title: alpha1-acid glycoprotein and alpha1-antitrypsin as early markers of treatment response in patients receiving the intensive phase of tuberculosis therapy.
abstract: The identification of early markers that predict the response to anti-tuberculosis treatment would facilitate evaluation of new drugs and improve patient management. This study aimed to determine whether selected acute phase proteins and micronutrients measured at the time of diagnosis and during the first weeks of treatment could predict treatment responses during the 2-month standard intensive phase of therapy. For this purpose, alpha1-antitrypsin, alpha1-acid glycoprotein, alpha2-macroglobulin, C-reactive protein, C3, C4, zinc, copper and selenium concentrations were measured in Brazilian patients with smear-positive tuberculosis at the time of diagnosis and 1, 3, 5 and 8 weeks after initiation of therapy. Patients were classified into fast (n=29), intermediate (n=18) and slow responders (n=10) if they were smear-negative at 3, 5 or 8 weeks of treatment. alpha1-acid glycoprotein on enrolment and 1 week of treatment, alpha1-antitrypsin at week 1 and C-reactive protein and C3 after 3 weeks of therapy were higher in slow responders than in fast responders. alpha1-antitrypsin and alpha1-acid glycoprotein may be helpful in predicting treatment response at the time of initiation of therapy, and could be used as early markers to identify patients with an increased likelihood of treatment failure.
authors.affiliation: Federal University of Sergipe, Departamento de Medicina, Campus da Saude, Rua Claudio Batista, Aracaju, Brazil.
authors.forename: Maria Luiza Doria
authors.initials: ML
authors.lastname: Almeida
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Barbieri
authors.forename: Ricardo Q
authors.initials: RQ
authors.lastname: Gurgel
authors.forename: Saddiq Tsimiri
authors.initials: ST
authors.lastname: Abdurrahman
authors.forename: Uthman Alhaji
authors.initials: UA
authors.lastname: Baba
authors.forename: C Anthony
authors.initials: CA
authors.lastname: Hart
authors.forename: Alan
authors.initials: A
authors.lastname: Shenkin
authors.forename: Angela Maria
authors.initials: AM
authors.lastname: Silva
authors.forename: Luiz
authors.initials: L
authors.lastname: de Souza
authors.forename: Luis Eduardo
authors.initials: LE
authors.lastname: Cuevas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000378:metabolism; D001798:Blood Proteins / Q000378:metabolism; D001938:Brazil; D002097:C-Reactive Protein / Q000378:metabolism; D003176:Complement C3 / Q000378:metabolism; D003181:Complement C4 / Q000378:metabolism; D005260:Female; D006023:Glycoproteins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009961:Orosomucoid / Q000378:metabolism*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012709:Serum Albumin; D000075462:Serum Albumin, Human; D013183:Sputum / Q000378:metabolism*; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000378:metabolism; D055815:Young Adult; D000515:alpha 1-Antitrypsin / Q000378:metabolism*
chemical_list: C422455:ALB protein, human; D000995:Antitubercular Agents; D015415:Biomarkers; D001798:Blood Proteins; D003176:Complement C3; D003181:Complement C4; D006023:Glycoproteins; D009961:Orosomucoid; D012709:Serum Albumin; D000515:alpha 1-Antitrypsin; D002097:C-Reactive Protein; D000075462:Serum Albumin, Human