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Free Content Post-treatment changes of six cytokines in active pulmonary tuberculosis: differences between patients with stable or increased fibrosis

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SETTING: Little information is available regarding the relationship between the fibrotic evolution of pulmonary tuberculosis (PTB) and cytokine levels in human bronchoalveolar lavage fluid (BALF) and serum.

OBJECTIVE: To evaluate correlations between profibrotic cytokine levels and post-treatment lung fibrotic evolution.

DESIGN: BALF and serum amounts of pro- or anti-inflammatory cytokines were obtained by ELISA before and 6 months after the start of anti-tuberculosis chemotherapy in 13 subjects with PTB. BALF levels were recalculated as ELF (epithelial lining fluid) levels by the urea method. High resolution computed tomography (HRCT) of both lungs was performed at the same time.

RESULTS: When comparing pre- and post-treatment radiological data, the scores for 2–10 mm nodules, consolidation and fibrosis presented significant differences (P < 0.05). Concomitantly, pre-treatment vs. 6 month concentrations of ELF IFN-γ and TNF-α were decreased (P < 0.05), while those of IL-4 and IL-10 were increased (P < 0.012). At serum level, IFN-γ decreased, as did TNF-α, TGF-β1 and PDGF-BB (P < 0.05). When the patients were subdivided into two groups, 1) stable or 2) increasing HRCT fibrosis score, significant increases in the second group were observed for ELF/serum values of TGF-β1 and ELF PDGF-BB (P < 0.05) at 6 months post-treatment. Only serum TGF-β1 values were significantly associated with the same group before treatment.

Keywords: HRCT; fibrogenic cytokines; fibrosis; pro-inflammatory cytokines; pulmonary tuberculosis; treatment

Document Type: Regular Paper

Affiliations: 1: Department of Clinical Pathology, General Hospital S Giovanni Calibita, Roma, Italy 2: Department of Cardiovascular and Respiratory Sciences, La Sapienza University, Roma, Italy 3: Department of Biochemistry, Catholic University of the Sacred Heart, Roma, Italy 4: Department of Radiology, Carlo Forlanini Hospital, Roma, Italy 5: Chest Clinic, Carlo Forlanini Hospital, Roma, Italy

Publication date: January 1, 2005

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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