Assessments of serum copper and zinc concentration, and the Cu/Zn ratio determination in patients with multidrug resistant pulmonary tuberculosis (MDR-TB) in Côte d’Ivoire

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Abstract

Background

In Côte d’Ivoire, multidrug-resistant tuberculosis (MDR-TB) is a serious public health problem with a prevalence estimated at 2.5% in 2006. Zinc and copper are essential Trace element needed to strengthen the immune system and also useful in the fight against tuberculosis. The Cu / Zn ratio is a good indicator of oxidative stress.

The principal aim of this study was to evaluate the serum concentration of some trace element and determine the Cu / Zn ratio in patients with multidrug resistant pulmonary tuberculosis (MDR-TB) before and after second line treatment of TB.

Methods

Blood samples were obtained from 100 MDR-TB patients after confirmation of their statu s through the microscopic and molecular diagnosis of resistance to Isoniazid and Rifampicin by GeneXpert. The concentration level of zinc and copper were determined using flame air / acetylene atomic absorption spectrometer (AAS) Type Varian Spectr AA-20 Victoria, Australlia.

Results

A significant decrease in zinc levels ( P < 0.05) and an increased Cu / Zn ratio ( P < 0.05) was observed in MDR-TB patients compared to controls TB free. During treatment a significant reduction in Cu / Zn ratio ( P < 0.05) was observed compared to the initial result.

Conclusions

The decrease in serum zinc level and the high Cu / Zn ratio could explain the immune system dysfunction and the high level of oxidative stress in patients with MDR-TB. Therefore the evaluation of the zinc and copper status could represent essential parameters in monitoring of TB second line treatment for better treatment management.

Electronic supplementary material

The online version of this article (doi:10.1186/s12879-017-2343-7) contains supplementary material, which is available to authorized users.

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Most cited references 15

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Contribution of Selected Vitamins and Trace Elements to Immune Function

Eva Wintergerst, Silvia Maggini, Dietrich H. Hornig (2007)

Adequate intakes of vitamins and trace elements are required for the immune system to function efficiently. Micronutrient deficiency suppresses immune functions by affecting the innate T-cell-mediated immune response and adaptive antibody response, and leads to dysregulation of the balanced host response. This increases the susceptibility to infections, with increased morbidity and mortality. In turn, infections aggravate micronutrient deficiencies by reducing nutrient intake, increasing losses, and interfering with utilization by altering metabolic pathways. Insufficient intake of micronutrients occurs in people with eating disorders, in smokers (both active and passive), in individuals with chronic alcohol abuse, in patients with certain diseases, during pregnancy and lactation, and in the elderly. With aging a variety of changes are observed in the immune system, which translate into less effective innate and adaptive immune responses and increased susceptibility to infections. Antioxidant vitamins and trace elements (vitamins C, E, selenium, copper, and zinc) counteract potential damage caused by reactive oxygen species to cellular tissues and modulate immune cell function through regulation of redox-sensitive transcription factors and affect production of cytokines and prostaglandins. Adequate intake of vitamins B 6 , folate, B 12 , C, E, and of selenium, zinc, copper, and iron supports a Th1 cytokine-mediated immune response with sufficient production of proinflammatory cytokines, which maintains an effective immune response and avoids a shift to an anti-inflammatory Th2 cell-mediated immune response and an increased risk of extracellular infections. Supplementation with these micronutrients reverses the Th2 cell-mediated immune response to a proinflammatory Th1 cytokine-regulated response with enhanced innate immunity. Vitamins A and D play important roles in both cell-mediated and humoral antibody response and support a Th2-mediated anti-inflammatory cytokine profile. Vitamin A deficiency impairs both innate immunity (mucosal epithelial regeneration) and adaptive immune response to infection resulting in an impaired ability to counteract extracellular pathogens. Vitamin D deficiency is correlated with a higher susceptibility to infections due to impaired localized innate immunity and defects in antigen-specific cellular immune response. Overall, inadequate intake and status of these vitamins and minerals may lead to suppressed immunity, which predisposes to infections and aggravates malnutrition.

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Iron, copper and immunocompetence.

