Cytokine Networks And Their Modulation And The Level Of Nitric Oxide In Patients With Multidrug-resistant Pulmonary Tuberculosis

ObjectiveTo explore the role of cytokine network and their modulations and the level of nitric oxide (NO) in the development of multidrug-resistant pulmonary tuberculosis (MDR-TB). MethodsSerum levels of interferon-gamma(IFN- V ),interleukin-12( IL-12),interleukin-lO(IL-lO) and transforming growth factor(TGF)-13 were measured by enzyme-linked immunoassay in 25 multidrug-resistant pulmonary tuberculosis patients (MDR-TB) with either moderately advanced (n=9) or advanced (n=16), also in 25 drug-sensitive pulmonary tuberculosis patients (DS-TB) with either moderately advanced (n=18) or advanced (n=7) and in 25 healthy controls. Serum level of NO was measured by Griess reaction in MDR-TB,DS-TB and controls. Results1. Compared with DS-TB patients or controls,patients with MDR-TB showed significantly lower serum concentrations of IFN- Y ,IL-12 and NO,but significantly higher levels of IL-10,TGF- ?.Compared with controls,patients with DS-TB showed significantly higher serum concentrations of IFN- Y ,IL-12 and NO . Compared with controls ,patients with DS-TB showed lower serum concentration of IL-10 ,higher serum concentration of TGF- ,but with no statistical difference .2. Compared with advanced MDR-TB patients, moderately advanced MDR-TB patients showed significantly higher serum concentrations of IL-12 and NO. Compared with advanced DS-TB patients,moderately advanced DS-TB patients showed significantly higher serum concentrations of IFN- Y ,IL-12,but significantly lower levels of IL-10 and TGF- .3. In controls and DS-TB patients the levels of IL-12 were positively correlated with IFN- Y ,but negatively correlated with IL-10 (PO.01). In MDR-TB patients levels of IL-12 were not correlated with IFN-YorIL-10.ConclusionPresent data suggested that imbalance in the cytokine network and NO were most pronounced in patients with MDR-TB. MDR-TB may be accompanied by a shift toward decreased levels of Thl cytokines and NO combined with enhanced levels of Th2 cytokine and TGF- . A poorly regulated cytokine network and NO may be involved in the development and progression of MDR-TB.