Delta-like 1 protein, vitamin D binding protein and fetuin for detection of Mycobacterium tuberculosis meningitis
Delta-like 1 protein, vitamin D binding protein and fetuin for detection of Mycobacterium tuberculosis meningitis
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DOI：
10.2217/bmm-2017-0373
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发表时间：
2018-07-01
影响因子：
2.2
通讯作者：
Boulware, David R.
中科院分区：
文献类型：
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作者：
Bahr, Nathan C.;Halupnick, Ryan;Boulware, David R.
目的：结核性脑膜炎（TBM）诊断困难，需要新的生物标志物。我们评估了δ样1蛋白（DLL 1）、维生素D结合蛋白（VDBP）和胎球蛋白的诊断效用。研究方法：生物标志物的浓度测定ELISA法在冷冻保存的脑脊液从139艾滋病毒感染的乌干达疑似脑膜炎。通过GeneXpert MTB/Rif或培养诊断TBM。队列诊断包括TBM（n = 22）、隐球菌性脑膜炎（n = 71）或无菌性脑膜炎（n = 16）和脑膜炎（n = 30）。结果：DLL 1（临界值1150 pg/ml）提供了32%的灵敏度和98%的特异性。加入胎球蛋白、隐球菌抗原和IFN-γ，敏感性分别为36%、63%和76%，特异性分别为98%、90%和92%。VDBP（截止值2.0 μ g/ml）提供了81%的灵敏度和68%的特异性，而胎球蛋白（截止值2 μ g/ml）提供了86%的灵敏度和68%的特异性。结论：脑脊液DLL 1、VDBP和胎球蛋白对TBM的诊断具有一定的诊断价值。
Aim: Tuberculosis meningitis (TBM) diagnosis is difficult, new biomarkers are needed. We evaluated the diagnostic utility of delta-like 1 protein (DLL1), vitamin D binding protein (VDBP) and fetuin. Methods: Biomarker concentrations were measured by ELISA in cryopreserved cerebrospinal fluid from 139 HIV-infected Ugandans with suspected meningitis. TBM was diagnosed by GeneXpert MTB/Rif or culture. Cohort diagnoses included TBM (n = 22), cryptococcal (n = 71), or aseptic meningitis (n = 16) and nomeningitis (n = 30). Results: DLL1 (cut-off value 1150 pg/ml) provided 32% sensitivity and 98% specificity. Adding fetuin, cryptococcal antigen and IFN-gamma resulted in sensitivities of 36, 63 and 76% with specificities of 98, 90 and 92%, respectively. VDBP (cut-off value 2.0 mu g/ml) provided 81% sensitivity and 68% specificity while fetuin (cut-off value 2 mu g/ml) provided a sensitivity of 86% and specificity of 68%. Conclusion: CSF DLL1, VDBP and fetuin exhibited fair diagnostic performance for TBM diagnosis.