment success group were similar to those in the treatment failure and recurrence groups (P = 0.6431 and P = 0.9045, respectively). In the treatment success group, serum anti-GPL core IgA levels were significantly and continuously reduced after initiating antibiotic treatment. No significant reductions in anti-GPL core IgA levels were observed in either the treatment failure or recurrence groups. Reduced levels of GPL core antibodies following antibiotic treatment correlated well with treatment outcomes (P = 0.0045).Conclusion: In this study, by performing serial measurements, we found that GPL core antibody levels were associated with disease activity and treatment outcomes in patients with MAC-LD. Time course analysis of anti-GPL core IgA levels clearly differentiated between patients who achieved treatment success and those who experienced treatment failure or disease recurrence.