The neuro-endocrine-immune relationship in pulmonary and pleural tuberculosis: A better local profile in pleural fluid

D'ATTILIO, L.; DIAZ, A.; FERNÁNDEZ, R.D.V.; BONGIOVANNI, B.; SANTUCCI, N.; DIDOLI, G.; LIOI, S.; GARDEÑEZ, W.; NANINNI, J.L.; DEL REY, A.; BESEDOVSKY, H.; BOTTASSO, O.; BAY, M.L.

INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE

INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D)

Lugar: Paris; Año: 2018 vol. 22 p. 321 - 327

1027-3719

BACKGROUND: Tuberculosis (TB) is a major health problem worldwide. In TB, the immune and central nervous systems modulate each other. The two main components of this network are the hypothalamicpituitary-Adrenal axis (HPA) and autonomic nervous system (ANS). OBJ E C T IVE : To elucidate neuro-endocrine-immune (NEI) interactions in pulmonary (PTB) or pleural (PLTB) TB, we analysed the relationship among compounds from these systems. METHODS : We quantified levels of catecholamines, hormones and cytokines in plasma from patients with PTB (n=46) or PLTB (n=12) and controls (n=32), and in the pleural fluid from PLTB patients. Transcript expression for genes involved in glucocorticoid-related function (quantitative real-Time polymerase chain reaction) was also analysed in mononuclear cells (MCs) from peripheral blood (PBMC) or pleural effusion (PEMC) compartments. RESULT S : Both patient groups had increased plasma levels of pro-And anti-inflammatory cytokines, cortisol, growth hormone (GH) and dopamine, whereas insulinlike growth factor 1 (IGF-1) and dehydroepiandrosterone levels were decreased. The pleural fluid contained increased levels of pro-inflammatory cytokines, GH and IGF-1 and reduced levels of steroid hormones compared with their plasma counterparts. PBMCs from PTB patients had increased expression of transcripts for 11b-hydroxysteroid dehydrogenase (11βHSD1) and a decreased glucocorticoid receptor (GR) ratio (GRα/ GRβ). In PLTB cases, expression of 11βHSD1 and GRα transcripts was higher in PEMCs. CONCLUS ION: PTB patients seem to display adverse NEI dysregulation. Changes in pleural fluid are compatible with a more effective NEI reaction.