Abstract
Background: It has been demonstrated that the pro-inflammatory cytokine macrophage migration inhibitory factor (MIF), which has chemokine-like properties, is a key player in a number of acute and long-term inflammatory disorders. However, nothing is known regarding the application of MIF as an inflammatory pathway marker in tuberculosis patients. The purpose of this study was to look at the relationship between MIF and IFN- and TNF-( relationship of MIF with IFN and TNF) in active pulmonary tuberculosis after anti-tuberculosis medication.
Methods: By using cytokine-specific ELISA, the serum levels of MIF, TNF, and IFN were assessed in 40 patients with APTB at four different times: at baseline, 3, 5, and 7 months after starting anti-tuberculosis medication. Additionally, we assessed the serum levels of MIF, TNF, and IFN in 40 healthy controls.
Results: Prior to the procedure, MIF serum levels were substantially higher (P<0.04) in patients with APTB than in normal subjects, and high MIF levels (13.0 ng/mL) were linked to high TNF- α levels (449.6 pg/mL). Following 3, 5, and 7 months of treatment, MIF levels were considerably lowered (P<0.02), with changes in TNF-α and IFNβ-serum levels. MIF levels and the paired TNF- level had a positive correlation at baseline (r=0.1102, P=0.0315) and after 7 months of treatment (r=0.09568, P=0.0363).
Conclusion: After anti-tuberculosis therapy, a decrease in MIF serum levels in APTB patients might enhance the host immune system's defence against Mycobacterium tuberculosis infection. Therefore, serum MIF levels may serve as a helpful measure for evaluating the efficacy of medication in APTB patients.

Key words: TNF-α, Macrophage migration inhibitory factor, Active pulmonary tuberculosis, IFN-γ