Influence of prednisone on serum level of tumor necrosis factor alpha, interferon gamma and interleukin-1 beta, in active pulmonary tuberculosis
Languages of publication
Introduction. Tumor necrosis factor alpha, interferon gamma and interleukin-1 beta modulate the interaction between T-cells and macrophages and play the key role in immune defense in Mycobacterium tuberculosis infection. Several studies have demonstrated that corticosteroids may improve clinical conditions of patients with active pulmonary tuberculosis. Aim. The aim of the study was a potential impact of prednisone on the early immune response in HIV-negative young adults with active pulmonary tuberculosis, during the first four weeks of treatment. Material and methods. The study included 38 adults, aged 18-39 years, with active pulmonary tuberculosis. The first group of patients received only anti-tuberculosis chemotherapy whereas the second group of patients was administered antituberculosis chemotherapy and 20 mg prednisone, once daily. Serum levels of tumor necrosis factor-alpha, interferon-gamma and interleukin 1-beta were measured using ELISA kits before treatment initiation as well after two and four weeks of treatment, in both study groups. Results. The highest serum levels of evaluated cytokines were observed before treatment initiation. Serum levels of cytokines were significantly decreased in patients who received anti-tuberculosis drugs and prednisone, compare to those not treated with prednisone (p<0.001), in all study periods. Conclusions. Adjunctive therapy, like 20 mg prednisone daily, remarkably inhibited the secretion of inflammatory cytokines during the early stage of active pulmonary tuberculosis in HIV-negative young adults, which is likely to be beneficial for this group of patients
1 - 3 - 2014
23 - 4 - 2014
- 1. Toosi Z. The inflammatory response in Mycobacterium tuberculosis infection. Arch Immunol Ther Exper. 2000;48:515-9.
- 2. Algood HMS, Lin PL, Yankura D, et al. TNF influences chemokine expression of macrophages in vitro and that of CD 11b+ cells in vivo during Mycobacterium tuberculosis infection. J Immunol. 2004;172:6846-57.
- 3. Dinarello CA. Proinflammatory cytokines. Chest. 2000;118:503-8.
- 4. Kelley J. State of the art cytokines of the lung. Am Rev Resp Dis. 1990;141:765-88.
- 5. Zganiacz A, Santosuasso M, Wang J, et al. TNF-alpha is a critical negative regulator of type 1 immune activation during intracellular bacterial infection. J Clin Invest. 2004;113:401-13.
- 6. Tsao TCY, Hong J-H, Li L-F, et al. Imbalances between its soluble receptor forms and interleukin-1 beta and interleukin-1-receptor antagonist in pulmonary tuberculosis. Chest. 2000;117:103-9.
- 7. Scanga CA, Mohan VP, Yu K, et al. T-cells cause reactivation tuberculosis despite continued expression of interferon gamma and nitric oxide synthase. J Exp Med. 2000;192:347-58.
- 8. Research Committee of the Tuberculosis Society of Scotland. Prednisolone in the treatment of pulmonary tuberculosis: a controlled trial. Br Med J. 1957;2:1131-4.
- 9. United States Public Health Service. Tuberculosis Therapy Trials; Preliminary observations from a controlled trial of prednisolone in the treatment of pulmonary tuberculosis. Am Rev Resp Dis. 1960;81;598-600.
- 10. Research Committee of the British Tuberculosis Association. Trial of corticotrophin and prednisone with chemotherapy in pulmonary tuberculosis: a two year radiographic follow-up. Tubercle. 1963;44:484-7.
- 11. Muthuswamy P, Hu YC, Carasso B, et al. Prednisone as adjunctive therapy in the management of pulmonary tuberculosis, report of 12 cases and review of the literature. Chest. 1995;107:1616-30.
- 12. Senderovitz T, Viscun K. Corticosteroids and tuberculosis. Res Med. 1994;88:565-9.
- 13. Weinstein HJ, Koler JJ. Adrenocorticosteroids in the treatment of tuberculosis. N Eng J Med. 1959;260:412-7.
- 14. Chan HS, Pang JA. Effects of corticosteroids on deteriotation of endobronchial tuberculosis during chemotherapy. Chest. 1989;96:1195-6.
- 15. World Medical Association Declaration of Helsinki. Ethical Principles for Medical Research Involving Human Subjects. 59 WMA General Assembly, Seoul, October 2008.
- 16. Tsao TC, Hong J, Huang C, et al. Increased TNF-alpha, IL-1 beta and Il-6 levels in the bronchoalveolar lavage fluid with the upregulation of their mRNA in macrophages lavaged from patients with active pulmonary tuberculosis. Tuber Lung Dis. 1999;79:279-85.
- 17. Barreto Pereira C, Palaci M, Leite OHM, et al. Monocyte cytokine secretion in patients with pulmonary tuberculosis differs from that of healthy infected subjects and correlates with clinical manifestations. Microb Infect. 2004;1:25-33.
- 18. Golden MP, Vikram HR. Extrapulmonary tuberculosis: An overview. Am Fam Physic. 2005;72:1761-8.
- 19. Chang JS, Huggett JF, Dheda K, et al. Mycobacterium tuberculosis induces selective upregulation of TLRs in the mononuclear leukocyte of patients with active pulmonary tuberculosis. J Immunol. 2006;176:3010-8.
- 20. Meintjes G, Wilkinson RJ, Morroni C, et al. Randomized placebo-controlled trial of prednisone for paradoxical tuberculosis-associated immune reconstruction inflammatory syndrome. AIDS. 2010;15:2381-90. [WoS]
Publication order reference