Changes in the levels of adipokines in newly diagnosed pulmonary tuberculosis patients in case of treatment failure

Authors

  • R. M. Yasinskyi Zaporizhzhia State Medical University, Ukraine,
  • O. M. Raznatovska Zaporizhzhia State Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2020.2.200618

Keywords:

tuberculosis, treatment failure, adipokines, leptin, adiponectin

Abstract

 

Improving the treatment efficacy for patients with newly diagnosed tuberculosis by reducing the number of treatment failure cases is very urgent issue nowadays.

Purpose. To define the characteristics of adipokines levels changes in newly diagnosed pulmonary tuberculosis patients in case of treatment failure by examining the levels of leptin, adiponectin and leptin/adiponectin ratio.

Materials and methods. A total of 58 patients with newly diagnosed pulmonary tuberculosis were the subject of this prospective study. The patients were divided into 2 groups: the first group was made up of 28 patients with the ineffectively treated newly diagnosed pulmonary tuberculosis; the second group (experimental group) consisted of 30 patients with successful treatment completion. The control group included 29 healthy voluntary donors. Changes in the levels of adipokines by measuring the blood serum leptin and adiponectin via enzyme linked immunosorbent assay using immunoassay analyzer Sirio S with “Mediagnost” kit (Germany) (ng/ml) were studied at the Scientific Medical Laboratory Center of Zaporizhzhia State Medical University. Leptin/adiponectin ratio was calculated mathematically (relative units). Blood samples were collected after an overnight fasting. Statistica for Windows 13.0 (Copyright 1984–2018 TIBCO Software Inc., all rights reserved, Licence No. JPZ8041382130ARCN10-J) software was used for the statistical analysis.

Results. The following significant changes in the adipokines levels have been found in patients with newly diagnosed pulmonary tuberculosis with massive pulmonary lesions and destructions of over 3 сm in diameter and positive sputum smear. These patients will be diagnosed with ineffective treatment. At the beginning of the antimycobacterial therapy, there was a significant 12.7 times decrease in leptin and 1.4 times increase in adiponectin indicators and 21 times decrease in the leptin/adiponectin ratio. The levels of leptin, adiponectin and leptin/adiponectin ratio were significantly worse than similar levels in patients, who completed the treatment efficiently. The level of the leptin was slightly increased during the antimycobacterial therapy, albeit being significantly reduced, and the level of the adiponectin continued to increase significantly. The leptin/adiponectin ratio was significantly lower than that in patients who completed the treatment efficiently.

Conclusions. Patients with newly diagnosed pulmonary tuberculosis with the risk of treatment failure are diagnosed with severe disorders of adipocyte functional activity, that antimycobacterial chemotherapy could not even restore the balance to the adipokine system and smooth down resulting concomitant variations in immune response. The findings showed the prognostic value of the changes in leptin, adiponectin and leptin/adiponectin ratio indicators at the beginning of the treatment in relation to treatment failure among patients with newly diagnosed pulmonary tuberculosis.

References

World Health Organization. (‎2018)‎. Global tuberculosis report 2018. https://apps.who.int/iris/handle/10665/274453.

DU Tsentr hromadskoho zdorovia Ministerstva okhorony zdorovia Ukrainy, DZ Tsentr medychnoi statystyky Ministerstva okhorony zdorovia Ukrainy, & Natsionalna medychna akademiia pisliadyplomnoi osvity im. P. L. Shupyka. (2019). Tuberkuloz v Ukraini [Tuberculosis in Ukraine]. Kyiv. https://phc.org.ua/sites/default/files/users/user90/TB_surveillance_statistical-information_2018_dovidnyk.pdf. [in Ukrainian].

Ayyappan, J. P., Vinnard, C., Subbian, S., & Nagajyothi, J. F. (2018). Effect of Mycobacterium tuberculosis infection on adipocyte physiology. Microbes and Infection, 20(2), 81-88. https://doi.org/10.1016/j.micinf.2017.10.008

Agarwal, P., Khan, S. R., Verma, S. C., Beg, M., Singh, K., Mitra, K., Gaikwad, A. N., Akhtar, M. S., & Krishnan, M. Y. (2014). Mycobacterium tuberculosis persistence in various adipose depots of infected mice and the effect of anti-tubercular therapy. Microbes and Infection, 16(7), 571-580. https://doi.org/10.1016/j.micinf.2014.04.006

Santucci, N., Díaz, A., Bianchi, E., Spinelli, S., D’Attilio, L., Bongiovanni, B., Dídoli, G., Brandan, N., Nannini, L., Bay, M. L., & Bottasso, O. (2014). Leptin does not enhance cell-mediated immune responses following mycobacterial antigen stimulation. The International Journal of Tuberculosis and Lung Disease, 18(8), 981-987. https://doi.org/10.5588/ijtld.13.0780

Ye, M., & Bian, L.-F. (2018). Association of serum leptin levels and pulmonary tuberculosis: a meta-analysis. Journal of Thoracic Disease, 10(2), 1027-1036. https://doi.org/10.21037/jtd.2018.01.70

Zubatkina, O. V., Dobrodeeva, L. K. & Popov, A. A. (2015). Znachimost' urovnya leptina pri otsenke sostoyaniya adaptivnogo immuniteta [Significance of leptin level in assessment of adaptive immunity]. Ekologiya cheloveka, (12), 16-20. [in Russian].

