Levels of inflammatory cytokines, adrenal steroids, and mRNA for GRa GRB and 11BHSD1 in TB pleurisy

DATTILIO L; DIAZ A; SANTUCCI N; BONGIOVANNI B; GARDEÑEZ W; MARCHESINI M; BOGUE C; DIDOLI G; BOTTASSO O; BAY ML

Tuberculosis (Edinb)

CHURCHILL LIVINGSTONE

Lugar: ESCOCIA; Año: 2013 vol. 93 p. 635 - 641

1472-9792

Our previous work on the immune-endocrine features of patients with pulmonary tuberculosis (TB) showed markedly decreased plasma levels of dehydroepiandrosterone (DHEA) together with augmented concentrations of Cortisol and pro- and anti-inflammatory cytokines. Studies in peripheral blood mononuclear cells (PBMC) indicated a lower mRNA alpha/beta ratio of glucocorticoid receptors -GR- together with a higher 11B-hydroxysteroid dehydrogenase type 1 (11BHSD1) mRNA expression in cases with severe pulmonary TB. Since Pleural TB (PLTB) is a rather benign manifestation of TB, we now analyzed the systemic and local immune-endocrine profile as well as the GRa, GRB, 11BHSD1 and 11BHSD2 transcripts in PBMC and pleural effusion mononuclear cells (PEMC) of patients with PLTB. PLTB patients had increased levels of IL-1B, IL-6 and IFNg together with reduced Cortisol and DHEA concentrations in pleural fluids. Also, a significantly increased expression of 11BHSD1 and GRa was found in PEMC compared to PBMC. Findings point out to an appropriate immune response and a substantial inflammatory reaction, wherein the low Cortisol concentrations may be equally effective, because of the increased expression of GRa and 11BHSD1 transcripts which may optimize the immunomodulatory properties of Cortisol.