The cytokine profile in granulomatous lung diseases

Twenty-five patients with new-onset pulmonary tuberculosis, 52 patients with active sarcoidosis, and 5 healthy donors were examined. Cytokines (IL-2, IL-4, IL-6, TNF-alpha, and gamma-1FN were determined by enzyme immunoassay in the serum and cultured mononuclear supernatant from peripheral blood. IL-2, TNF-alpha, and gamma-IFN) were found in the sera of all the examinees. There were significant differences in the presence of IL-4 that was more commonly detected in sarcoidosis than in tuberculosis (96.2% versus 68%; p = 0.001) and in healthy individuals (40%; p = 0.0001) and in the presence of IL-6 (84.6% in patients with sarcoidosis; 20% in healthy individuals; p = 0.0015; 12% in patients with tuberculosis; p < 0.0001). Supernatant studies showed that IL-4 was absent in 25% of patients with sarcoidosis, nor gamma-IFN in 21.7% of patients with tuberculosis and in 12.5% of patients with sarcoidosis. In tuberculosis, the mean levels of IL-2, IL-4, IL-6, TNF-alpha, and gamma-IFN were greater than those in the control group; but these differences were not statistically significant primarily due to the fact that there was a great scatter of readings. In sarcoidosis, the serum levels of IL-4 (40.9 +/- 38.5 pg/ml) and IL-6 (19.0 +/- 2.7 pg/ml) were significantly higher than those in healthy individuals (p = 0.01 and p = 0.026, respectively) and in patients with tuberculosis (p = 0.0005 and p < 0.0001). The supernatant from patients with tuberculosis showed no significant differences in the content of cytokines than that from donors. In patients with sarcoidosis, the increase in the level of TNF-alpha (757.8 +/- 142.8 pg/ml) was statistically significant, as compared with the controls (p = 0.036) and patients with tuberculosis (p = 0.018), so as that of gamma-IFN (272.9 +/- 58.0 pg/ml), as compared with patients with tuberculosis (p = 0.046). Thus, the serum levels of IL-6 and IL-4 and the capacity of monocytes and macrophages for synthesizing TNF-alpha and gamma-IFN may be used as an auxiliary criterion for the nosological diagnosis of sarcoidosis and tuberculosis.