Correlation of inflammatory cytokines on corrected QT interval in rifampicin-resistant tuberculosis patients

Tutik Kusmiati; Ni Made Mertaniasih; Johanes Nugroho Eko Putranto; Budi Suprapti; Soedarsono; Nadya Luthfah; Winariani Koesoemoprodjo; Aryani Prawita Sari

doi:10.1016/j.amsu.2021.102862

Correlation of inflammatory cytokines on corrected QT interval in rifampicin-resistant tuberculosis patients

Ann Med Surg (Lond). 2021 Sep 14:70:102862. doi: 10.1016/j.amsu.2021.102862. eCollection 2021 Oct.

Authors

Tutik Kusmiati^{1

2}, Ni Made Mertaniasih³, Johanes Nugroho Eko Putranto⁴, Budi Suprapti⁵, Soedarsono², Nadya Luthfah⁴, Winariani Koesoemoprodjo², Aryani Prawita Sari²

Affiliations

¹ Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
² Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
³ Department of Clinical Microbiology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
⁴ Department of Vascular and Cardiology Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
⁵ Faculty of Pharmacy, Universitas Airlangga - Universitas Airlangga Teaching Hospital, Surabaya, Indonesia.

Abstract

Background: The cases of Rifampicin-Resistant Tuberculosis (RR-TB) in our country have increased every year and RR-TB deaths are thought to be caused by prolongation of the QTc interval due to side effects of anti-tuberculosis drugs. Thus, cytokines are needed to be used as early markers of prolongation of the QTc interval in RR-TB patients.

Objective: This study aims to analyze the correlation of inflammatory cytokines on QTc interval in RR-TB patients who received shorter regimens.

Methods: This study uses a case-control study with a time series conducted in the period September 2019 to February 2020 in one of the referral hospitals for Tuberculosis in Indonesia. Cytokines levels from blood samples were measured using the ELISA method, while QTc intervals were automatically recorded using an electrocardiography machine. The statistical analysis used was the Chi-square test, Man Whitney test, Independence t-test, and Spearman-rank test with p < 0.05.

Results: There was no significant correlation between inflammatory cytokines and QTc prolongation in intensive phase which TNF-α value (6.8 pg/ml; r = 0.207; p = 0.281), IL-1β (20.13 pg/ml; r = 0.128; p = 0.509), and IL-6 (43.17 pg/ml; r = -0.028; p = 0.886). Meanwhile, in the continuation phase, the values for TNF-α (4.79 pg/ml; r = 0.046; p = 0.865), IL-1β (7.42 pg/ml; r = -0.223; p = 0.406), and IL- 6 (40.61 pg/ml; r = -0.147; p = 0.586).

Conclusion: inflammatory cytokines (TNF-α, IL-1β, and IL-6) cannot be used to identify QTc interval prolongation in RR-TB patients who received shorter regimens.

Keywords: BMI, Body mass index; Ca, Calcium; IL-1β; IL-1β, interleukin-1β; IL-6; IL-6, interleukin 6; K, Potassium; MDR, multidrug resistance; QTc prolongation; RR-TB; RR-TB, Rifampicin-Resistant Tuberculosis; TB, tuberculosis; TNF-α; TNF-α, Tumor necrosis factor alpha; WHO, World Health Organization.