Levels of tumour necrosis factor‐α and IL‐1α in newly diagnosed and multidrug resistant tuberculosis

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Abstract
Background:  The pro‐inflammatory cytokines tumour necrosis factor (TNF)‐α and IL‐1α play key roles in host defence against tuberculosis (TB) but there is little knowledge of their levels in multidrug resistant TB (MDR‐TB). The aim of the present study was to investigate the levels of TNF‐α and IL‐1α and their relationship with the levels of T helper (CD4+), T suppressor (CD8+) and total lymphocytes (CD45+) in newly diagnosed TB (N‐TB) and MDR‐TB.Methodology:  This study assessed 19 N‐TB patients (M/F : 17/2) and 11 MDR‐TB patients (M/F : 10/1). Serum TNF‐α and IL‐1α were assessed by ELISA. Lymphocyte expression of CD45, CD4, CD8, CD3, CD23, CD19 and CD95 were determined by flow cytometry.Results:  The levels of TNF‐α, IL‐1α, and CD4, CD4/CD8, CD45, CD19, CD23 and CD95 positive lymphocytes were lower in MDR‐TB than in N‐TB patients (P < 0.05). Statistically, there was a positive correlation between TNF‐α and IL‐1α (r = 0.92) for both MDR‐TB and N‐TB. For both groups, both TNF‐α and IL‐1α correlated with CD4+ lymphocytes (r = 0.48). TNF‐α and IL‐1α showed negative correlations with CD8+ lymphocytes (r = −0.81, r = −0.73) (P < 0.01) in MDR‐TB patients.Conclusion:  The lower levels of cytokines and numbers of T helper lymphocytes in MDR‐TB compared with N‐TB implies that the immune profiles of the two groups are different, and may be important in the natural history of the disease.

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