Dependence of Human-Beta-Defensin-1, Ferritin and Interleukin-6 Levels on the Spectrum of Drug Resistance and Regimens of Anti-Tuberculosis Therapy in Patients with Pulmonary Tuberculosis

Objective — to explore the correlation between the levels of Human-beta-defensin-1, ferritin and Interleu­kin-6 and the spectrum of drug resistance, as well as the treatment regimens in patients with pulmonary tuberculosis. Materials and methods. This study included 100 patients with pulmonary tuberculosis, divided into two groups: Group 1 (n = 52) with drug-susceptible tuberculosis and Group 2 (n = 48) with drug-resistant tuber­culosis, including patients with multidrug-resistant (MDR-TB) and pre-extensively drug-resistant tuberculosis. Diagnostic assessments included chest X-rays and sputum examinations using microscopic, molecular-genetic and cultural methods. Levels of HBD-1, ferritin and IL-6 were measured using ELISA on fasting blood samples at the onset of treatment and after 60 days. Data analysis was performed using Statistica 8.0 software. Results and discussion. In patients with drug-susceptible tuberculosis, the initial levels of biomarkers were significantly higher compared to their levels after 60 treatment doses. Specifically, Human-beta-defensin-1 (HBD-1) decreased from (23.38 ± 3.48) pg/mL initially to (11.83 ± 2.30) pg/mL after 60 doses; ferritin decreased from (117.47 ± 12.34) ng/mL to (85.74 ± 13.25) ng/mL; and Interleukin-6 (IL-6) decreased from (87.49 ± 8.43) pg/mL to (51.37 ± 5.15) pg/mL. Conversely, in patients with drug-resistant tuberculosis, while IL-6 levels also showed a significant decrease from (99.78 ± 8.52) pg/mL at the onset to (67.59 ± 8.28) pg/mL after 60 doses, both HBD-1 and ferritin levels increased post-treatment. HBD-1 levels rose from (21.43 ± 4.39) pg/mL to (30.69 ± 5.06) pg/mL, and ferritin levels from (105.13 ± 8.72) ng/mL to (153.43 ± 20.29) ng/mL. Conclusions. In patients with drug-susceptible tuberculosis, levels of HBD-1, ferritin and IL-6 significantly decrease after 60 days of treatment. This decrease correlates with a reduction in clinical and radiographic symptoms of tuberculosis and the cessation of bacterial excretion. Conversely, in patients with drug-resistant tuberculosis, levels of HBD-1 and ferritin increase after 60 doses of treatment, likely due to a delayed reduction in bacterial load and a prolonged active immune response. However, IL-6 levels significantly decrease, suggesting its primary role in initiating the anti-tuberculosis immune response. The lack of significant differences in these biomarkers between patients with drug-susceptible and drug-resistant tuberculosis at the onset of treatment suggests that drug resistance does not inherently affect the severity of tuberculosis inflammation or the activity of the initial anti-tuberculosis immune response.