Different cytokine patterns correlate with the extension of disease in pulmonary tuberculosis

The relative amounts of different pro- and anti-inflammatory cytokines rele ased at the site of infection by bronchoalveolar lavage (BAL) cells may inf luence the presentation of tuberculosis. To investigate this hypothesis the in situ release by BAL cells of the following cytokines was measured and c orrelated with the chest X-ray findings of 43 patients with pulmonary tuber culosis: interleukin (IL)-8, macrophage inflammatory protein-1 alpha (MIP-1 alpha), IL-6, tumor necrosis factor-alpha (TNF-alpha), transforming growth factor-beta (TGF-beta), interferon-gamma (IFN-gamma), IL-2, IL-4 and IL-5, The release of IL-8 and IL-6 decreased with the progression of the disease , while the release of MIP-1 alpha was increased in patients with advanced tuberculosis, The release of TNF-alpha and TGF-P did not differ between pat ients with or without cavitary lesions. The Th1 (IFN-gamma and IL-2) and Th 2 (IL-4 and IL-5) cytokine release exhibited a gradual increment with the a dvance of tuberculosis. Thus, our data provide evidence that a Th0 cytokine pattern is predominant at the site of pulmonary tuberculosis. In conclusio n, immunoparalysis status could not be observed in our patients with severe tuberculosis.