The purpose of this study was to evaluate the cytokine profile in patients with tuberculosis before and during treatment and the association with the clinical picture of the disease.

Twenty-two patients with active pulmonary tuberculosis and 30 PPD positive healthy controls were included in the study. Serum cytokine concentrations (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-12 and IFN-γ) were measured before and in the second month of antituberculosis treatment by ELISA. Additionally, the effect of smear positivity, degree of spread of the disease and the state of the disease (new case, relapse, or multidrug-resistant case) on these cytokine levels were investigated. Of the 22 patients, 9 had mild, 6 moderate and 7 extensive pulmonary involvement. Seventeen patients were new, 3 were relapse and 2 were MDR cases. Eight patients had sputum AFB negative smears and 14 had positive smear. Significant differences between cytokine levels of the patients and the controls and between cytokine levels before and in the second month of treatment existed only for IL-6 (p<0.001 and p=0.001, respectively). Multivariate analysis showed that being a MDR case was determinant factor of TH1 response (p=0.012) and smear positivity and being MDR case were determinants of TH2 response (p=0.034 and p=0.015). Serum cytokine levels are affected by varying balance rather than by increase or decrease in tuberculosis patients. Additionally, clinical picture of disease affects the cytokine levels during the treatment.