Efficacy and safety of intravenous chemotherapy during intensive treatment phase in patients with newly diagnosed pulmonary tuberculosis

Introduction: The purpose of our study was to examine the efficacy and safety of intravenous chemotherapy during intensivetreatment phase in patients with newly diagnosed pulmonary tuberculosis (pulmonary TB). Material and methods: The study involved 92 patients with newly diagnosed pulmonary TB aged between 20 and 68. All patientswith newly diagnosed pulmonary TB and chemosensitive tuberculosis were enrolled in the study. The patients were allocated totwo groups. The first (control) group of 46 patients received standard chemotherapy orally. The second (main) group consistedof 46 patients who were prescribed isoniazid, rifampin, ethambutol by i.v. transfusion, and pyrazinamide orally as a part of thestandard treatment. Results: Symptoms of intoxication and chest manifestations in pulmonary TB patients from the second group were eliminated fasterthan the same symptoms in the group 1. In the group 2, the mycobacterial clearance in sputum smears was reduced more rapidly, and up to2 months it was reached in 37 patients (80.43%), while in the control group in 25 patients (54.35%),p = 0.0066. Destructionhealing and inflitrative change alleviation after 4 months was reached in 38 patients (82.61%) (in control group — 28 (60.87%),(p = 0.0192). No additional negative effects were detected when compared with the control group at any time. Conclusions: Thanks to i.v. chemotherapy, clinical manifestations of the in-patients with pulmonary TB were eliminated faster,severe side effects of anti-TB drugs were not noticed, time of bacterial clearance and healing destruction reduced, healing frequencyof destructions increased and the residual changes decreased

Association of interleukins genes polymorphisms with multi-drug resistant tuberculosis in Ukrainian population

Introduction: Multi-drug resistant tuberculosis (MDR TB) is a significant health problem in some parts of the world. Three major cytokines involved in TB immunopathogenesis include IL-2, IL-4 and IL-10. The susceptibility to MDR TB may be genetically determined. The aim of the study was to assess the association of IL-2, IL-4, IL-10 gene polymorphisms with multi-drug resistant tuberculosis (MDR TB) in Ukrainian population. Material and methods: We observed 140 patients suffering from infiltrative pulmonary tuberculosis (PT) and 30 apparently healthy subjects. The patients were assigned to two groups whether they suffer or do not suffer from pulmonary MDR TB. Interleukin gene (IL) polymorphisms, particularly T330G polymorphism in the IL-2 gene, C589T polymorphism in the IL-4 gene and G1082A polymorphism in the IL-10 gene were studied through polymerase chain reaction. Circulating levels of IL-2, IL-4 and IL-10 in venous blood were estimated using ELISA. Results: Prior to treatment, patients with PT showed significant increase of IL-2 levels and decrease of IL-4 and IL-10 levels compared to apparently healthy subjects. Circulating IL-4 and IL-10 levels were significantly decreased whilst serum IL-2 level was significantly increased in patients with MDR TB compared to non-MDR TB. Low IL-4 and IL-10 secretion and considerable IL-2 alterations were shown to be significantly associated with mutations of homozygous and heterozygous genotypes affecting C589T polymorphism in the IL-4 gene, G1082A polymorphism in the IL-10 gene and T330G polymorphism in the IL-2 gene in patients with PT. Conclusions: Heterozygous genotype and mutations homozygous genotypes gene in polymorphisms determining specified cytokines’ production is a PT risk factor and may lead to disease progression into chronic phase. Heterozygous genotype of aforementioned cytokine genetic polymorphisms was significantly the most frequent in patients with MDR TB

Association of interleukins genes polymorphisms with multi-drug resistant tuberculosis in Ukrainian population

