Antioxidant status, C-reactive protein and iron status in patients with pulmonary tuberculosis

The objective of this study was to evaluate the influence of acute pulmonary tuberculosis and the effect of drug therapy on markers of oxidative stress (malondialdehyde [MDA] and total antioxidant status [TAS]), C-reactive protein (CRP) and iron body status indices.

Forty patients with active pulmonary tuberculosis from the Advisory Clinic for Chest and Respiratory Diseases in Mosul City, Iraq, were included in this study, with fifty healthy age and sex matched subjects as controls. Assessment of serum concentrations of MDA, TAS, CRP, serum iron, total iron binding capacity, transferring saturation percent and ferritin were done for both patients and controls. After two months of therapy with a daily dose of isoniazid 75 mg, rifampicin 150mg, pyraziamide 400 mg, and ethambutol 275 mg, the same parameters were reassessed for the patients.

After two months of therapy, there was a significant reduction in the levels of MDA, CRP, and ferritin, with a significant increase in the TAS, serum iron, and transferring saturation percentage with an insignificant effect on the total iron binding capacity in comparison with the patients' pre-therapy values.

Active pulmonary tuberculosis is associated with oxidative stress; the increase in the levels of CRP indicated that pulmonary tuberculosis is associated with an inflammatory response. The initial two months therapy led to significant improvement in oxidative stress and suppression of inflammatory responses. Newly diagnosed cases of pulmonary tuberculosis often had chronic anaemia of inflammation, but this therapy resulted in a significant correction of such anaemia.