Abstract

Multi-drug resistant tuberculosis (MDR TB) is a significant health problem in some parts of the world. Three major cytokines involved in TB immunopathogenesis include IL-2, IL-4 and IL-10. The susceptibility to MDR TB may be genetically determined. The aim of the study was to assess the association of IL-2, IL-4, IL-10 gene polymorphisms with multi-drug resistant tuberculosis (MDR TB) in Ukrainian population. We observed 140 patients suffering from infiltrative pulmonary tuberculosis (PT) and 30 apparently healthy subjects. The patients were assigned to two groups whether they suffer or do not suffer from pulmonary MDR TB. Interleukin gene (IL) polymorphisms, particularly T330G polymorphism in the IL-2 gene, C589T polymorphism in the IL-4 gene and G1082A polymorphism in the IL-10 gene were studied through polymerase chain reaction. Circulating levels of IL-2, IL-4 and IL-10 in venous blood were estimated using ELISA. Prior to treatment, patients with PT showed significant increase of IL-2 levels and decrease of IL-4 and IL-10 levels compared to apparently healthy subjects. Circulating IL-4 and IL-10 levels were significantly decreased whilst serum IL-2 level was significantly increased in patients with MDR TB compared to non-MDR TB. Low IL-4 and IL-10 secretion and considerable IL-2 alterations were shown to be significantly associated with mutations of homozygous and heterozygous genotypes affecting C589T polymorphism in the IL-4 gene, G1082A polymorphism in the IL-10 gene and T330G polymorphism in the IL-2 gene in patients with PT. Heterozygous genotype and mutations homozygous genotypes gene in polymorphisms determining specified cytokines' production is a PT risk factor and may lead to disease progression into chronic phase. Heterozygous genotype of aforementioned cytokine genetic polymorphisms was significantly the most frequent in patients with MDR TB.

Highlights

  • Multi-drug resistant tuberculosis (MDR TB) is a significant health problem in some parts of the world

  • Serum Interleukin gene (IL)-2 level significantly decreased in patients with pulmonary TB following two months of routine treatment compared to IL-2 level prior to treatment

  • Estimation of relative risk of pulmonary TB development has revealed that carriers of homozygous (GG) or heterozygous (TG) genotypes of T330G polymorphism in the IL-2 gene (RR = 1.87, [1.32; 2.64], p < 0.05) are at 1.87 times higher risk to develop the disease than carriers of homozygous genotype (TT) (Table 2)

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Summary

Introduction

Multi-drug resistant tuberculosis (MDR TB) is a significant health problem in some parts of the world. The aim of the study was to assess the association of IL-2, IL-4, IL-10 gene polymorphisms with multi-drug resistant tuberculosis (MDR TB) in Ukrainian population. Heterozygous genotype of aforementioned cytokine genetic polymorphisms was significantly the most frequent in patients with MDR TB. There is a growing number of strains that are resistant to one or more anti-TB drugs constituting the main cause for decreasing efficiency of chemotherapy, increasing number of patients with destructive forms, increasing frequency of significant residual post-tuberculosis alterations and increasing incidence of TB relapses. Association of interleukins genes polymorphisms with multi-drug resistant tuberculosis may occur [4, 5]. TB incidence associated with multi-drug resistance grows year by year [6]

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