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Pro-Asthma Inflammatory Components In Pulmonary Tuberculosis

1El-Desouki E. Fouda, 2Hamdy M. Zoair, 1Alaa EL-Din M. Nafie

1Department of Internal Medicine & Al-Azhar University Center for Immunology & Allergic Diseases and 2Department of chest diseases Al-Azhar University, Cairo, Egypt.

Some tuberculous patients may develop signs and symptoms of bronchial asthma, following initiation or completion of anti-tuberculous chemotherapy. On the other hand, some studies indicate the downregulation of the atopic state following tuberculous or viral infection. The present study was undertaken to investigate the immune modulation produced by mycobacterium. TB infection which my contribute to the development of bronchial asthma. To accomplish this aim we studied pro-allergic inflammatory components including IgE, IL-4 and IL-13 levels in serum and broncho alveolar lavage (BAL) in patients suffering from pulmonary TB with and without bronchial asthma to show the relation between these components and the degree of TB lesions. The study has demonstrated high levels of circulating IgE, IL-4 and IL-13 in pulmonary TB patients, with or without asthma association, as compared with a control group of healthy individuals. BAL IL-4 and IL-13 levels in patients associated with asthma were higher than serum levels. Also, IL-4 levels in the serum and in the BAL as well as total serum IgE, were significantly higher in advanced than mild and moderate TB lesions. These findings indicate that TB infection may exacerbate allergic disorders including bronchial asthma and suggesting that the more severe the disease becomes, the higher the levels of serum IL-4, IL-13 and IgE.