Changes in Serum Cytokine Levels in Active Tuberculosis With Treatment

Abstract

It has been reported that IFN-γ, TNF-α, and IL-12 stimulate, and that IL-10, TGF-β, and IL-4 suppress the protective immune response against tuberculosis. We aim to evaluate changes in the serum levels of pro and antiinflammatory cytokines in active pulmonary tuberculosis (APTB) and the possible effects of treatment on these changes. Serum IL-12p40, IL-4, IL-10, TNF-α, IFN-γ, and TGF-β1 levels were determined in 20 APTB cases (group 1) before and 2, 4, and 6 months after therapy. The same parameters were also determined in 9 inactive pulmonary tuberculosis (IPTB) cases (group 2) and 9 healthy controls (HC, group 3). Before treatment, the mean serum IFN-γ, TNF-α, and IL-10 levels in group 1 were statistically higher than those in group 2 (P = .001, P = .024, P = .016, resp) or group 3 (P = .003, P = .002, P = .011, resp). The levels in group 1 decreased significantly after treatment (P = .001 for IFN-γ, P = .004 for TNF-α, P = .000 for IL-10). The serum levels of IL-12p40 were significantly higher in group 1 than in group 3 (P = .012) and decreased insignificantly after treatment. There was no difference in serum IL-4 and TGF-β1 levels among the groups (P > .05). Because the serum IL-12p40, IL-10, TNF-α, and IFN-γ levels were high in APTB, we believe that these cytokines have important roles in the immune response to Mycobacterium tuberculosis (M tuberculosis). These parameters could be used in follow-up as indicators of the success of APTB therapy.

Citocinas e proteínas de fase aguda do soro como marcadores de regressão da resposta inflamatória ao tratamento da tuberculose pulmonar

“…These results are in agreement with those of other studies. (24,26) In one study mentioned previously, (14) the cytokine levels were found to be equivalent to those of the control group at the end of therapy. Again, the divergences in the results are likely related to the differences in the methodology used by the authors, the clinical status of the patients studied, the period of evolution of the disease or treatment and other factors.…”

“…There is evidence to suggest that TNF-α is necessary at the beginning of the inflammatory process in order to limit the multiplication of mycobacteria. (18,19,26) Other studies demonstrated that high TNF-α initial levels in PTB decreased significantly during the treatment, while the inflammatory process decreased at the same time. (14,26) In the present study, TNF-α production by monocytes, stimulated or not, was also lower in the controls than in the patients before treatment, after three months of treatment and at the end of treatment.…”

“…(18,19,26) Other studies demonstrated that high TNF-α initial levels in PTB decreased significantly during the treatment, while the inflammatory process decreased at the same time. (14,26) In the present study, TNF-α production by monocytes, stimulated or not, was also lower in the controls than in the patients before treatment, after three months of treatment and at the end of treatment. Although cytokine production in the patients was always higher than in the controls, it decreased significantly during the treatment, and the final levels were lower than the baseline levels.…”

“…This makes the therapeutic test more reliable and allows the effect of antituberculous treatment to be determined. In Brazil, 26.7% of all patients with suspected pulmonary tuberculosis (PTB) are treated without diagnostic confirmation, the treatment being based solely on clinical, radiological and APR marker findings characteristic of granulomatous processes. (11) The aim of the present study was to evaluate the effect that treatment has on the inflammatory process in patients with PTB.…”

Association of Dietary and Serum Cholesterol with Active Pulmonary Tuberculosis: A Hospital Based Study

“…This issue may be addressed in the present study by the presence of lower albumin (natural antioxidant) in those with active pulmonary tuberculosis. Proinflammatory cytokines like IL-6, IL-1, TNF-α and IFN's which are known to down regulate serum lipid levels by interfering withlipid metabolism (Vanet.al 1994;Henrich 1990) have also been shown to increase during the onset of active tuberculosis (FigenDeveci et al, 2005).…”