Karyadi Elvina, Dolmans Wil M V, West Clive E, Van Crevel Reinout, Nelwan Ronald H H, Amin Zulkifli, Gross Rainer, Van der Ven-Jongekrijg Johanna, Van der Meer Jos W M
SEAMEO-TROPMED Regional Center for Community Nutrition, PO Box 3852, Jakarta 10037, Indonesia.
Asia Pac J Clin Nutr. 2007;16(2):218-26.
Although several studies have dealt with the patterns of cytokine production in tuberculosis, little is known about the association between nutrient deficiencies and cytokines in tuberculosis. The objective of this study was to assess the concentration of cytokines related to nutritional status during tuberculosis. In 41 untreated tuberculosis patients and matched healthy controls in an urban hospital in Indonesia, we measured: height and weight, parameters of iron, vitamin A and zinc; and cytokines concentrations in the circulation and production in whole blood cultures. Plasma interleukin-6 (IL-6) and interleukin-1 receptor antagonist (IL-1ra) were significantly higher in patients than in controls. Patients with cavities (n=26) had higher concentrations of IL-6 than patients without cavities (n=15). Body mass index <18.5 kg/m2 was associated with high concentrations of tumor necrosis factor-alpha (TNF-alpha) and IL-6. Anaemia was associated with high concentrations of IL-6 and IL-1ra. Zinc deficiency was associated with high LPS-stimulated production of TNF-alpha and IL-1ra. Marginal plasma retinol concentrations were associated with high concentrations of IL-6 after LPS stimulation. In conclusion, low concentrations of micronutrients in tuberculosis were associated with increased cytokine production. An intervention study would allow causality to be examined.
尽管已有多项研究探讨了结核病中细胞因子的产生模式，但对于营养缺乏与结核病中细胞因子之间的关联却知之甚少。本研究的目的是评估结核病期间与营养状况相关的细胞因子浓度。在印度尼西亚一家城市医院的41例未经治疗的结核病患者及匹配的健康对照中，我们测量了：身高和体重、铁、维生素A和锌的参数；以及循环中的细胞因子浓度和全血培养物中的细胞因子产生情况。患者血浆白细胞介素-6（IL-6）和白细胞介素-1受体拮抗剂（IL-1ra）显著高于对照组。有空洞的患者（n = 26）的IL-6浓度高于无空洞的患者（n = 15）。体重指数<18.5 kg/m²与高浓度的肿瘤坏死因子-α（TNF-α）和IL-6相关。贫血与高浓度的IL-6和IL-1ra相关。锌缺乏与脂多糖刺激后TNF-α和IL-1ra的高产生相关。边缘性血浆视黄醇浓度与脂多糖刺激后高浓度的IL-6相关。总之，结核病中微量营养素浓度低与细胞因子产生增加有关。一项干预研究将有助于检验因果关系。
