. A partly normalization in the immune-endocrine circulating profile of tuberculosis patients undergoing specific treatment

DIAZ A; BONGIOVANNI B; DATTILIO L; SANTUCCI N; DIDOLI G; BRANDAM N; NANNINI L; RADCLIFFE S; BOTTASSO O; BAY ML

Milán

Congreso; 15th International Congress of Immunology, Milán 22-27 Agosto 2013 (Abstract P4.05.11).; 2013

IUIS

Tuberculosis (TB) continues to be a global health problem. Extending our earlier findings in which untreated TB patients revealed imbalanced immune-endocrine responses, we have now analyzed the immune-endocrine profile throughout the 6-month course of specific treatment and 3 month following its completion. Twenty healthy controls (HCo) and 19 age- and sex-matched TB -HIV negative- patients were bled at diagnosis (T0), two (T2), four (T4) and 6 months (T6) of treatment as well as 3 months later (T9). At diagnosis patients showed a low BMI (p<0.001) and lymphoproliferative response (p<0.05), without no major changes in clinical laboratory tests; respect to HCo. The two former ones increased during treatment. Lymphoproliferation reached values similar to HCo at T9, whereas BMI showed a partial recovery remaining below the values seen in HCo. Analysis of plasma endocrine compounds (Cortisol and dehydroepiandrosterone -DHEA), cytokines (IFN-g, IL-6, TGF-b, IL-4, IL-17), C reactive protein and peripheral T regulatory cells were carried out at the same time-points. Pro-inflammatory mediators were increased at T0, as was the Cortisol/DHEA ratio (p<0.01 vs. HCo, all cases). Such an increase coexisted with a high percentage of T regulatory cells, augmenting even further at T2 (p<0.05); the time when inflammatory compounds decreased. Throughout treatment Cortisol remained a little but significantly increased, whereas DHEA levels reached the values seen in HCo, collectively resulting in a restored Cortisol/DHEA ratio. While the clinical improvement resulting from antituberculosis treatment coincided with a decreased inflammatory pattern, the activity of hipothalamous-pituitary-adrenal axis remained somewhat disturbed.