PROBIOTIC’S IMPACT ON IMMUNE SYSTEM MARKES IN PERIPHERAL BLOOD MONONUCLEAR CELLS IN RIFAMPICIN-RESISTANT TUBERCULOSIS PATIENTS AS ADDITIONAL THERAPY OF ANTI-TUBERCULOSIS DRUGS

Victoria Yulita Fitriani

Lactobacillus acidophilus and Lactobacillus reuteri are generally strong inducers of Th1 cytokines. Th1-mediated immune responses are cucial for the elimination of Mycobacterium tuberculosis. New drug development to improve therapeutic efficacy is one way to overcome the low success rate of treatment of rifampicin-resistant tuberculosis. This study aimed to evaluate the ability of Lactobacillus acidophilus BioLA246 and Lactobacillus reuteri BioLR321 to modulate cellular immune responses in rifampin-resistant tuberculosis patients. The first stage of research examines the probiotic characteristics of bacteria. The second stage analyzed bacteria's effect on the immune response of rifampicin-resistant tuberculosis patients. Twenty-three PBMCs from four-week-treated, rifampicin-resistant patients were incubated for four days using RPMI 1640 complete medium, BioLA246, BioLR321, and PHA-L. Using flow cytometry, T-helper cells, T-cytotoxic cells, and Treg were examined, while IFN-γ and TNF-α were examined using ELISA. Statistical analysis of the data used the Friedman test, followed by a posthoc test if there was a significant difference between the groups (p<0.05). The probiotic characteristics test, which included pH and bile salt resistance, antimicrobial activity, and antibiotic resistance, revealed that both bacteria could survive in the gastrointestinal environment, had antimicrobial activity, and were resistant to amikacin, kanamycin, streptomycin, and meropenem, with this resistance not potentially transferable. These findings suggest that both bacteria display probiotic characteristics. Both bacteria were able to reduce the percentage of CD3⁺CD4⁺ T cells and increase TNF-α levels (p<0.05) but did not affect CD3⁺CD8⁺ T cells, Tregs, and IFN-γ (p>0.05). Lactobacillus acidophilus BioLA246 and Lactobacillus reuteri BioLR321 have shown the ability to modulate the immune response in rifampin-resistant tuberculosis, hence they may be considered as adjuvant therapy to improve tuberculosis treatment effectiveness.

Keywords : Characteristics, Lactobacillus acidophilus, Lactobacillus reuteri, T-cells, Cytokines, PHA-L