Serum GPL core antibody levels are associated with disease activity and treatment outcomes in Mycobacterium avium complex lung disease following first line antibiotic treatment,Respiratory Medicine

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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
Respiratory Medicine ( IF 3.5 ) Pub Date : 2021-08-26 , DOI: 10.1016/j.rmed.2021.106585
Kiyoharu Fukushima ₁ , Seigo Kitada ₂ , Yuki Matsumoto ₃ , Sho Komukai ₄ , Tomoki Kuge ₅ , Takahiro Kawasaki ₅ , Takanori Matsuki ₅ , Daisuke Motooka ₃ , Kazuyuki Tsujino ₅ , Mari Miki ₅ , Keisuke Miki ₅ , Shota Nakamura ₃ , Hiroshi Kida ₅

Affiliation

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.

中文翻译：

在一线抗生素治疗后，血清 GPL 核心抗体水平与鸟分枝杆菌复合肺病的疾病活动和治疗结果相关

背景

目前不存在鸟分枝杆菌复合肺病 (MAC-LD)病程或治疗结果的客观血清生物标志物。针对糖肽脂 (GPL) 核心的血清 IgA 抗体水平对 MAC-LD 具有良好的诊断准确性。然而，它们在监测和预测 MAC-LD 一线抗生素治疗后的病程和结果方面的有用性仍不清楚。

方法

我们进行了一项单中心回顾性队列研究，以调查 GPL 核心 IgA 抗体系列测量在监测 133 名 MAC-LD 患者在一线抗生素治疗后疾病进程中的效用。

结果

根据化疗后的细菌学结果，将患者分为治疗失败 [n = 46 (34.6%)]、复发 [n = 19 (14.3%)] 或治疗成功 [n = 68 (51.1%)] 组。治疗成功组治疗前血清抗 GPL 核心 IgA 水平与治疗失败组和复发组相似（分别为P = 0.6431 和P = 0.9045）。在治疗成功组中，开始抗生素治疗后血清抗 GPL 核心 IgA 水平显着且持续降低。在治疗失败或复发组中没有观察到抗 GPL 核心 IgA 水平的显着降低。抗生素治疗后 GPL 核心抗体水平降低与治疗结果密切相关（P = 0.0045)。