Plasma interleukin-18 levels are a biomarker of innate immune responses that predict and characterize tuberculosis-associated immune reconstitution inflammatory syndrome

Hong Yien Tan, Yean Kong Yong, Bruno B Andrade, Esaki M Shankar, Sasheela Ponnampalavanar, Sharifah Faridah Syed Omar, Gopalan Narendran, Adeeba Binti Kamarulzaman, Soumya Swaminathan, Irini Sereti, Suzanne Mary Crowe, Martyn A French

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Abstract

BACKGROUND: : Tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is a substantial problem in HIV/TB coinfected patients commencing antiretroviral therapy (ART). The immunopathogenesis of TB-IRIS includes increased production of proinflammatory chemokines and cytokines, including interleukin-18, which is a signature cytokine of the nucleotide-binding domain and leucine-rich repeat pyrin containing protein-3 inflammasome. We compared plasma levels of interleukin-18 and other biomarkers of monocyte/macrophage activation in the prediction and characterization of TB-IRIS. METHODS: : Biomarkers were assayed pre-ART and during TB-IRIS, or equivalent time-point, in a case-control study of Malaysian HIV patients with paradoxical or unmasking TB-IRIS (n=15), TB no IRIS (n=14), and no TB or IRIS (n=15). Findings for interleukin-18 were verified in another cohort of patients with paradoxical TB-IRIS (n=26) and their controls (n=22) from India. RESULTS: : Interleukin-18 was higher in TB-IRIS patients pre-ART and during the event in both Malaysian patients (P
Original languageEnglish
Pages (from-to)421 - 431
Number of pages11
JournalAIDS
Volume29
Issue number4
DOIs
Publication statusPublished - 2015

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