Ocular Tuberculosis Diagnosis Through Biomarkers: Clinical Relevance of Serum C1q and Whole Blood Interferon Gene Signature Score.

IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Ocular Immunology and Inflammation Pub Date : 2025-01-01 Epub Date: 2024-06-24 DOI:10.1080/09273948.2024.2368670
Rina La Distia Nora, Ikhwanuliman Putera, Benjamin Schrijver, Gurmeet Singh, Marleen Bakker, Mei Riasanti, Lukman Edwar, Made Susiyanti, Yulia Aziza, Josianne C E M Ten Berge, Saskia M Rombach, P Martin van Hagen, Ratna Sitompul, Willem A Dik
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Abstract

Purpose: To assess the clinical relevance of pathophysiology-based biomarkers, specifically serum C1q and whole blood interferon gene signature score (IGSS), in ocular tuberculosis (OTB) diagnosis by conducting an integrative analysis of clinical presentations and treatment response.

Methods: This retrospective cohort study analysed data from 70 patients with suspected OTB at a tertiary care uveitis practice in Indonesia. Serum C1q levels and whole blood IGSS were quantified. Patients were categorized into four quadrants based on their biomarker profiles: quadrant 1 (high C1q & low IGSS), quadrant 2 (high C1q & high IGSS), quadrant 3 (low C1q & high IGSS), and quadrant 4 (low C1q & low IGSS). Characteristics of clinical presentations, work-up results, and treatment outcomes were explored according to the predefined quadrants.

Results: We identified that the majority of OTB patients diagnosed with concurrent active pulmonary TB were in quadrant 1, 2, or 3 (20/23, 87.0%). Twenty-seven patients (27/47, 57.4%) with clinically undifferentiated uveitis were in quadrant 4 (p < 0.001). Among patients in quadrants 1, 2, and 3, completion of a full course of antitubercular treatment (ATT) was associated with a lower number of patients showing persistence or recurrence of ocular inflammation compared to those who were not fully treated with ATT (14.3% vs 85.7%, p = 0.001).

Conclusions: Based on the analysis of clinical features and treatment outcomes, patients with elevated levels of either or both serum C1q and whole blood IGSS may reflect active TB disease in the eye, necessitating full ATT management.

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通过生物标志物诊断眼结核:血清 C1q 和全血干扰素基因签名评分的临床意义。
目的:通过对临床表现和治疗反应进行综合分析,评估基于病理生理学的生物标志物(尤其是血清C1q和全血干扰素基因特征评分(IGSS))在眼结核(OTB)诊断中的临床相关性:这项回顾性队列研究分析了印度尼西亚一家三级眼色素膜炎诊所的 70 名疑似 OTB 患者的数据。对血清 C1q 水平和全血 IGSS 进行了量化。根据患者的生物标志物特征将其分为四个象限:第1象限(高C1q和低IGSS)、第2象限(高C1q和高IGSS)、第3象限(低C1q和高IGSS)和第4象限(低C1q和低IGSS)。根据预先确定的象限探讨了临床表现、检查结果和治疗效果的特征:我们发现,大多数确诊并发活动性肺结核的 OTB 患者属于第 1、2 或 3 象限(20/23,87.0%)。临床未分化葡萄膜炎的 27 例患者(27/47,57.4%)位于第 4 象限(P = 0.001):根据对临床特征和治疗结果的分析,血清 C1q 和全血 IGSS 水平升高或同时升高的患者可能反映出眼部存在活动性结核病,需要进行全面的 ATT 治疗。
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来源期刊
CiteScore
6.20
自引率
15.20%
发文量
285
审稿时长
6-12 weeks
期刊介绍: Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.
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