INTRODUCTION: Multi-drug resistant tuberculosis (MDR TB) is a significant health problem in some parts of the world. Three major cytokines involved in TB immunopathogenesis include IL-2, IL-4 and IL-10. The susceptibility to MDR TB may be genetically determined. The aim of the study was to assess the association of IL-2, IL-4, IL-10 gene polymorphisms with multi-drug resistant tuberculosis (MDR TB) in Ukrainian population. MATERIAL AND METHODS: We observed 140 patients suffering from infiltrative pulmonary tuberculosis (PT) and 30 apparently healthy subjects. The patients were assigned to two groups whether they suffer or do not suffer from pulmonary MDR TB. Interleukin gene (IL) polymorphisms, particularly T330G polymorphism in the IL-2 gene, C589T polymorphism in the IL-4 gene and G1082A polymorphism in the IL-10 gene were studied through polymerase chain reaction. Circulating levels of IL-2, IL-4 and IL-10 in venous blood were estimated using ELISA. RESULTS: Prior to treatment, patients with PT showed significant increase of IL-2 levels and decrease of IL-4 and IL-10 levels compared to apparently healthy subjects. Circulating IL-4 and IL-10 levels were significantly decreased whilst serum IL-2 level was significantly increased in patients with MDR TB compared to non-MDR TB. Low IL-4 and IL-10 secretion and considerable IL-2 alterations were shown to be significantly associated with mutations of homozygous and heterozygous genotypes affecting C589T polymorphism in the IL-4 gene, G1082A polymorphism in the IL-10 gene and T330G polymorphism in the IL-2 gene in patients with PT. CONCLUSIONS: Heterozygous genotype and mutations homozygous genotypes gene in polymorphisms determining specified cytokines’ production is a PT risk factor and may lead to disease progression into chronic phase. Heterozygous genotype of aforementioned cytokine genetic polymorphisms was significantly the most frequent in patients with MDR TB.INTRODUCTION: Multi-drug resistant tuberculosis (MDR TB) is a significant health problem in some parts of the world. Three major cytokines involved in TB immunopathogenesis include IL-2, IL-4 and IL-10. The susceptibility to MDR TB may be genetically determined. The aim of the study was to assess the association of IL-2, IL-4, IL-10 gene polymorphisms with multi-drug resistant tuberculosis (MDR TB) in Ukrainian population. MATERIAL AND METHODS: We observed 140 patients suffering from infiltrative pulmonary tuberculosis (PT) and 30 apparently healthy subjects. The patients were assigned to two groups whether they suffer or do not suffer from pulmonary MDR TB. Interleukin gene (IL) polymorphisms, particularly T330G polymorphism in the IL-2 gene, C589T polymorphism in the IL-4 gene and G1082A polymorphism in the IL-10 gene were studied through polymerase chain reaction. Circulating levels of IL-2, IL-4 and IL-10 in venous blood were estimated using ELISA. RESULTS: Prior to treatment, patients with PT showed significant increase of IL-2 levels and decrease of IL-4 and IL-10 levels compared to apparently healthy subjects. Circulating IL-4 and IL-10 levels were significantly decreased whilst serum IL-2 level was significantly increased in patients with MDR TB compared to non-MDR TB. Low IL-4 and IL-10 secretion and considerable IL-2 alterations were shown to be significantly associated with mutations of homozygous and heterozygous genotypes affecting C589T polymorphism in the IL-4 gene, G1082A polymorphism in the IL-10 gene and T330G polymorphism in the IL-2 gene in patients with PT. CONCLUSIONS: Heterozygous genotype and mutations homozygous genotypes gene in polymorphisms determining specified cytokines’ production is a PT risk factor and may lead to disease progression into chronic phase. Heterozygous genotype of aforementioned cytokine genetic polymorphisms was significantly the most frequent in patients with MDR TB

Efficacy and safety of quercetin and polyvinylpyrrolidone in treatment of patients with newly diagnosed destructive pulmonary tuberculosis in comparison with standard antimycobacterial therapy

Objective/background: The objective/background of this work was to study the efficacy and safety of quercetin and polyvinylpyrrolidone (QP) in the treatment of patients with newly diagnosed destructive pulmonary tuberculosis in comparison with standard antimycobacterial therapy. Materials and methods: The study involved 124 patients aged between 20 years and 70 years with newly diagnosed destructive pulmonary tuberculosis. Patients were allocated to two groups. The first (control) group of patients received standard antimycobacterial and pathogenetic therapy and included 31 (25.00 ± 3.89%) patients. The second (main) group of patients received QP therapy in addition to chemotherapy and included 93 (75.00 ± 3.89%) patients. Results: Intoxication symptoms in the second group were reduced following 1.33 ± 0.15 months, whereas in the first group intoxication symptoms were reduced following 2.64 ± 0.20 months, p < .001. Conclusion: Administration of QP combined with chemotherapy in patients with newly diagnosed destructive pulmonary tuberculosis resulted in a comparatively quick reduction of disease manifestation

