Abstract
The present study was carried out in the Sahariya tribe of Central India, which reportedly have high prevalence of pulmonary tuberculosis. Total serum LDH and its tissue specific isoforms were estimated in TB patients and matched healthy controls to test the utility of LDH as diagnostic marker for tuberculosis. About 210 sputum positive cases and 328 age and sex matched sputum negative controls were recruited. The spectrophotometeric and densitometric analysis of each LDH isoform was carried out in both cases and controls. The mean values of serum LDH were estimated and compared for each class by t-test. The statistical comparisons were made between sputum negative controls and sputum positive cases by Mann-Whitney’s U test. The spectrophotometric estimation of serum LDH revealed significant (P=0.0016) increase in its level in cases (290 IU/L) as compared to controls (248 IU/L). The densitometric analysis of individual LDH isoforms in cases and controls demonstrated significant elevation in LDH1 (P>0.05), LDH2 (P>0.05) and LDH3 (P<0.005) in sputum positive cases in comparison to sputum negative controls. Our study revealed a positive correlation between serum LDH level and the presence of mycobacteria and their load, suggesting utility of LDH as an important diagnostic marker of tuberculosis induced stress, at least in tribal areas lacking access to modern clinical tests.
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Lossos IS, Breuer R, Intrator O, Sonenblick M. Differential diagnosis of pleural effusion by lactate dehydrogenase isoenzyme analysis. Chest 1997;111:648–651.
Sevinc A, Sari R, Fadillioglu E. The utility of lactate dehydrogenase isozyme pattern in the diagnostic evaluation of malignant and nonmalignant ascites. J Natl Med Assoc 2005;97:79–84.
Amader E, Pochen EJ. Serum Lactic dehydrogenase activity and radio active scanning in diagnosis of pulmonary embolism. Ann Intern Med 1966;65:1247.
Agrawal RK. Observations on pleural effusion with special reference to enzyme study and pleural biopsy. MD Thesis (Medicine), University of Indore, Indore: 1968.
Zimmermann MG, Henry JB. Serum enzyme estimation as an aid to diagnosis. In: Clinical Diagnosis, Philadelphia: WB Saunders Co, 1969:558.
Brijidshore, Nagrath SP. Serum and pleural fluid lactic dehydrogenase activity in tuberculous pleural effusion. J Ase Phy Ind 1970;18:15.
Nussinovitch M, Finkelstein Y, Elishkevitz KP, Volovitz B, Harel D, Klinger G, et al. Cerebrospinal fluid lactate dehydrogenase isoenzymes in children with bacterial and aseptic meningitis. Translational Res 2009;154(4):214–218.
Shahi KS, Bhandari G, Rajput P, Singh A. Testicular tuberculosis masquerading as testicular tumor. Ind J Cancer 2009;4(46):250–252.
Yun SJ, Choi MS, Piao MS, Lee JB, Kim SJ, Won YH, Lee SC. Serum Lactate Dehydrogenase is a novel marker for the evaluation of disease severity in the early stage of toxic epidermal necrolysis. Dermatol 2008;217:254–259.
Hagadorn JE, Bloor CM, Yang MS. Elevated plasma activity of lactate dehydrogenase isoenzyme-3 (LDH3) in experimentally induced immunologic lung injury. Am J Path 1971;64:575–584.
Drent M, Cobben NAM, Henderson RF, Wouters EFM, van Dieijen-Visser M. Usefulness of lactate dehydrogenase and its isoenzymes as indicators of lung damage and inflammation. Eur Respir J 1996;9:1736–1742.
Carré PC, Mortenson RL, King TE, Noble PW, Sable CL, Riches DW. Increased expression of the interleukin-8 gene by alveolar macrophages in idiopathic pulmonary fibrosis. A potential mechanism for the recruitment and activation of neutrophils in lung fibrosis. J Clin Invest 1991;88:1802–1810.
Henderson RF, Muggenburg BA, editors. Bronchoalveolar lavage in animals. In: RP. Baughman, Editor. Bronchoalveolar Lavage, Mosby Year Book, St Louis: 1992:265–287.
Lynch JP, Standiford TJ, Roffe MW, Kunkel SL, Strieter RM. Neutrophilic alveolitis in idiopathic pulmonary fibrosis. The role of interleukin-8. Am Rev Respir Dis 1992;145:1433–1439.
Billalabeitia EG, Hitt R, Fernandez J, Conde E, Tello FM, Salamanca RE, et al. Pre-treatment serum lactate dehydrogenase level is an important prognostic factor in high-grade extremity osteosarcoma. Clin Translational Oncol 2009;11(7):479–483.
Song MK, Chung JS, Seol YM, Kwon BR, Shin HJ, Choi YJ, Cho GJ. Influence of lactate dehydrogenase and cyclosporine a level on the Incidence of acute graft-versus-host disease after allogeneic stem cell transplantation. J Korean Med Sci 2009;24:555–560.
Zhao YH, Zhou M, Liu H, Ding Y, Khong HT, Yu D, et al. Up regulation of lactate dehydrogenase A by ErbB2 through heat shock factor 1 promotes breast cancer cell glycolysis and growth. Oncogene 2009;28:3689–3701.
Chakma T, Rao PV, Pall S, Kaushal LS, Datta M, Tiwary RS. Survey of pulmonary tuberculosis in a primitive tribe of Madhya Pradesh. Ind J Tub 1996;43:85.
Sharma PR, Jain S, Tiwari PK. Elevated level of serum LDH2 and LDH3 in sputum three positive TB patients of Sahariya Tribe: A preliminary study. Clin Biochem 2007;40:1414–1419.
Cruickshank R, editor. Medical Microbiology, 12th ed. Edinburgh, London and New York: Churchill Livingstone, Medical division of Longmans Group Ltd., 1975: 11pp.
Rajpal S, Dhingra VK, Agarwal JK. Sputum grading as predictor of treatment outcome in pulmonary tuberculosis. Ind J Tub 2002;49:139.
RNTCP at a Glance Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi, India, 2006.
Bach MK, Brashler JR, Petzold EN, Sanders ME. Superoxide production by human eosinophils can be inhibited in an agonistselective manner. J Immunol Methods 1991;142:243.
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Sharma, P.R., Jain, S., Bamezai, R.N.K. et al. Utility of serum LDH isoforms in the assessment of mycobacterium tuberculosis induced pathology in TB patients of Sahariya tribe. Indian J Clin Biochem 25, 57–63 (2010). https://doi.org/10.1007/s12291-010-0012-3
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DOI: https://doi.org/10.1007/s12291-010-0012-3