Noradrenaline and adrenaline in patients with tuberculosis with different degree of lung compromise

D´ATTILIO L; BONGIOVANNI B; SANTUCCI N; DIAZ A; DIDOLI G; BAY ML; BOTTASSO O; BESEDOVSKY H; DEL REY A

Dresden

Congreso; 8th Congress of the International Society of Neuroimmunomodulation, October 20-22 2011; 2011

International Society for Neuroimmunomodulation (ISNIM)

Noradrenaline and Adrenaline in Patients with Tuberculosis with Different Degree of Lung Compromise L. D’Attilio1, B. Bongiovanni1, N. Santucci1, A. Díaz1, G. Dídoli1, M.L. Bay1, O. Bottasso1, H.O. Besedovsky2,A. del Rey2 1Instituto de Inmunología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Argentina, 2Department of Immunophysiology, Institute of Physiology and Pathophysiology, Marburg, Germany Mycobacterium tuberculosis is one of the most important human pathogens and infects 9.3 million people each year, leading to 1.3 million deaths. Tuberculosis (TB) is characterized by stimulation of the immune system, and concomitant activation of neuro-immune regulatory circuits, which are indispensable to limit pulmonary damage. However, in most cases, the net result is a progressive infection. We have previously shown that patients suffering from severe pulmonary TB show a marked deregulation of the hypothalamus-pituitaryadrenal (HPA) axis, as reflected by increased cortisol and markedly decreased dehydroepiandrosterone levels in plasma. It is well established that the HPA axis and the sympathetic nervous system (SNS) usually operate in a coordinated fashion. Thus, as a first approach to study the activity of the SNS during TB, plasma levels of noradrenaline (NA), adrenaline (A), and dopamine (DA) were quantified by HPLC, cortisol by EIA, and IL-1beta, IL-6, IL-18 by ELISA. Thirty three adult male patients with different degree of pulmonary involvement (7 mild, 16 moderate and 10 advanced), and 24 age- and sex-matched healthy controls were included in this study. DA levels were significantly increased in TB patients as compared to controls, and the increase was even more pronounced in those with advanced TB. Although no significant differences between patients and controls were detected in NA and A concentrations in plasma, a significant positive correlation between NA and cortisol levels was detected in the patients, who also had the highest IL-6, IL-18, and IL-1beta concentrations. A significant positive correlation between the concentrations of IL-1beta and NA, A and DA in plasma was also detected in the patients. The changes in plasma catecholamine levels in patients with severe TB and their association with increased pro-inflammatory cytokines and cortisol concentrations suggest an active role of the SNS in the pathophysiology of this infectious disease.