Levels of tumour necrosis factor-α and IL-1a in newly diagnosed and multidrug resistant tuberculosis

Background: The pro-inflammatory cytokines tumour necrosis factor (TNF)-alpha and IL-1 alpha play key roles in host defence against tuberculosis (TB) but there is little knowledge of their levels in multi-drug resistant TB (MDR-TB). The aim of the present study was to investigate the levels of TNF-alpha and IL-1 alpha and their relationship with the levels of T helper (CD4'), T suppressor (CD8') and total lymphocytes (CD45(+)) in newly diagnosed TB (N-TB) and MDR-TB. Methodology: This study assessed 19N-TB patients (M/F: 17/2) and 11 MDR-TB patients (M/F: 10/1). Serum TNF-alpha and IL-1 alpha were assessed by ELISA. Lymphocyte expression of CD45, CD4, CD8, CD3, CD23, CD19 and CD95 were determined by flow cytometry. Results: The levels of TNF-alpha, IL-1 alpha, and CD4, CD4/CD8, CD45, CD19, CD23 and CD95 positive lymphocytes were lower in MDR-TB than in N-TB patients (P < 0.05). Statistically, (here was a positive correlation between TNF-alpha and IL-1 alpha (r = 0.92) for both MDR-TB and N-TB. For both groups, both TNF-alpha and IL-1 alpha. correlated with CD4' lymphocytes (r = 0.48). TNF-alpha and IL-1 alpha showed negative correlations with CD8(+) lymphocytes (r = -0.81, r = -0.73) (P < 0.01) in MDR-TB patients. Conclusion: The lower levels of cytokines and numbers of T helper lymphocytes in MDR-TB compared with N-TB implies that the immune profiles of the two groups are different, and may be important in the natural history of the disease.