title: Elevated IP-10 and IL-6 from bronchoalveolar lavage cells are biomarkers of non-cavitary tuberculosis.
abstract: BACKGROUND
  Active TB disease can destroy lung parenchyma leading to cavities. Immune responses that predispose or protect individuals from lung damage during TB are poorly defined.
  
  
  OBJECTIVE
  To sample lung immune cells and assay bronchoalveolar lavage (BAL) cell cytokine production.
  
  
  METHODS
  Enrolled subjects (n = 73) had bilateral infiltrates and underwent BAL.
  
  
  RESULTS
  All had sputum culture demonstrating Mycobacterium tuberculosis and 22/73 (30%) had cavities on their chest radiograph. Those with cavities at presentation had a higher percentage of polymorphonuclear neutrophils (PMN) in BAL as well as lower inducible protein (IP) 10 (P < 0.01) and interleukin (IL) 6 (P = 0.013) in BAL cell supernatants compared to those without cavities. There was no correlation between cavities and other BAL or serum cytokines. IP-10 was negatively associated with BAL PMN. IP-10 and IL-6 expression above median reduces the odds of cavities by 79% and 78% in logistic regression models. IP-10 and IL-6 clustered with interferon-gamma and tumour necrosis factor-alpha in a principal component analysis, while IL-4 clustered with PMN.
  
  
  CONCLUSIONS
  Increasing IP-10 and IL-6 production by BAL cells is associated with non-cavitary TB in patients who present with radiographically advanced TB. IP-10 and IL-6 may reflect an effective T-helper 1 immune control pathway for TB, attenuating tuberculous lung destruction.
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY 10016, USA.
authors.forename: A
authors.initials: A
authors.lastname: Nolan
authors.forename: R
authors.initials: R
authors.lastname: Condos
authors.forename: M L
authors.initials: ML
authors.lastname: Huie
authors.forename: R
authors.initials: R
authors.lastname: Dawson
authors.forename: K
authors.initials: K
authors.lastname: Dheda
authors.forename: E
authors.initials: E
authors.lastname: Bateman
authors.forename: W N
authors.initials: WN
authors.lastname: Rom
authors.forename: M D
authors.initials: MD
authors.lastname: Weiden
mesh_terms: D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000382:microbiology; D016022:Case-Control Studies; D054357:Chemokine CXCL10 / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D009504:Neutrophils / Q000382:microbiology; D025341:Principal Component Analysis; D011859:Radiography; D013183:Sputum / Q000382:microbiology; D018417:Th1 Cells; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging / Q000382:microbiology / Q000503:physiopathology*; D055815:Young Adult
chemical_list: C114753:CXCL10 protein, human; D054357:Chemokine CXCL10; D015850:Interleukin-6