Neuron-specific enolase as a novel biomarker reflecting tuberculosis activity and treatment response

Abstract

Background/Aims:It is not clear which tests are indicative of the activity and severity of tuberculosis (TB). This study aimed to investigate the predictive value of neuron-specific enolase (NSE) and to determine the origin of NSE in TB patients.Methods:A single-center retrospective analysis was conducted on newly diagnosed TB patients between January and December 2010. Patients were categorized into one of two disease groups (focal segmental or extensive) based on chest X-ray. Pre- and post-treatment NSE concentrations were evaluated. To determine the origin of serum NSE concentration, NSE staining was compared with macrophage-specific CD68 staining in lung tissues and with a tissue microarray using immunohistochemistry and immunofluorescence.Results:A total of 60 newly diagnosed TB patients were analyzed. In TB patients, NSE serum concentration was significantly increased and NSE level decreased after treatment (p < 0.001). In proportion to serum high-sensitivity C-reactive protein concentration, the mean serum concentration of NSE in the extensive group (25.12 ng/mL) was significantly higher than that in the focal segmental group (20.23 ng/mL, p = 0.04). Immunohistochemical staining revealed a large number of macrophages that stained positively for both NSE and CD68 in TB tissues. In addition, NSE signals mostly co-localized with CD68 signals in the tissue microarray of TB patients.Conclusions:Our results suggest that NSE may be a practical parameter that can be used to monitor TB activity and treatment response. Elevated serum NSE level originates, at least in part, from macrophages in granulomatous lesions.

The CD14 (−159 C/T) SNP is associated with sCD14 levels and allergic asthma, but not with CD14 expression on monocytes

“… 29 , but contrary to this work our asthma patient cohort displays above-normal NSE levels in serum. Monocytes/macrophages appear to be a possible source of NSE 27 , 33 , and increased numbers of monocytes as well as a correlation of them with NSE levels were demonstrated in our study. However, other plausible sources of NSE are eosinophils or injured epithelial cells during pulmonary infiltration 26 , while the neuronal distress or hypoxia occurring in the lung also could play a role during the disease 29 .…”

“…IgE showed a positive correlation with eosinophil, monocyte and, to a lesser extent, lymphocyte blood count, underlying the relevance of these subsets in allergic asthma pathogenesis (Table 2 ). Since activation of eosinophils and macrophages has been associated to enhanced NSE levels under some pathological conditions 26 , 27 , we also undertook the measurement of this enzyme in serum samples. As Table 2 shows, it was found a positive correlation of IgE, eosinophils and monocytes with NSE (Table 2 ), which prompted us to examine the utility of this parameter as an additional marker of allergic asthma.…”

“…NSE is the neuronal isomer of the glycolytic enzyme 2-phospho-D-glycerate hydrolase, and a typical biomarker of small cell lung cancer 28 . Nevertheless, changes in non-malignant inflammatory lung diseases have also been found 27 , 29 – 32 , since this enzyme can translocate towards the cell surface upon proper stimulatory signals to enhance a proinflammatory response 33 . Our results support the presence of higher NSE levels in men, as previously reported by Collazos et al .…”

Disseminated tuberculosis masquerading as a neuroendocrine tumour

“…While we interpreted neuron-specific enolase as a marker of NET, it is currently also being evaluated as a marker of TB infection in Asia 16. Chromogranin A is sensitive for NET, but the specificity can be adversely affected in patients with renal failure 17.…”

Neuroendocrine Breast Carcinomas Share Prognostic Factors with Gastroenteropancreatic Neuroendocrine Tumors: A Putative Prognostic Role of Menin, p27, and SSTR-2A

“…The first, neuronspecific enolase (NSE) is found in neurons and other cells of neuronal origin, including neuroendocrine cells. The role of NSE has been studied in multiple cancers as well as in other diseases; increased serum NSE correlates with tuberculosis activity [4], predicts poor prognosis in smallcell lung cancer [5], and appears to be associated with brain metastases of breast cancer [6]. Because of the prognostic feature of NSE in other neuroendocrine-related cancers, the role of NSE in NEBC may be relevant.…”