Manuel Olivares, Hernando J. Olivos, Juan Munoz … (2007)

Microminerals including copper and iron are essential to immunity and health in human beings. The development of powerful tools in analytical cell biology and molecular genetics has facilitated efforts to identify specific cellular and molecular functions of trace elements in the maturation, activation and functions of host defence mechanisms. Selected recent reports about the role of copper and iron nutrition on immune functions are critically analysed here. Effects of trace element supplementation on infectious morbidity are also reviewed. While micromineral deficiencies, in general, may have widespread effects on nearly all components of immune response, these effects can be reversed by supplementation. However, the conflicting effects of iron deficiency and iron supplementation in vitro on the defensive systems reveals the urgent need for further additional information on the in vivo situation. In the elderly, vaccination against respiratory infections is likely to protect only 30-70% of the population. However, it may be possible to modulate immune function and ultimately reduce the severity of infections through micronutrient supplementation. Thus, microminerals contribute to the maintenance of the balance between immunity and health in humans.

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Changes in serum selenium, copper, zinc levels and cu/zn ratio in patients with pulmonary tuberculosis during therapy.

T Ciftci, B Ciftci, O Yis … (2003)

The effectiveness and success of antituberculosis therapy is mainly measured by its ability to identify the organism in the sputum. In certain cases, available tuberculosis tests are not satisfactory and do not provide enough information on the effectiveness of antituberculosis therapy. Copper (Cu), zinc (Zn), and selenium (Se) are the essential elements that play a crucial role in the immune system. The serum levels of these elements vary in many diseases including tuberculosis. In this study, we investigate whether the serum levels of Cu, Zn, and Se change during antituberculosis therapy. We have included 22 pulmonary tuberculosis cases that were newly diagnosed with positive sputum and 18 healthy subjects. At the beginning and 2 mo after therapy, serum levels of Cu, Zn, and Se were measured by atomic absorption spectrometry. Despite Se and Cu levels not being affected during the treatment, we found that there was a significant increase in the levels of Zn and a decrease in the Cu/Zn ratio. Serum Zn levels and the Cu/Zn ratio could be used as a valuable laboratory tool for the clinicians to assess response to therapy or effectiveness of the ongoing antituberculosis therapy.

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Author and article information

Contributors

Gnogbo Alexis Bahi: alexisbahi@yahoo.fr

Lydie Boyvin: boyvinlyd@yahoo.fr

Souleymane Méité: Souley_ci@yahoo.fr

Gervais Melaine M’Boh: mbohgervais@yahoo.fr

Kadjowely Yeo: yeokadjowely@yahoo.fr

Kouassi Raymond N’Guessan: kouassinguessan@pasteur.ci

Alain Dit Philippe Bidié: alphbid@yahoo.fr

Allico Joseph Djaman: djamanj@yahoo.fr , josephdjaman@pasteur.ci

Journal

Journal ID (nlm-ta): BMC Infect Dis

Journal ID (iso-abbrev): BMC Infect. Dis

Title: BMC Infectious Diseases

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2334

Publication date (Electronic): 11 April 2017

Publication date PMC-release: 11 April 2017

Publication date Collection: 2017

Volume: 17

Electronic Location Identifier: 257

Affiliations

[1 ]GRID grid.418523.9, Department of clinical and Fondamental Biochemistry, , Pasteur Institute of Cote d’Ivoire (IPCI), ; 01 BP 490, Abidjan, 01 Côte d’Ivoire

[2 ]Pharmacodynamics Laboratory of Biochemical, University FélixHouphouët- Boigny (UFHB), Abidjan 01 BP V34, Abidjan, 01 Côte d’Ivoire

Article

Publisher ID: 2343

DOI: 10.1186/s12879-017-2343-7

PMC ID: 5387198

PubMed ID: 28399817

SO-VID: e4e3ab93-5250-4ea6-8e1a-4bb813cec24b

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 15 October 2016

Date accepted : 25 March 2017

Custom metadata

ScienceOpen disciplines: Infectious disease & Microbiology

Keywords: abidjan,trace elements,cu/zn ratio,mdr-tb,second-line anti-tb drugs

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ScienceOpen disciplines: Infectious disease & Microbiology

Keywords: abidjan, trace elements, cu/zn ratio, mdr-tb, second-line anti-tb drugs

Assessments of serum copper and zinc concentration, and the Cu/Zn ratio determination in patients with multidrug resistant pulmonary tuberculosis (MDR-TB) in Côte d’Ivoire

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Abstract

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Methods

Results

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Point-Of-Care Testing for Tuberculosis

Most cited references 15

Contribution of Selected Vitamins and Trace Elements to Immune Function

Iron, copper and immunocompetence.

Changes in serum selenium, copper, zinc levels and cu/zn ratio in patients with pulmonary tuberculosis during therapy.

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