1Mabrouk Ghonaim, 2Rawhia El-Edel and 3Ahmed Rabie El-Arbagy
Departments of 1Microbiology and Immunology, 2Clinical pathology and 3Internal Medicine Faculty of Medicine, Menoufiya University, Egypt.
Soluble interleukin-2 receptor alpha (sIL-2Ra) is
a marker of T lymphocyte activation, while neopterin is a marker for the
activation of the monocyte/ macrophage axis. In this study, serum levels of
sIL-2Ra and
neopterin were determined in patients with pulmonary TB to assess their
relation to the clinical, and laboratory parameters of disease activity and the
effect of treatment on their levels. The study included 44 patients with active
pulmonary TB, 6 patients with inactive disease and 20 controls. diagnosis was based on clinical,
radiological and laboratory assessment (including chest X-ray, ESR, C-reactive
protein (CRP), tuberculin testing and examination of sputum for tubercle
bacilli). sIL-2Ra and
neopterin were determined by enzyme immunoassay and radioimmunoassay
respectively. Results showed a significant (p< 0.001) elevation of sIL-2Ra
level in TB patients with active disease (1253 ± 492 pg/ml) as compared to controls (412 ± 173
pg/ml). The neopterin level was also higher in active TB patients (45.8 ± 17.1
nmol/L) than controls (5.2 ±
1.8 n mol/L). Patients with active disease showed significantly (p< 0.001)
higher levels of both sIL-2Ra
and neopterin as compared to those with inactive disease. Moreover, TB patients
with extensive lesions showed significantly (p< 0.001) higher levels
compared to those with localized lesions. On the other hand, there was no
significant difference between patients with cavitation or pleurisy and those
without. However, there was a significant (p< 0.01) positive correlation of
both sIL-2Ra and
neopterin with ESR and CRP values, and a significant (p< 0.001) decline of
both of them after 2 months of antituberculous chemotherapy as compared to
their levels before treatment. In conclusion, sIL-2Ra and neopterin serum levels are
increased in patients with pulmonary TB and can be used as markers for disease
activity and follow up of antituberculous treatment.