Serum cytokine TNF-α, IL-4, sIL-2R and IFN-γ progress in monitoring bacterial load and anti-tuberculosis treatment

doi:10.19982/j.issn.1000-6621.20220167

Abstract

Abstract:

Objective:To explore the predictive value of serum cytokines TNF-α, IL-4, sIL-2R and IFN-γ for antituberculosis treatment in patients with pulmonary tuberculosis. Methods:By a prospective cohort study method, 67 patients diagnosed active pulmonary tuberculosis admitted to Beijing Chest Hospital Affiliated to Capital Medical University from December 2017 to June 2019 were enrolled according to the enrollment criteria. Serum cytokine levels of TNF-α, IL-4, sIL-2R and IFN-γ were measured by enzyme-linked immunosorbent assay (ELISA) from patients before treatment, 1-2 months and 6 months after treatment. ROC curve analysis was performed to determine the best cut-off value, and treatment progress were predicted with this as the cut-off value. Results:The levels of SIL-2R (14.1 (11.2,19.1) pg/ml) after 1-2 months of treatment, TNF-α (686.6 (226.9,1030.5) pg/ml) after 6 months of treatment, IFN-γ (357.0 (273.4,431.0) pg/ml) after 1-2 months of treatment were significantly lower than that before treatment (16.7 (12.9, 23.9), 848.3 (345.2, 1201.6), 490.0 (303.6,607.9) pg/ml, respectively), with the statistically difference (χ²=15.276, P=0.036; χ²=33.421, P=0.002; χ²=31.111, P=0.000). ROC analysis showed that when serum TNF-α at 845.2 pg/ml and IFN-γ at 393.3 pg/ml,the AUC of therapeutic effectiveness were 0.594 (P=0.013) and 0.651 (P=0.017). With the best cut-off value as the reference standard, serum IFN-γ and TNF-α level above the cut-off value before treatment were 43 cases (64.2%) and 34 cases (50.7%), respectively. In 1-2 months after treatment, 14 cases (20.9%) were positive with the serum IFN-γ significantly lower than that before treatment (χ²=34.634, P=0.000). In 6 months after treatment, 19 cases (28.4%) were positive with the serum TNF-α significantly lower than that before treatment (χ²=53.181, P=0.013). Conclusion:Both serum TNF-α and IFN-γ levels might be useful biomarkers for monitoring treatment progress.

Key words: Tuberculosis, Cytokines, Biological assay, Treatment outcome

CLC Number:

R393.7
R52

Nie Wenjuan, Shi Wenhui, Liu Peiying, Yang Yang, Wang Jun, Wang Qingfeng, Chu Naihui. Serum cytokine TNF-α, IL-4, sIL-2R and IFN-γ progress in monitoring bacterial load and anti-tuberculosis treatment[J]. Chinese Journal of Antituberculosis, 2022, 44(10): 1022-1027. doi: 10.19982/j.issn.1000-6621.20220167

Figures/Tables 3

References 27

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治疗阶段	TNF-α	IL-4	sIL-2R	IFN-γ
治疗前	848.3(345.2,1201.6)	589.7(398.8,675.6)	16.7(12.9,23.9)	490.0(303.6,607.9)
治疗1~2个月	460.1(189.7,891.2)	502.8(365.9,638.3)	14.1(11.2,19.1)^a	357.0(273.4,431.0)^a
治疗6个月	686.6(226.9,1030.5)^a	530.4(344.2,648.4)	16.8(11.2,21.0)	419.0(252.2,511.1)

细胞因子	界值 (pg/ml)	治疗前		治疗1~2个月		治疗6个月		χ²值	P值
细胞因子	界值 (pg/ml)	阳性例数	阳性率(%)	阳性例数	阳性率(%)	阳性例数	阳性率(%)	χ²值	P值
TNF-α	845.2	34	50.7	-	-	19	28.4	53.181	0.013
sIL-2R	15.0	41	61.2	34	50.7	-	-	19.400	0.296
IFN-γ	393.3	43	64.2	14	20.9	-	-	34.634	0.000