Cytokines Related to Nutritional Status in Patients with Untreated Pulmonary Tuberculosis in Indonesia

印尼未治療肺結核病人細胞激素與營養狀況有關

Elvina Karyadi ； Wil MV Dolmans ； Clive E West ； Reinout Van Crevel ； Ronald HH Nelwan ； Zulkifli Amin ； Rainer Gross ； Johanna Van der Ven-Jongekrijg ； Jos WM Van der Meer

《Asia Pacific Journal of Clinical Nutrition》 16卷2期 (2007/06) Pp. 218-226

https://doi.org/10.6133/apjcn.2007.16.2.04

摘要

雖然幾個研究已經探討過結核的細胞激素產生型態，但是結核病人的營養素缺乏與細胞激素間的關係所知有限。本研究目的為評估在結核病期間，細胞激素的濃度與營養狀況的相關。在印尼城市的醫院，41名未治療的結核病人與其配對的健康對照組，我們測量其身高與體重、鐵、維生素A及鋅；以及在循環中和全血培養產生的細胞激素濃度。病人的血漿中介白質-6（IL-6）及介白質-1接受體拮抗物（IL-1ra）顯著的較對照組高。有肺部空洞的病人（n=26）比起沒有空洞的病人（n=15）有較高的IL-6濃度。身體質量指數小於18.5kg/m^2與較高濃度的腫瘤壞死因子-α（TNF-α）及IL-6有關。貧血者有較高的IL-6及IL-1ra。鋅缺乏與高的LPS-刺激產生TNF-α及IL-1ra有關。血漿視網醇濃度臨界缺乏與經LPS刺激後高濃度的IL-6相關。綜合以上，肺結核病人低微量營養素濃度與細胞激素產生增加有關。介入性研究將可評估其因果關係。

關鍵字

介白質-6 ； 腫瘤壞死因子-α ； 介白質-1接受體拮抗物 ； 身體質量指數 ； 微量營養素

並列摘要

Although several studies have dealt with the patterns of cytokine production in tuberculosis, little is known about the association between nutrient deficiencies and cytokines in tuberculosis. The objective of this study was to assess the concentration of cytokines related to nutritional status during tuberculosis. In 41 untreated tuberculosis patients and matched healthy controls in an urban hospital in Indonesia, we measured: height and weight, parameters of iron, vitamin A and zinc; and cytokines concentrations in the circulation and production in whole blood cultures. Plasma interleukin-6 (IL-6) and interleukin-1 receptor antagonist (IL-1ra) were significantly higher in patients than in controls. Patients with cavities (n=26) had higher concentrations of IL-6 than patients without cavities (n=15). Body mass index ＜18.5 kg/m^2 was associated with high concentrations of tumor necrosis factor-α (TNF-α) and IL-6. Anaemia was associated with high concentrations of IL-6 and IL-1ra. Zinc deficiency was associated with high LPS-stimulated production of TNF-α and IL-1ra. Marginal plasma retinol concentrations were associated with high concentrations of IL-6 after LPS stimulation. In conclusion, low concentrations of micronutrients in tuberculosis were associated with increased cytokine production. An intervention study would allow causality to be examined.

並列關鍵字

interleukin-6 ； tumor necrosis factor-α ； interleukin-1 receptor antagonist ； body mass index ； micronutrient