Proresolving mediator profiles in cerebrospinal fluid are linked with disease severity and outcome in adults with tuberculous meningitis
Tuberculous meningitis (TBM) is the most lethal form of tuberculosis infection, characterized by a dysregulated immune response that frequently leads to neurologic injury and death despite the best available treatment. The mechanisms driving the inflammatory response in TBM are not well understood....
| Main Authors: | , , , , , , , , , |
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| 格式: | Journal article |
| 語言: | English |
| 出版: |
Federation of American Society of Experimental Biology
2019
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| _version_ | 1826260699165229056 |
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| author | Colas, RA Nhat, LTH Thuong, NTT Gómez, EA Ly, L Thanh, HH Mai, NTH Phu, NH Thwaites, GE Dalli, J |
| author_facet | Colas, RA Nhat, LTH Thuong, NTT Gómez, EA Ly, L Thanh, HH Mai, NTH Phu, NH Thwaites, GE Dalli, J |
| author_sort | Colas, RA |
| collection | OXFORD |
| description | Tuberculous meningitis (TBM) is the most lethal form of tuberculosis infection, characterized by a dysregulated immune response that frequently leads to neurologic injury and death despite the best available treatment. The mechanisms driving the inflammatory response in TBM are not well understood. To gain insights into these mechanisms, we used a lipid mediator-profiling approach to investigate the regulation of a novel group of host protective mediators, termed specialized proresolving mediators (SPMs), in the cerebrospinal fluid (CSF) of adults with TBM. Herein, using CSF from patients enrolled into a randomized placebo-controlled trial of adjunctive aspirin treatment, we found distinct lipid mediator profiles with increasing disease severity. These changes were linked with an up-regulation of inflammatory eicosanoids in patients with severe TBM and a decrease in the production of a number of SPMs. CSF proresolving mediator concentrations were also associated with 80-d survival. In survivors, we found a significant increase in proresolving mediator concentrations, including the lipoxygenase 5-derived 13-series resolvin (RvT)2, RvT4, and 15-epi-lipoxin B4, compared with those who died. Of note, treatment of patients with high-dose aspirin led to a decrease in the concentrations of the prothrombic mediator thromboxane A2, reduced brain infarcts, and decreased death in patients with TBM. Together, these findings identify a CSF SPM signature that is associated with disease severity and 80-d mortality in TBM.-Colas, R. A., Nhat, L. T. H., Thuong, N. T. T., Gómez, E. A., Ly, L., Thanh, H. H., Mai, N. T. H., Phu, N. H., Thwaites, G. E., Dalli, J. Proresolving mediator profiles in cerebrospinal fluid are linked with disease severity and outcome in adults with tuberculous meningitis. |
| first_indexed | 2024-03-06T19:09:50Z |
| format | Journal article |
| id | oxford-uuid:16645d9f-1bbe-4158-8cf9-81a97a94c237 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:09:50Z |
| publishDate | 2019 |
| publisher | Federation of American Society of Experimental Biology |
| record_format | dspace |
| spelling | oxford-uuid:16645d9f-1bbe-4158-8cf9-81a97a94c2372022-03-26T10:31:05ZProresolving mediator profiles in cerebrospinal fluid are linked with disease severity and outcome in adults with tuberculous meningitisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:16645d9f-1bbe-4158-8cf9-81a97a94c237EnglishSymplectic ElementsFederation of American Society of Experimental Biology2019Colas, RANhat, LTHThuong, NTTGómez, EALy, LThanh, HHMai, NTHPhu, NHThwaites, GEDalli, JTuberculous meningitis (TBM) is the most lethal form of tuberculosis infection, characterized by a dysregulated immune response that frequently leads to neurologic injury and death despite the best available treatment. The mechanisms driving the inflammatory response in TBM are not well understood. To gain insights into these mechanisms, we used a lipid mediator-profiling approach to investigate the regulation of a novel group of host protective mediators, termed specialized proresolving mediators (SPMs), in the cerebrospinal fluid (CSF) of adults with TBM. Herein, using CSF from patients enrolled into a randomized placebo-controlled trial of adjunctive aspirin treatment, we found distinct lipid mediator profiles with increasing disease severity. These changes were linked with an up-regulation of inflammatory eicosanoids in patients with severe TBM and a decrease in the production of a number of SPMs. CSF proresolving mediator concentrations were also associated with 80-d survival. In survivors, we found a significant increase in proresolving mediator concentrations, including the lipoxygenase 5-derived 13-series resolvin (RvT)2, RvT4, and 15-epi-lipoxin B4, compared with those who died. Of note, treatment of patients with high-dose aspirin led to a decrease in the concentrations of the prothrombic mediator thromboxane A2, reduced brain infarcts, and decreased death in patients with TBM. Together, these findings identify a CSF SPM signature that is associated with disease severity and 80-d mortality in TBM.-Colas, R. A., Nhat, L. T. H., Thuong, N. T. T., Gómez, E. A., Ly, L., Thanh, H. H., Mai, N. T. H., Phu, N. H., Thwaites, G. E., Dalli, J. Proresolving mediator profiles in cerebrospinal fluid are linked with disease severity and outcome in adults with tuberculous meningitis. |
| spellingShingle | Colas, RA Nhat, LTH Thuong, NTT Gómez, EA Ly, L Thanh, HH Mai, NTH Phu, NH Thwaites, GE Dalli, J Proresolving mediator profiles in cerebrospinal fluid are linked with disease severity and outcome in adults with tuberculous meningitis |
| title | Proresolving mediator profiles in cerebrospinal fluid are linked with disease severity and outcome in adults with tuberculous meningitis |
| title_full | Proresolving mediator profiles in cerebrospinal fluid are linked with disease severity and outcome in adults with tuberculous meningitis |
| title_fullStr | Proresolving mediator profiles in cerebrospinal fluid are linked with disease severity and outcome in adults with tuberculous meningitis |
| title_full_unstemmed | Proresolving mediator profiles in cerebrospinal fluid are linked with disease severity and outcome in adults with tuberculous meningitis |
| title_short | Proresolving mediator profiles in cerebrospinal fluid are linked with disease severity and outcome in adults with tuberculous meningitis |
| title_sort | proresolving mediator profiles in cerebrospinal fluid are linked with disease severity and outcome in adults with tuberculous meningitis |
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