唾液IgA作为头颈癌术后化疗患者微生物感染的替代生物标志物

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Journal of Laboratory Physicians Pub Date : 2023-06-01 DOI:10.1055/s-0042-1757720
Preeti Chavan, Vivek Bhat, Amit Joshi, Tejpal Gupta, Vedang Murthy, Vanita Noronha, Divya Rathish, Kumar Prabhash
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引用次数: 1

摘要

目的放疗(RT)和化疗(CT)是头颈部肿瘤治疗的重要选择。常见的并发症是微生物定植或粘膜表面感染。这些感染通常是由细菌或酵母引起的。唾液蛋白具有缓冲活性和免疫球蛋白,特别是免疫球蛋白A (IgA),保护口腔组织、粘膜表面和牙齿免受各种微生物的侵害。本研究描述了常见的微生物,并评估了唾液IgA在预测这组粘膜炎患者微生物感染中的作用。方法对150例接受CTRT治疗的成人头颈癌患者,分别在治疗前、治疗3周和治疗6周进行评估。从口腔黏膜收集的口腔拭子在微生物实验室进行微生物处理。唾液经西门子维格自动化生化分析仪检测IgA水平。结果铜绿假单胞菌和肺炎克雷伯菌是本组患者最常见的病原菌,其次是大肠杆菌和A群溶血链球菌。ctrt后患者的细菌感染发生率(61%)较ctrt前患者(49.33%)显著增加(p = 0.0203)。细菌和真菌感染患者(n = 135/267)的唾液IgA水平与未感染患者(n = 66/183)相比显著升高(p = 0.003)。结论在本研究中观察到ctrt后患者细菌感染的发生率明显增加。本研究还表明,头颈癌术后口腔黏膜炎患者发生感染与高唾液IgA水平相关,它可能作为这些患者感染的替代生物标志物。
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Salivary IgA as a Surrogate Biomarker for Microbial Infections in Postoperative Patients Receiving Chemo-Radio-Therapy for Head and Neck Cancer.

Objective  Radiotherapy (RT) and chemotherapy (CT) are important treatment options in patients with head and neck cancers. A common complication of this is microbial colonization or infection of mucosal surfaces. These infections may commonly be due to bacteria or yeasts. Salivary proteins with their buffering activity and immunoglobulin, especially immunoglobulin A (IgA), protect oral tissue, mucosal surfaces, and teeth from various microorganisms. This study characterizes the common microorganisms encountered and evaluates the role of salivary IgA in predicting microbial infections in this group of patients with mucositis. Methods  A total of 150 adult head and neck cancer patients on CTRT were evaluated at baseline and at the end of 3 and 6 weeks, respectively. Oral swabs collected from buccal mucosa were processed in the microbiology laboratory for the presence of microorganisms. Saliva was processed for IgA level estimation on Siemens Dimension Automated biochemistry analyzer. ResultsPseudomonas aeruginosa and Klebsiella pneumonia e were the most common organisms found in our patients, followed by Escherichia coli and group A beta-hemolytic Streptococci . A significant increase ( p  = 0.0203) in the incidence of bacterial infection was observed in post-CTRT patients (61%) compared to pre-CTRT patients (49.33%). There was significant increase in levels of salivary IgA ( p  = 0.003) in patients with bacterial and fungal infection ( n  = 135/267) when compared to those in samples showing no growth ( n  = 66/183). Conclusion  A significant increase in the incidence of bacterial infection in post-CTRT patients was observed in this study. This study also indicated that postoperative head and neck cancer patients with oral mucositis that developed an infection were associated with high salivary IgA levels, and it may serve as a surrogate biomarker of infection in these patients.

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来源期刊
Journal of Laboratory Physicians
Journal of Laboratory Physicians MEDICINE, GENERAL & INTERNAL-
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发文量
99
审稿时长
31 weeks
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