[The dynamic changes of tuberculosis related cytokines during disease progression].

OBJECTIVE:To study the dynamic changes of tuberculosis related cytokines among patients during the different courses of treatment, and to analyze their influences on the development and prognoses of tuberculosis. METHODS:All patients with active tuberculosis were enrolled from Guangzhou, Shenzhen and Foshan TB control institutes. There were a total of 68 cases, 36 males and 32 females, aged 19 to 50 years [ average (30±9) years]. All the TB patients received standard chemotherapy regimen of anti-tuberculosis, and were divided into 2 groups: one completed treatment group (cured or clinically cured 38 cases) and 1 uncompleted treatment group (treatment failure or need to extend treatment, 30 cases). Peripheral blood serum at 0, 2, 6 month during the treatment from 68 tuberculosis patients were collected, and the concentration of IFN-γ,IL-4,IL-17,TGF-β,TNF-α and IL-10 were detected by ELISA tests. RESULTS:The concentration of IFN-γ, TGF-β and IL-4 in all enrolled patients showed significant decrease (from 23.2 ng/L to 22.3 ng/L, from 169.1 ng/L to 123.2 ng/L; 65.0 ng/L to 31.9 ng/L) (t=2.67, 2.35 and 3.41, P<0.05) along with the extension of treatment. IL-10 increased significantly (12.9 ng/L) in the uncompleted treatment group but declined significantly (5.38 ng/L) (P<0.05) in the completed treatment group at the end of 6 month. Meanwhile, IL-4 decreased significantly (P<0.05) in the completed treatment group but no significant changes were observed in the uncompleted treatment group. Th1/Th2 (IFN-γ/IL-4) raised gradually in the completed treatment group (0 month <2 month <6 month, t=6.32, 6.03 and 5.85, P<0.05), while it was only at 6 month in the uncompleted treatment group (0 month <6 month, t=3.7, P<0.05). And the ratio of Th1/Th2 in the completed treatment group was significantly higher than that in the uncompleted group treatment (P<0.05). CONCLUSION:It suggests that the changes of Th1 cytokines (IFN-γ, TGF-β) and the Th1/Th2 balance play an important role in the pathogenesis, development and prognosis of TB. The suppression of IFN-γ, TGF-β or Th1/Th2 balance may be an important factor influencing the prognosis of TB.