Soluble Urokinase Plasminogen Activator Receptor (Supar) Is Prospective Biomarker To Evaluate Treatment Progress In Children With Pulmonary Tuberculosis During Maintenance Phase

Soluble urokinase

Article Abstract
Aims: Childhood pulmonary tuberculosis (TB) is still a major problem in developing countries. One of the difficulty in TB management is lack of biomarkers to evaluate treatment response.This study aimed to investigate the role of plasma soluble urokinase-type plasminogen activator receptor (suPAR) as a biomarker to evaluate response to anti tuberculosis treatment in children with pulmonary TB.

Methods: Twenty five children aged 2–10 years with pulmonary TB in Dr Saiful Anwar Hospital, Malang from February 2012 to January 2013 were enrolled into the study. The plasma suPAR level was measured using ELISA prior to anti-tuberculosis treatment and two, four, six months after treatment initiation. Clinical parameters were observed including coughs, lymphadenitis, nutritional status and X-ray. Ten healthy children served as a control group.

Result: All TB patients showed high plasma suPAR levels prior to anti TB treatment (4.77 +1.51 ng/mL) and did not change (p = 0.0001>0.05) after two months (4.89+1.61 ng/mL) of treatment. However, it decreased significantly after four months (2.51+1.81 ng/mL) and six months of treatment (0.27+0.64 ng/mL). By the end of therapy the level of suPAR reached a value that was lower than control group (1.58+0.09 ng/mL). The reduce of suPAR level was not parallel to clinical improvement after two months treatment.

Conclusion: the suPAR level is elevated in childhood pulmonary TB and significantly decreased after four months of anti tuberculosis treatment. This imply that suPAR is not appropriate biomarker to evaluate TB treatment response in childhood TB after intensive phase of therapy. However, it is a prospective biomarker to monitor the efficacy of therapy in the maintenance phase after two months therapy.

Article Citation

Tri Yudani MR, Hamid MA, Kusuma MSC, Olivianto E. Soluble urokinase plasminogen activator receptor (suPAR) is prospective biomarker to evaluate treatment progress in children with pulmonary tuberculosis during maintenance phase. Edorium J Pediatr 2017;1:6–11.

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