The activated T -lymphocytes produce lymphokines that help to prevent macrophages from leaving the site of inflammation, induce fusion and giant cell formation, chemotaxis and enhanced killing by macrophages. As a result of mycobacterial infection and the subsequent T -lymphocyte activation, slL2R molecules are released into the circulation. The present work aimed at evaluating the level of soluble interleukin-2 receptor in patients with active pUlmonary tuberculosis and illustrating the effect of anti-tuberculosis chemotherapy on it. The study was undertaken on 25 patients (15 males and 10 females) with newly diagnosed active pulmonary tuberculosis (Group-I). Fifteen apparently healthy persons (10 males and 5 females) served as control (Group-2). All were subjected to thorough history taking, full clinical examination, complete blood examination, erythrocyte sedimentation rate, liver and Kidney function tests, fasting and 2 hr postprandial blood sugar, plain x-ray chest P.A. and lateral views, tuberculin skin testing by Mantoux method, sputum for acid fast bacilli by Z.N. stain (at diagnosis and every month then after) and estimation of serum soluble Interleukin-2 receptor (before treatment, 3 months and 6 months after treatment). It was found that the level of s IL-2R is significantly higher in tuberculous patients at diagnosis as compared to controls (Mean sIL-2R before treatment was 2287.6±1364, 359.5±190.2 U/mI in groupl and 2 respectively, P < 0.001). Although the level of s IL-2R after 3 and 6 months of treatment was still significantly higher than controls, it showed significant gradual decline at the third month that continued through the sixth month of treatment (Mean sIL-2R was 1373.1±457.47, 1021.9±231.42 U/mI after 3 and 6 months of treatment respectively). It is concluded that the level of s IL-2R is significantly high in patients with active pUlmonary tuberculosis. It declines gradually with anti-tuberculous chemotherapy but does not return to the normal le\'el at the end of 6-month course treatment. Soluble IL-2R can be used as an adjuvant test in the diagnosis, follow up of the disease and assessment of treatment. Further work is needed to assess its role in detecting reactivation of infection with Mycobacterium tuberculosis. |
