Abstract
Background: Macrophages, as the first defense mechanism in Mycobacterium tuberculosis infection, play the important role in pulmonary TB pathogenesis. The increasing prevalence of pulmonary TB is followed by the increasing prevalence of diabetes mellitus (DM). DM patients have 4,7 times higher risk to develop pulmonary TB compared to patients without DM, since DM can increase the frequency and severity of an infection, including pulmonary TB.Aim: To analyze macrophage activity (phagocytosis, intracellular killing, and IFN-γsynthesis) of TBDM and TB non-DM patient.Method: This experimental study used a PBMC cultured sample from TB-DM and TB non-DM patient’s which undergo observation of macrophage activity (phagocytic, intracellular killing and IFN-γsynthesis). The data were taken from microscopic observation of TB-DM and TB non-DM patients, colony growth of viable M. tuberculosis and the IFN-γlevel secreted by macrophages.Result: The result showed that macrophages of TB-DM patient’s were less amount of phagocytosedM. tuberculosis, a little amount of formed vacuoles and giant cells, secrete low level of IFN-γ, and more viable M. tuberculosis(from subculture).Conclusions: Macrophages of TB-DM patients are reduced phagocytic activity toward M. tuberculosis which is this macrophages are less activated.Bangladesh Journal of Medical Science Vol.17(1) 2018 p.107-111
Highlights
TB-diabetes mellitus (DM) is a significant health problem in Indonesia
The study results showed that the mononuclear cells in the buffy coat layer from the peripheral blood of the TB-DM patients consists of monocytes and lymphocytes
Monocytes of TB-DM patients which have matured into macrophages within 7 days were co-cultured with M. tuberculosis
Summary
TB-DM is a significant health problem in Indonesia. This two diseases exacerbate clinical manifestastions and affect treatment outcomes of one another. Indonesia rank 4th worldwide for its high number of TB patients 1,2,3 World Health Organization expects that TB control will become more difficult with the increasing number of diabetes mellitus (DM) patients, due to DM is one of the risk factors for TB deterioration. DM patients have 4,7 times higher risk to develop pulmonary TB.[4] This is due to the treatment of MDRDM cases,which one of its aim is to restore the function of the immune system, i.e. immunostimulant.[7] Less activated alveolar macrophage of pulmonary TB patients with DM reduces the interaction between T lymphocyte and macrophage, resulting in defect of M. tuberculosis elimination. Aim: To analyze macrophage activity (phagocytosis, intracellular killing, and IFN-γsynthesis) of TBDM and TB non-DM patient. Method: This experimental study used a PBMC cultured sample from TB-DM and TB non-DM patient’s which undergo observation of macrophage activity (phagocytic, intracellular killing and IFN-γsynthesis). Conclusions: Macrophages of TB-DM patients are reduced phagocytic activity toward M. tuberculosis which is this macrophages are less activated
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