@article {Tadokera1248, author = {R. Tadokera and G. Meintjes and K.H. Skolimowska and K.A. Wilkinson and K. Matthews and R. Seldon and N.N. Chegou and G. Maartens and M.X. Rangaka and K. Rebe and G. Walzl and R.J. Wilkinson}, title = {Hypercytokinaemia accompanies HIV{\textendash}tuberculosis immune reconstitution inflammatory syndrome}, volume = {37}, number = {5}, pages = {1248--1259}, year = {2011}, doi = {10.1183/09031936.00091010}, publisher = {European Respiratory Society}, abstract = {Increased access to combination antiretroviral therapy in areas co-endemic for tuberculosis (TB) and HIV-1 infection is associated with an increased incidence of immune reconstitution inflammatory syndrome (TB-IRIS) whose cause is poorly understood. A case-control analysis of pro- and anti-inflammatory cytokines in TB-IRIS patients sampled at clinical presentation, and similar control patients with HIV-TB prescribed combined antiretroviral therapy who did not develop TB-IRIS. Peripheral blood mononuclear cells were cultured in the presence or absence of heat-killed Mycobacterium tuberculosis for 6 and 24 h. Stimulation with M. tuberculosis increased the abundance of many cytokine transcripts with interleukin (IL)-1β, IL-5, IL-6, IL-10, IL-13, IL-17A, interferon (IFN)-γ, granulocyte-macrophage colony-stimulating factor (GM-CSF) and tumour necrosis factor (TNF) being greater in stimulated TB-IRIS cultures. Analysis of the corresponding proteins in culture supernatants, revealed increased IL-1β, IL-2, IL-6, IL-8, IL-10, IL-12p40, IFN-γ, GM-CSF and TNF in TB-IRIS cultures. In serum, higher concentrations of TNF, IL-6, and IFN-γ were observed in TB-IRIS patients. Serum IL-6 and TNF decreased during prednisone therapy in TB-IRIS patients. These data suggest that cytokine release contributes to pathology in TB-IRIS. IL-6 and TNF were consistently elevated and decreased in serum during corticosteroid therapy. Specific blockade of these cytokines may be rational approach to immunomodulation in TB-IRIS.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/37/5/1248}, eprint = {https://erj.ersjournals.com/content/37/5/1248.full.pdf}, journal = {European Respiratory Journal} }