[The dynamic changes of tuberculosis related cytokines during disease progression]

To study the dynamic changes of tuberculosis related cytokines among patients during the different courses of treatment, and to analyze their influences on the development and prognoses of tuberculosis.

All patients with active tuberculosis were enrolled from Guangzhou, Shenzhen and Foshan TB control institutes. There were a total of 68 cases, 36 males and 32 females, aged 19 to 50 years [ average (30±9) years]. All the TB patients received standard chemotherapy regimen of anti-tuberculosis, and were divided into 2 groups: one completed treatment group (cured or clinically cured 38 cases) and 1 uncompleted treatment group (treatment failure or need to extend treatment, 30 cases). Peripheral blood serum at 0, 2, 6 month during the treatment from 68 tuberculosis patients were collected, and the concentration of IFN-γ,IL-4,IL-17,TGF-β,TNF-α and IL-10 were detected by ELISA tests.

The concentration of IFN-γ, TGF-β and IL-4 in all enrolled patients showed significant decrease (from 23.2 ng/L to 22.3 ng/L, from 169.1 ng/L to 123.2 ng/L; 65.0 ng/L to 31.9 ng/L) (t=2.67, 2.35 and 3.41, P<0.05) along with the extension of treatment. IL-10 increased significantly (12.9 ng/L) in the uncompleted treatment group but declined significantly (5.38 ng/L) (P<0.05) in the completed treatment group at the end of 6 month. Meanwhile, IL-4 decreased significantly (P<0.05) in the completed treatment group but no significant changes were observed in the uncompleted treatment group. Th1/Th2 (IFN-γ/IL-4) raised gradually in the completed treatment group (0 month <2 month <6 month, t=6.32, 6.03 and 5.85, P<0.05), while it was only at 6 month in the uncompleted treatment group (0 month <6 month, t=3.7, P<0.05). And the ratio of Th1/Th2 in the completed treatment group was significantly higher than that in the uncompleted group treatment (P<0.05).

It suggests that the changes of Th1 cytokines (IFN-γ, TGF-β) and the Th1/Th2 balance play an important role in the pathogenesis, development and prognosis of TB. The suppression of IFN-γ, TGF-β or Th1/Th2 balance may be an important factor influencing the prognosis of TB.