Occurrence of drug resistance, associated risk factors, and expression of cytokine IL-33 in human TB patients.

BACKGROUND

Tuberculosis (TB) is a contagious disease caused by Mycobacterium tuberculosis (M. tuberculosis). There are different forms of TB, and pleural TB is crucial regarding patient care and outcomes. The present study evidenced drug resistance in human pleural TB patients, risk factors, and expression of cytokine IL-33.

METHODS

A total of 152 serum and pleural fluid samples from symptomatically suspected patients were collected, and Gene Xpert confirmed 54 male and 28 female patients as positive for TB. The confirmed TB samples were subjected to enzyme linked immunosorbent assay, and complete blood analysis was performed in comparison to healthy controls.

RESULTS

Out of 82 Gene Xpert-detected positive samples of M. tuberculosis, 16 samples were found to be resistant to rifampicin. The IL-33 was significantly raised in pleural TB patients of different age groups and both genders compared to healthy controls, i.e., the mean serum IL-33 level was 25.17 pg/ml in patients < 30 years of age, 23.10 pg/ml in those aged 30-50 years, 23.05 pg/ml in patients > 50 years, and 12.74 pg/ml in the control group. The pleural TB patients with comorbidities, i.e., HIV, hepatitis B and C, lung cancer, diabetes, and smoking, revealed up-regulated expression of IL-33 compared to healthy controls. The IL-33 level in pleural TB patients showed a weak correlation with other blood parameters across different age groups. In patients < 30 years of age, the level of IL-33 was weakly correlated with protein, lactate dehydrogenase (LDH), and differential leukocyte count (i.e., neutrophils), while in the 30-50 years group, it was weakly correlated with lymphocytes, protein, and LDH. In patients > 50 years of age, total leukocyte count, neutrophils, and lymphocytes revealed a weak correlation.

CONCLUSION

The pleural TB patients were resistant to the first-line drug rifampicin, and cytokine IL-33 was increased in pleural TB patients across all age groups.