Establishment of elevated serum levels of IL-10, IL-8 and TNF-beta as potential peripheral blood biomarkers in tubercular lymphadenitis: a prospective observational cohort study

Background: Tubercular lymphadenitis (TL) is the most common form of extra-pulmonary tuberculosis (TB) consisting about 15-20% of all TB cases. The currently available diagnostic modalities for (TL), are invasive and involve a high index of suspicion, having limited accuracy. We hypothesized that TL would have a distinct cytokine signature that would distinguish it from pulmonary TB (PTB), peripheral tubercular lymphadenopathy (LNTB), healthy controls (HC), other lymphadenopathies (LAP) and cancerous LAP. To assess this twelve cytokines (Tumor Necrosis Factor (TNF) -alpha, Interferon (IFN) -gamma, Interleukin (IL)-2, IL-12, IL-18, IL-1beta, IL-10, IL-6, IL-4, IL-1 Receptor antagonist (IL-1Ra), IL-8 and TNF-beta, which have a role in pathogenesis of tuberculosis, were tested as potential peripheral blood biomarkers to aid the diagnosis of TL when routine investigations prove to be of limited value. Methods and Findings: A prospective observational cohort study carried out during 2010-201...背景：结核性淋巴结炎（Tubercular lymphadenitis, TL）是最常见的肺外结核（extra-pulmonary tuberculosis, TB）类型，约占所有结核病例的15%~20%。当前针对TL的诊断手段均为有创操作，且依赖高度怀疑的临床思维，诊断准确性有限。本研究提出假设：结核性淋巴结炎具有独特的细胞因子特征，可将其与肺结核（pulmonary TB, PTB）、外周结核性淋巴结病（peripheral tubercular lymphadenopathy, LNTB）、健康对照（healthy controls, HC）、其他淋巴结病（lymphadenopathies, LAP）及癌性淋巴结病相区分。为验证该假设，我们选取了12种在结核发病机制中发挥作用的细胞因子作为潜在外周血生物标志物进行检测，包括肿瘤坏死因子-α（Tumor Necrosis Factor, TNF-α）、干扰素-γ（Interferon, IFN-γ）、白细胞介素-2（Interleukin, IL-2）、IL-12、IL-18、IL-1β、IL-10、IL-6、IL-4、白细胞介素-1受体拮抗剂（IL-1 Receptor antagonist, IL-1Ra）、IL-8及TNF-β，以期在常规检查价值有限时辅助TL的诊断。方法与结果：本研究为一项于2010-201……年间开展的前瞻性观察队列研究。