Improved immune-endocrine profile in tuberculosis patients under specific treatment

BONGIOVANNI, BETTINA; D'ATTILIO, LUCIANO; SANTUCCI, NATALIA; DÍAZ, ARIANA; BOGUE, CRISTINA; GARDEÑEZ, WALTER; DÍDOLI, GRISELDA; LIOI, SUSANA; BOTTASSO, OSCAR; BAY, MARÍA LUISA

Buenos Aires

Congreso; French-Argentine Immunology Congress; 2010

Tuberculosis (TB) remains a mayor cause of morbidity and mortality around the world. The proper mechanisms underlying divergent disease outcome are not fully understood. Earlier studies in TB patients revealed imbalanced immune-endocrine responses with increased and reduced concentrations of Cortisol (Cort) and DHEA, respectively, resulting in a higher Cort/DHEA ratio linked to disease severity. Information about the evolution of the immunoendocrine response during antibiotic therapy of TB is nearly negligible. To proceed with, we have now investigated the levels of both adrenal steroids and pro-inflammatory compounds like IL-1â and C reactive protein in TB patients (n=10) upon completion of four months of specific treatment. 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 µg/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 two months after specific treatment (T2) revealed a decrease of CRP (p<0.03), Cort, (p<0.05) 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]. Moreover, there was a correlation between ∆IL-1â (T0-T2) and ∆Cort/DHEAS balance (T0-T2) (r=0.94). Such immune-endocrine profile is compatible with the establishment of a better anti-infectious response.