Title: Levels of tumor necrosis factor-alpha (TNF-α) and Interferon gamma (IFN-γ) s During Tuberculosis treatment
Abstract: Cytokines play a major role in protection against Mycobacterium tuberculosis infection and regulate the immune responses at a cellular level. A T helper 1 (Th1) cytokine interferon gamma (IFN-γ) is one of the most important cytokines which activate the macrophages to produce tumor necrosis factor-alpha (TNF-α). At physiological levels, TNF-α has anti-microbial activities through the apoptotic effect. Excessive production of TNF-α have been implicated in immunopathogenesis of tuberculosis. The aim of the present study was to determine Th1 cytokine profile in patients with tuberculosis to identify immunological marker for follow up of the disease activity, and on the other hand, to study the outcome of anti-tuberculosis treatment. To examine this, blood samples were collected at several intervals before and during the treatment with anti-tuberculosis drugs. Levels of IFN-γ, TNF-α pre and during treatment using commercial available enzyme-linked immune-sorbent assay (ELISA). Data were analyzed using SPSS 20. Receiver Operating Characteristic (ROC) Curve analysis has been carried out to assess their discriminative power and to determine cut-off values. Analysis has been carried out further by calculating other measures of diagnostic test accuracy.The results showed that the levels of TNF- were significantly increased in patients before and after the treatment than those in control (p=0.001). Levels for IFN-γ were not statistically different between patients and controls (p=0.351). A decrease in TNF-α levels dose not conflict with the finding that IFN-γ had highest level in patients under treatment as the difference between those and newly diagnosed patients was not statistically different. TNF-α can be used as a marker for TB severity, having that the area under the curve (AUC) for TNF-α is .824 (95% CI: .737 - .912). For the chosen cut-off level of 5pg/ml, it has a sensitivity of 85% and a lower specificity of 70%. TNF-α test is most beneficial where prevalence is very low or very high. Keywors: Cytokines levels, TNF-, IFN-, TB treatment
Publication Year: 2013
Publication Date: 2013-01-01
Language: en
Type: article
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