title: Increased TNF-alpha, IL-1 beta and IL-6 levels in the bronchoalveolar lavage fluid with the upregulation of their mRNA in macrophages lavaged from patients with active pulmonary tuberculosis.
abstract: METHODS
  We hypothesized that patients with active pulmonary tuberculosis (TB) have tubercular pneumonitis and that alveolar macrophages at these sites release proinflammatory cytokines, resulting in high levels of cytokines in alveolar epithelial lining fluid.
  
  
  OBJECTIVE
  To measure cytokine levels in bronchoalveolar lavage fluid (BALF) and to confirm the source of any cytokines by examination of alveolar macrophage cytokine mRNA.
  
  
  METHODS
  Seventeen active pulmonary TB patients and 15 healthy controls were prospectively studied. Bronchoalveolar lavage (BAL) was performed, proinflammatory cytokine levels were determined and alveolar macrophages isolated from BALF were prepared for RNA extraction and Northern blot analysis.
  
  
  RESULTS
  Compared with healthy controls, TNF-alpha, IL-1 beta and IL-6 in BALF were all significantly higher in patients with active pulmonary TB, 298.7 +/- 85.9 vs. 8.9 +/- 2.7 (P = 0.0001); 164.4 +/- 67.5 vs. 8.9 +/- 2.7 (P = 0.003); 969.2 +/- 214.2 vs. 86.4 +/- 17.0 (mean +/- SE pg/ml) (P = 0.0001), respectively. Only TNF-alpha and IL-6 levels were significantly higher in sera of active pulmonary TB patients, 92.3 +/- 28.7 vs. 3.5 +/- 1.2; 15.2 +/- 5.4 vs. 2.1 +/- 2.1, respectively. Northern blot analysis revealed increased gene expression of these alveolar macrophage cytokines in patients with active pulmonary TB compared healthy controls.
  
  
  CONCLUSIONS
  Significantly higher levels of TNF-alpha, IL-1 beta and IL-6 were found in BALF from patients with active pulmonary TB, and were released by alveolar macrophages in the TB lesions.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan. drtsao@adm.cgmh.com.tw
authors.forename: T C
authors.initials: TC
authors.lastname: Tsao
authors.forename: J
authors.initials: J
authors.lastname: Hong
authors.forename: C
authors.initials: C
authors.lastname: Huang
authors.forename: P
authors.initials: P
authors.lastname: Yang
authors.forename: S K
authors.initials: SK
authors.lastname: Liao
authors.forename: K S
authors.initials: KS
authors.lastname: Chang
mesh_terms: D000328:Adult; D015152:Blotting, Northern; D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology*; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis* / Q000096:biosynthesis / Q000235:genetics; D015850:Interleukin-6 / Q000032:analysis* / Q000096:biosynthesis / Q000235:genetics; D016676:Macrophages, Alveolar / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012333:RNA, Messenger / Q000235:genetics; D014397:Tuberculosis, Pulmonary / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis* / Q000096:biosynthesis / Q000235:genetics; D015854:Up-Regulation
chemical_list: D007375:Interleukin-1; D015850:Interleukin-6; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha