Department of Population and Quantitative Health Sciences
Bacterial Infections and Mycoses | Biological Factors | Diagnosis | Enzymes and Coenzymes | Immunology and Infectious Disease | Therapeutics
Purpose: Multidrug-resistant tuberculosis (MDR-TB) remains a challenge of global TB control, with difficulty in early detection of drug-sensitive tuberculosis (DS-TB). We investigate the diagnostic significance of IDO as a potential biomarker to discriminate MDR patients among the TB patients.
Patients and methods: Plasma indoleamine 2,3-dioxygenase (IDO) was measured by the ratio of kynurenine (Kyn) to tryptophan (Trp) concentrations, using high performance liquid chromatography-mass spectrometry (LC-MS/MS). Chest computed tomography (CT) imaging signs from TB patients were collected and analyzed in 18 DS-TB patients, 16 MDR-TB patients, 6 lung cancer (LC) patients, and 11 healthy individuals. Lung imaging signs from TB patients were collected and analyzed.
Results: We found that plasma IDO activity was significantly higher in the MDR-TB patients than in the DS-TB patients (p=0.012) and in the LC patients (p=0.003). We evaluated the diagnostic significance of plasma IDO activity in discriminating the MDR-TB group from the DS-TB group using a receiver operating characteristic (ROC) curve. With a cutoff level of 46.58 uM/mM, the diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for IDO activity were 87.50%, 72.22%, 73.68%, and 86.67%, respectively. Plasma IDO activity was higher in cavity cases than in non-cavity cases (p=0.042), proving a positive correlation between lung cavity number and cavity size (p < 0.05, separately) among all the TB patients studied.
Conclusion: Our findings confirmed that plasma IDO activity might have an auxiliary diagnosis value for early discrimination of MDR-TB patients from DS-TB patients. Among the TB patients with cavitary lung lesions, higher plasma IDO activity can indicate a higher risk of MDR-TB.
IDO, LC-MS/MS, MDR-TB, cavitary lung lesion
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DOI of Published Version
Infect Drug Resist. 2019 May 14;12:1265-1276. doi: 10.2147/IDR.S202369. eCollection 2019. Link to article on publisher's site
Infection and drug resistance
Shi, Wen; Wu, Juan; Tan, Qi; Hu, Chun-Mei; Zhang, Xia; Pan, Hong-Qiu; Yang, Zhen; He, Meng-Yu; Yu, Min; Zhang, Bo; Xie, Wei-Ping; and Wang, Hong, "Plasma indoleamine 2,3-dioxygenase activity as a potential biomarker for early diagnosis of multidrug-resistant tuberculosis in tuberculosis patients" (2019). Open Access Articles. 3847.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 3.0 License