PMID- 38101267
OWN - NLM
STAT- MEDLINE
DCOM- 20240108
LR  - 20240328
IS  - 1873-281X (Electronic)
IS  - 1472-9792 (Linking)
VI  - 144
DP  - 2024 Jan
TI  - mRNA profiling of cytokines to understand paradoxical response in HIV-uninfected 
      tuberculous meningitis.
PG  - 102463
LID - S1472-9792(23)00186-5 [pii]
LID - 10.1016/j.tube.2023.102463 [doi]
AB  - Paradoxical reaction (PR) in tuberculous meningitis (TBM) is a major management 
      issue. We report mRNA profiling of cytokines to understand PR in HIV-uninfected 
      TBM patients. 72 patients with TBM were included, and their clinical, MRI, and 
      mRNA profiling of tumor necrosis factor (TNF) alpha, interleukin (IL) 6, IL10 and 
      interferon (IFN) gamma genes in the peripheral blood mononuclear cells were done at 
      admission and 6 weeks of antitubercular treatment. Cytokine profiling was done 
      using reverse transcriptase polymerase chain reaction. PR was defined if repeat 
      MRI at 6 weeks revealed new or increase in exudates, tuberculoma, hydrocephalus 
      or infarctions. Outcome was defined at 6 months using modified Rankin Scale 
      (mRS), and categorized as death, poor and good. 44 (61.1 %) patients had PR, and 
      28 (38.9 %) had paradoxical tuberculoma (PT). The expression of IL6 and TNFalpha 
      genes were higher in PR and PT groups. Stage of meningitis and hydrocephalus at 
      admission predicted PR. Patients with PR and PT had more frequently poor outcome. 
      About three-fifth HIV-uninfected TBM patients have PR and two-fifth have PT. 
      Paradoxical reaction is associated with higher expression of IL6 and TNFalpha. 
      Patients with severe meningitis with hydrocephalus develop PR more frequently.
CI  - Copyright (c) 2023 Elsevier Ltd. All rights reserved.
FAU - Kalita, Jayantee
AU  - Kalita J
AD  - Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical 
      Sciences, Raebareli Road, Lucknow, 226014, Uttar Pradesh, India. Electronic 
      address: jayanteek@yahoo.com.
FAU - Shukla, Ruchi
AU  - Shukla R
AD  - Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical 
      Sciences, Raebareli Road, Lucknow, 226014, Uttar Pradesh, India.
FAU - Pandey, Prakash C
AU  - Pandey PC
AD  - Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical 
      Sciences, Raebareli Road, Lucknow, 226014, Uttar Pradesh, India.
FAU - Singh, Vivek
AU  - Singh V
AD  - Department of Radio diagnosis Sanjay Gandhi Post Graduate Institute of Medical 
      Sciences, Raebareli Road, Lucknow, 226014, Uttar Pradesh, India.
FAU - Haldar, Rudrashish
AU  - Haldar R
AD  - Department of Anesthesiology, Sanjay Gandhi Post Graduate Institute of Medical 
      Sciences, Raebareli Road, Lucknow, 226014, Uttar Pradesh, India.
FAU - Misra, Usha K
AU  - Misra UK
AD  - Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical 
      Sciences, Raebareli Road, Lucknow, 226014, Uttar Pradesh, India.
LA  - eng
PT  - Journal Article
DEP - 20231209
PL  - Scotland
TA  - Tuberculosis (Edinb)
JT  - Tuberculosis (Edinburgh, Scotland)
JID - 100971555
RN  - 0 (Cytokines)
RN  - 0 (Interleukin-6)
RN  - 0 (Tumor Necrosis Factor-alpha)
SB  - IM
MH  - Humans
MH  - *Tuberculosis, Meningeal/diagnosis/drug therapy/genetics
MH  - Cytokines/genetics
MH  - *Mycobacterium tuberculosis/genetics
MH  - Interleukin-6/genetics
MH  - Tumor Necrosis Factor-alpha/genetics
MH  - Leukocytes, Mononuclear
MH  - *Hydrocephalus/complications
MH  - *Tuberculoma
MH  - *HIV Infections/complications/drug therapy/genetics
OTO - NOTNLM
OT  - Cytokines
OT  - IRIS
OT  - MRI
OT  - Meningitis
OT  - Paradoxical tuberculoma
COIS- Declaration of Competing interest The Author(s) declare(s) that there is no 
      conflict of interest.
EDAT- 2023/12/16 11:43
MHDA- 2024/01/08 06:43
CRDT- 2023/12/15 18:15
PHST- 2023/09/01 00:00 [received]
PHST- 2023/11/29 00:00 [revised]
PHST- 2023/12/05 00:00 [accepted]
PHST- 2024/01/08 06:43 [medline]
PHST- 2023/12/16 11:43 [pubmed]
PHST- 2023/12/15 18:15 [entrez]
AID - S1472-9792(23)00186-5 [pii]
AID - 10.1016/j.tube.2023.102463 [doi]
PST - ppublish
SO  - Tuberculosis (Edinb). 2024 Jan;144:102463. doi: 10.1016/j.tube.2023.102463. Epub 
      2023 Dec 9.