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No. of pages: 193

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Abstract:

Introduction:Tuberculosis (TB) is a communicable disease that has afflicted man for centuries. It is one of the commonest causes of death from infectious diseases in the world. Nigeria is ranked among the 22 countries with the highest TB burden in the world. The discovery of host or pathogen specific biomarkers of TB for diagnosis, treatment, and prognosis has of recent become top research priority globally. The pathogenesis of TB involves cell-mediated immune response against Mycobacterium tuberculosis and different cytokines have been found to be specifically involved in the pathogenesis of pulmonary TB. Cytokines which are a group of regulatory molecules that permit contactindependent communication between the cells of the human body have been considered to be candidate biomarkers for TB. There has been a lot of TB- related research but to the best of our knowledge no prospective study has concurrently and intermittently measured the blood levels of Tumor necrosis factor alpha (TNFα), Interleukin 1 beta (IL-1 β) and Interleukin 6 (IL-6) in Nigerian TB patients from commencement of TB treatment to the end of short course chemotherapy. This study aims at documenting the serum concentrations of these three cytokines (IL-1 β; IL-6; and TNFα) in eligible TB patients using human ELISA kits, from the time of diagnosis to completion of six months short course chemotherapy of TB. This prospective study is expected to yield useful information that would be utilized in the quest for better biomarkers to improve TB management.

Methodology:The study was a prospective observational study carried out at the Chest Clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu with the written permission of UNTH Management. The research proposal was approved by the Research Ethics Committee of UNTH Enugu. Freshly diagnosed drug-naive adult TB patients of both genders who met the inclusion criteria were recruited after giving informed consent. Uniform standard WHO - approved treatment was prescribed for and supplied to the patients. Each subject was followed up for six months starting from their respective times of recruitment into the project. Healthy volunteers were also recruited. Blood samples were taken at zero time (i.e. after diagnosis and enrolment into study but before ingestion of TB drugs); at 2 months of treatment; and also at 6months of treatment. Serum concentrations of Interleukin 1 beta (IL-1 β); Interleukin 6 (IL-6); and Tumor necrosis factor alpha (TNFα) were measured using human ELISA kits (e-Bioscience, USA). Erythrocyte Sedimentation Rate (ESR) was measured by Westergren method and Haemoglobin concentration was estimated by the Cyanmethaemoglobin method. Total leukocyte count and differential counts for the percentage counts of Neutrophils, Lymphocytes, Monocytes, Basophils, and Eosinophils were done by routine manual microscopy. Results were analysed using Graphpad prism and SPSS computer soft-wares and displayed as tables, pie, and bar charts..