Increased Cytokines Response in Patients with Tuberculosis Complicated with Chronic Obstructive Pulmonary Disease

Shenjie Tang,Yun Shen,Xiaohui Hao,Haiyan Cui,Lan Yao,Jian An Huang,Zhanjun Zhang,Hua Sun,Lin Fan,Emma H Wilson

doi:10.1371/journal.pone.0062385

Abstract

ObjectivesTo explore the change and its significance of cytokines in patients with pulmonary tuberculosis complicated with COPD.MethodsThe immune function of 152 cases of pulmonary tuberculosis with COPD was detected to compare with 150 cases of patients with pulmonary tuberculosis, 157 cases of patients with COPD and 50 cases of healthy volunteers who were in the hospital during the same period. T lymphocyte cell population in peripheral blood was detected by flow cytometry. The serum levels of sIL-2R, IL-6, IFN-γ, TNF-α were measured using ELISA.ResultsThe percentage of CD4+ T cells in TB patients with or without COPD and COPD patients without TB was significantly lower than that in control group. The percentage of CD4+ T cells in patients with TB and COPD was significantly lower than that in the non-COPD TB patients. The percentage of CD8+ T cells was higher in the TB patients group than that in control group. The CD4+/CD8+ ratio in the TB patients group was significantly lower than that in control group. The concentrations of sIL-2R, IL-6, TNF-α, IFN-γ in TB patients with or without COPD and COPD patients without TB were significantly higher than those in control group. In addition, sIL-2R, IL-6, TNF-α concentrations in the patients with TB and COPD were higher than those in the non-COPD TB patients. The concentrations of sIL-2R, IL-6, TNF-α, IFN-γ in COPD patients with TB were significantly higher than those in COPD patients without TB. There was a significant negative correlation between serum levels of TNF-α, IL-6 and FEV1 (%, predicted) in COPD without TB group.ConclusionsThe patients with pulmonary tuberculosis complicated with COPD were impaired in cellular immunity, and its extent of immune impairment is more serious than those of the patients with pulmonary tuberculosis and the patients with COPD.

Highlights

In recent years, pulmonary tuberculosis (TB) has begun to rebound quickly worldwide, especially in developing countries
The study population consisted of 152 TB with Chronic Obstructive Pulmonary Disease (COPD) patients, 150 TB without COPD patients, 157 COPD without TB and 50 healthy volunteers
The percentage of CD8+ T cells was higher in the TB patients group than that in control group (P = 0.000)

Summary

Introduction

Pulmonary tuberculosis (TB) has begun to rebound quickly worldwide, especially in developing countries. China is one of the world’s 22 countries with the highest burden of TB [1]. The prevalence of Chronic Obstructive Pulmonary Disease (COPD) is increasing worldwide. It is estimated that COPD will become the third-leading cause of death by 2020 [2]. Previous studies have shown that COPD is a frequent comorbid condition in TB patients. Different studies show that COPD is the one of independent risk factors for death in TB patients [3] and associated with drug-resistant TB [4].These results have raised concern that the increasing global burden of COPD will further enhance the incidence of active TB especially in settings with high burden of TB

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