{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:09:01Z","timestamp":1788952141190,"version":"build-2803163510"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare peripheral blood immune\u2013inflammatory profiles between patients with pulmonary tuberculosis complicated by central nervous system tuberculosis (PTB + CNS-TB) and those with pulmonary tuberculosis alone (PTB), and to identify laboratory parameters associated with disease severity in PTB + CNS-TB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included 4,829 inpatients with tuberculosis (January 2018\u2013March 2026), comprising a PTB group (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a04,578) and a PTB + CNS-TB group (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0251). Propensity score matching (1:4) was performed using sex, age, body mass index, albumin, and hemoglobin, yielding 246 PTB + CNS-TB patients and 954 matched PTB controls. PTB + CNS-TB cases were further stratified by Medical Research Council (MRC) grading (Grade I:\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0165; Grades II\u2013III:\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a086). Covariate-adjusted analyses with FDR correction were used to screen severity-associated parameters; LASSO and Firth\u2019s logistic regression were applied to identify mutually independent factors and to construct a severity assessment model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, PTB + CNS-TB patients exhibited a distinct bidirectional pattern characterized by reduced peripheral lymphocyte counts and lower peripheral T-cell counts (CD3\n                      <jats:sup>+<\/jats:sup>\n                      , CD4\n                      <jats:sup>+<\/jats:sup>\n                      , and CD8\n                      <jats:sup>+<\/jats:sup>\n                      ) and CD45\n                      <jats:sup>+<\/jats:sup>\n                      lymphocytes counts, alongside increased neutrophil-related inflammatory indices (including neutrophil count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index) (all P &amp;lt; 0.05). Within the PTB + CNS-TB cohort, severe disease was associated with higher white blood cell and neutrophil-related measures (notably NEU% and NLR) and more pronounced cerebrospinal fluid (CSF) abnormalities, particularly elevated CSF protein and decreased CSF chloride, whereas peripheral T-cell subset parameters did not differ significantly by severity. Multivariable modeling identified CSF protein, NEU%, and albumin as mutually independent factors associated with severe disease. A combined model including these three markers showed good internal discrimination (AUC\u00a0=\u00a00.772; bootstrap-corrected AUC\u00a0=\u00a00.767) and calibration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PTB + CNS-TB is associated with reduced peripheral lymphocyte\/T-cell subset counts accompanied by heightened a neutrophil-predominant inflammatory profile. Among PTB + CNS-TB patients, disease severity shows a closer association with neutrophil-related indices and routine CSF parameters, particularly CSF protein, than with peripheral T-cell subset counts. A model incorporating NEU%, CSF protein, and albumin may aid in severity assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1899254","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:12:07Z","timestamp":1788948727000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Immune-inflammatory profiles and disease severity in pulmonary tuberculosis complicated by central nervous system tuberculosis"],"prefix":"10.3389","volume":"16","author":[{"given":"Muxing","family":"Chen","sequence":"first","affiliation":[{"name":"Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital","place":["Fuzhou, China"]},{"name":"Department of Tuberculosis, Fuzhou Pulmonary Hospital of Fujian","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Wu","sequence":"additional","affiliation":[{"name":"Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital","place":["Fuzhou, China"]},{"name":"Department of Tuberculosis, Fuzhou Pulmonary Hospital of Fujian","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis, Fuzhou Pulmonary Hospital of Fujian","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiandong","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis, Fuzhou Pulmonary Hospital of Fujian","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youfei","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis, Fuzhou Pulmonary Hospital of Fujian","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongru","family":"Li","sequence":"additional","affiliation":[{"name":"Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1007\/s10753-014-9978-y","article-title":"The relationship between inflammatory marker levels and pulmonary tuberculosis severity","volume":"38","author":"Abakay","year":"2015","journal-title":"Inflammation"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1949","DOI":"10.1016\/j.radcr.2024.02.019","article-title":"Intraocular tuberculosis masquerading as ocular tumor: A case report","volume":"19","author":"Abera","year":"2024","journal-title":"Radiol. 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