Skuteczność i bezpieczeństwo dożylnej chemioterapii w fazie intensywnego leczenia chorych na świeżo rozpoznaną gruźlicą płuc

WSTĘP: Celem badania była ocena skuteczności i bezpieczeństwa dożylnej chemioterapii w fazie intensywnego leczenia chorych na świeżo rozpoznaną gruźlicę płuc. MATERIAŁ I METODY: Do badania włączono 92 chorych ze świeżo rozpoznaną gruźlicą płuc w wieku 20–68 lat. U wszystkich uczestników badania wykazano wrażliwość na leki przeciwgruźlicze. Chorych przydzielono do dwóch grup: grupa kontrolna złożona z 46 chorych, którzy otrzymali standardowe leczenie doustnie, oraz grupa badana złożona z 46 pacjentów, którzy byli leczeni izoaniazydem, rifampicyną i etambutolem dożylnie i pyrazynamidem podawanym doustnie. WYNIKI: Objawy intoksykacji i objawy oddechowe ustępowały szybciej w grupie leczonej dożylnie w porównaniu z grupą leczoną terapią standardową. U chorych z grupy badanej czas do uzyskania ujemnych wyników badania plwociny był krótszy. Po dwóch miesiącach leczenia negatywny wynik badania plwociny uzyskano u 37 chorych z grupy badanej (80,43%) i u 25 chorych z grupy kontrolnej (54,35%), p = 0,0066. Wygojenie zmian destrukcyjnych i naciekowych po 4 miesiącach leczenia uzyskano u 38 chorych z grupy badanej (82,61%) i u 28 chorych z grupy kontrolnej (60,87%), p = 0,0192. W żadnym z badanych punktów czasowych nie stwierdzono negatywnych efektów leczenia dożylnego w porównaniu z leczeniem standardowym. WNIOSKI: Dzięki chemioterapii dożylnej stosowanej w warunkach szpitalnych u chorych na gruźlicę płuc manifestacje kliniczne ustępowały szybciej, nie obserwowano poważnych zdarzeń niepożądanych, uzyskano skrócenie czasu do negatywizacji wyników badania plwociny i gojenia zmian, odsetek chorych, u których uzyskano ustąpienie zmian destrukcyjnych był wyższy, a odsetek chorych ze zmianami resztkowymi — niższy w grupie leczonej dożylnie.WSTĘP: Celem badania była ocena skuteczności i bezpieczeństwa dożylnej chemioterapii w fazie intensywnego leczenia chorych na świeżo rozpoznaną gruźlicę płuc. MATERIAŁ I METODY: Do badania włączono 92 chorych ze świeżo rozpoznaną gruźlicą płuc w wieku 20–68 lat. U wszystkich uczestników badania wykazano wrażliwość na leki przeciwgruźlicze. Chorych przydzielono do dwóch grup: grupa kontrolna złożona z 46 chorych, którzy otrzymali standardowe leczenie doustnie, oraz grupa badana złożona z 46 pacjentów, którzy byli leczeni izoaniazydem, rifampicyną i etambutolem dożylnie i pyrazynamidem podawanym doustnie. WYNIKI: Objawy intoksykacji i objawy oddechowe ustępowały szybciej w grupie leczonej dożylnie w porównaniu z grupą leczoną terapią standardową. U chorych z grupy badanej czas do uzyskania ujemnych wyników badania plwociny był krótszy. Po dwóch miesiącach leczenia negatywny wynik badania plwociny uzyskano u 37 chorych z grupy badanej (80,43%) i u 25 chorych z grupy kontrolnej (54,35%), p = 0,0066. Wygojenie zmian destrukcyjnych i naciekowych po 4 miesiącach leczenia uzyskano u 38 chorych z grupy badanej (82,61%) i u 28 chorych z grupy kontrolnej (60,87%), p = 0,0192. W żadnym z badanych punktów czasowych nie stwierdzono negatywnych efektów leczenia dożylnego w porównaniu z leczeniem standardowym. WNIOSKI: Dzięki chemioterapii dożylnej stosowanej w warunkach szpitalnych u chorych na gruźlicę płuc manifestacje kliniczne ustępowały szybciej, nie obserwowano poważnych zdarzeń niepożądanych, uzyskano skrócenie czasu do negatywizacji wyników badania plwociny i gojenia zmian, odsetek chorych, u których uzyskano ustąpienie zmian destrukcyjnych był wyższy, a odsetek chorych ze zmianami resztkowymi — niższy w grupie leczonej dożylnie

