Inflammatory and immunogenetic markers in correlation with pulmonary tuberculosis.
OBJECTIVE
To describe serum levels of the cytokines IL-10, TNF-α, and IFN-γ, as well as polymorphisms in the genes involved in their transcription, and their association with markers of the acute inflammatory response in patients with pulmonary tuberculosis.


METHODS
This was a descriptive, longitudinal study involving 81 patients with pulmonary tuberculosis treated at two referral hospitals. We collected data on sociodemographic variables and evaluated bacteriological conversion at the eighth week of antituberculosis treatment, gene polymorphisms related to the cytokines studied, and serum levels of those cytokines, as well as those of C-reactive protein (CRP). We also determined the ESR and CD4+ counts.


RESULTS
The median age of the patients was 43 years; 67 patients (82.7%) were male; and 8 patients (9.9%) were infected with HIV. The ESR was highest in the patients with high IFN-γ levels and low IL-10 levels. IFN-γ and TNF-α gene polymorphisms at positions +874 and -238, respectively, showed no correlations with the corresponding cytokine serum levels. Low IL-10 levels were associated with IL-10 gene polymorphisms at positions -592 and -819 (but not -1082). There was a negative association between bacteriological conversion at the eighth week of treatment and CRP levels.


CONCLUSIONS
Our results suggest that genetic markers and markers of acute inflammatory response are useful in predicting the response to antituberculosis treatment.
Federal University of Rio de Janeiro, School of Medicine Clementino Fraga Filho, University Hospital, Rio de Janeiro, Brazil.
Beatriz Lima Alezio
BL
Muller
Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rio de Janeiro, Brazil.
Daniela Maria de Paula
DM
Ramalho
Federal University of Rio de Janeiro, School of Medicine Clementino Fraga Filho, University Hospital, Rio de Janeiro, Brazil.
Paula Fernanda Gonçalves dos
PF
Santos
Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rio de Janeiro, Brazil.
Eliene Denites Duarte
ED
Mesquita
Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital.
Afranio Lineu
AL
Kritski
Federal University of Rio de Janeiro, School of Medicine, Clementino Fraga Filho University Hospital, Rio de Janeiro, Brazil.
Martha Maria
MM
Oliveira
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D018791:CD4 Lymphocyte Count; D005260:Female; D005819:Genetic Markers; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007371:Interferon-gamma / Q000097:blood* / Q000235:genetics; D016753:Interleukin-10 / Q000097:blood* / Q000235:genetics; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D012959:Socioeconomic Factors; D014397:Tuberculosis, Pulmonary / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood* / Q000235:genetics; D055815:Young Adult
D015415:Biomarkers; D005819:Genetic Markers; C573415:IFNG protein, human; D018836:Inflammation Mediators; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007371:Interferon-gamma; D002097:C-Reactive Protein