Assessment of Tumour Necrosis Factor-Alpha-Neutrophil Ratio as a Marker of Inflammation in Adult Patients with Pulmonary Tuberculosis in Zaria, Nigeria

Abstract

Background: Tuberculosis (TB) remains a significant cause of morbidity and mortality worldwide. Complications of the disease is associated with the host’s inflammatory response. This study was designed to determine the use of tumour necrosis factor-alpha (TNF-α)-neutrophil ratio as a biomarker of inflammation among adult patients with pulmonary tuberculosis in Zaria.

Materials and Methods: Ninety adults consisting of 30 drug-naïve (DNTB) TB patients, 30 TB patients on treatment (TTB) and 30 apparently healthy controls (HC) were enrolled into this study. Plasma concentration of TNF-α was determined using ELISA while the % neutrophils count was determined microscopically. Thereafter, ratio of TNF-α to neutrophils was calculated appropriately.

Results: There was significant elevation in TNF-α concentration in TTB compared with the HC. In contrast, there was significant reduction in the mean percentage neutrophil count in TTB compared with the HC. In DNTB, there was significant elevation in mean percentage neutrophil count compared with the HC and TTB. There was significant elevation in the median TNF-α-neutrophil ratio in TTB compared with the HC while there was significant reduction in the ratio in DNTB compared with TTB. No significant difference was observed in the ratio when DNTB was compared with the HC.

Conclusion: The ratio of TNF-α to neutrophil appears to be dependent on the treatment-status of patients with tuberculosis. The use of the ratio as a surrogate marker of inflammation in patients with tuberculosis requires further study.