Neurocysticercosis with symptomatic epilepsy manifestation

Aim To present a unique case of a 22-year-old male patient with symptomatic epilepsy manifestation on a background of neurocysticercosis (NCC). Methods An Indian student in Kharkiv, who lived in rural parts in India, presented with sudden episodes of seizure followed by severe headaches. Laboratory analyses and neurological status (MRI) were performed. Results Neurological status of the patient revealed nystagmus and difficulty in performing co-ordination tests. General analysis of blood showed raised eosinophil count to 8%. The MRI showed a few small conglomerating peripherally enhancing thick-walled infective granulomas in left frontal lobe with extensive surrounding oedema in the left fronto-parietal lobe. The patient was treated with albendazol, levipil, methylprednisolone and pantoprazole. Clinical symptoms and subsequent MRI showed improvement. Conclusion Neurocysticercosis is often misdiagnosed in the early stages, which leads to adverse outcomes. Although seizures are the most common clinical manifestation, it is a symptom that is not found in majority of the patients. The NCC of adult onset accompanying epileptic seizures is not well studied and a link between the helminthic invasion, epilepsy and psychiatric conditions needs to be established. This disease is potentially eradicable with wellplanned eradication programs targeting all stages of Taenia solium life cycle

Związek wariantów polimorficznych genów kodujących interleukiny z występowaniem wielolekoopornej gruźlicy w populacji Ukrainy

WSTĘP: Gruźlica wielolekooporna (MDR-TB) stanowi poważny problem zdrowotny w pewnych regionach świata. Interleukiny 2 (IL-2), 4 (IL-4) i 10 (IL-10) odgrywają istotną rolę w immunopatogenezie gruźlicy. Podatność na gruźlicę wielolekooporną może być genetycznie uwarunkowana. Celem badania była ocena związku pomiędzy polimorfizmem genów IL-2, IL-4, IL-10 a występowaniem gruźlicy wielolekoopornej w populacji ukraińskiej. MATERIAŁ I METODY: Do badania włączono 140 chorych na gruźlicę naciekową i 30 osób zdrowych (grupa kontrolna). Wyodrębniono grupę chorych na gruźlicę wielolekooporną (MDR TB) i gruźlicę z zachowaną opornością na leki przeciwgruźlicze (non-MDR TB). Zbadano polimorfizm T330G genu IL-2, C589T genu IL-4 i G1082A genu IL-10 przy zastosowaniu łańcuchowej reakcji polimerazy. Stężenia IL-2, IL-4 and IL-10 w surowicy oznaczono za pomocą testu ELISA. WYNIKI: Przed leczeniem u chorych na gruźlicę stężenia w surowicy IL-2 były wyższe, a IL-4 i IL-10 niższe w porównaniu z grupą kontrolną. Stężenia IL-4 i IL-10 były istotnie niższe, podczas gdy stężenie IL-2 było istotnie wyższe w grupie MDR TB w porównaniu z pozostałymi chorymi (non- MDR TB). Opisane zmiany związane były z homozygotycznymi lub heterozygotycznymi mutacjami polimorficznymi C589T genu IL-4, G1082A genu IL-10 i T330G genu IL-2. WNIOSKI: Mutacje genów badanych cytokin mogą stanowić czynnik ryzyka gruźlicy i prowadzić do progresji i przewlekania się choroby. W grupie MDR TB genotypy heterozygotyczne badanych cytokin występowały najczęściej.WSTĘP: Gruźlica wielolekooporna (MDR-TB) stanowi poważny problem zdrowotny w pewnych regionach świata. Interleukiny 2 (IL-2), 4 (IL-4) i 10 (IL-10) odgrywają istotną rolę w immunopatogenezie gruźlicy. Podatność na gruźlicę wielolekooporną może być genetycznie uwarunkowana. Celem badania była ocena związku pomiędzy polimorfizmem genów IL-2, IL-4, IL-10 a występowaniem gruźlicy wielolekoopornej w populacji ukraińskiej. MATERIAŁ I METODY: Do badania włączono 140 chorych na gruźlicę naciekową i 30 osób zdrowych (grupa kontrolna). Wyodrębniono grupę chorych na gruźlicę wielolekooporną (MDR TB) i gruźlicę z zachowaną opornością na leki przeciwgruźlicze (non-MDR TB). Zbadano polimorfizm T330G genu IL-2, C589T genu IL-4 i G1082A genu IL-10 przy zastosowaniu łańcuchowej reakcji polimerazy. Stężenia IL-2, IL-4 and IL-10 w surowicy oznaczono za pomocą testu ELISA. WYNIKI: Przed leczeniem u chorych na gruźlicę stężenia w surowicy IL-2 były wyższe, a IL-4 i IL-10 niższe w porównaniu z grupą kontrolną. Stężenia IL-4 i IL-10 były istotnie niższe, podczas gdy stężenie IL-2 było istotnie wyższe w grupie MDR TB w porównaniu z pozostałymi chorymi (non- MDR TB). Opisane zmiany związane były z homozygotycznymi lub heterozygotycznymi mutacjami polimorficznymi C589T genu IL-4, G1082A genu IL-10 i T330G genu IL-2. WNIOSKI: Mutacje genów badanych cytokin mogą stanowić czynnik ryzyka gruźlicy i prowadzić do progresji i przewlekania się choroby. W grupie MDR TB genotypy heterozygotyczne badanych cytokin występowały najczęściej

