Association of Chest Radiography Pattern with Interleukin-4, Interferon Gamma and Antigen 60 Immunoglobulin G in Pulmonary Tuberculosis

Abstract

Background: This study aimed to investigate the differences in chest radiography lesions of pulmonary tuberculosis patients in relation to changes of circulating cytokines and antibody response. Methods: Thirty healthy controls and 49 tuberculosis patients who had a positive sputum culture for Mycobacterium tuberculosis were recruited into the study. Plasma samples were obtained within 2 weeks of beginning treatment. The plasma levels of antigen 60 immunoglobulin G (A60 IgG), interfero-gamma (IFN-γ) and interleukin-4 (IL-4) were measured utilizing enzyme-linked immunosorbent assay (ELISA) kits. The cytokine level was shown as pg/ml, and the A60 IgG level was shown as units. Results: No differences in plasma IL-4 were found between the healthy controls and tuberculosis patients. The tuberculosis patients experienced higher levels of plasma IFN-γ than the healthy controls. Plasma IL-4 and IFN-γ levels were not associated with chest radiography lesions. Plasma A60 IgG was significantly higher in the tuberculosis patients than the healthy controls. The A60 IgG level in the tuberculosis patients with an extensively affected parenchyma was significantly higher than in those with a limitedly affected parenchyma. Conclusion: The IFN-γ level was elevated in patients with active pulmonary tuberculosis. No significant change in IL-4 levels in tuberculosis patients was found. This suggests that the cellular immune response is critical in tuberculosis infection. The cellular or humoral immune response does not characterize tuberculosis patients with different lesions in the chest radiography. The A60 IgG level was higher in patients with extensive disease, and there was no association with cavity involvement. More antibody production accompanied with tuberculosis infection characterizes extensive disease.