Abstract
Background: The different treatment outcomes of pulmonary tuberculosis (TB) are likely to result from a complex interaction between the host and the pathogen. Aim: To determine the association of serum cytokine concentration with clinical, radiological and drug-susceptible outcomes of active pulmonary TB patients. Method: A hospital based prospective follow-up study design was conducted in two urban centers in Lucknow (UP), India under Directly Observed Treatment Short-course. Newly diagnosed Acid-fast Bacilli (AFB) positive cases between the age group of 12 to 65 years were enrolled. Each participant was interviewed and completed a structured questionnaire to provide demographic information. Outcomes were evaluated by clinical, radiological and drug-susceptibility testing. The immunological parameters were used to assess the levels of IL-2, IL-4, IL-10 and IFN-γ. Results: A total of 185 newly diagnosed patients were recruited. Out of these, 92.4% AFB-positive patients completed the study. The mean(±SD) age was 29(±12) years. There was significant (p=0.03) differences in the concentration of IL-4, IL-10 and IFN-γ at six month between the patients with complete and incomplete radiological clearance. Out of AFB smear positive patients, 91.2% were culture positive and subjected to drug-susceptibility test. Of these, 82.6% isolates were sensitive to all the drugs and 17.3% isolates were resistant to any drug. The IL-2, IL-4, IFN-γ and IL-10 concentrations were significantly (p=0.05) different between drug sensitive and resistant patients at six month. Conclusion: This study concluded that increased IL-4 production associated with the patients to be incomplete radiological clearance and drug resistant.
- © 2014 ERS