Endometrial cytokine expression from clinically suspected genital tuberculosis patients at tertiary care hospitals in Dhaka

Objective: The objective of this study was to measure gamma interferon (IFN-gamma) and tumor necrosis factor alpha (TNF-alpha) expression in endometrial tissue and/or aspirate from suspected genital tuberculosis patients with ectopic pregnancy and infertility in Bangladesh.& nbsp;Methodology: A total 78 women of clinically suspected genital tuberculosis patients were enrolled as study population. These patients underwent manual vaccum aspiration (MVA) procedure, and endometrial tissues and/or aspirates were collected. Ziehl-Neelsen staining (Z-N staining) and Lowen-Stein Jensen (L-J) culture were done to detect Mycobacterium. The study participants were categorized as genital tuberculosis positive cases, genital tuberculosis negative cases and presumptive for tuberculosis cases based on the case definition used in this study. TNF-alpha and IFN-gamma were measured by ELISA. Statistical analysis was done using SPSS (version-22).& nbsp;Results: Out of 78 participants, pro-inflammatory cytokines IFN-gamma and TNF-alpha were significantly increased in TB positive patients than TB negative patients (p < 0.05). IFN-gamma value of TB positive patients (41.26 +/- 41.05) was higher than TB negative (22.94 +/- 44.51) patients. TNF-alpha value (44.31 +/- 64.22) of TB positive patients was higher than TB negative (15.86 +/- 41.45) patients. IFN-gamma and TNF-alpha value of presumptive for tuberculosis cases were not statistically significant. According to ROC analysis, cut off value for IFN-gamma was 23.5 and for TNF-alpha was 10 with highest sensitivity and specificity of 66.7%, 89.3%, and 66.7% and 73.1% respectively.& nbsp;Conclusion: IFN-gamma and TNF-alpha were significantly higher in TB positive patients and it may act as a potential biomarker for diagnosis of genital tuberculosis.