Ann Lab Med 2018; 38(1): 9-16  
Serum Macrophage Migration Inhibitory Factor as a Biomarker of Active Pulmonary Tuberculosis
Zhong-bo Shang, M.D.1, Jun Wang, M.D.2,*, Shou-gang Kuai, M.D.1,2,*, Yin-yin Zhang, M.D.2, Qin-fang Ou, M.D.3, Hao Pei, M.D.2, and Li-hua Huang, M.D.3
Department of Clinical Laboratory1, Wuxi Huishan People’s Hospital, Wuxi, Jiangsu; Departments of Clinical Laboratory2 and Respiratory Medicine3, The Fifth People’s Hospital of Wuxi, Affiliated to Jiangnan University, Wuxi, Jiangsu, China
Correspondence to: Shou-gang Kuai
Departments of Clinical Laboratory, Huishan People’s Hospital, 214187, Wuxi, Jiangsu, China
Tel: +86-0510-83318119
Fax: +86-0510-68918000
E-mail: kuaishougang@163.com
* Zhong-bo Shang and Jun Wang are co-first authors.
Received: November 23, 2016; Revised: May 10, 2017; Accepted: September 20, 2017; Published online: January 1, 2018.
© The Korean Society for Laboratory Medicine. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Macrophage migration inhibitory factor (MIF), a pro-inflammatory cytokine with chemokine-like functions, has been shown to play a central role in several acute and chronic inflammatory diseases. However, limited information is available regarding the use of MIF as an inflammatory pathway marker in patients with tuberculosis. This study aimed to investigate the association of MIF with IFN-γ and TNF-α in active pulmonary tuberculosis (APTB) following anti-tuberculosis treatment.
Methods: The MIF, TNF-α, and IFN-γ serum levels were determined in 47 patients with APTB by cytokine-specific ELISA at four phases: prior to anti-tuberculosis drug treatment (baseline), and following 2, 4, and 6 months of treatment. In addition, we measured the MIF, TNF-α, and IFN-γ serum levels in 50 health controls.
Results: MIF serum levels were significantly elevated (P〈0.05) in patients with APTB prior to treatment compared with that in control subjects, and TNF-α ≥449.7 pg/mL was associated with high MIF levels (≥13.1 ng/mL). MIF levels were significantly reduced (P〈0.01) following 2, 4, and 6 months of treatment, with variations in TNF-α and IFN-γ serum levels. MIF levels were positively correlated with the paired TNF-α level at baseline (r=0.1103, P=0.0316) and following 6 months of treatment (r=0.09569, P=0.0364).
Conclusions: A reduction in the MIF serum levels in patients with APTB following anti-tuberculosis treatment may positively affect host immune protection against Mycobacterium tuberculosis infection. Thus, serum MIF levels may constitute a useful marker for assessing therapy effectiveness in patients with APTB.
Keywords: Macrophage migration inhibitory factor, TNF-α, IFN-γ, Active pulmonary tuberculosis


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