학술논문
Molecular assessment of mycobacterial burden in the treatment of nontuberculous mycobacterial disease.
Document Type
Academic Journal
Author
Ellis HC; Host Defence Unit, Royal Brompton Hospital, London, UK.; Imperial College London, London, UK.; Moffatt MF; Imperial College London, London, UK.; Churchward C; Imperial College London, London, UK.; Cuthbertson L; Imperial College London, London, UK.; Cookson WOC; Imperial College London, London, UK.; Loebinger MR; Host Defence Unit, Royal Brompton Hospital, London, UK.; Imperial College London, London, UK.
Source
Publisher: European Respiratory Society Country of Publication: England NLM ID: 101671641 Publication Model: eCollection Cited Medium: Print ISSN: 2312-0541 (Print) Linking ISSN: 23120541 NLM ISO Abbreviation: ERJ Open Res Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2312-0541
Abstract
Introduction: Nontuberculous pulmonary disease causes significant morbidity and mortality. Efforts to tackle infections are hampered by the lack of reliable biomarkers for diagnosis, assessment and prognostication. The aim of this study was to develop molecular assays capable of identifying and quantifying multiple nontuberculous mycobacterial (NTM) species and to examine their utility in following individual patients' clinical courses.
Methods: DNA was extracted from 410 sputum samples obtained longitudinally from a cohort of 38 patients who were commencing treatment for either Mycobacterium abscessus or Mycobacterium avium complex or who were patients with bronchiectasis who had never had positive cultures for mycobacteria. NTM quantification was performed with quantitative PCR assays developed in-house.
Results: The molecular assays had high in vitro sensitivity and specificity for the detection and accurate quantification of NTM species. The assays successfully identified NTM DNA from human sputum samples ( in vivo sensitivity: 0.86-0.87%; specificity: 0.62-0.95%; area under the curve: 0.74-0.92). A notable association between NTM copy number and treatment (Friedman ANOVA (df)=22.8 (3), p≤0.01 for M. abscessus treatment group) was also demonstrated.
Conclusion: The quantitative PCR assays developed in this study provide affordable, real-time and rapid measurement of NTM burden, with significant implications for prompt management decisions.
Competing Interests: Conflict of interest: M.R. Loebinger reports the following relationships outside the submitted work: consulting fees received from Insmed, Savara, Parion, Armata, Chiesi, Zambon and Astra Zeneca; lecture fees received from Grifols and Insmed; Infection Group Chair for the European Respiratory Society. The remaining authors have nothing to disclose.
(Copyright ©The authors 2023.)
Methods: DNA was extracted from 410 sputum samples obtained longitudinally from a cohort of 38 patients who were commencing treatment for either Mycobacterium abscessus or Mycobacterium avium complex or who were patients with bronchiectasis who had never had positive cultures for mycobacteria. NTM quantification was performed with quantitative PCR assays developed in-house.
Results: The molecular assays had high in vitro sensitivity and specificity for the detection and accurate quantification of NTM species. The assays successfully identified NTM DNA from human sputum samples ( in vivo sensitivity: 0.86-0.87%; specificity: 0.62-0.95%; area under the curve: 0.74-0.92). A notable association between NTM copy number and treatment (Friedman ANOVA (df)=22.8 (3), p≤0.01 for M. abscessus treatment group) was also demonstrated.
Conclusion: The quantitative PCR assays developed in this study provide affordable, real-time and rapid measurement of NTM burden, with significant implications for prompt management decisions.
Competing Interests: Conflict of interest: M.R. Loebinger reports the following relationships outside the submitted work: consulting fees received from Insmed, Savara, Parion, Armata, Chiesi, Zambon and Astra Zeneca; lecture fees received from Grifols and Insmed; Infection Group Chair for the European Respiratory Society. The remaining authors have nothing to disclose.
(Copyright ©The authors 2023.)