Role of TNF-α on the Function of Erythropoietin and Haematological Profile in Pulmonary Tuberculosis Patients

• Main Authors: Harish Bhat, Jeevan G Ambekar, Anand Kumar Harwalkar, Nilima Dongre, Kusal K Das
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2018-08-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: anaemia; bacterial burden; erythroid progenitors; haemoglobin
• Online Access: https://jcdr.net/articles/PDF/11850/36754_CE[Ra1]_F(SHU)_PF1(MLS_SL)_PFA(MLS_MJ_SL)_PB(MJ_SL)_PN(SL).pdf

Introduction: Pulmonary Tuberculosis (PTB) is one of the major causes for morbidity and mortality to the mankind and India accounts for over one fourth of global Tuberculosis (TB) burden. In PTB, the expression of inflammatory cytokine Tumour Necrosis Factor-Alpha (TNF-α) increases with increase in bacterial burden, which in turn interfere with Erythropoietin (EPO) action and play a vital role in pathophysiology of anaemia. Aim: To study the role of TNF-α on EPO function and its correlation with haematological profile in different grades of PTB. Materials and Methods: The present cross-sectional study was conducted at Navodaya Medical College Hospital and Research Centre, Raichur, Karnataka, India from January 2016 to January 2017. The study included 180 newly diagnosed sputum positive PTB cases and 100 healthy controls. The PTB was confirmed by microscopic examination of sputum specimen of the cases for the detection of Acid Fast Bacilli (AFB). Both cases and controls were subjected to haematological analysis by automated cell counter and serum TNF-α and EPO by ELISA method. The statistical analysis was performed by using SPSS version 16.0 software. The results were analysed with descriptive statistics, wherever appropriate. Results: The mean haematological parameters between PTB cases and controls showed statistically significant differences (p<0.05). We reported statistically significant differences in serum levels of TNF-α and EPO among PTB cases and controls (p<0.001 and p<0.001 respectively). We compared mean values for serum TNF-α, EPO and Haemoglobin (Hb) levels in PTB patients with different sputum AFB grading and noted statistically significant association between AFB grading and TNF-α, AFB grading and EPO and also AFB grading and Hb (p<0.001 respectively) in PTB. We observed inverse correlation between TNF-α and EPO (r=-0.49, p<0.001) and TNF-α and Hb (r=-0.58, p<0.001) in PTB cases. Further, we found no correlation between EPO and Hb (r=-0.101, p>0.05) in PTB cases. Conclusion: Increased bacterial burden was associated with increased TNF-α and relative deficiency of EPO. Increased TNF-α and proportionately decreased EPO values were accordant with Hb level and further anaemia in PTB. Hence, during the treatment, therapeutic administration of recombinant human EPO could be useful to combat anaemia and also for better prognostic impact in PTB.