Multimodal Evaluation of Pulmonary Rehabilitation in Newly Diagnosed Tuberculosis Patients Using Respiratory Culture-Based Microbiome Profiling and Inflammatory Biomarkers

OBJECTIVE Pulmonary rehabilitation (PR) plays a vital role in enhancing lung function and exercise capacity in individuals with pulmonary conditions. This study evaluated the clinical effectiveness of an 8-week PR program in newly diagnosed pulmonary tuberculosis (TB) patients through the assessment of lung function, exercise capacity, inflammatory biomarkers, and respiratory microbiome changes. METHODS Sixty newly diagnosed TB patients were enrolled, with 30 completing the 8-week PR program. Pulmonary function (FEV, FVC, FEV/FVC) and exercise capacity (6-minute walk test, 6MWT) were measured before and after PR. Inflammatory biomarkers (CRP, IL-6, TNF-) and sputum microbiome profiles were assessed. ROC curves and multiple regression models identified biomarkers that were predictive of functional improvement. RESULTS PR led to significant improvements: FEV increased from 2.50 ± 0.60 L to 3.10 ± 0.50 L (p < 0.001), FVC from 3.20 ± 0.70 L to 3.70 ± 0.60 L (p = 0.002), and 6MWT distance from 350.00 ± 40.00 m to 400.00 ± 50.00 m (p = 0.003). Oxygen saturation improved from 93.00 ± 2.00% to 95.00 ± 1.00% (p = 0.022). Inflammatory markers decreased significantly: CRP 18.00 ± 7.00 to 10.00 ± 5.00 mg/L (p < 0.001), IL-6 25.00 ± 8.00 to 15.00 ± 6.00 pg/mL (p < 0.001), and TNF- 50.00 ± 20.00 to 32.00 ± 15.00 pg/mL (p = 0.002). ROC analysis identified CRP as the strongest predictor of improvement (AUC = 0.84). Multiple regression confirmed CRP as an independent predictor of lung function and exercise capacity gains. CONCLUSIONS An 8-week PR program significantly improved lung function, exercise capacity, and reduced systemic inflammation in TB patients, with CRP emerging as a key biomarker for predicting rehabilitation outcomes.