The clinical recovery of tuberculosis patients undergoing specific treatment is associated with changes in the immune and neuroendocrine responses.

Abstract Tuberculosis (TB) caused by Mycobacterium tuberculosis is a health problem worldwide. Patients with pulmonary TB show a neuro-immune-endocrine imbalance characterized by an impaired cellular immunity together with increased plasma levels of cortisol, pro- and anti-inflammatory cytokines and markedly decreased dehydroepiandrosterone (DHEA) levels. Extending these findings, we now investigated the immune-endocrine profile of TB patients undergoing specific treatment. Patients (n = 24) were bled at diagnosis (T0), 2, 4, 6 months after treatment initiation and 3 months following its completion. At T0, TB patients showed increased plasma levels of interleukin-6 (IL-6), C reactive protein, interferon-gamma (IFN-γ) and transforming growth factor beta (TGF-β). These mediators decreased during treatment, reaching levels similar to those from healthy controls (n = 26). Specific treatment led to an increased lymphoproliferative response along with clinical improvement. Newly diagnosed patients had low levels of DHEA, with increased cortisol amounts and cortisol/DHEA ratio, which normalized upon specific treatment. As regards glucocorticoid receptors (GR), TB patients at diagnosis presented a reduced mRNA GRα/GRβ ratio in their peripheral blood mononuclear cells. Furthermore, multivariate analysis showed that cortisol/DHEA ratio was positively associated with inflammatory mediators for which this ratio may constitute a disease biomarker. Anti-mycobacterial treatment results in a better immune-endocrine scenario for the control of physiopathological processes accompanying disease development and hence implied in clinical recovery.

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DHEA Cortisol Díaz A1, Bongiovanni B1, D'Attilio L1, Santucci N1, Dídoli G1, Fernández RDV1, Kovalevski L2, Lioi S3, Gardeñez W4, Brandan N5, Nannini LJ5, Besedovsky H6, Del Rey A6, Bottasso O1, Bay ML1.

Author Information

1. Instituto de Inmunología Clínica y Experimental de Rosario, UNR-CONICET, 2000 Rosario, Santa Fe, Argentina.
2. Facultad de Ciencias Económicas y Estadística, UNR, Escuela de Estadística, 2000 Rosario, Santa Fe, Argentina.
3. Laboratorio Central Rosario, Hospital Provincial del Centenario, 2000 Rosario, Santa Fe, Argentina.
4. Servicio de Neumonología, Hospital Provincial del Centenario, 2000 Rosario, Santa Fe, Argentina.
5. Servicio de Neumonología, Hospital Escuela Eva Perón, 2152 Granadero Baigorria, Santa Fe, Argentina.
6. Institute of Physiology and Pathophysiology, Philipps University, Faculty of Medicine, 35037 Marburg, Germany.
Pathog Dis. 2017 Sep 29;75(7). doi: 10.1093/femspd/ftx087.
© FEMS 2017. All rights reserved.
Link: https://www.ncbi.nlm.nih.gov/pubmed/28854691

by Oleg Vishnevski | Sep 29, 2017