Queiroz Maria Alice Freitas, Lima Sandra Souza, Amoras Ednelza da Silva Graça, Sousa Francisca Dayse Martins de, Souza Iury de Paula, Nunes Juliana Abreu Lima, Brasil-Costa Igor, Cayres-Vallinoto Izaura Maria Vieira, Ishak Ricardo, Vallinoto Antonio Carlos Rosário
Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (UFPA), Belem 66075-110, Brazil.
Graduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará (UFPA), Belem 66075-110, Brazil.
Microorganisms. 2022 Oct 20;10(10):2075. doi: 10.3390/microorganisms10102075.
Several factors are associated with the development of different clinical forms of tuberculosis (TB). The present study evaluated epidemiological variables and cytokine levels in samples from 89 patients with TB (75 with pulmonary TB and 14 with extrapulmonary TB) and 45 controls. Cytokines were measured by flow cytometry (Human Th1/Th2/Th17 Cytometric Bead Array kit). The TB group had a higher frequency of individuals who were 39 years of age or older, married, with primary education or illiterate and had a lower family income (p < 0.05). All individuals with extrapulmonary TB reported that they were not working, and the main reasons were related to disease symptoms or treatment. The levels of IFN-γ (OR = 4.06) and IL-4 (OR = 2.62) were more likely to be elevated in the TB group (p = 0.05), and IFN-γ levels were lower in patients with extrapulmonary TB compared to those with pulmonary TB (OR = 0.11; p = 0.0050). The ROC curve was applied to investigate the diagnostic accuracy of IFN-γ levels between the different clinical forms of tuberculosis, resulting in high AUC (0.8661; p < 0.0001), sensitivity (93.85%) and specificity median (65.90%), suggesting that IFN-γ levels are useful to differentiate pulmonary TB from extrapulmonary TB. The dysregulation of pro- and anti-inflammatory cytokine levels represent a risk for the development of TB and contribute to the pathogenesis of the disease, especially variation in IFN-γ levels, which may determine protection or risk for extrapulmonary TB.
多种因素与不同临床类型的结核病（TB）的发生发展相关。本研究评估了89例结核病患者（75例肺结核患者和14例肺外结核患者）及45例对照样本中的流行病学变量和细胞因子水平。通过流式细胞术（人Th1/Th2/Th17细胞计数微球阵列试剂盒）检测细胞因子。结核病组中39岁及以上、已婚、接受过小学教育或文盲且家庭收入较低的个体频率更高（p<0.05）。所有肺外结核患者均表示未工作，主要原因与疾病症状或治疗有关。结核病组中IFN-γ（OR=4.06）和IL-4（OR=2.62）水平更可能升高（p=0.05），与肺结核患者相比，肺外结核患者的IFN-γ水平较低（OR=0.11；p=0.0050）。应用ROC曲线研究不同临床类型结核病之间IFN-γ水平的诊断准确性，结果显示AUC较高（0.8661；p<0.0001）、敏感性（93.85%）和特异性中位数（65.90%），表明IFN-γ水平有助于区分肺结核和肺外结核。促炎和抗炎细胞因子水平的失调是结核病发生发展的一个风险因素，并有助于疾病的发病机制，尤其是IFN-γ水平的变化，这可能决定肺外结核的易感性或患病风险。
