Title: Study of Inflammatory Markers in Sputum Positive Patients of Pulmonary Tuberculosis and its Response to Anti-tubercular Treatment
Authors: Mohd Yousoof Dar, B K Menon, Sarfaraz Jamal
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.113
Abstract
Studies have shown that active tuberculosis is associated with elevated systemic inflammatory markers like ESR, CRP, IL-6, SAA, TNF-a, IFN-γ and many others. We aim to evaluate the serum levels of serum CRP and IFN-γ in active pulmonary tuberculosis (APTB) and the possible effects of ATT treatment on these cytokine levels. A total of 54 patients with the diagnosis of APTB and 20 healthy volunteers as controls were taken for study. The study showed that patients of APTB have significantly elevated baseline levels of serum CRP levels (mean+SD) of 21.71± 6.37mg/dl and serum IFN-γ (mean+SD) of 41.47±43.25 pg/ml compared to controls with serum CRP levels of < 5mg/dl and serum IFN-γ of 1.81±1.6pg/ml pg/ml respectively. Both serum CRP and serum IFN-γ levels decreased significantly with duration of treatment with CRP levels of 7.7±4.23 mg/dl at 2 months vs 2.41±1.5mg/dl at end 6 months and serum IFN-γ of 12.53±8.33 pg/ml at 2 months and 2.47±1.55 pg/ml at end of 6 months of ATT respectively with a statistically significant of p value < 0.00. Sputum IFN-γ levels were also elevated in cases with baseline values of 24.92±16.53 pg/ml which decreased to 7.68±5.17 pg/ml after 2 months and further to 3.86±3.12 pg/ml at end of 6 months of ATT respectively with a statistically significant of p value < 0.00.
In conclusion, our observations reveal that patients with APTB have significantly elevated serum CRP and IFN-γlevels compared to normal healthy individuals and these levels decrease significantly with duration of treatment. Therefore serum CRP and IFN-γlevels may be useful adjuvant markers in cases of APTB to monitoring response to treatment besides clinical and radiological feature who cannot produce adequate sputum in follow up.
Keywords: APTB: active pulmonary tuberculosis, ATT: anti-tubercular treatment, CRP: C-reactive protein, IFN-γ: Interferon gamma.
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