Impact of Latent Tuberculosis on Inflammatory Biomarkers in Crohns Disease: A Comparative Study of Cytokines, CRP, and Calprotectin

Abstract

Latent tuberculosis (LTB) in Crohns disease patients could impact the inflammatory profile and treatment approach. Many cytokines, such as IL12, IL23, and TNF-, are critical in both Crohns disease and mycobacterial infections; the exclusion of LTB-positive patients is important before initiation of immunotherapy because it may influence disease activity and inflammatory markers. This study compared and evaluated the levels of pro-inflammatory cytokines (TNF-, IL-12, and IL-23) and fecal calprotectin and CRP in sick persons with Crohns disease who have latent TB infection and have not received immune-based therapy, and those who do not. The current research involved the enrollment of 100 patients with inflammatory bowel disease (IBD). Among them, 25 patients were diagnosed with latent tuberculosis infection (LTBI) based on the Gold-Gold-interferon-gamma release assay (IGRA). Patients who showed an IGRA negative (75), later received immunotherapy and were considered as the treated group. The Inflammatory markers (CRP and fecal calprotectin) and cytokine levels (TNF-, IL-12, and IL-23) have been measured and compared between the treated group (n=75) and the untreated group (n=25). No significant correlation has been identified between the IGRA test and different cytokines. Smokers patients show higher levels of biomarker vs. non-smokers. Crohns disease patients who underwent treatment, including aminosalicylates (5-ASA), corticosteroids, and immunomodulators, had statistically significant differences in Inflammatory biomarker levels, calprotectin, interleukin-23 (IL-23), and interleukin-12 (IL-12), compared to those who did not receive any treatment, in which all biomarkers were markedly elevated in untreated patients. Fecal calprotectin levels showed statistically significant positive correlations with all measured inflammatory biomarkers. This study reported that Latent Tuberculosis infection in Crohns disease (CD) could not significantly affect the level of TNF-, IL-12, IL-23, CRP, and fecal calprotectin. Form other hand, pro-inflammatory cytokines and calprotectin levels are significantly impacted by immune-based therapy.