Perna, V., Pérez-Pérez, A., Fernández-Riejos, P., Polo-Padillo, J., Batista, N., Domínguez-Castellano, A., & Sánchez-Margalet, V. (2013). Effective treatment of pulmonary tuberculosis restores plasma leptin levels. European Cytokine Network, 24(4), 157-161. https://doi.org/10.1684/ecn.2014.0346

Lin, H.-H., Wu, C.-Y., Wang, C.-H., Fu, H., Lönnroth, K., Chang, Y.-C., & Huang, Y.-T. (2017). Association of Obesity, Diabetes, and Risk of Tuberculosis: Two Population-Based Cohorts. Clinical Infectious Diseases, 66(5), 699-705. https://doi.org/10.1093/cid/cix852

Santucci, N., D’Attilio, L., Kovalevski, L., Bozza, V., Besedovsky, H., del Rey, A., Bay, M. L., & Bottasso, O. (2011). A Multifaceted Analysis of Immune-Endocrine-Metabolic Alterations in Patients with Pulmonary Tuberculosis. PLOS ONE, 6(10), Article e26363. https://doi.org/10.1371/journal.pone.0026363

Silva, D. R., Skupien, E. C., Lazzari, T. K. & Coutinho, S. E. (2017, May 19-24). Relation of Leptin, TNF-Alpha and IL-6 with Respiratory and Peripheral Muscle Strength, and Nutritional Status in Active Pulmonary Tuberculosis. American Journal of Respiratory and Critical Care Medicine, 195, Article А2074. https://www.atsjournals.org/doi/pdf/10.1164/ajrccm-conference.2017.195.1_MeetingAbstracts.A2074.

Yurt, S., Erman, H., Korkmaz, G. G., Kosar, A. F., Uysal, P., Gelisgen, R., Simsek, G., & Uzun, H. (2013). The role of feed regulating peptides on weight loss in patients with pulmonary tuberculosis. Clinical Biochemistry, 46(1-2), 40-44. https://doi.org/10.1016/j.clinbiochem.2012.09.008

Keicho, N., Matsushita, I., Tanaka, T., Shimbo, T., Hang, N. T. L., Sakurada, S., Kobayashi, N., Hijikata, M., Huu Thuong, P., & Thi Lien, L. (2012). Circulating Levels of Adiponectin, Leptin, Fetuin-A and Retinol-Binding Protein in Patients with Tuberculosis: Markers of Metabolism and Inflammation. PLOS ONE, 7(6), Article e38703. https://doi.org/10.1371/journal.pone.0038703

Kim, J. H., Lee, C.-T., Yoon, H. I., Song, J., Shin, W. G., & Lee, J. H. (2010). Relation of ghrelin, leptin and inflammatory markers to nutritional status in active pulmonary tuberculosis. Clinical Nutrition, 29(4), 512-518. https://doi.org/10.1016/j.clnu.2010.01.008

Zheng, Y., Ma, A., Wang, Q., Han, X., Cai, J., Schouten, E. G., Kok, F. J., & Li, Y. (2013). Relation of Leptin, Ghrelin and Inflammatory Cytokines with Body Mass Index in Pulmonary Tuberculosis Patients with and without Type 2 Diabetes Mellitus. PLOS ONE, 8(11), Article e80122. https://doi.org/10.1371/journal.pone.0080122

Santucci, N., D’Attilio, L., Besedovsky, H., del Rey, A., Bay, M. L., & Bottasso, O. (2010). A Clinical Correlate of the Dysregulated Immunoendocrine Response in Human Tuberculosis. Neuroimmunomodulation, 17(3), 184-187. https://doi.org/10.1159/000258719

Shpagin, I. S., Shpagina, L. A., Gerasimenko, O. N., Panacheva, L. A., Seledtsova, L. A. & Sukhaterina, N. A. (2015). Nutritivnyi status pri arterial'noi gipertenzii i v sochetanii s khronicheskoi obstruktivnoi bolezn'yu legkikh [Nutritive status at arterial hypertensia and combined with chronic obstructive pulmonary disease]. Journal of Siberian Medical Sciences, (6). https://elibrary.ru/download/elibrary_25940257_48078286.pdf. [in Russian].

Ministry of Health of Ukraine. (2014, September 04). Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry tuberkulozi [On approval and introduction of medical and technological documents on standardization of medical care in tuberculosis (No. 620)]. https://zakon.rada.gov.ua/rada/show/ru/v0620282-14.

Kleynhans, L., Ruzive, S., Ehlers, L., Thiart, L., Chegou, N. N., Conradie, M., Kriel, M., Stanley, K., van der Spuy, G. D., Kidd, M., van Helden, P. D., Walzl, G., & Ronacher, K. (2017). Changes in Host Immune–Endocrine Relationships during Tuberculosis Treatment in Patients with Cured and Failed Treatment Outcomes. Frontiers in Immunology, 8, 690. https://doi.org/10.3389/fimmu.2017.00690

Downloads

How to Cite

1.
Yasinskyi RM, Raznatovska OM. Changes in the levels of adipokines in newly diagnosed pulmonary tuberculosis patients in case of treatment failure. Zaporozhye Medical Journal [Internet]. 2020Apr.13 [cited 2024Jul.17];22(2). Available from: http://zmj.zsmu.edu.ua/article/view/200618

Issue

Section

Original research