Changes of Plasma Interleukin-1 Receptor Antagonist, Interleukin-8 and other Serologic Markers during Chemotherapy in Patients with Active Pulmonary Tuberculosis

BACKGROUND: The human immune response to Mycobacterium tuberculosis is mediated by macrophages and T-lymphocytes. The alveolar macrophage phagocyting mycobacterium produces interleukin (IL) -1 as an inflammatory mediator, and IL-8 as a cytokine for leukocyte recruitment and granuloma formation. Interleukin-1 receptor antagonist (IL-1ra) is an internal antagonist of IL-1. METHODS: Plasma levels of IL-1ra and IL-8 and other serologic markers were measured in 18 patients with active tuberculosis before treatment and after 2 months and 6 months of treatment. RESULTS: During treatment with antituberculous medication, patients showed significant changes in hemoglobin, hematocrit, white blood cells (WBC), platelet, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ferritin and plasma IL-1ra. After 2 months of treatment, ESR and CRP diminished significantly; after 6 months, hemoglobin increased while WBC, platelet, ESR, CRP and ferritin decreased significantly compared to their pre-treatment levels. There were two groups: patients with delayed therapeutic responses, and patients with early responses. At each point of observation, the former group of patients showed lower body weight and lower levels of hemoglobin and hematocrit, and higher levels of WBC, platelet, ESR, IL-8 and IL-1ra than the latter group. During the course of the treatment, we observed considerable differences in body weight, body mass index, hemoglobin, hematocrit, WBC and platelet counts, ESR, CRP and ferritin in both the early-response and delayed-response groups. CONCLUSION: We believe that the plasma concentrations of IL-1ra and IL-8, which showed different peaks during the course of treatment, reflected their different functions and patterns of secretion. Moreover the concentrations did not seem as sensitive as other inflammatory markers to evaluate disease activity during antituberculosis treatment. However, IL-1ra can be considered a marker for disease activity and response to treatment.

Changes of plasma interleukin-1 receptor antagonist, interleukin-8 and other serologic markers during chemotherapy in patients with active pulmonary tuberculosis / 대한내과학회지

BACKGROUND: The human immune response to Mycobacterium tuberculosis is mediated by macrophage and T-lymphocyte. The alveolar macrophage phagocyting mycobacterium produced interleukin (IL)-1 as an inflammatory mediator and IL-8 as a cytokine for leukocyte recruitment and granuloma formation. Interleukin-1 receptor antagonist (IL-1ra) is an internal antagonist of IL-1. METHODS: Plasma levels of IL-1ra and IL-8 and other serologic markers were measured in 18 patients with active tuberculosis before treatment and after 2 months and 6 months of treatment. RESULTS: During treatment with antituberculous medication, patients showed significant changes of hemoglobin, hematocrit, white blood cell (WBC), platelet counts, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ferritin and plasma IL-1ra. After 2 months of treatment, ESR and CRP were significantly diminished as compared with those before treatment. After 6 months of treatment, hemoglobin was increased and WBC, platelet counts, ESR, CRP and ferritin decreased significantly as compared with those before treatment. At each point of observation the group of delayed therapeutic response showed lower body weight, hemoglobin and hematocrit and higher WBC, platelet counts, ESR, IL-8 and IL-1ra than those of early responsive group. During the time course of treatment, significant differences were observed in body weight, body mass index, hemoglobin, hematocrit, WBC, platelet counts, ESR, CRP and ferritin for each group of early and delayed response. CONCLUSION: Plasma concentrations of IL-1ra and IL-8 might indirectly reflect their different patterns of secretion and functions with different peaks during the course of treatment and they seemed not so sensitive as other inflammatory markers to evaluate the disease activity during antituberculous treatment. However, IL-1ra can be considered a marker of disease activity and response of treatment.