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

SANTUCCI, NATALIA; D'ATTILIO, LUCIANO; KOVALEVSKY, LEANDRO; BESEDOVSKY, HUGO; DEL REY, ADRIANA; BAY, MARíA LUISA; BOTTASSO, OSCAR

Dresden

Congreso; 8th International ISNIM Congress 2011; 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 theconcentrations of leptin, adiponectin, IL-6, IL-1b, ghrelin, CRP, cortisol and DHEA as well as thein vitro immune response (lymphoproliferation and IFNg 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 IFNg present in 24 h culture supernatants from TB patients and the ConA-driven proliferation. Immune-endocrine alterations in TB patients may promote an adverse environment for the development of protective responses, control of tissue damage and metabolic balance.