Original Article PLASMA NEOPTERIN AND PEROXIDE LEVELS IN PULMONARY TUBERCULOSIS PATIENTS ON CHEMOTHERAPY WITH OR WITHOUT

Objectives: Neopterin and H2O2 are products of cellular (macrophage) activation. The exact roles of these secretions by activated macrophages in protection against tuberculosis remain unclear. In the present study, the changes in the levels of neopterin and total plasma peroxides (TPP) were assessed in pulmonary tuberculosis (PTB) patients on chemotherapy with (C+M) or without (C- M) micronutrient supplementation. Methodology: Thirty-eight newly diagnosed PTB patients were selected for this study. Twenty patients were treated with anti-tuberculosis drugs and micronutrient (C+M) while 18 PTB-patients were treated with only anti-tuberculosis chemotherapy (C-M). Plasma neopterin and TPP concentrations were measured by enzymes linked immunosorbent assay (ELISA) and colorimetric method respectively. Results: All PTB patients had elevated neopterin (p=0.02) and TPP (p=0.00) levels when compared with the non-PTB controls. Plasma level of neopterin and TPP declined significantly in C+M after 2 weeks of treatment (p = 0.00, p=0.01 respectively) and also after 4 weeks of treatment (p = 0.01 and p=0.00 respectively) when compared with baseline levels before treatment. No significant change was observed in the levels of neopterin and TPP in C-M after 4 weeks of treatment when compared with baseline value before treatment. Conclusion: Micronutrient supplementation enhanced the decline in the levels of neopterin and TPP after two weeks of treatment. Chemotherapy alone did not produce significant reduction. Therefore, micronutrient supplementation of PTB drugs with synthetic antioxidants or naturally occurring ones (fruits and vegetables) should be attempted