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Expression of HLA-DR, GM-CSF, CD38, and IFN-? CD4 Lymphocytes Isolated from Patients Pre- and Post-intensive Phase of Tuberculosis Treatment

Abstract

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

Blood circulating immune response such as Mycobacterium tuberculosis (Mtb)- specific CD4 T cells biomarkers are promising alternatives for evaluation of tuberculosis (TB) treatment. The objective of this study was to compare the expression of HLA-DR, GM-CSF, CD38, and IFN-γ on PPD specific CD4 lymphocytes of patients pre- and post-intensive phase of TB treatment. The expression of HLADR, GM-CSF, CD38, and IFN-γ on PPD-specific CD4 lymphocytes isolated from TB patients before and those who completed intensive phase of TB treatment were measured using flow cytometry and compared and presented as percentage. TB cases were diagnosed with GenXpert and confirmed with Mtb culture. To assess the difference of expression of the markers between pre- and post- treatment, a student's t-test was employed. In a total, 18 TB patients in each group were recruited, with the mean age of 38±12.43 and 39.44±11.50 years old for pre- and post- treatment group, respectively. The mean BMI was 21.18±1.93 in pretreatment group and 21.03±1.65 in post-treatment group. The percentage of expression of GM-CSF was significantly lower in pre-treatment group compare to the post-treatment group (52.23 ± 12.81 vs. 60.75 ± 9.58) with p=0.022. In contrast, the expression of HLA-DR and CD38 was significantly lower in posttreatment group compare to the pre-treatment group with p=0.006 and p=0.019, respectively. No significance was found in the expression of IFN-γ in pre-treatment compare to post-treatment group. The expression of HLA-DR, GM-CSF and CD38 was significantly different between newly diagnosed TB patients with Mtb positive and post-treatment TB patients (i.e., Mtb negative), suggesting the potential of these markers as biomarkers to diagnose active Mtb infection and to evaluate treatment effectivity.

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