Cytokine profile in children with newly diagnosed tuberculosis

Abstract

Nowadays, the most important task of children's phthisiology is to increase the effectiveness of children with tuberculosis treatment, and in the first priority should be given to the first time diagnosed tuberculosis (FTDTB). Examination of the immune system state by cytokine profile in blood serum studying is paid to sufficient attention, as cytokines are the system which regulates the entire complex of organism protective reactions, and immunological dysregulation is the cause of pathological process increasing. There few data of the cytokine profile state studying in children with FTDTB inUkraine in the available literature and various combinations of cytokines comprehensively with other immunological parameters are studied. According to our studies of the blood serum cytokine profile state in adult patients with tuberculosis, the reliable indices of immune system changes are interleukin (IL)-2, IL-6, IL-4 and IL-10. The aim of the work is to study the indicators of blood serum cytokine profile (IL-2, IL-6, IL-4, IL-10) in children with FTDTB. Materials and methods. The study of the cytokine profile indicators has been performed in 28 children with FTDTB, aged from 1 to 16 years old (an average age was 9.2 ± 1.1 years). The indicators of the cytokine profile were studied by researching the levels of IL-2, IL-6, IL-4, IL-10 in blood serum by ELISA technique on the equipment of Sirio S immuno-enzyme reader using “Bender MedSystems GmbH” (Austria) kit (pkg/ml). These indicators were evaluated at the beginning of antimycobacterial therapy intensive phase. Results . Despite the fact that according to the data from BCG vaccination, 42.8 % of children suffering from FTDTB had full immunity, the changes of cytokine profile indicators at the beginning of the disease were determined in 96.4 % of cases. The peculiarities of cytokine profile changes in sick children were a significant decrease in the content of anti-inflammatory cytokine IL-4, increase in the content of proinflammatory cytokine IL-2 and decrease in the content of IL-6. With a decrease in immunity to tuberculosis infection created by BCG vaccine, a significant increase in IL-2 level in blood serum was determined. Conclusions . The obtained data indicate that activation of Th1-type cell-mediated immune response (increase in IL-2 content and imbalance of cytokines with the prevalence of its production) is determined in children with FTDTB at the beginning of treatment, and the specific process does not have an active inflammatory reaction which is the cause of its progression (low content of IL-6). Therefore, in this category of children the factors of tuberculosis favorable course are determined at the beginning of treatment.