Plasma indoleamine 2,3-dioxygenase activity as a potential biomarker for early diagnosis of multidrug-resistant tuberculosis in tuberculosis patients

Multidrug-resistant tuberculosis (MDR-TB) remains a challenge of global TB control, with difficulty in early detection of drug-sensitive tuberculosis (DS-TB). We investigate the diagnostic significance of IDO as a potential biomarker to discriminate MDR patients among the TB patients. Plasma indolea...

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Bibliographic Details
Published in:Infection and drug resistance 2019-05, Vol.12, p.1265-1276
Main Authors: Shi, Wen, Wu, Juan, Tan, Qi, Hu, Chun-Mei, Zhang, Xia, Pan, Hong-Qiu, Yang, Zhen, He, Meng-Yu, Yu, Min, Zhang, Bo, Xie, Wei-Ping, Wang, Hong
Format: Article
Language:English
Subjects:
Cancer
Cancer patients
CAT scans
cavitary lung lesion
Chromatography
Diagnostic imaging
Evaluation
High performance liquid chromatography
IDO
LC-MS/MS
Liquid chromatography
Lung cancer
Lung diseases
Mass spectrometry
MDR-TB
Medical research
Microbial drug resistance
Original Research
Spectroscopy
Tomography
Tryptophan
Tuberculosis
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Summary:Multidrug-resistant tuberculosis (MDR-TB) remains a challenge of global TB control, with difficulty in early detection of drug-sensitive tuberculosis (DS-TB). We investigate the diagnostic significance of IDO as a potential biomarker to discriminate MDR patients among the TB patients. Plasma indoleamine 2,3-dioxygenase (IDO) was measured by the ratio of kynurenine (Kyn) to tryptophan (Trp) concentrations, using high performance liquid chromatography-mass spectrometry (LC-MS/MS). Chest computed tomography (CT) imaging signs from TB patients were collected and analyzed in 18 DS-TB patients, 16 MDR-TB patients, 6 lung cancer (LC) patients, and 11 healthy individuals. Lung imaging signs from TB patients were collected and analyzed. We found that plasma IDO activity was significantly higher in the MDR-TB patients than in the DS-TB patients ( =0.012) and in the LC patients ( =0.003). We evaluated the diagnostic significance of plasma IDO activity in discriminating the MDR-TB group from the DS-TB group using a receiver operating characteristic (ROC) curve. With a cutoff level of 46.58 uM/mM, the diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for IDO activity were 87.50%, 72.22%, 73.68%, and 86.67%, respectively. Plasma IDO activity was higher in cavity cases than in non-cavity cases ( =0.042), proving a positive correlation between lung cavity number and cavity size (
ISSN:1178-6973
1178-6973
DOI:10.2147/IDR.S202369