Serum cytokine concentrations do not parallel Mycobacterium tuberculosis-induced cytokine production in patients with tuberculosis. Clin Infect Dis 36

We measured serum cytokine concentrations and Mycobacterium tuberculosis–stimulated cytokine production by peripheral blood mononuclear cells (PBMCs) obtained from persons infected with M. tuberculosis. Serum interferon-g (IFN-g) and interleukin-10 (IL-10) concentrations were elevated in patients with tuberculosis com-pared with healthy persons who had reactions to tuberculin skin tests, but IL-18 concentrations were not. In contrast, M. tuberculosis–stimulated PBMCs from patients with tuberculosis produced less IFN-g and IL-18 but similar amounts of IL-10, compared with PBMCs from healthy subjects who had reactions to tuberculin skin tests. Pretreatment of PBMCs from healthy subjects with reaction to tuberculin with serum from patients with tuberculosis inhibited IFN-g production in response to M. tuberculosis, and inhibition was blocked by anti–IL-10. Thus, serum concentrations of IFN-g, IL-18, and IL-10 do not parallel M. tuberculosis–induced cytokine levels, and increased IL-10 serum levels in patients with tuberculosis inhibit IFN-g production in response to mycobacterial antigens. IFN-g plays a fundamental role in the immune response to tuberculosis. Mice with a targeted deletion of the IFN-g gene are highly susceptible to tuberculosis [1, 2], and patients with defective receptors for IFN-g or IL-12 ar