Association between effectiveness of tuberculosis treatment and cytochrome P-4502E1 polymorphism of the patients

Context: The risk of antituberculosis (TB) drug‑induced liver injury could be determined by patients’ genotype polymorphism of the xenobiotic‑metabolizing enzymes. To find the meaning of cytochrome P‑4502E1 (CYP2E1) polymorphism in TB patients. Corresponding of CYP2E1 polymorphism in TB patients with the level of isoniazid and rifampicin as well as for the outcome and toxicity development during inpatient TB treatment. Methods: CYP2E1 genotype was detected with the help of polymerase chain reaction and endonuclease analysis. The level of rifampicin, isoniazid, diene conjugates (DC), and catalase activity in the blood was determined spectrophotometrically. We have considered medical records at the beginning and at the end of inpatient treatment. Statistical Analysis Used: Kruskal–Wallis, ANOVA, and Chi‑square tests were used in this study. Results: The concentration of rifampicin 6 h after its intake was 17.6% higher in carriers of slow metabolizer (SM) CYP2E1 genotype than in patients with rapid metabolizer (RM) genotype that proved a participation of hepatic enzyme CYP2E1 in metabolism of rifampicin. According to obtained results in TB patients with RM genotype, the indexes of cytolysis (alanine aminotransferase, aspartate aminotransferase) and bile stasis (gamma‑glutathione transferase) were higher comparatively to SM genotype both before and after inpatient treatment. This correlated with a higher concentration of DC in the blood (+8.6%) and lower plasma catalase activity (−50.0%) in the patients with RM genotype comparatively with the patients with SM genotypes. Conclusion: Polymorphism of CYP2E1 genotype is an important criterion for the development of hepatotoxicity before and during TB treatment while increased rifampicin level has no influence on it

Efficacy and safety of quercetin and polyvinylpyrrolidone in treatment of patients with newly diagnosed destructive pulmonary tuberculosis in comparison with standard antimycobacterial therapy

