Asthma-chronic obstructive pulmonary syndrome (ACOS) is
a disorder sharing the components of the asthma and COPD. The
ACOS considered as a system inflammation disease. The cytokines
such as interleukin-6 (IL-6) [1] and interleukin -10 (IL-10) associated
with ACOS [2]. The IL-6 enhancing the inflammation of lung and
IL-10 attenuate the inflammation of lung [3,4]. In the ACOS, forced
expiratory volume in one second (FEV1%) predicted was inversely
associated with IL-6 level, [5] and cardiovascular disease [6] was
associated with an increased IL-6 level [1]. The higher level of IL-6
and lower level IL-10 were found in the ACOS.Therefore the ACOS
have the poor lung function and higher frequency of the acute exacerbation
[2]. Meanwhile, the ACOS have the higher risk of the neurodegenerative
diseases [7] in accordance with these speculations.
The incidence of the PTB was higher in the ACOS cohort [8]. The
IL-6 and IL-10 were associated with the active PTB [9]. The lower
level of IL-10 was found in the drug-resistant PTB [10]. Meanwhile,
the higher level of IL-6 may be associated with the active PTB progression
and is related the radiological severity also [11].
The bacilli loading associated with the chest X-ray [11] and
high-resolution computer tomography grading may have a better
role for predict the bacilli loading support these findings [12-14].
In versa, the increased IL-10 may have an antibacterial effect on the
TB [15,16]. The IL-10 as biomarkers of the host response to PTB
during convalescence from, and the absence of, active PTB [17].
Moreover, the IL-10 in accordance with the CXR progressive change
in initial, recovery and recurrent stage of the PTB [18,19]. The statin
may attenuate the inflammation of the airway such as asthma
[20]. Meanwhile, the COPD cohort with statin use have the lower
incidence of the PTB [21]. The report of the up-regulation of the
stains by increased level of IL-10 and down –regulation of the IL-6
in the COPD cohort in line with these reports [22]. The statins ame
liorated the level of these interleukins may attenuate the inflammation
of lung. In addition, statins effective against TB in macrophages
and enhance the activity of the first-line anti-TB regimen in animal
study support these speculations also [23].
Therefore, the satins use may have the less incident of the PTB
in ACOS.These speculations need more researches for confirmation.
However, the role of the IL-6 and IL-10 in PTB may play a different
role in the different stage in different cohort and other cytokines
such as interleukin-2(IL-2) or interleukin-4(IL-4) also play a role of
the radiological recovery in PTB patients [9,18,19,24]. The association
of the cytokines, statins with the PTB among the ACOS cohort
warrant more researches.