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Possible impact of variations in some Cytokine levels during menstrual cycle in women of reproductive age infected with Pulmonary Tuberculosis at Nnewi, Nigeria'

Nkiruka Rose Ukibe, Solomon Nwabueze Ukibe, Emmanuel Ikechukwu Onwubuya, Chinedum Charles Onyenekwe, Ifeoma Nwamaka Monago, Obiageli Fidelia Emelumadu, Ifeoma Chinwe Ikegwuonu, Innocent Nwabueze Okonkwo, Joseph Eberendu Ahaneku

Objective: The second leading cause of human mortality from infectious diseases worldwide is Mycobacterium tuberculosis (Mtb). This chronic infection is accompanied by prolonged cytokine production, which might affect the immuno-reproductive communication and favour the establishment of an adverse state. This was a prospective study designed to evaluate possible impact of some cytokine variations on menstrual cycle in TB infected females.

Methods: A total of 90 premenopausal females aged (18-45) years were randomly recruited and grouped into 30 Symptomatic TB, 30 Symptomatic TB females on ATT and 30 Control females. Blood samples were collected at follicular (Fp) and luteal phases (Lp) of menstrual cycle for determination of IL-8, IL-6, TNFα, IL-4, CD4+ T-cells, and Absolute Lymphocytes counts using enzyme-linked immunosorbent assay (ELISA), Cyflow SL Green Cytometer and Sysmex K21N Hematology Analyzer respectively.

Results: There was significantly higher IL-6, IL-8, IL-4 and TNFα with lower CD4 T-cells and Abs Lym counts in TB and TB on ATT compared to Control females at both phases of menstrual cycle (P<0.05). All the cytokines were significantly lowered with higher CD4 T-cells in TB on ATT compared to TB females at both phases (P<0.05). Hypogonadism correlated positively with pro and anti-inflammatory cytokines

Conclusion: The study revealed significant cytokine alterations which suggest active inflammatory process while CD4 T-cells and Abs Lym dropped showing some degree of derangement in cellular immunity at both phases of menstrual cycle; which tends to normalize on treatment. This may affect the reproductive potentials in these women.