Serum Levels of Seven General Cytokines in Acute Brucellosis Before and After Treatment

Figures & data

Table 1 Characterization of Individuals with Acute Brucellosis and Healthy Controls

Variable	Healthy Controls n=26	Acute Brucella Infection n=30
Age (y), (mean [range])	44 (24–65)	42 (21–65)
Gender (M/F ratio)	19/7	21/9
Mode of transmission, no. (%)
Contact with infected animals	NA	23 (76.67)
Consumption of unpasteurized dairy products	NA	2 (6.67)
Consumption of undercooked meat of sheep	NA	3 (10.00)
No obvious history of contact	NA	2 (6.67)
Symptoms and signs, no. (%)
Fevers	0	26 (86.67)
Sweating	0	22 (73.33)
Arthralgias	0	14 (46.67)
Low back pain	0	14 (46.67)
Weakness	0	6 (20.00)
Chill	0	8 (26.67)
Headaches	0	1 (3.33)
Dizziness	0	2 (6.67)
Dyspepsia	0	2 (6.67)
Abdominal pain	0	1 (3.33)
cough	0	3 (10.00)
Testicular swelling and pain	0	1 (3.33)
Hepatomegaly	0	1 (3.33)
Time from symptoms, n (%)
<28 days	NA	28 (93.33)
28–56 days	NA	2 (6.67)
Diagnostic tests, n (%)
Positive Rose-Bengal test	0	30 (100)
Positive Agglutination test (SAT)	NA	30 (100)
Positive Blood culture	NA	13 (43.33)

Note: The SAT titre ≥ 1/160.

Abbreviations: SAT, serum agglutination test; NA, not available.

Table 2 Serum Th1/Th2/Th17 Cytokine Levels and General Inflammatory Markers in Patients with Acute Brucellosis Pre- and Post-Treatment and Healthy Controls

Markers	Healthy Controls (n = 26) Median (IQR)	Pre-Treatment (n = 30) Median (IQR)	Post-Treatment (n = 30) Median (IQR)	P-value (Pre-Treated vs Post-Treated)
cytokines
IL-2 (pg/mL)	16.75 (14.40–18.55)	25.46 (17.65–36.28) **	17.65 (16.29–20.00)	0.001
IL-4 (pg/mL)	21.08 (19.51–23.39)	24.14 (20.89–27.19) *	22.62 (21.85–25.84) **	NS
IL-6 (pg/mL)	22.93 (12.78–38.78)	57.26 (15.69–121.00) **	28.18 (11.13–163.9)	NS
IL-10 (pg/mL)	5.22 (4.038–6.27)	7.13 (5.80–9.68) **	5.92 (5.22–7.30) *	0.017
TNF-α (pg/mL)	11.06 (7.67–35.98)	9.72 (7.67–20.65)	22.33 (11.77–59.35) *	0.037
IFN-γ (pg/mL)	5.22 (4.21–6.43)	10.13 (7.38–15.85) **	6.67 (5.22–8.19) *	0.003
IL-17A (pg/mL)	17.88 (12.36–25.18)	23.46 (12.88–31.68)	19.98 (15.27–29.74)	NS
Inflammatory markers
CRP (mg/L)	0.35 (0.09–1.05)	3.63 (1.79–6.92) **	0.32 (0.13–0.81)	<0.001
ESR (mm/h)	12.90 (8.75–14.13)	35.15 (20.40–44.02) **	10.65 (7.78–13.30)	<0.001
WBC (×10^9/L)	5.29 (3.57–5.99)	5.05 (3.59–5.53)	5.25 (3.86–6.02)	NS

Notes: Data are presented as median [interquartile range, (IQR)] and analysed using Mann–Whitney U-test or Wilcoxon ranked sum test; *P < 0.05 versus healthy controls; **P < 0.01 versus healthy controls.

Abbreviations: IL, interleukin; IFN, interferon; TNF, tumor necrosis factor; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; WBC, white blood cell; NS, no significance.

Figure 1 Serum IL-2, IFN-γ, TNF-α, IL-17A, IL-4, IL-6, and IL-10 levels in patients with brucellosis before and after treatment and in healthy controls. Comparisons of the level of seven cytokines, including (A) IL-2, (B) IFN-γ, (C) TNF-α, (D) IL-17A, (E) IL-4, (F) IL-6, and (G) IL-10 in patients with acute brucellosis before treatment (pre-treatment) and at 6 weeks after treatment (post-treatment) and healthy controls (HC) (n = 30, 30, and 26, respectively) are shown. Values are expressed in Log₁₀ (pg/mL). Medians are indicated with horizontal lines. P values were calculated using the Mann–Whitney U-test for differential analysis of controls and patients and the Wilcoxon matched-pair signed-rank test for comparisons of patients before and after treatment.

Table 3 Correlations Between Serum Th1/Th2/Th17 Cytokines with General Inflammatory Markers in Patients with Acute Brucellosis (n = 30)

Cytokines	CRP		ESR		WBC
	R	P	R	P	R	P
IL-2	0.550	0.002	−0.207	0.273	0.146	0.443
IL-4	−0.603	0.741	−0.260	0.165	0.210	0.265
IL-6	0.525	0.003	−0.031	0.871	0.301	0.106
IL-10	0.308	0.097	0.045	0.814	0.148	0.435
TNF-α	0.334	0.071	−0.102	0.593	−0.211	0.264
IFN-γ	0.111	0.561	−0.074	0.696	−0.152	0.423
IL-17A	−0.152	0.423	−0.058	0.762	0.248	0.186

Notes: R, Spearman correlation coefficient.

Abbreviations: IL, interleukin; IFN, interferon; TNF, tumor necrosis factor; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; WBC, white blood cell.

Figure 2 Correlations between selected serum Th1/Th2/Th17 cytokines and CRP. Spearman correlation coefficient (R) was used to evaluate correlations between CRP and serum IL-2 (A) and IL-6 (B) in patients with acute brucellosis (n=30).