ABSTRACT
Tuberculosis [TB], is one of the major common air born infectious bacteria! diseases whichremains a major worldwide health problem with global mortality. To evaluate the efficiency of serurr samples compared to sputum for the early diagnosis of TB, and to evaluate the levels of superoxide dismutase [SOD], catalase [CAT], total antioxidant status [TAS] and tumor necrosis factor-a [TNF-alpha] in patients witt pulmonary tuberculosis [PTB]. One hundred patients with clinically suspected PTB and 25 healthy individuals were enrolled in the study. According to the bacteriological results, 78 patients were diagnosed as having PTB infection. These cases were categorized into 69 culture positive cases [sputum anc serum PCR positive patients [n=42], sputum PCR positive and serum PCR negative patients [n=16] and sputurr and serurr. PCR negative patients [n=11]] and 9 culture negative and sputum PCR positive cases witi radiological lung abnormalities suggestive for PTB. For these 78 cases, erythrocyte SOD, CAT, serum TAS an? TNF-alpha were determined. Twenty two patients were culture negative and negative for both sputum and serun PCR. They had no PTB and were not involved in biochemical studies. In all 78 PTB patients erythrocyte SOD, CAT and serum TAS levels were statistically lower than controls [p<0.05], while TNF-alpha was highly significantly .increased [p=0.001]. There was a significant direct linear correlation between SOD and CA" and TAS [p<0.0001, r= 0.78; p<0.0001, r= 0.88; p<0.0001, r=0.80 respectively] and a significant reverse linea correlation between TNF-alpha and SOD, CAT and TAS level [p<0.0001 r=-0.55; p<0.0001, r=-0.51; p<0.0001, r= 0.65 respectively]. Although the sputum culture is still the gold standard for the diagnosis of patientt with PTB, sputum PCR is an efficient method that could be used as an alternative to the culture for the rapk identification of PTB cases. The lower levels of SOD, CAT and TAS may be improved by the antioxidant therap which may help in better prognosis. Also anti TNF-alpha therapy may help in decreasing the elevated level of TNF-alpha shown in all PTB patients