Aim. The aim of the study was a potential impact of prednisone on the early immune response in HIV-negative young adults with active pulmonary tuberculosis, during the first four weeks of treatment.Material and methods. The study included 38 adults, aged 18-39 years, with active pulmonary tuberculosis. The first group of patients received only anti-tuberculosis chemotherapy whereas the second group of patients was administered antituberculosis chemotherapy and 20 mg prednisone, once daily. Serum levels of tumor necrosis factor-alpha, interferon-gamma and interleukin 1-beta were measured using ELISA kits before treatment initiation as well after two and four weeks of treatment, in both study groups.Results. The highest serum levels of evaluated cytokines were observed before treatment initiation. Serum levels of cytokines were significantly decreased in patients who received anti-tuberculosis drugs and prednisone, compare to those not treated with prednisone (p<0.001), in all study periods.Conclusions. Adjunctive therapy, like 20 mg prednisone daily, remarkably inhibited the secretion of inflammatory cytokines during the early stage of active pulmonary tuberculosis in HIV-negative young adults, which is likely to be beneficial for this group of patients.

Introduction. Anti-inflammatory, separate from anti-thrombotic activity of low molecular weight heparin, is still not well documented.Aim. We estimated the influence of enoxaparin on serum levels of tumor necrosis factor alpha, as the pro-inflammatory cytokine, and interleukin-12, as the heparin-binding, anti-inflammatory cytokine, in patients with exacerbations of chronic obstructive pulmonary disease.Material and methods. Seventy-three consecutive patients (48 males, 25 females) aged 56-75 years without thromboembolic history, were enrolled into the study. They were randomized to group who received enoxaparin in one daily dose 40 mg, or to group who did not receive it. Patients receiving oral anti-coagulants were excluded from the study. Using ELISA approach, we evaluated serum levels of tumor necrosis factor-alpha and interleukin-12 at the following periods: before the first dose of enoxaparin, after 7 days of treatment and 14 days of treatment. Serum level of the C-reactive protein was evaluated simultaneously.Results. In enoxaparin recipients statistically significant (p<0.01) decreasing of TNF-alpha serum levels (from 168.33 pg/ml in admission, to 85.67 pg/ml in the end of study) to compare enoxaparine non-recipients, was observed. Interleukin-12 serum levels were significantly higher in enoxaparine recipients both after 7 days (67.46 pg/ml) and 14 days (89.32 pg/ml) of the study (p<0.05). C-reactive proteins serum levels were significantly higher in enoxaparine non-recipients than recipients (p<0.05) in all study period.Conclusions. Enoxaparin in daily dose 40 mg, significantly depressed serum levels of TNF-alpha and promote serum levels of interleukin-12. Enoxaparin administration may be beneficial for the patients with COPD exacerbation during the first 14 days of treatment.