Hypercytokinaemia accompanies HIV-tuberculosis immune reconstitution inflammatory syndrome

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dc.contributor.authorTadokera R.
dc.contributor.authorMeintjes G.
dc.contributor.authorSkolimowska K.H.
dc.contributor.authorWilkinson K.A.
dc.contributor.authorMatthews K.
dc.contributor.authorSeldon R.
dc.contributor.authorChegou N.N.
dc.contributor.authorMaartens G.
dc.contributor.authorRangaka M.X.
dc.contributor.authorRebe K.
dc.contributor.authorWalzl G.
dc.contributor.authorWilkinson R.J.
dc.date.accessioned2011-05-25T08:49:49Z
dc.date.available2011-05-25T08:49:49Z
dc.date.issued2011
dc.description.abstractIncreased access to combination antiretroviral therapy in areas co-endemic for tuberculosis (TB) and HIV-1 infection is associated with an increased incidence of immune reconstitution inflammatory syndrome (TB-IRIS) whose cause is poorly understood. A case-control analysis of pro- and anti-inflammatory cytokines in TB-IRIS patients sampled at clinical presentation, and similar control patients with HIV-TB prescribed combined antiretroviral therapy who did not develop TB-IRIS. Peripheral blood mononuclear cells were cultured in the presence or absence of heat-killed Mycobacterium tuberculosis for 6 and 24 h. Stimulation with M. tuberculosis increased the abundance of many cytokine transcripts with interleukin (IL)-1β, IL-5, IL-6, IL-10, IL-13, IL-17A, interferon (IFN)-γ, granulocyte-macrophage colony-stimulating factor (GM-CSF) and tumour necrosis factor (TNF) being greater in stimulated TB-IRIS cultures. Analysis of the corresponding proteins in culture supernatants, revealed increased IL-1β, IL-2, IL-6, IL-8, IL-10, IL-12p40, IFN-γ, GM-CSF and TNF in TB-IRIS cultures. In serum, higher concentrations of TNF, IL-6, and IFN-γ were observed in TB-IRIS patients. Serum IL-6 and TNF decreased during prednisone therapy in TB-IRIS patients. These data suggest that cytokine release contributes to pathology in TB-IRIS. IL-6 and TNF were consistently elevated and decreased in serum during corticosteroid therapy. Specific blockade of these cytokines may be rational approach to immunomodulation in TB-IRIS. Copyright©ERS 2011.
dc.description.versionArticle
dc.identifier.citationEuropean Respiratory Journal
dc.identifier.citation37
dc.identifier.citation5
dc.identifier.citation1248
dc.identifier.citation1259
dc.identifier.issn9031936
dc.identifier.other10.1183/09031936.00091010
dc.identifier.urihttp://hdl.handle.net/10019.1/14700
dc.titleHypercytokinaemia accompanies HIV-tuberculosis immune reconstitution inflammatory syndrome
dc.typeArticle
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