The neuro-endocrine-immune relation in pulmonary and pleural tuberculosis. A Better local profile in pleural fluid

D'ATTILIO LUCIANO DAVID,; DÍAZ ARIANA; FERNÁNDEZ, ROCÍO DEL VALLE; BONGIOVANNI BETTINA; SANTUCCI NATALIA; DÍDOLI GRISELDA; LIOI SUSANA; GARDEÑEZ, WALTER; NANNINI, LUIS J.; DEL REY ADRIANA; BESEDOSKI HUGO,; BOTTASSO OSCAR; BAY MARÍA 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

Antecedents: Tuberculosis (TB) is a major health problem worldwide. The immune and the central nervous systems modulate each other. Two main components of this network are the hypothalamic-pituitary-adrenal axis (HPA) and autonomic nervous system (ANS). Aims: To elucidate the neuro-endocrine-immune (NEI) interactions encompassing pulmonary (PTB) or pleural (PLTB) TB, we analyzed 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 (HCo-n=32); and in pleural fluid (F) from PLTB. Transcript expression for glucocorticoid-related function genes (qRT-PCR) was also analyzed in mononuclear cells from the peripheral (PBMC) or pleural (PEMC) compartments.Results: Both patient groups had increased plasma amounts of pro- and anti-inflammatory cytokines, cortisol, growth hormone (GH) and dopamine, whereas IGF-1 and dehydroepiandrosterone were decreased. F contained increased levels of pro-inflammatory cytokines, GH and IGF-1 and decreased steroid hormones respect to plasma counterparts. PBMC from PTB had augmented transcripts for 11β-Hydroxysteroid Dehydrogenase (11βHSD1) and a decreased glucocorticoid receptor (GR) ratio (GRα/GRβ). In PLTB cases, 11βHSD1 and GRα transcripts were higher in PEMC. Conclusion: PTB patients seem to display an adverse NEI dysregulation. Changes in pleural fluid are compatible with a more effective NEI reaction.