Objective/Background: The aim of this work was to study the efficacy and safety of quercetin and polyvinylpyrrolidone (QP) in the treatment of patients with newly diagnosed destructive pulmonary tuberculosis (TB) in comparison with standard antimycobacterial therapy. Materials and methods: The study involved 124 patients aged between 20 years and 70 years with newly diagnosed destructive pulmonary TB. Patients were allocated to two groups. The first (control) group received standard antimycobacterial and pathogenetic therapy and included 31 (25.0 ± 3.89%) patients. The second (main) group of patients received QP therapy in addition to chemotherapy and included 93 (75.0 ± 3.89%) patients. All patients received standard chemotherapy, consisting of oral isoniazid (0.3g), rifampicin (0.6g), pyrazinamide (2g), ethambutol (1.2g), and/or an intramuscular injection of streptomycin (1g) with a dose reduction after the intensive phase of therapy. The anti-TB drugs were procured through the centralized national supply system in Ukraine. QP was used at a dose of 0.5g in 100 mL 0.9% sodium chloride solution intravenously once per day for 10 days, starting on admission to hospital. Results: Intoxication symptoms in the second group were reduced after 1.33 ± 0.15 months, whereas in the first group, intoxication symptoms were reduced following 2.64 ± 0.20 months (p <0.001). Moreover, respiratory symptom regression in the second group was observed after 1.43 ± 0.30 months, whereas in the first group, it was after 2.33 ± 0.30 months (p <0.05). Bacillary excretion period evaluated within 3 months was reduced, as it was shown by 97.67 ± 1.63% in the main group compared to 72.41 ± 8.45% (p <0.05) in the control group. In addition, the period of cavity healing was reduced to 2.86 ± 0.15 months in the main group compared to 3.43 ± 0.20 months (p <0.05) in the control group. Residual radiological lung damage findings (mild or slight or even no signs) were observed in 84 (90.32 ± 3.07%) patients in the main group versus 22 (70.97 ± 8.15%) patients in the control group. Significant residual radiological lung damage findings were observed in nine (9.68 ± 3.07%) patients in the main group and in nine (29.03 ± 8.15%) patients in the control group (p <0.05). In addition, QP increased anti-TB drug tolerance by 20.42% and had an immunomodulatory effect. Conclusion: Administration of QP combined with chemotherapy in patients with newly diagnosed destructive pulmonary TB resulted in a rapid reduction in disease manifestation

Interleukin-10 gene polymorphism is associated with multi-drug resistant tuberculosis during the intensive phase of standard chemotherapy

Objective/background: To study whether interleukin (IL)-10 gene polymorphism is associated with multi-drug resistant tuberculosis (MDR TB) during the intensive phase of standard chemotherapy. Methods: The study comprised 170 individuals in Kharkiv region of Ukraine including 74 patients with pulmonary MDR TB (Group 1), 66 patients without MDR TB (Group 2), and 30 healthy donors (Group 3). Serum level of IL-10 was evaluated by enzyme-linked immunosorbent assay (pg/L). Measurements of serum samples were conducted before or during the initial days after hospital admission and after 2 months on antituberculous therapy. Investigations of IL-10 gene polymorphism were performed using restriction analysis of the amplification products of specific regions of the genome. The method of investigation (for the sets real-time) — an allele-specific PCR using intercalating coloring Sybr Green. Polymorphism G1082A of gene IL-10 rs1800896 were genotyped with amplification-refractory mutation system-polymerase chain reaction. Results: In Group 1, the level of IL-10 was (38.01 ± 0.78) pg/L, compared with 43.88 ± 0.70 in Group 2, and 50.25 ± 1.26 in Group 3 (p <0.05 among the groups). In Group 1, 56 (75.68 ± 4.99%) patients had heterozygote GA genotype, 11 (14.86 ± 4.14%) patients had homozygote AA genotype, and seven (9.46 ± 3.40%) patients had homozygote GG genotype. In Group 2, 41 (62.12 ± 5.97%) patients had homozygote AA genotype, 17 (25.76 ± 5.38%) patients had heterozygote GA genotype, and eight (12.12 ± 4.02%) patients had homozygote GG genotype. In Group 3, 17 (56.67 ± 9.05%) healthy donors had homozygote GG genotype, seven (23.33 ± 7.72%) healthy donors had heterozygote GA genotype, and six (20.0 ± 7.30%) healthy donors had homozygote AA genotype (p <0.05 among the groups). Following 2 months antituberculous therapy treatment, there was a significant increase in IL-10 levels in Group 1 (44.58 ± 0.78) and Group 2 (50.59 ± 0.99; p <0.05 between the groups), when compared to the beginning of therapy and after 2 months (p <0.001). Conclusion: Compared to the healthy control group, patients with TB had significantly lower levels of IL-10. This coincided with a greater frequency of heterozygote GA genotype in Group 1 and homozygote AA genotype in Group 2. Further studies are warranted to determine whether a higher number of patients without MDR TB have a causal immunogenetic relationship with IL-10 gene polymorphisms than patients with MDR TB. Standard 2-month TB therapy results in reversal of inflammation characterized by increased IL-10 to a level comparable to that in healthy donors. IL-10 is an immune correlate of treatment outcome and can help to identify a better strategy for TB management. TB chemotherapy may have an immunomodulatory effect of an anti-inflammatory nature