Altered immune-endocrine circuits in patients with pulmonary tuberculosis and its relation with an adverse metabolic status and impaired in vitro immune responses

SANTUCCI N; DATTILIO L; KOVALEVSKI L; BESEDOVSKY H; DEL REY A; BAY ML; BOTTASSO O

Dresden

Congreso; 8th Congress of the International Society for Neuroimmunomodulation; 2011

ISNIM

Our study investigated the circulating levels of factors involved in immuno-inflammatory responses and the regulation of food consumption in TB patients, to ascertain for a relation between certain immunoendocrine patterns with their clinical status and in vitro immune response. Accordingly, 53 patients with active untreated TB, 27 household contacts and 25 healthy controls, showing no age- or sex-related differences, were analysed for the concentrations of leptin, adiponectin, IL-6, IL-1â, ghrelin, CRP, cortisol and DHEA as well as the in vitro immune response (lymphoproliferation and IFN-g production). TB patients had a lower BMI, reduced levels of leptin and DHEA together with increased concentrations CRP, IL-6, cortisol, IL-1â and nearly significant adiponectin values. Comparisons within TB patients revealed that BMI and leptin levels decreased with disease aggravation, whereas higher concentrations of IL-6, CRP, IL-1â, cortisol, and ghrelin were seen in cases with moderate to severe TB. HHC had lower and higher levels of DHEA and IL-6, respectively, in relation to Co. Group classification by means of discriminant analysis and the k-nearest neighbourhood method showed that TB patients clearly differentiated from the other groups depicting high values of PCR and lower values of DHEA and BMI. Correlation studies identified a positive correlation of BMI with leptin, the latter being negatively associated with IL-6, CRP and ghrelin. By opposite, adiponectin, IL-6, CRP and to some extent IL-1b were positively associated among them and inversely correlated with DHEA and BMI. Furthermore, plasma leptin levels were positively associated with the basal amount of IFN-ã present in 24 h culture supernatants from TB patients and the ConA-driven proliferation. Imune-endocrine alterations in TB patients may promote an adverse environment for the development of protective responses, control of tissue damage and metabolic balance.