Study on the relationship between changes of immune cells and TNF-α in peripheral blood of patients with multidrug-resistant and extensively drug-resistant tuberculosis

T. Song, L.-J. Li, J.-L. Liu, S.-J. Geng

Ward 4, Department of Internal Medicine-Tuberculosis, The Chest Hospital of Hebei (Hebei Research Institute of Tuberculosis Control), Shijiazhuang, Hebei, China. twgd4495@163.com

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• Infectious Diseases

OBJECTIVE: To investigate the relationship between changes in CD4- and CD8-positive immune cells and TNF-α in the peripheral blood of patients affected by multidrug-resistant and extensively drug-resistant tuberculosis.

PATIENTS AND METHODS: 179 patients suffering from tuberculosis treated in the Chest Hospital of Hebei from April 2010 to December 2015 were selected for the study. There were 47 cases affected by drug-resistant tuberculosis and 132 cases affected by non-drug-resistant tuberculosis. The control group included 183 healthy subjects examined during the same period. ELISA was used to compare and analyze serum levels of TNF-α, CD4- and CD8-positive cell levels, and CD4/CD8 ratio in the two groups.

RESULTS: CD4- and CD8-positive cell count, CD4/CD8 ratio, and serum TNF-a were significantly higher in patients with drug-resistant tuberculosis compared with healthy controls and the non-drug-resistant tuberculosis patients (p < 0.05). There was a positive correlation between TNF-α level and CD4/CD8 ratio (r=0.892, p < 0.05). Before treatment, the differences in the levels of TNF-a in the different groups of drug-resistant patients were insignificant (p >0.05). After treatment, the levels of TNF-a in the different groups of drug-resistant patients were decreased, except for patients with extensively drug-resistant tuberculosis, whose levels were significantly decreased compared with before treatment (t = 0.648, p>0.05). The differences in the levels of TNF-α in the other groups of patients before and after treatment were statistically significant (t = 8.497, 6.258, 5.346, p < 0.05, fully sensitive tuberculosis single drug-resistant tuberculosis, multidrug-resistant tuberculosis, respectively).

CONCLUSIONS: The level of TNF-α plays a critical role in the evaluation of the severity of patients with drug-resistant tuberculosis and it has a clinical value.

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