Comparison of Immunological Surface Marker of CD4 + Lymphocytes in Patients with Pulmonary Tuberculosis Pre- and Post-Intensive Phase of Treatment

Abstract

Herry Priyanto, Muhammad Amin, Jusak Nugraha, Paul Edward Hutchinson

Immunological surface marker of CD4+ lymphocytes such as interleukin-2 (IL-2) is a potential marker for tuberculosis (TB) diagnosis and treatment evaluation. This study aimed to compare the expression of CD4+ lymphocyte IL-2 in patients with pulmonary TB, pre- and post-intensive phase of treatment. TB patients were diagnosed with GenXpert and confirmed with Mycobacterium tuberculosis (Mtb) culture. The expression of CD4+ lymphocytes IL-2, measured by flow cytometry, was compared between newly diagnosed TB patients and TB patients who completed intensive phase of TB treatment. A student’s t-test was used to compare the expression of CD4+ lymphocyte IL-2 between pre- and post-treatment groups. Thirty-six patients were recruited and divided evenly into two groups. The mean age of participants was 38±12.43 years for pre-treatment group and 39.44±11.50 years for post-treatment group, while the mean body mass index was 21.18±1.93 and 21.03±1.65 in pre- and post-treatment group, respectively. The expression of IL-2 on CD4+ lymphocytes was significantly lower in pre-treatment compare to post-treatment group (68.43±18.74 vs. 80.59±10.76, p=0.040). Further analysis showed that the expression of CD4+ lymphocytes IL-2+ GM-CSF+ was significantly lower (p<0.001) in pre-treatment compared to the post-treatment group (4.47±2.88 vs. 10.19±4.76, respectively). The area under the ROC curve (AUC) of CD4+ lymphocyte IL-2 was 0.70 (95%CI: 0.52, 0.87), suggesting its potential as a predictor of sputum conversion. In conclusion, the expression of CD4+ lymphocyte IL-2 was significantly higher in post-intensive TB treatment group compared to the newly diagnosed TB patients, suggesting its potential as a biomarker for rapid TB diagnosis and treatment evaluation.