الفهرس 
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Abstract
Wasting is a systemic manifestation of tuberculosis and is
often thought to affect the severity and outcome of the disease.
When tuberculosis infection occurs, a variety of chemokines and
cytokines are secreted from infected cells and tissue macrophages.
TNF alpha and several cytokines are thought to play a role in
the relationship between TB, nutritional status and host immune
response.
TNF alpha increases early in the disease and takes part in the
pathogenesis and prevention of mycobacterial infection.
This study was carried out on 40 active pulmonary TB patients
in (group A) in addition to 10 apparently healthy subjects (group B).
The patients were classified into 3 subgroups according to lesion:
(Minimal-lesion, Moderately-advanced lesion and Far-advanced
lesion).TNF-α levels was measured by Sandwich ELISA method
before and 2months after treatment. Body mass index (BMI) and chest X-rays were also evaluated.
The results of study showed:
The mean value of BMI ± SD in TB cases before treatment and
TB cases after treatment were (15.97± 2.55, 25.04±31.55) respectively
with P value 0.03. The mean value of TNF alpha (17832.00) & SD
(23396.87) in TB cases before treatment, The mean value of TNF
alpha (13447.00) & SD (4889.65) in TB cases after treatment, the
mean value of TNF alpha (278.05) & SD (142.58) in control with P
value <0.01. There was significant difference between serum TNF
alpha regarding symptomatology before and after treatment with
significant P value <0.001 and there was positive correlation between serum TNF alpha and clinical severity among cases with significant P
value 0.003. There was negative correlation between serum TNF
alpha and BMI among cases with significant P value <0.05.
There was significant difference between serum TNF alpha
regarding radiology before and after treatment with significant P value
<0.001. There was positive correlation between serum TNF alpha and
radiological severity among cases with P value <0.086
There was significant difference between serum TNF alpha
regarding sputum Ziel Neelsen stain before and after treatment with
significant P value <0.001. There was positive correlation between
serum TNF alpha and laboratory severity stain among cases with P
value 0.148.
from this study, it can be concluded that:
1- Serum TNF-α level was significantly higher in tuberculous group
as compared to control group.
2- Significant negative correlations were found between serum
TNF-α and BMI in tuberculous group.
3- Significant positive correlations were found between serums
TNF-α and clinical severity in tuberculous group.
4- Insignificant positive correlations were found between serums
TNF-α and radiological severity in tuberculous group.
5- Insignificant positive correlations were found between serum
TNF-α and laboratory severity in tuberculous group.