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Clinical and Diagnostic Laboratory Immunology, July 2002, p. 818-823, Vol. 9, No. 4
1071-412X/02/$04.00+0     DOI: 10.1128/CDLI.9.4.818-823.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Sputum Cytokine Levels in Patients with Pulmonary Tuberculosis as Early Markers of Mycobacterial Clearance

Universidade Federal do Espírito Santo, Núcleo Doenças Infecciosas, Vitória, ES, Brazil,¹ Case Western Reserve University, University Hospitals of Cleveland,² Veterans Affairs Medical Center, Cleveland, Ohio 44106,³ University of Medicine and Dentistry of New Jersey, Newark, New Jersey 07103⁴

Received 4 January 2002/ Returned for modification 13 February 2002/ Accepted 2 May 2002

Sputum and serum from patients with active pulmonary tuberculosis (TB), healthy purified protein derivative-positive adults, and patients with bacterial pneumonia were collected to simultaneously assess local immunity in the lungs and peripheral blood. To determine whether cytokine profiles in sputum from TB patients and control subjects were a reflection of its cellular composition, cytospin slides were prepared in parallel and assessed for the presence of relative proportions of epithelial cells, neutrophils, macrophages, and T cells. Gamma interferon (IFN-) in sputum from TB patients was markedly elevated over levels for both control groups. With anti-TB therapy, IFN- levels in sputum from TB patients decreased rapidly and by week 4 of treatment were comparable to those in sputum from controls. Further, IFN- levels in sputum closely followed mycobacterial clearance. Although detected at fourfold-lower levels, IFN- immunoreactivities in serum followed kinetics in sputum. TNF-, interleukin 8 (IL-8) and IL-6 also were readily detected in sputum from TB patients at baseline and responded to anti-TB therapy. In contrast to IFN-, however, TNF- and IL-8 levels also were elevated in sputum from pneumonia controls. These data indicate that sputum cytokines correlate with disease activity during active TB of the lung and may serve as potential early markers for sputum conversion and response to anti-TB therapy.

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