Evaluation of Immunoglobulin Levels in Pulmonary Tuberculosis Patients on Anti-Tuberculosis Therapy in Owerri, Imo State, Nigeria
Keywords:
Pulmonary tuberculosis, immunoglobulins, IgG, IgA, IgM, IgE, and anti-tuberculosis therapy are all important terms.Abstract
Pulmonary tuberculosis (PTB) is a persistent infectious illness characterised by prolonged immunological activation. Cell-mediated immunity is fundamental to tuberculosis control; but, humoral immune responses, indicated by variations in serum immunoglobulin levels, can significantly influence disease development and treatment efficacy. Anti-tuberculosis therapy (ATT) may affect immunoglobulin profiles; however, data from Nigerian populations are still scarce.This study assessed and compared the mean serum concentrations of immunoglobulin G (IgG), immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin E (IgE) in pulmonary tuberculosis patients on anti-tuberculosis treatment with seemingly healthy control participants. A cross-sectional comparison study was executed with 300 volunteers, consisting of 150 pulmonary tuberculosis patients undergoing anti-tuberculosis therapy and 150 seemingly healthy controls. Blood samples were taken from veins, and standard immunoassay methods were used to find the levels of IgG, IgA, IgM, and IgE in the serum. The data were presented as mean ± standard deviation (SD). Statistical comparisons among groups were conducted, with p < 0.05 regarded as statistically significant. The mean serum IgG levels in PTB patients on therapy were significantly elevated compared to controls (1473.24 ± 124.07 mg/dL vs 1356.17 ± 40.91 mg/dL; p = 0.001). There was a statistically significant difference in serum IgA levels between the two groups. The PTB patients had lower levels than the controls (212.19 ± 21.32 mg/dL vs 231.47 ± 11.66 mg/dL; p = 0.001). The IgM levels in PTB patients were somewhat elevated compared to controls (126.30 ± 7.01 mg/dL vs 125.30 ± 5.33 mg/dL), although this difference lacked statistical significance (p = 0.06). In PTB patients receiving therapy, mean serum IgE levels were substantially higher than in controls (97.42 ± 25.58 IU/mL vs 83.33 ± 5.76 IU/mL; p = 0.001). Patients with pulmonary TB undergoing anti-tuberculosis therapy demonstrate notable changes in serum immunoglobulin profiles, marked by increased IgG and IgE levels and decreased IgA levels in comparison to healthy controls. These results underscore the role of humoral immune responses in tuberculosis and indicate that immunoglobulin evaluation may be a valuable tool for monitoring immunological status throughout treatment.
References
1. Islam, R. E., Zewdie, M., Mussa, D., Abebe, Y., Ottenhoff, T. H. M., Franken, K. L. M. C., Abebe, F., and Wassie, L. (2025). The role of IgA and IgG in Mycobacterium tuberculosis infection. Clinical and Experimental Immunology, uxaf001.
2. Liu, Q., Que, S., Qiu, Y., Tang, M., Liu, S., Yang, G., Wang, Y., Deng, A., Hu, X., Lian, X., and Gao, Q. (2025). Host immune response to Mycobacterium tuberculosis infection. Journal of Inflammation Research, 18(2), 8429–8445.
3. Lourens, R., Singh, G., Arendse, T., Thwaites, G., and Rohlwink, U. (2025). Tuberculous meningitis across the lifespan. The Journal of Infectious Diseases, 231(5), 1101–1111.
4. Greene, D., Moore Fried, J., and Wang, J. (2025). IgE in allergic diseases. Immunological Reviews, 334(1), e70057.
5. Palmieri, F., Petrone, L., Fortune, S. M., Ottenhoff, T. H. M., Lauffenburger, D. A., Goletti, D., Joosten, S. A., and Alter, G. (2021). Antibody subclass and glycosylation shift following effective TB treatment. Frontiers in Immunology, 12, 679973.
6. Shamji, M. H., Valenta, R., Jardetzky, T., Verhasselt, V., Durham, S. R., Würtzen, P. A., and van Neerven, R. J. J. (2021). The role of allergen-specific IgE, IgG, and IgA in allergic disease. Allergy, 76(12), 3627–3641.
7. Ilyas, U., Mahmood, A., Pansuriya, A. M., Umar, Z., and Landry, I. (2022). Miliary tuberculosis: A case report highlighting the diagnostic challenges associated with the condition. Cureus, 14(9), e29339.
