Tumor Necrosis Factor-Alpha and Interleukin-10 in Whole Blood Is Associated with Disease Progression in Pulmonary Mulitdrug-Resistant Tuberculosis Patients

Abstract

Background: Cytokine production profiles may reflect the clinical pictures of patients with tuberculosis (TB). Objective: We examined the relationship between cytokine levels and clinical parameters indicating the state of disease in active pulmonary TB patients. Methods: We measured interferon (IFN)-γ, tumor necrosis factor (TNF)-α and interleukin (IL)-10 levels in whole blood after stimulation with culture filtrate protein of Mycobacterium tuberculosis in 33 multi-drug resistant (MDR)-TB and 51 non-MDR-TB patients. Results: No significant difference was found in IFN-γ production between non-MDR-TB and MDR-TB patients, but there was a marked reduction in TNF-α production in MDR-TB patients accompanied by a moderate increase in IL-10 levels. In contrast, the presence of cavity was associated with a significant increase in IFN-γ, whereas no difference in TNF-α between the cavity and non-cavity group was observed. Those who have TB lesions in the left lung showed lower levels of IFN-γ and TNF-α and higher IL-10 levels than the patients with lesions on the right side. IFN-γ levels were significantly increased in those with moderate or advanced lesions compared with patients with mild lesions. TNF-α and IL-10 levels did not change with disease severity. The number of M. tuberculosis bacilli in sputum was closely associated with TNF-α levels. The patient group with high value (+++) of sputum culture acid-fast bacilli produced significantly reduced levels of TNF-α compared with medium (++) and low (+) values. Conclusion: These findings suggest that IFN-γ, TNF-α or IL-10 production patterns in whole blood are associated with disease progression in active pulmonary TB.