Changes in Serum Selenium, Copper, Zinc Levels and Cu/Zn Ratio in Patients with Pulmonary Tuberculosis During Therapy

Abstract

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.

Alterations in serum levels of trace elements in tuberculosis and HIV infections

“…The high serum copper concentrations observed in the TB patients were also in line with previous reports (Bogden et al, 1977;Ahmad et al, 1985;Ciftci et al, 2003;Koyanagi et al, 2004). The elevated serum levels of copper may reflect a nonspecific increase in serum concentration of copperbinding protein, ceruloplasmin (Beisel, 1976).…”

“…The low zinc concentrations in serum observed in adult Ethiopian TB patients was in agreement with the reports from India (Ahmad et al, 1985), Indonesia (Karyadi et al, 2000), Turkey (Ciftci et al, 2003) and Ecuador (Koyanagi et al, 2004). The decline was probably due to redistribution of zinc from serum to other tissues (Cousins and Leinart, 1988) or reduction of zinc-carrier proteins and or a rise in the production of metallothionein, a protein that transports zinc to the liver (Gabay and Kushner, 1999).…”

“…In line with this, a study in China also revealed an increase in serum copper after therapy (Yu, 1989). Ciftci et al (2003) observed a significant increase in serum zinc and a significant decrease in copper/zinc ratio in Turkish patients with pulmonary TB 2 months after anti-TB chemotherapy. Even though a full course anti-TB therapy requires 6 months of treatment, the serum level of selenium, zinc, copper and copper/zinc ratio, as observed in the first 2 months of treatment, may give an important clue in monitoring response to therapy.…”

“…In these complex interactions among TB, HIV infection and the host immune response, trace elements play important roles (Failla, 2003). Although variation in the concentrations of essential trace elements was reported in several pathological conditions (Beck et al, 1990;Graham et al, 1991;Rosas et al, 1995;Hua-Dong et al, 1999;Karyadi et al, 2000;Karakas et al, 2001;Kuo et al, 2002;Ciftci et al, 2003;Hamed et al, 2004;Meram et al, 2004), their levels in sera of TB patients with HIV coinfection and their changes in concentration after therapy is not yet well documented. This study was, therefore, aimed at comparing serum levels of iron, copper, zinc, and selenium from TB patients with and without HIV coinfection with those of healthy subjects, and also to investigate changes in their serum concentrations before and after an intensive phase of anti-TB chemotherapy.…”

Contribution to diagnostics/prognostics of tuberculosis in children. II. Indicative value of metal ions and biochemical parameters in serum

“…In addition to investigations dealing with adult patients (e.g., refs. [1][2][3][4][5][6], there are only a few papers dealing with childhood tuberculosis (7-10).…”