8. Gill, C. M., Dolan, L., Piggott, L. M., and McLaughlin, A. M. (2022). New developments in tuberculosis diagnosis and treatment. Breathe, 18(1), 210149.
9. Consonni, F., Chiti, N., Ricci, S., Venturini, E., Canessa, C., Bianchi, L., Lippi, F., Montagnani, C., Giovannini, M., Chiappini, E., Galli, L., Azzari, C., and Lodi, L. (2022). Unbalanced serum immunoglobulins in clinical subtypes of pediatric tuberculosis disease. Frontiers in Pediatrics, 10, 908963.
10. Herrera, M. T., Guzmán-Beltrán, S., Bobadilla, K., Santos-Mendoza, T., Flores-Valdez, M. A., Gutiérrez-González, L. H., and González, Y. (2022). Human pulmonary tuberculosis: Understanding the immune response in the bronchoalveolar system. Biomolecules, 12(8), 1148.
11. Yang, Q., Han, J., Shen, J., Peng, X., Zhou, L., and Yin, X. (2022). Diagnosis and treatment of tuberculosis in adults with HIV. Medicine, 101(35), e30405.
12. Oladimeji, O., Oladimeji, K. E., Nanjoh, M., Banda, L., Adeleke, O. A., Apalata, T., Mbokazi, J., and Hyera, F. L. M. (2022). Contributory factors to successful tuberculosis treatment in Southwest Nigeria: A cross-sectional study. Tropical Medicine and Infectious Disease, 7(8), 194.
13. Gupta, R. K., Lucas, S. B., Fielding, K. L., and Lawn, S. D. (2015). Prevalence of tuberculosis in post-mortem studies of HIV-infected adults and children in resource-limited settings: A systematic review and meta-analysis. AIDS, 29(15), 1987–2002.
14. Riccardi, N., Canetti, D., Martini, M., Diaw, M. M., Di Biagio, A., Codecasa, L., Barberis, I., Bragazzi, N. L., and Besozzi, G. (2020). The evolution of a neglected disease: Tuberculosis discoveries in the centuries. Journal of Preventive Medicine and Hygiene, 61(1), E9–E12.
15. Zellweger, J. P., Sotgiu, G., Corradi, M., and Durando, P. (2020). The diagnosis of latent tuberculosis infection (LTBI): Currently available tests, future developments, and perspectives to eliminate tuberculosis (TB). La Medicina del Lavoro, 111(3), 170–183.
16. Fukunaga, R., Glaziou, P., Harris, J. B., Date, A., Floyd, K., and Kasaeva, T. (2021). Epidemiology of tuberculosis and progress toward meeting global targets – Worldwide, 2019. Morbidity and Mortality Weekly Report, 70(12), 427–430.
17. Sharma, S. K., Mohan, A., and Kohli, M. (2021). Extrapulmonary tuberculosis. Expert Review of Respiratory Medicine, 15(7), 931–948.
18. Zhao, E. J., Cheng, C. V., Mattman, A., and Chen, L. Y. C. (2021). Polyclonal hypergammaglobulinaemia: Assessment, clinical interpretation, and management. The Lancet Haematology, 8(5), e365–e375.
19. Grace, P. S., Dolatshahi, S., Lu, L. L., Cain, A., Fu, J., Li, J., Liu, Z., Zheng, S., Li, X., Ning, X., Wang, J., Gao, W., and Li, G. (2022). Sex-specific differences in the clinical profile among patients with tracheobronchial tuberculosis. International Journal of General Medicine, 15, 5741–5750.
20. Dabitao, D., and Bishai, W. R. (2023). Sex and gender differences in tuberculosis pathogenesis and treatment outcomes. Current Topics in Microbiology and Immunology, 441, 139–183.
21. Stewart, P., Patel, S., Comer, A., Muneer, S., Nawaz, U., Quann, V., Bansal, M., and Venketaraman, V. (2023). Role of B cells in Mycobacterium tuberculosis infection. Vaccines, 11(5), 955.
22. Villar-Hernández, R., Ghodousi, A., Konstantynovska, O., Duarte, R., Lange, C., and Raviglione, M. (2023). Tuberculosis: Current challenges and beyond. Breathe, 19(1), 220166.
23. Okeke, C., Okonkwo, R., Ibeh, N., Chukwuma, O., and Okeke, C. (2023). Assessment of gender differences in some inflammatory cytokines of tuberculosis patients before and during treatment. African Health Sciences, 23(3), 336–342.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Ukamaka Edward, Festus Chidi Emengaha, Eberechi Nwanguma (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
