Neuron-specific enolase as a novel biomarker reflecting tuberculosis activity and treatment response.
OBJECTIVE
It is not clear which tests are indicative of the activity and severity of tuberculosis (TB). This study aimed to investigate the predictive value of neuron-specific enolase (NSE) and to determine the origin of NSE in TB patients.


METHODS
A single-center retrospective analysis was conducted on newly diagnosed TB patients between January and December 2010. Patients were categorized into one of two disease groups (focal segmental or extensive) based on chest X-ray. Pre- and post-treatment NSE concentrations were evaluated. To determine the origin of serum NSE concentration, NSE staining was compared with macrophage-specific CD68 staining in lung tissues and with a tissue microarray using immunohistochemistry and immunofluorescence.


RESULTS
A total of 60 newly diagnosed TB patients were analyzed. In TB patients, NSE serum concentration was significantly increased and NSE level decreased after treatment (p < 0.001). In proportion to serum high-sensitivity C-reactive protein concentration, the mean serum concentration of NSE in the extensive group (25.12 ng/mL) was significantly higher than that in the focal segmental group (20.23 ng/mL, p = 0.04). Immunohistochemical staining revealed a large number of macrophages that stained positively for both NSE and CD68 in TB tissues. In addition, NSE signals mostly co-localized with CD68 signals in the tissue microarray of TB patients.


CONCLUSIONS
Our results suggest that NSE may be a practical parameter that can be used to monitor TB activity and treatment response. Elevated serum NSE level originates, at least in part, from macrophages in granulomatous lesions.
Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Sung-Jin
SJ
Nam
Department of Biochemistry, Kosin University College of Medicine, Busan, Korea.|Cancer Research Institute, Kosin University College of Medicine, Busan, Korea.
Jee-Yeong
JY
Jeong
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Tae-Won
TW
Jang
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Mann-Hong
MH
Jung
Department of Pathology, Kosin University College of Medicine, Busan, Korea.
Bong-Kwon
BK
Chun
Department of Parasitology and Genetics, Kosin University College of Medicine, Busan, Korea.
Hee-Jae
HJ
Cha
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Chul-Ho
CH
Oak
D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D008168:Lung / Q000187:drug effects* / Q000201:enzymology / Q000382:microbiology; D008264:Macrophages / Q000187:drug effects* / Q000201:enzymology / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011237:Predictive Value of Tests; D056910:Republic of Korea; D012189:Retrospective Studies; D046888:Tissue Array Analysis; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D015854:Up-Regulation; D055815:Young Adult; D000097382:CD68 Molecule
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D000995:Antitubercular Agents; D015415:Biomarkers; D002097:C-Reactive Protein; D010751:Phosphopyruvate Hydratase; C067980:CD68 antigen, human; D000097382:CD68 Molecule
C-reactive protein; Diagnosis; Phosphopyruvate hydratase; Response; Tuberculosis, pulmonary