Telomere shortening correlates with immune dysregulation and severity in pulmonary tuberculosis

Telomere shortening is suspected to influence the severity of inflammation and tissue damage in tuberculosis. This study aims to analyze the association between telomere length and inflammatory cytokines in tuberculosis patients. The study was conducted at Persahabatan National Respiratory Referral Hospital and Jakarta Islamic Hospital Cempaka Putih between October 2024 and March 2025. Adult tuberculosis patients who met the criteria were enrolled. Relative Telomere Length (RTL), Tumor Necrosis Factor α (TNF-α), and Interleukin 10 (IL-10) levels were measured from peripheral blood mononuclear cells using Quantikine Enzyme-Linked Immunosorbent Assay (ELISA) kits, and chest X-rays (CXR) were graded into minimal or extensive disease to assess severity. A total of 64 tuberculosis patients were enrolled, with a mean age of 41.36 ± 16.23 years, and the majority of subjects were male (68%). The analysis revealed significant differences in Body Mass Index (BMI) (p = 0.01), RTL (p = 0.03), and TNF-α (p = 0.02) among the tuberculosis patients and healthy subjects. A negative correlation was observed between RTL and TNF-α (p = 0.04), whereas no significant association was found with IL-10 (p > 0.05). Patients with extensive radiographic lesion had significantly shorter telomeres than those with minimal lesion (p = 0.021). Telomere shortening is closely associated with the pro-inflammatory response in tuberculosis, as reflected by its significant association with elevated TNF-α levels and higher extensive disease severity based on radiographic findings.