2015
DOI: 10.1371/journal.pone.0129552
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Cytokine Kinetics in the First Week of Tuberculosis Therapy as a Tool to Confirm a Clinical Diagnosis and Guide Therapy

Abstract: BackgroundMany patients treated for tuberculosis (TB) in low and middle income countries are treated based on clinical suspicion without bacteriological confirmation. This is often due to lack of rapid simple accurate diagnostics and low healthcare provider confidence in the predictive value of current tests. We previously reported in an animal TB model that levels of host markers rapidly change in response to treatment initiation.MethodsWe assessed the potential of host biomarker kinetics of TB patients durin… Show more

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Cited by 10 publications
(16 citation statements)
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References 23 publications
(30 reference statements)
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“…Detailed studies focused on disclosure of patient biomarker with prognostic profiles to demonstrate the disease or treatment success, but remained elusive [76,77]. None the less, the kinetics of nonspecific disease-associated biomarkers are increasingly recognized as having potential for the monitoring of treatment success and could play a role in guiding the therapy of complex (M[X]DR-TB) cases [78,79]. Host-derived markers are universally present in healthy and disease individuals and the levels present in healthy individuals are in almost all cases already established.…”
Section: Potential Role Of Host-derived Biomarkers In Treatment Guidancementioning
confidence: 99%
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“…Detailed studies focused on disclosure of patient biomarker with prognostic profiles to demonstrate the disease or treatment success, but remained elusive [76,77]. None the less, the kinetics of nonspecific disease-associated biomarkers are increasingly recognized as having potential for the monitoring of treatment success and could play a role in guiding the therapy of complex (M[X]DR-TB) cases [78,79]. Host-derived markers are universally present in healthy and disease individuals and the levels present in healthy individuals are in almost all cases already established.…”
Section: Potential Role Of Host-derived Biomarkers In Treatment Guidancementioning
confidence: 99%
“…Early evidence suggests that these responses will be informative before culture or microscopic conversion is currently detected [78,79,89,90]. Thus, as measuring the response of host biomarker kinetics has the potential to be both simple and rapid [91], measuring biomarkers deserve attention.…”
Section: Potential Role Of Host-derived Biomarkers In Treatment Guidancementioning
confidence: 99%
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“…Some of these biomarkers have the potential for point-of-care measurement, notably IP-10. [63,64] The clinical value for treatment optimization and the predictive power of these markers needs to be established in larger trials in different patient populations. To date, no biomarkers have been included in treatment evaluation.…”
Section: Biomarkersmentioning
confidence: 99%
“…TB is associated with increased serum IP-10 levels [93,[95][96][97], and at completion of therapy, levels are significantly lower than before treatment/at diagnosis. [64,98,99] This decrease is also measurable in the first weeks of therapy, [63,93] and therefore measurement of the kinetics of this cytokine during treatment may provide useful information on whether patients are responding to the prescribed drugs. It is also notable that host markers are present and detectable in all individuals.…”
Section: Biomarkersmentioning
confidence: 99%