Abstrakt

The role of cytokines in fibrinolysis: A case study of active tuberculosis.

Patience A Akpan, Josephine O Akpotuzor, Eme E Osim

Objective: Active tuberculosis (TB) is a disease arising from infection by the Mycobacterium tuberculosis complex which induces a state of chronic inflammation. The inflammatory response is mediated by the release of cytokines which have the potential to initiate disturbance of the fibrinolytic system. The aim of this study is to assess the role of cytokines in fibrinolysis in a condition of chronic inflammation such as active tuberculosis. Methods: Case-control study design was employed. One hundred and twenty (120) TB patients and 120 apparently healthy subjects aged 15-60 years and gender-matched were recruited for this study. Active tuberculosis was diagnosed by the presence of acid fast bacilli in sputum smear microscopy, X-ray or clinical assessment. Fibrinogen concentration (FIB) was measured by Clauss technique while fibrin degradation product (FDP), interferon gamma (IFN-?) and interleukin 10 (IL-10) were measured by sandwich enzyme immunoassay (ELISA) using standard kits. Data obtained were analysed using Student?s T-test and one-way ANOVA on statistical package for social sciences (SPSS) version 20 software. Pearson?s correlation was used to express relationship and significance was set at P ? 0.05. Results: Results obtained showed significantly higher (P<0.05) fibrinogen concentration, fibrin degradation product, interferon gamma as well as interleukin 10 levels of active TB patients versus control subjects indicating the presence of infection-induced inflammatory response which mediates acute phase reaction as well as increase fibrinolytic activity. Significant positive correlations (P<0.05) were observed between fibrinogen concentration and fibrin degradation product as well as between fibrinogen concentration and interleukin 10 level. Fibrinogen concentration, fibrin degradation product and interleukin 10 levels decreased significantly with progress in anti-tuberculosis therapy hence they could serve as useful indices in monitoring the response of tuberculosis patients to treatment. Conclusion: It is concluded that the cytokines interferon-? and interleukin 10 contribute significantly to increase fibrinolytic activity as seen in active tuberculosis with haemorrhage as possible sequel.