Evaluation of circulating serum cathelicidin levels as a potential biomarker to discriminate between active and latent tuberculosis in Uganda
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Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
PloS one
Abstract
Tuberculosis remains a major public health problem worldwide accounting for 1.4 million
deaths annually. LL-37 is an effector molecule involved in immunity with both antimicrobial
and immunomodulatory properties. The purpose of this study was to compare LL-37 circulatory
levels among participants with active and latent tuberculosis and to determine its ability
to discriminate between the two infectious states.
Methods
A cross-sectional study was performed among 56 active tuberculosis patients, 49 latent
tuberculosis individuals, and 43 individuals without tuberculosis infection. The enzymelinked
immunosorbent assay was used to assess LL-37 levels. Data analysis was performed
using STATA software and Graph pad Prism version 8. Mann-Whitney U test was used for
correlation between variables with two categories and the Kruskal-Wallis test for three or
more categories.
Results
The study had more female participants than males, with similar median ages across the
three groups, 29.5, 25.0, and 23.0 years respectively. Active tuberculosis patients had significantly
higher LL-37 levels compared to those with latent tuberculosis and without tuberculosis.
The median/interquartile ranges were 318.8 ng/ml (157.9–547.1), 242.2 ng/ml
(136.2–579.3), 170.9 ng/ml (129.3–228.3); p = 0.002 respectively. Higher LL-37 was found
in the male participant with median/interquartile range, 424.8 ng/ml (226.2–666.8) compared to the females 237.7 ng/ml (129.6–466.6); p = 0.045. LL-37 had better discriminatory
potential between active tuberculosis and no tuberculosis (AUC = 0.71, sensitivity
71.4% specificity = 69.8%) than with latent tuberculosis (AUC = 0.55, sensitivity = 71.4%,
specificity = 44.9%). There was moderate differentiation between latent tuberculosis and no
tuberculosis (AUC = 0.63, sensitivity = 44.9% specificity = 90.7%).
Conclusion
Significantly higher LL-37 levels were observed among active tuberculosis patients than
those without tuberculosis infection and were, therefore able to discriminate between active
tuberculosis and other tuberculosis infectious states, especially with no tuberculosis. Further
assessment of this biomarker as a screening tool to exclude tuberculosis is required.
Description
Keywords
Serum cathelicidin levels, Biomarker, Latent tuberculosis
Citation
Acen EL, Kateete DP, Worodria W, Olum R, Joloba ML, Bbuye M, et al. (2022) Evaluation of circulating serum cathelicidin levels as a potential biomarker to discriminate between active and latent tuberculosis in Uganda. PLoS ONE 17(8): e0272788. https://doi.org/10.1371/journal. pone.0272788