Serum trace metal and ceruloplasmin variability in individuals treated for pulmonary tuberculosis

SETTING: Investigation of trace metal behaviour during the treatment of active pulmonary tuberculosis (PTB) patients residing in Romania. OBJECTIVE: To assess, follow and identify serum iron (Fe), copper (Cu) and zinc (Zn) levels in patients diagnosed and treated for active PTB. DESIGN: Chemical and statistical analysis of various biochemical parameters in 47 subjects diagnosed with active PTB and 170 healthy Romanian residents. RESULTS: Copper and ceruloplasmin levels were increased in patients with active PTB compared to the control group (P < 0.01), while the serum Zn level was significantly lower than in healthy subjects (P < 0.01) or within the normal range. The present study shows that there is a significant correlation between serum Cu concentrations and ceruloplasmin. CONCLUSIONS: This study provides preliminary evidence that Zn and Fe redistribution is operating as a primary host defence mechanism to reduce the availability of metals for microbial metabolism during infection. The study also calls attention to the fact that anti-tuberculosis treatment is sufficient to enhance the concentration of the antioxidant species (Cu and ceruloplasmin). The data obtained suggest that serum Cu, Zn and Cu/Zn levels may serve as indirect pointers in the diagnosis of a disease but they cannot be considered as specific markers for TB.