The adrenal steroid response during tuberculosis and its effects on the mycobacterial-driven IFN-gamma production of patients and their household contacts

BOZZA VERÓNICA V,; D'ATTILIO LUCIANO DAVID,; DÍDOLI GRISELDA,; SANTUCCI NATALIA; NANNINI LUIS; BOGUE CRISTINA,; DEL REY ADRIANA,; BESEDOSKI HUGO,; BAY MARÍA LUISA,; BOTTASSO OSCAR,

ANNALS OF THE NEW YORK ACADEMY OF SCIENCES.

New York academys of Science

Lugar: New York ; Año: 2009 vol. 1153 p. 247 - 255

0077-8923

ABSTRACT: Earlier studies revealed that patients with tuberculosis (TB) haveimbalanced immuno-endocrine responses and that adrenal steroids (cortisol anddehydroepiandrosterone –DHEA-) can modify their specific cell-mediated immuneresponse. Since most household contacts (HHCs) of contagious TB patients develop asub-clinical and self-controlled process (latent tuberculosis), we studied some featuresof their immune and endocrine responses, particularly those related to the hypothalamicpituitary-adrenal (HPA) axis. Nineteen HHCs, 24 untreated TB patients (15 moderate, 9advanced) and 18 healthy controls (Co) of similar age were studied. Patients hadincreased and reduced levels of cortisol and DHEA, respectively. DHEA levels werealso reduced in HHCs. Stimulation of peripheral blood mononuclear cells (PBMC) withM. tuberculosis sonicate resulted in increased in vitro lymphoproliferation in HHCs,while advanced patients showed the lowest response. Significantly higher amounts ofIFN-γ were detected in supernatants from stimulated PBMC of HHCs when comparedto Co and TB patients. Addition of cortisol to the cultures inhibited mycobacterialantigen-driven IFN-g production in all groups, although HHCs supernatants containedsignificantly higher concentrations. In contrast, addition of DHEA to cultures of cellsfrom HHCs resulted in increased IFN-g levels. These results suggest the existence of aparticular immuno-endocrine relation assuring a preserved IFN-g production in healthyhousemates of TB patients.