Pulmonary Functions and Inflammatory Biomarkers in Post-Pulmonary Tuberculosis Sequelae

Abstract

Background: Post-tuberculosis (TB) sequelae is a commonly encountered clinical entity, especially in high TB burden countries. This may represent chronic anatomic sequelae of previously treated TB, with frequent symptomatic presentation. This pilot study was aimed to investigate the pulmonary functions and systemic inflammatory markers in patients with post-TB sequelae (PTBS) and to compare them with post-TB without sequelae (PTBWS) participants and healthy controls.Methods: A total of 30 participants were enrolled, PTBS (n=10), PTBWS (n=10), and healthy controls (n=10). Pulmonary function tests included spirometry and measurement of airway impedance by impulse oscillometry. Serum levels of matrix metalloproteinase (MMP)-1, transforming growth factor-β, and interferon-γ were estimated.Results: Slow vital capacity (SVC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, and peak expiratory flow were significantly lower in PTBS as compared to controls. SVC and FEV1 were significantly less in PTBS as compared to PTBWS. Total airway impedance (Z5), total airway resistance (R5), central airway resistance (R20), area of reactance (Ax), and resonant frequency (Fres) were significantly higher and respiratory reactance at 5 and 20 Hz (X5, X20) were significantly lower in PTBS as compared to PTBWS. Spirometry parameters correlated with impulse oscillometry parameters in PTBS. Serum MMP-1 level was significantly higher in PTBS as compared to other groups.Conclusion: Significant pulmonary function impairment was observed in PTBS, and raised serum MMP-1 levels compared with PTBWS and healthy controls. Follow-up pulmonary function testing is recommended after treatment of TB for early diagnosis and treatment of PTBS.

Recent Prevalence of and Factors Associated With Chronic Obstructive Pulmonary Disease in a Rapidly Aging Society: Korea National Health and Nutrition Examination Survey 2015–2019

“…For example, in Korea, a very rapidly aging society, 4 the smoking rate has recently decreased in men and remained the same in women, 5 and the prevalence of tuberculosis has decreased, 6 among factors related to the prevalence of COPD. 7 Thus, to accurately evaluate the prevalence of and factors associated with COPD, representative nationwide data reflecting factors associated with COPD are essential. However, few rapidly aging or aged societies have such nationwide representative databases.…”

Transforming growth factor-β and matrix metalloproteinases as potential biomarkers of fibrotic lesions induced by tuberculosis: a systematic review and meta-analysis

“…The seven included studies were primary studies conducted in five countries with a total sample size of 365. Of the seven studies, one used a case–control design,13 two used a cross-sectional design14 15 and four used a prospective cohort study design 10 16–18. Five studies assessed the outcome of parenchymal lung fibrosis, while the other two assessed residual pleural thickening (RPT).…”

“…Five studies assessed the TGF-β level as a potential biomarker in forming fibrotic lesions in patients with TB with a total of 197 participants 13–15 17 18. Four studies reported that the TGF-β level had a significantly higher level in the presence of tissue fibrosis compared with non-fibrosis 13 14 17 18.…”

“…Four studies reported that the TGF-β level had a significantly higher level in the presence of tissue fibrosis compared with non-fibrosis 13 14 17 18. Meanwhile, one study reported that TGF-β levels were higher in fibrotic lesions than in non-fibrotic lesions, but the difference was statistically insignificant 15. Furthermore, two studies assessed the difference in TGF-β levels in minimal lung fibrosis and extensive lung fibrotic lesion compared with the healthy group 14 17.…”

“…Three studies assessed the MMP-1 level as a potential biomarker in the formation of fibrotic lesions in patients with TB, with a total of 202 participants 10 15 16. Of three studies, one reported that MMP-1 polymorphisms had a significant correlation with the formation of parenchymal lung fibrosis in patients with TB.…”