To Compare the Serum Apoptosis-associated Markers Between Patients With Active TB and Patients With LTBI Clinical Trial
Official title:
The Role of Apoptosis Associated Markers in Pathogenesis of Pulmonary Tuberculosis
To compare the serum apoptosis-associated markers between patients with active TB and patients with LTBI To evaluate the efficiency of apoptosis-associated markers to differentiate potential of active TB from LTBI
Background: Tuberculosis (TB) remains the most important infectious disease worldwide. For
controlling TB, the important strategy includes not only adequate anti-tuberculous treatment
but also well control of latent TB infection (LTBI). Latent TB infection (LTBI) has 10% of
reactivation or more in patients with immuno-compromised disorder. Although LTBI can be
detected by interferon-gamma release assay (IGRA) or tuberculin skin test, how to predict
who will become active TB from LTBI is still unclear but important. In overall prophylactic
treatment for LTBI, the lengthy duration and possible serious side effect too scared to
general application especially 90% of population who may not get illness. Therefore, to
recognize who develop active TB from LTBI is important for targeted prophylactic therapy.
The good marker is not discovered at present. When TB bacilli arrive our lung, macrohage is
the first line defense and necrosis rather than apoptosis is the dominant form of cell
death, which affords a protective milieu for M. tuberculosis. Though the apoptosis is
suppressed in TB, the apoptosis-associated markers have rarely been investigated in human
LTBI vs. active TB. We set up a cohort study to detect active TB developing from LTBI and
first-step conduct a case control study to compare apoptosis markers between LTBI and active
TB for evaluating the apoptosis markers in discriminating TB infection status. The
significant markers should be verified in further cohort study of LTBI patients.
Hypothesis: The apoptosis-associated markers, including Fas ligand, Decoy-receptor 3,
Lipoxin, and prostaglandin E2, are discriminative in patients with active TB from those with
LTBI and thus might predict the potential of being active TB from LTBI.
Study Aims:
To compare the serum apoptosis-associated markers between patients with active TB and
patients with LTBI To evaluate the efficiency of apoptosis-associated markers to
differentiate potential of active TB from LTBI Methods: We prospectively enroll patients
with active TB (n=100) and LTBI (n=100), defined by IGRA. Blood sample would be collected
before they received definite treatment after yielding informed consent. We will examine
serum apoptosis-associated markers including Fas ligand, Decoy-receptor 3, Lipoxin, and
prostaglandin E2, and other cytokines and chemokines in serum sample and supernatant from
T-cell after TB antigen stimulation. Their clinical characteristics will be recorded. We
compare the laboratory and clinical data between the two groups and analyze the efficacy of
diagnostic help from these markers.
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Observational Model: Case Control, Time Perspective: Prospective