Cytokine profile and efficacy of chemotherapy depending on thyroid state in patients with pulmonary tuberculosis.
Objective of the study is definition of cytokine balance and the outcomes of chemotherapy of tuberculosis patients depending on their thyroid state. Materials and methods: 60 tuberculosis patients with pulmonary: 30 persons with unchanged thyroid gland and 30 persons with autoimmune thyroiditis and followed subclinical hypothyroidism were compared for the structure and the function of thyroid gland, cytokine balance and outcomes of antituberculosis chemotherapy. Thyroid glands of all patients were scanned by ultrasound. The levels of free thyroxine, thyroid stimulating hormone and antibodies to thyroglobulin and thyroid peroxidase in the serum were defined. At the same time the levels of tumor necrosis factor-α, interferon- γ and interleukins-2, -6, and -4 were measured. Outcomes of chemotherapy was estimated on the ground of general criterions: term and rate of stopping of bacilli excretion and healing of caverns in lungs. Results and discussion: In a comparative analysis of the data obtained, it was found that in tuberculosis patients with autoimmune thyroiditis and subclinical hypothyroidism compared with tuberculosis patients without thyroid pathology free thyroxine values in average decrease, the level of thyroid-stimulating hormone increases and levels of antibodies to both thyroglobulin and especially to thyroid peroxidase increase. In patients with concomitant autoimmune thyroiditis with subclinical thyroiditis, levels of pro-inflammation cytokines TNF-α, INF-γ, IL-2, IL-6 were significantly lower when compared with patients without thyroid pathology, and the level of anti-inflammation cytokine IL IL-4 was higher in a group of patients with autoimmune thyroiditis. Efficacy of chemotherapy was better in tuberculosis patients without thyroid pathology. These changes can be explained by a lower level of T4 in the systemic circulation of people with autoimmune thyroiditis and subclinical hypothyroidism. Conclusion: subclinical hypothyroidism accompanying concomitant autoimmune thyroiditis suppresses cytokine response in tuberculosis patients. That is followed worsening of treatment response during antituberculosis chemotherapy. Screening of thyroid state is recommended for TB patients for timely definition of thyroid pathology and its compensation if needed for improvement of the outcomes of antituberculosis chemotherapy.
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Frick LR, Rapanelli M, Bussman UA, Kleche AJ, et al. Involvement of thyroid hormones in the alterations of T-cell immunity and tumour progression. Biol. Psychiatry. 2009;65:935-42.
Baloch Z, Carayon P, Conte-Devolx B, Demers LM, Feldt-Rasmussen U, Henry JF, et al. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid. 2003;13:3-126.
Ladel CH, Blum C, Dreher A, et al Lethal tuberculosis in interleukin-6 deficient mutant mice. Infect Immunol. 1997;65:4843-49.
Perrotta C, Buldorini M, Assi E, et al The thyroid hormone triiodothyronine controls macrophage maturation and functions. Immunol. And Inf. Dis. 2014;184:230-47.
Lin HY, Thacore H, Davies FB, Mortino IJ, et al Potentiation by thyroxine of interferon-gamma-induced HLA-DR expression is protein kinase A- and C-dependent. J. Interferon Cytokine Res. 1996;16(1):17-24.
Hodkinson CF, Simpson EEA, Beattie JH, et al. Preliminary evidence of immune function modulation by thyroid hormones in healthy men and women aged 55-77 years. J. Endocrinol. 2009;202:55-63.
Franchimont P, Reuter A, Vrindts-Gevaert Y, Bastings M, Malaise M, Sondag C, Frere MC, Gysen P. Production of tumor necrosis factor-alpha, interferon-gamma and interleukin-2 by peripheral blood mononuclear cells of subjects suffering from rheumatoid arthritis. Scand J Rheumatol. 1988;17(3):203-12.
Reinfenberg K, Kopf M, Kaufmann SH. Lethal tuberculosis in interleukin-6-deficient mice. Infect Immunol. 1997;65:4843-49.
Verbon A, Suffermans N, Van Deventer SJH, Van Der Poll T. Serum concentration of cytokines in patients with active tuberculosis (TB) and after treatment. Clin Exp Immunol. 1999;115:110-13.
Shiratsuchi H, Johnson JL, Ellner JJ Bidirections effects of cytokines on the growth of M. avium within human monocytes. J.Immunol. 1999;146:3165-70.
Van Snick J Interleukin 6; an overview. Ann Rev Immunol. 1990;8:253-78.
Vallis RS, Ellner JJ. Cytokines and tuberculosis. J. Leuk Biol. 1994;55:676-81.
De Vito P, Incerpi S, Pedersen JZ, et al Thyroid hormones as modulators of immune activators at cellular level. Thyroid. 2011;21:879-90.
GOST Style Citations
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- Involvement of thyroid hormones in the alterations of T-cell immunity and tumour progression / L.R. Frick, M. Rapanelli, U.A. Bussman, A.J. Kleche [et al.] // Biological Psychiatry. – 2009. – Vol. 65. – P. 935-942.
- Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease / Z. Baloch, P. Carayon, B. Conte-Devolx [et al.] // Thyroid. – 2003. – Vol. 13. – P. 3-126.
- Ladel C.H. Lethal tuberculosis in interleukin-6 deficient mutant mice / C.H. Ladel, C. Blum, A. Dreher [et al.] // Infect. Immunol. – 1997. – Vol. 65. – P. 4843-4849.
- Perrotta C. The thyroid hormone triiodothyronine controls macrophage maturation and functions / C. Perrotta, M. Buldorini,E. Assi// Immunol. Infect. Diseases. – 2014 – Vol. 184. – P. 230-247.
- Potentiation by thyroxine of interferon-gamma-induced HLA-DR expression is protein kinase A- and C-dependent / H.Y. Lin, H. Thacore, F.B. Davies [et al.] // J. Interferon Cytokine Researches.- 1996.- Vol. 16, N 1.- P.17-24.
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- Production of tumor necrosis factor-alpha, interferon-gamma and interleukin-2 by peripheral blood mononuclear cells of subjects suffering from rheumatoid arthritis / P. Franchimont, A. Reuter, Y. Vrindts-Gevaert [et al.] // Scand. J. Rheumatology. – 1988. – Vol. 17, N 3. – P. 203-212.
- Reinfenberg K. Lethal tuberculosis in interleukin-6-deficient mice / K. Reinfenberg, M. Kopf, S. H. Kaufmann // Infect. Immunol. –1997. – Vol. 65. – P. 4843-4849.
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