title: Levels of tumour necrosis factor-alpha and IL-1alpha in newly diagnosed and multidrug resistant tuberculosis.
abstract: BACKGROUND
  The pro-inflammatory cytokines tumour necrosis factor (TNF)-alpha and IL-1alpha 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-alpha and IL-1alpha 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.
  
  
  METHODS
  This study assessed 19 N-TB patients (M/F : 17/2) and 11 MDR-TB patients (M/F : 10/1). Serum TNF-alpha and IL-1alpha 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-alpha, IL-1alpha, 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-alpha and IL-1alpha (r = 0.92) for both MDR-TB and N-TB. For both groups, both TNF-alpha and IL-1alpha correlated with CD4+ lymphocytes (r = 0.48). TNF-alpha and IL-1alpha showed negative correlations with CD8+ lymphocytes (r = -0.81, r = -0.73) (P < 0.01) in MDR-TB patients.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Chest Department, Medical Faculty, Istanbul University, Istanbul, Turkey. tulincag@ttnet.net.tr
authors.forename: Tülin
authors.initials: T
authors.lastname: Cağatay
authors.forename: Bayram
authors.initials: B
authors.lastname: Kiran
authors.forename: Sibel
authors.initials: S
authors.lastname: Yurt
authors.forename: Ziya
authors.initials: Z
authors.lastname: Gülbaran
authors.forename: Filiz
authors.initials: F
authors.lastname: Kosar
authors.forename: Penbe
authors.initials: P
authors.lastname: Cağatay
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents; D015415:Biomarkers / Q000097:blood; D016516:CD4-CD8 Ratio; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007375:Interleukin-1 / Q000097:blood*; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012720:Severity of Illness Index; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D007375:Interleukin-1; D014409:Tumor Necrosis Factor-alpha