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Tumor necrosis factor (TNF)-\u03b1 is essential for granuloma formation and is a potent activator of monocyte chemotactic protein (MCP-1, CCL2). CCL2 is essential for recruitment of monocytes and T cells and has been shown to play a role in protection against tuberculosis. Interleukin -8 (CXCL8) is a potent activator of neutrophils. Increased levels of CCL2, CXCL8 and TNF\u03b1 are reported in tuberculosis but their significance in different forms of tuberculosis is as yet unclear. We have used an<jats:italic>ex vivo<\/jats:italic>assay to investigate differences in immune parameters in patients with either pulmonary or extra-pulmonary tuberculosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Serum levels of CCL2, CXCL8 and TNF\u03b1 were measured in patients with pulmonary tuberculosis (N = 12), extra-pulmonary tuberculosis (N = 8) and BCG-vaccinated healthy volunteers (N = 12). Whole blood cells were stimulated with non-pathogenic<jats:italic>Mycobacterium bovis<\/jats:italic>bacille-Calmette Guerin (BCG) vaccine strain or bacterial lipopolysaccharide (LPS) and cyto\/chemokines were monitored in supernatants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Circulating serum levels of CXCL8 and TNF\u03b1 were raised in all tuberculosis patients, while CCL2 levels were not. There was no difference in spontaneous cytokine secretion from whole blood cells between patients and controls.<jats:italic>M. bovis<\/jats:italic>BCG-induced<jats:italic>ex vivo<\/jats:italic>CCL2 secretion was significantly greater in pulmonary as compared with both extra-pulmonary tuberculosis patients and endemic controls. In response to LPS stimulation, patients with pulmonary tuberculosis showed increased CCL2 and TNF\u03b1 responses as compared with the extra-pulmonary group. BCG-, and LPS-induced CXCL8 secretion was comparable between patients and controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CCL2 is activated by TNF\u03b1 and is essential for recruitment of monocytes and T cells to the site of mycobacterial infection. Increased CCL2 activation in pulmonary tuberculosis may result in a stronger cellular response as compared with extra-pulmonary tuberculosis patients, and this may contribute to the localization of infection to the pulmonary site.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1471-2172-6-14","type":"journal-article","created":{"date-parts":[[2005,7,7]],"date-time":"2005-07-07T18:13:38Z","timestamp":1120760018000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Elevated ex vivo monocyte chemotactic protein-1 (CCL2) in pulmonary as compared with extra-pulmonary tuberculosis"],"prefix":"10.1186","volume":"6","author":[{"given":"Zahra","family":"Hasan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irfan","family":"Zaidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bushra","family":"Jamil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Aslam","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akbar","family":"Kanji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabia","family":"Hussain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2005,7,7]]},"reference":[{"key":"75_CR1","first-page":"99","volume-title":"Global Tuberculosis Control","author":"WHO","year":"2003","unstructured":"WHO: Global Tuberculosis Control. 2003, 99-101."},{"key":"75_CR2","first-page":"1597","volume":"160","author":"A Fanning","year":"1999","unstructured":"Fanning A: Tuberculosis: 6. 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