Assessment of Cytokine (α-TNF) with Erythropoietin and their Correlation in Pulmonary Tuberculosis with Anaemia

Globally tuberculosis is the 9th leading cause of death worldwide. As pulmonary tuberculosis (PTB) is a chronic disease, anaemia of inflammation due to bacterial burden play a vital role in pathophysiology of anaemia. Inflammation interferes with erythropoietin (EPO) function.

Methods: The present study was an analytical type of case control study. The study included 100 newly diagnosed anaemic PTB cases and 50 newly diagnosed non anaemic PTB controls. The PTB was confirmed by microscopic examination of sputum specimen for the detection of Acid-Fast Bacilli (AFB). Both cases and controls were subjected to hematological analysis by automated cell counter and serum α-TNF and EPO by ELISA method.

Results: Statistically significant difference was observed in levels of both α-TNF and EPO in anemic and non-anemic PTB groups (p<0.001). α-TNF (214.56±82.30) levels were found to be significantly higher in anaemic PTB group while EPO level (58.44 ±14.97) were found to be significantly higher in non anaemic PTB group. Significant inverse correlation (r1=cases, r2=controls) was observed between α-TNF and EPO (r=-0.257, p<0.05) and α-TNF and Hb (r=-0.202, p<0.05) in both the groups.

Conclusion: Increased α-TNF with decreased EPO and hemoglobin infers that inflammation interferes with normal functioning of EPO and probably contributes in induction of anemia in tuberculosis patients.