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Serum GPL core antibody levels are associated with disease activity and treatment outcomes in Mycobacterium avium complex lung disease following first line antibiotic treatment - 19/10/21

Doi : 10.1016/j.rmed.2021.106585 
Kiyoharu Fukushima a, b, , Seigo Kitada c, Yuki Matsumoto d, Sho Komukai e, f, Tomoki Kuge a, Takahiro Kawasaki a, Takanori Matsuki a, Daisuke Motooka d, Kazuyuki Tsujino a, Mari Miki a, Keisuke Miki a, Shota Nakamura d, Hiroshi Kida a
a Department of Respiratory Medicine, National Hospital Organization, Osaka Toneyama Medical Centre, 5-1-1 Toneyama, Toyonaka, Osaka, Japan 
b Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan 
c Department of Respiratory Medicine, Yao Tokushukai General Hospital, 1-17 Wakakusa-cho, Yao, Osaka, Japan 
d Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases (RIMD), Osaka University, 3-1 Yamadaoka, Suita, Osaka, Japan 
e Department of Biomedical Statistics, Graduate School of Medicine, Osaka University, Osaka, Japan 
f Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Osaka, Japan 

Corresponding author. Department of Respiratory Medicine, National Hospital Organization, Osaka Toneyama Medical Centre, 5-1-1 Toneyama, Toyonaka, Osaka, Japan.Department of Respiratory MedicineNational Hospital OrganizationOsaka Toneyama Medical Centre5-1-1 ToneyamaToyonakaOsakaJapan

Abstract

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. Pretreatment 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.

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Highlights

There are no objective serum biomarkers for Mycobacterium avium complex lung disease (MAC-LD).
We conducted a single-center retrospective cohort study to investigate the utility of serial measurements of GPL core IgA antibodies.
GPL core antibody levels were associated with MAC-LD disease activity and treatment outcomes.

Le texte complet de cet article est disponible en PDF.

Keywords : Enzyme immunoassay, Serodiagnosis, Mycobacterium avium complex


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Vol 187

Article 106585- octobre 2021 Retour au numéro
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