title: Association of serum levels of iron, copper, and zinc, and inflammatory markers with bacteriological sputum conversion during tuberculosis treatment.
abstract: Iron, copper, and zinc are key micronutrients that play an important role in the immune response to Mycobacterium tuberculosis. The present study aimed to evaluate the association between serum levels of those micronutrients, inflammatory markers, and the smear and culture conversion of M. tuberculosis during 60 days of tuberculosis treatment. Seventy-five male patients with pulmonary tuberculosis (mean age, 40.0 ± 10.7 years) were evaluated at baseline and again at 30 and 60 days of tuberculosis treatment. Serum levels of iron, copper, zinc, albumin, globulin, C-reactive protein, and hemoglobin, and smear and cultures for M. tuberculosis in sputum samples were analyzed. Compared to healthy subjects, at baseline, patients with PTB had lower serum iron levels, higher copper levels and copper/zinc ratio, and similar zinc levels. During the tuberculosis treatment, no significant changes in the serum levels of iron, zinc, and copper/zinc were observed. Lower serum copper levels were associated with bacteriological conversion in tuberculosis treatment (tuberculosis-negative) at 30 days but not at 60 days (tuberculosis-positive). C-reactive protein levels and the C-reactive protein/albumin ratio were lower in tuberculosis-negative patients than in tuberculosis-positive patients at 30 and 60 days after treatment. Albumin and hemoglobin levels and the albumin/globulin ratio in patients with pulmonary tuberculosis increased during the study period, regardless of the bacteriological results. High serum globulin levels did not change among pulmonary tuberculosis patients during the study. Serum copper levels and the C-reactive protein/albumin ratio may be important parameters to evaluate the persistence of non-conversion after 60 days of tuberculosis treatment, and they may serve as predictors for relapse after successful treatment.
authors: Montreal Chest Institute, McGill University, Montreal, Quebec, Canada, milena_mila2003@yahoo.com.br.
authors: Milena Lima de
authors: ML
authors: Moraes
authors: Daniela Maria de Paula
authors: DM
authors: Ramalho
authors: Karina Neves
authors: KN
authors: Delogo
authors: Pryscila Fernandes Campino
authors: PF
authors: Miranda
authors: Eliene Denites Duarte
authors: ED
authors: Mesquita
authors: Hedi Marinho
authors: HM
authors: de Melo Guedes de Oliveira
authors: Antônio Ruffino
authors: AR
authors: Netto
authors: Marcelino José
authors: MJ
authors: Dos Anjos
authors: Afrânio Lineu
authors: AL
authors: Kritski
authors: Martha Maria
authors: MM
authors: de Oliveira
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D003300:Copper / Q000097:blood*; D004977:Ethambutol / Q000627:therapeutic use; D006454:Hemoglobins / Q000378:metabolism; D054884:Host-Pathogen Interactions / Q000187:drug effects; D006801:Humans; D007249:Inflammation / Q000097:blood; D007501:Iron / Q000097:blood*; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000502:physiology; D011718:Pyrazinamide / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D012709:Serum Albumin / Q000378:metabolism; D012712:Serum Globulins / Q000378:metabolism; D013183:Sputum / Q000382:microbiology*; D013997:Time Factors; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000097:blood* / Q000188:drug therapy / Q000382:microbiology; D015032:Zinc / Q000097:blood*
chemical_list: D000995:Antitubercular Agents; D015415:Biomarkers; D006454:Hemoglobins; D012709:Serum Albumin; D012712:Serum Globulins; D011718:Pyrazinamide; D003300:Copper; D004977:Ethambutol; D002097:C-Reactive Protein; D007501:Iron; D015032:Zinc; D007538:Isoniazid; D012293:Rifampin