ABSTRACT
@#Abstract: Objective To investigate the correlation of serum exosomal microRNA (exomiR)-27a with drug resistance and adverse outcomes in pulmonary tuberculosis (PTB), to provide new evidence for the development of anti-tuberculosis treatment. Methods From May 2018 to June 2020, 326 patients with PTB in the Eighth Affiliated Hospital of Xinjiang Medical University were selected and divided into 228 patients with active TB (active group) and 98 patients with latent TB infection (latent group), and 100 healthy subjects were included as controls. The serum exosomes of all subjects were extracted and identified by transmission electron microscopy, nanoparticle particle size analyzer and flow cytometry. The expression level of serum exomiR-27a was detected by real-time quantitative PCR. The diagnostic value of serum exomiR-27a in PTB was analyzed by receiver operating characteristic (ROC) curve. Drug resistance in patients with active PTB was recorded after standard treatment. The effect of serum exomiR-27a on the incidence of adverse outcomes was analyzed. Results The characterization of serum exosomes confirmed that exosomes were successfully isolated from serum. Compared with the control group 0.92(0.63, 1.17), the expression of serum exomiR-27a was up-regulated in the active group 1.55(1.18, 2.09) and the latent group 1.27 (0.96, 1.65), and the expression of exomiR-27a in the active group was higher than that in the latent group (P<0.05). PTB patients with high serum exomiR-27a expression (≥1.50) had poorer chest radiography and a higher proportion of chronic hepatitis comorbidities (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of serum exomiR-27a distinguishing control and active group was 0.838 (95%CI: 0.795-0.880) and the AUC of serum exomiR-27a distinguishing normal and latent group was 0.766 (95%CI: 0.701-0.830). Patients in the active group received standard antituberculosis therapy (≥6 months). The expression level of serum exomiR-27a in drug-resistant patients was higher than that in sensitive patients (P<0.001), and the expression level of serum exomiR-27a in multi-drug resistant tuberculosis patients was higher than that in single-drug resistant tuberculosis patients (P<0.001). Logistic regression analysis showed that elevated serum exomiR-27a was an independent predictor of PTB resistance (P<0.001). High expression of serum exomiR-27a indicated a higher incidence of adverse outcomes (log rank=15.725, P<0.001). Conclusions High expression of serum exomiR-27a is helpful in the diagnosis and prediction of adverse outcomes of PTB.
ABSTRACT
@#Abstract： Objective To analyze the changes of cytokine levels in patients with sensitive pulmonary tuberculosis and drug-resistant pulmonary tuberculosis before and after anti-tuberculosis treatment. Methods The clinical data of 213 pulmonary tuberculosis patients admitted to the Eighth Affiliated Hospital of Xinjiang Medical University from August 2019 to October 2020 were collected, and divided into a sensitive pulmonary tuberculosis group and a drug-resistant pulmonary tuberculosis group, of which 141 were in the sensitive group and 72 in the drug-resistant group , and the pro-inflammatory factors tumor necrosis factor-α (TNF-α), IL-6, IL-17, interferon-γ (IFN-γ) and anti-inflammatory factors IL-10 and IL-4 in plasma before treatment, 3 months and 6 months after treatment were compared. Results Compared with the healthy group, the levels of plasma IL-6 in the sensitive group and the resistant group were significantly increased, difference was statistically significant (P<0.01). The plasma levels of IFN-γ and IL-17 in the sensitive group were increased, and the difference was statistically significant (P<0.05). Compared with before treatment, the levels of IL-6 and IL-4 in the plasma of the sensitive group after 6 months of treatment were lower than those after 3 months of treatment, and the difference was statistically significant (P<0.05), and IFN-γ was significantly decreased (P<0.001). After 6 months of treatment, the IL-10 content was lower than that before treatment, and the difference was statistically significant (P<0.05), and the IFN-γ decreased significantly (P<0.000 1). The levels of IFN-γ at 3 months were higher than those in the resistant group, and the difference was statistically significant (P<0.01). After 6 months of treatment, there was no significant difference in the content of IFN-γ between the sensitive group and the resistant group. The effective rate of CT absorption was 70% in the sensitive group and only 43.33% in the resistant group at 3 months of treatment, and there was no significant difference in the effective rate between the two groups after 6 months of treatment. Conclusions Detection of pro-inflammatory cytokines and anti-inflammatory cytokines in plasma can provide reference for host-directed therapy of pulmonary tuberculosis. Understanding this important feature of cytokines on pathogen-host interactions can provide new insights into the study of virulence mechanisms and may provide new approaches for immune intervention in pulmonary tuberculosis.