Improved Cortisol/DHEAS balance in tuberculosis patients undergoing

BONGIOVANNI, BETTINA; DáTTILIO, LUCIANO; SANTUCCI, NATALIA; RAMOS, PAULA; BOGUE, CRISTINA; GARDEñEZ, WALTER; LIOI, SUSANA; BOTTASSO, OSCAR; BAY, MARíA LUISA

Congreso; V Reunión Anual de la Sociedad Latinoaméricana de Tuberculosis y otras Micobacteriosis; 2010

There is a bidirectional communication between the neuroendocrine and immune systems, in particular, the hypothalamus-pituitary-adrenal axis which plays a critical role in maintaining immune homeostasis. In former studies we demonstrated that active pulmonary tuberculosis (TB) is characterized by increased and reduced concentrations of Cortisol (Cort) and DHEA, respectively, resulting in a higher Cort/DHEA ratio. To proceed with, we have now investigated the levels of both adrenal steroids and pro-inflammatory compounds like IL-1 and C reactive protein in TB patients upon completion of two months of specific treatment (T2, n=14). Healthy controls (HCo, n=13) and household contacts (HHC, n=8) were also included for comparison purposes. Adrenal steroids were assayed by electrochemioluminicence (ECH, Roche), whereas IL-1 and CRP were determined by ELISA (Invitrogen) and turbitest (CRP-High sensitivity, Winner Lab). At the time of diagnosis (T0), TB showed higher levels of Cort (median ìg/dl, 75%-25%): 29.1 (14.3-43.2), respect HHC 16.7 (12.3-47.0) and HCo 19.2 (12.0-22.8); p<0.05. DHEAS concentrations showed no between-group differences. The Cort/DHEAS balance was significantly higher in TB [TB 0.3 (0.15-0.57); HHC 0.11 (0.043-0.35); HCo 0.083 (0.067-0.15); p<0.01]. Higher concentrations of IL-1 and CRP were also found in TB cases (p<0.001). Paired comparisons between T0 and T2 revealed a decrease of pro-inflammatory mediators (i.e., CRP, p<0.03), Cort, with a mild increase of DHEAS values that lead to a significant reduction of Cort/DHEAS balance [T0: 0.395 (0.12-0.90); T2: 0.188 (0.12-0.44,) p<0.03]. Such immune-endocrine profile is compatible with the establishment of a better anti-infectious response.