Candidate Biomarkers to Distinguish Spinal Tuberculosis From Mechanical Back Pain in a Tuberculosis Endemic Setting

BackgroundSpinal tuberculosis (TB) may have a variable, non-specific presentation including back pain with- or without- constitutional symptoms. Further tools are needed to aid early diagnosis of this potentially severe form of TB and immunological biomarkers may show potential in this regard. The a...

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Autores principales:	Theresa N. Mann, Johan H. Davis, Gerhard Walzl, Caroline G. Beltran, Jacques du Toit, Robert P. Lamberts, Novel N. Chegou
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	tuberculosis spine biomarkers back pain inflammation cytokines Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/50813e54c0834b99ba3e69c561ccfc05
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spelling	oai:doaj.org-article:50813e54c0834b99ba3e69c561ccfc052021-11-18T07:22:50ZCandidate Biomarkers to Distinguish Spinal Tuberculosis From Mechanical Back Pain in a Tuberculosis Endemic Setting1664-322410.3389/fimmu.2021.768040https://doaj.org/article/50813e54c0834b99ba3e69c561ccfc052021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fimmu.2021.768040/fullhttps://doaj.org/toc/1664-3224BackgroundSpinal tuberculosis (TB) may have a variable, non-specific presentation including back pain with- or without- constitutional symptoms. Further tools are needed to aid early diagnosis of this potentially severe form of TB and immunological biomarkers may show potential in this regard. The aim of this study was to investigate the utility of host serum biomarkers to distinguish spinal TB from mechanical back pain.MethodsPatients with suspected spinal TB or suspected mechanical back pain were recruited from a tertiary hospital in the Western Cape, South Africa, and provided a blood sample for biomarker analysis. Diagnosis was subsequently confirmed using bacteriological testing, advanced imaging and/or clinical evaluation, as appropriate. The concentrations of 19 host biomarkers were evaluated in serum samples using the Luminex platform. Receiver Operating Characteristic (ROC) curves and General Discriminant Analysis were used to identify biomarkers with the potential to distinguish spinal TB from mechanical back pain.ResultsTwenty-six patients with spinal TB and 17 with mechanical back pain were recruited. Seven out of 19 biomarkers were significantly different between groups, of which Fibrinogen, CRP, IFN-γ and NCAM were the individual markers with the highest discrimination utility (Area Under Curve ROC plot 0.88-0.99). A five-marker biosignature (CRP, NCAM, Ferritin, CXCL8 and GDF-15) correctly classified all study participants after leave-one-out cross-validation.ConclusionThis study identified host serum biomarkers with the potential to diagnose spinal TB, including a five-marker biosignature. These preliminary findings require validation in larger studies.Theresa N. MannTheresa N. MannJohan H. DavisJohan H. DavisGerhard WalzlCaroline G. BeltranJacques du ToitRobert P. LambertsRobert P. LambertsNovel N. ChegouFrontiers Media S.A.articletuberculosisspinebiomarkersback paininflammationcytokinesImmunologic diseases. AllergyRC581-607ENFrontiers in Immunology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	tuberculosis spine biomarkers back pain inflammation cytokines Immunologic diseases. Allergy RC581-607
spellingShingle	tuberculosis spine biomarkers back pain inflammation cytokines Immunologic diseases. Allergy RC581-607 Theresa N. Mann Theresa N. Mann Johan H. Davis Johan H. Davis Gerhard Walzl Caroline G. Beltran Jacques du Toit Robert P. Lamberts Robert P. Lamberts Novel N. Chegou Candidate Biomarkers to Distinguish Spinal Tuberculosis From Mechanical Back Pain in a Tuberculosis Endemic Setting
description	BackgroundSpinal tuberculosis (TB) may have a variable, non-specific presentation including back pain with- or without- constitutional symptoms. Further tools are needed to aid early diagnosis of this potentially severe form of TB and immunological biomarkers may show potential in this regard. The aim of this study was to investigate the utility of host serum biomarkers to distinguish spinal TB from mechanical back pain.MethodsPatients with suspected spinal TB or suspected mechanical back pain were recruited from a tertiary hospital in the Western Cape, South Africa, and provided a blood sample for biomarker analysis. Diagnosis was subsequently confirmed using bacteriological testing, advanced imaging and/or clinical evaluation, as appropriate. The concentrations of 19 host biomarkers were evaluated in serum samples using the Luminex platform. Receiver Operating Characteristic (ROC) curves and General Discriminant Analysis were used to identify biomarkers with the potential to distinguish spinal TB from mechanical back pain.ResultsTwenty-six patients with spinal TB and 17 with mechanical back pain were recruited. Seven out of 19 biomarkers were significantly different between groups, of which Fibrinogen, CRP, IFN-γ and NCAM were the individual markers with the highest discrimination utility (Area Under Curve ROC plot 0.88-0.99). A five-marker biosignature (CRP, NCAM, Ferritin, CXCL8 and GDF-15) correctly classified all study participants after leave-one-out cross-validation.ConclusionThis study identified host serum biomarkers with the potential to diagnose spinal TB, including a five-marker biosignature. These preliminary findings require validation in larger studies.
format	article
author	Theresa N. Mann Theresa N. Mann Johan H. Davis Johan H. Davis Gerhard Walzl Caroline G. Beltran Jacques du Toit Robert P. Lamberts Robert P. Lamberts Novel N. Chegou
author_facet	Theresa N. Mann Theresa N. Mann Johan H. Davis Johan H. Davis Gerhard Walzl Caroline G. Beltran Jacques du Toit Robert P. Lamberts Robert P. Lamberts Novel N. Chegou
author_sort	Theresa N. Mann
title	Candidate Biomarkers to Distinguish Spinal Tuberculosis From Mechanical Back Pain in a Tuberculosis Endemic Setting
title_short	Candidate Biomarkers to Distinguish Spinal Tuberculosis From Mechanical Back Pain in a Tuberculosis Endemic Setting
title_full	Candidate Biomarkers to Distinguish Spinal Tuberculosis From Mechanical Back Pain in a Tuberculosis Endemic Setting
title_fullStr	Candidate Biomarkers to Distinguish Spinal Tuberculosis From Mechanical Back Pain in a Tuberculosis Endemic Setting
title_full_unstemmed	Candidate Biomarkers to Distinguish Spinal Tuberculosis From Mechanical Back Pain in a Tuberculosis Endemic Setting
title_sort	candidate biomarkers to distinguish spinal tuberculosis from mechanical back pain in a tuberculosis endemic setting
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/50813e54c0834b99ba3e69c561ccfc05
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Candidate Biomarkers to Distinguish Spinal Tuberculosis From Mechanical Back Pain in a Tuberculosis Endemic Setting

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