PURPOSE: It has been long recognized that T Lymphocytes are essential in the immunity against tuberculosis. This study aimed to evaluate serum levels of interleukin-2 receptors in patients with active pulmonary tuberculosis and their levels change following antituberculosis chemotherapy.
METHODS: Twenty five patients with newly diagnosed active pulmonary tuberculosis and fifteen adult healthy control subjects had participated in this study. Plain X-ray chest, postero-anterior and lateral views (at diagnosis and after two months of start of treatment); tuberculin skin testing (by Mantoux Method); sputum for acidfast bacilli by Zeil Nelsen stain (at diagnosis and every month after start of treatment); and estimation of serum soluble interleukin-2 receptor levels (before, after 3 months and after 6 months of treatment start) were done to all subjects. All patients were treated with standard anti-tuberculosis drugs (INH-RIF-ETB-PZ).
RESULTS: Serum levels of interleukin-2 receptors (IL-2R, u/ml) were significantly higher in patients group with a statistically highly significant difference between patients (pretreatment; three and six months after treatment) and control subjects (p<0.05). Also,there was a highly significant difference in serum interleukin-2 receptor levels in patients at different periods of treatment (pretreatment, 3 and 6 months after treatment) (p<0.05). This difference was, also, directly proportional to the differences in ESR, total leucocytic count and lymphocytes.
CONCLUSION: The IL-2R serum levels were significantly higher in patients with active pulmonary tuberculosis and gradually decline with anti- tuberculosis chemotherapy, but does not return to the normal levels at the end of the treatment course. These high IL-2R levels were directly proportional to the disease severity.
CLINICAL IMPLICATIONS: Use of serum interleukin-2 receptors(s IL-2R) levels as an assistant test in the diagnosis of pulmonary tuberculosis especially smear-negative patients; diagnosis of extra-pulmonary tuberculosis; in assessment of severity of the disease; follow up of the disease; assessment of the efficacy of treatment with different regimens and development of drug resistance; diagnosis of reactivity of the disease and assessment of new drugs used in treatment of tuberculosis.
DISCLOSURE: Tawfik Elsaid, No Financial Disclosure Information; No Product/Research Disclosure Information