URINARY NEOPTERIN A SURROGATE MARKER OF ACTIVE TUBERCULOSIS AND ASSESMENT OF TREATMENT OUTCOME
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Abstract
Background- There are several advancements in the diagnostic tests of tuberculosis but obtaining material from nonproductive pulmonary as well as extrapulmonary cases still remains a challenge. This prompted us to search for a non invasive marker to diagnose active TB.
Methods- Total 100 subjects were enrolled in study. Categorization of patients into active, LTBI and control done with the help of Mantoux test, IGRA, smear microscopy and CBNAAT. 10 to 15 ml spot urine sample from all the subjects was collected in sterile container and sent to pathology lab for the estimation of neopterin level in urine by ELISA method determined by optical density. Patients having active disease antitubercular treatment started after doing baseline urinary nepoterin test and follow up test was also done at the end of 3 month and 6 month ( end of treatment).
Results- Our study compare the urinary neopterin value between active TB, latent TB and normal subjects. It was found that there was statistically significant difference in the base line urinary neopterin level among active cases , LTBI and control. Among active TB cases after the initiation of standard first line anti tubercular treatment follow up urinary neopterin test was also done at 3 months and at 6 months. Comparing urinary neopterin from base line to 3 month and at 6 month it was found statistically significant ( p value<0.05). Further more on comparison of urinary neopterine at 3 month and 6 month it was statistically insignificant (p value >0.05).
Conclusion-Urinary neopterin can be considered as a surrogate marker to diagnose active TB and treatment outcome.
References
2. U. Sester, M. Fousse, J. Dirks et al., “Whole-blood flowcytometricanalysisofantigen-specificCD4T-cellcytokineprofiles distinguishes active tuberculosis from non-active states,” PLoSONE,vol.6,no.3,ArticleIDe17813,2011.
3. M.Eisenhut,“Neopterin in diagnosis and monitoring of infectious diseases,” Journal of Biomarkers, vol. 2013, Article ID 196432,10pages,2013.
4. J. Westermann, F. Thiemann, L. Gerstner et al., “Evaluation of a new simple and rapid enzyme-linked immunosorbent assay kit for neopterin determination,” Clinical Chemistry and LaboratoryMedicine,vol.38,no.4,pp.345–353,2000.
5. Flavall E. A., Crone E. M., Moore G. A. & Gieseg S. P. (2008) Dissociation of neopterin and 7, 8-dihydroneopterin from plasma components before HPLC analysis, Journal of Chromatography B. 863, 167– 171. https://doi.org/10.1016/j.jchromb.2007.12.019 PMID: 18234568
6. S. D. Lawn, A. D. Kerkhoff, M. Vogt, R. Wood, Diagnostic accuracy of a low-cost, urine antigen, point-of-care screening assay for HIV-associated pulmonary tuberculosis before antiretroviral therapy: A descriptive study. Lancet Infect. Dis. 12, 201–209 (2012).
7. Y. Hanifa, L. Telisinghe, K. L. Fielding, J. L. Malden, G. J. Churchyard, A. D. Grant, S. Charalambous, The diagnostic accuracy of urine lipoarabinomannan test for tuberculosis screening in a South African correctional facility. PLOS ONE 10, e0127956 (2015)
8. Fuchs D, Jaeger H, Popescu M, Reibnegger G, Werner ER, Kaboth W, et al. Comparison of serum and urine neopterin concentrations in patients with HIV-1 infection. Clin Chim Acta Int J Clin Chem. 1990;187(2):125–130
9. I.Yuksekol,M.Ozkan,O.Akguletal.,“Urinary neopterin measurement as a non-invasive diagnostic method in pulmonary tuberculosis,” International Journal of Tuberculosis and Lung Disease,vol.7,no.8,pp.771–776,2003.
10. Michael Eisenhut, DougalS.Hargreaves,2et al Journal of Biomarkers Volume 2016, Article ID 5643853, 6 pages http://dx.doi.org/10.1155/2016/5643853
11. Flonza Isa, Sean Collins et al F.Isa etal. / EBioMedicine 31 (2018) 157–165
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Dr. Alok Chandra
Professor & Head, Department of Respiratory Medicine, United Institute of Medical Science, Prayagraj, Uttar Pradesh, India
Dr. Bal Krishna Kushwaha
Respiratory Medicine, United Institute of Medical Science, Prayagraj, Uttar Pradesh, India
Dr. Shveta Sachdeva
Assistant Professor, Department of Pathology, Motil Lal Nehru Medical College, Prayagraj, Uttar Pradesh
Dr. Saumya Singh
Professor & Head, Department of Microbiology, United Institute of Medical Science, Prayagraj, Uttar Pradesh, India