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.