Changes in the immune and endocrine responses of patients with pulmonary tuberculosis undergoing specific treatment

We evaluated immune and endocrine status following antituberculosis treatment in HIV‐negative patients with newly diagnosed tuberculosis (TB). Treatment led to a decrease in IL‐6, IL‐1β, and C‐reactive protein levels. Cortisol levels decreased throughout the anti‐TB treatment, particularly after 4 months, but changes were less pronounced than those seen in proinflammatory mediators. Specific therapy resulted in increased dehydroepiandrosterone (DHEA) levels, which peaked after 4 months and started to decline after 6 months of treatment, reaching levels below those detected at inclusion. In contrast, in most patients, dehydroepiandrosterone sulfate (DHEAS) levels remained unchanged, although a trend toward increased concentrations was observed in a few cases 3 months after the treatment was finished. Specific therapy also resulted in more balanced cortisol/DHEA and cortisol/DHEAS ratios. Etiologic treatment involves favorable immune and endocrine changes, which may account for its beneficial effects.