Tumor necrosis factor-, Interleukin-10, and oxidant/ antioxidant status in patients with pulmonary tuberculosis: Effect therapy, a follow up study

Abstract

To evaluate the oxidant / antioxidant status (represented by serum malondialdehyde"MDA"and total antioxidant status "TAS") at diagnosis and then at two-weeks intervals during the first two months intensive therapy, with the levels of tumors necrosis factor-ï¡ (TNF- ï¡) and interleukin-10 (IL-10) before starting therapy and by the end of the 2 months therapy in newly diagnosed patients with pulmonary tuberculosis (PTB) in comparison to healthy controls. Out of 52 patients interviewed and examined, only 46 patients with active PTB consented to participate in this study. Initially blood sample was taken and assay of serum MDA, TAS, TNF-ï¡ and IL-10 was done. Then patients were put on intensive 2 months therapy as 4 tablets of Rimstar ® ( a fixed dose tablets containing isoniazid, rifampicin , pyrazinamide and ethambutol) daily. During therapy and at 2 weeks intervals, blood samples were taken and assay of serum MDA and TAS were done till the end of suggested period of the study, where assay of TNF-ï¡ and IL-10 also have been done. Included in this study also 46 healthy, non-smoker, age and sexmatched volunteers as a control group for the initial laboratory results of MDA, TAS, TNF-ï¡ and IL-10. For both patients and controls, calculation of the body mass index (BMI) was done using especial equation. There was a significant increase in the serum levels of MDA, TNF-ï¡ and IL-10, with a significant decrease in the TAS in patients with PTB in the pre-therapy stage in comparison to healthy controls. During therapy, there was a gradual increase in TAS and a gradual decrease in MDA at the 2 weeks intervals till the end of the intensive. 2-months therapy. By the end of suggested period of the study, there was a significant reduction in the serum level of MDA, TNF-ï¡ and IL-10 with a significant increase in TAS levels, in comparison to the pre-therapy stage. Acute PTB was associated with an oxidative stress and changes in some cytokines levels and the initial 2 months intensive therapy was associated with a reduction in oxidative stress (as reflected by reduction in MDA and an increase in TAS levels) and reverse the changes in TNF-ï¡ and IL-10 levels induced by the disease.