Abstract
Background: Intestinal tuberculosis (ITB) have significant immunological similarity with Crohn’s disease (CD). T helper cells and various cytokines secreted by them play a very crucial role in the pathogenesis of both the diseases. It is of great clinical relevance in a country like India to perform a comparative study between CD and ITB with respect to pathogenesis.
 Objectives: To study the levels of four cytokines(IL-4,IL-17, IFN-ϒ & TGF-β1 ) s in serum of patients with CD & ITB which indirectly reflects the levels of CD4+ T cells.
 Material and method: An observational, cross-sectional study was done on patients, attending Gastroenterolory clinic in a tertiary care hospital, with features of ileitis, colitis or ileo-colitis due to CD or ITB.12 cases of Crohn’s disease & 13 cases of intestinal tuberculosis were taken( control-20 cases). 5 biopsies were taken from the ulcerated mucosa & 3 biopsies were taken from normal mucosa. H & E study & serum levels of four cytokines(IL-4,IL-17, IFN-ϒ & TGF-β1 ) were estimated.
 Results & analysis: In CD & ITB we found marginal increase of IFN-ϒ & TGF-β1 compared to control. IL17 level was found decreased in ITB compared to control (p=0.001).CD4+ T cells study by ELISA also showed significant increase in the concentration of IFN-γ (p=0.007) in ITB. There was no change in IL4 levels.
 Conclusion: Cytokines have an important role in the pathogenesis of grannulomatuos inflammatory bowel diseases. The identification of cytokines & their role in the pathogenesis might be helpful for future therapy based on cytokines, and anti-cytokine antibodies.
 Bangladesh Journal of Medical Science Vol.20(4) 2021 p.784-789
Highlights
Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis
Mean values of various cytokines in Crohn’s disease (CD) were 1.529167,0,9.57,8.696 for IFN-γ, Interleukin 4 (IL-4), IL-17 & TGF-β1 respectively
Table[3].Levels of various cytokines in serum obtained by ELISA in control group
Summary
Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. The primary site of infection is lung, other sites like intestine, meninges, bones, lymph nodes can get affected .The gastrointestinal tract is, the most susceptible tissue to inflammatory responses even in normal conditions, because of its constant exposure to various bacterial antigens and antigens in food and toxic factors. The inflammatory bowel disease (IBD) entity includes predominantly two forms: Crohn’s Disease (CD)& Ulcerative Colitis (UC). Though pathogenesis of this group of diseases is not fully. T helper cells and various cytokines secreted by them play a very crucial role in the pathogenesis of both the diseases. It is of great clinical relevance in a country like India to perform a comparative study between CD and ITB with respect to pathogenesis. The identification of cytokines & their role in the pathogenesis might be helpful for future therapy based on cytokines, and anti-cytokine antibodies
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