Received by the Editorial Office: September 02, 2026
Accepted for publication: September 28, 2026
Published online: September 30, 2026
UDC: 616.24-002.5-08-097
DOI: 10.26212/2227-1937.2026.92.49.010
Article type: Narrative literature review
CXCL10/IP-10 AND IL-18 AS IMMUNOLOGICAL BIOMARKERS IN PATIENTS WITH NEWLY DIAGNOSED PULMONARY TUBERCULOSIS: A LITERATURE REVIEW
Yermekbayeva K.Zh.1, Dilmagambetov D.S.1, Almagambetova A.S.1,
Zimina V.N.2, Adilova A.U.3, Tanzharykova G. N.1
1NJSC “West Kazakhstan Marat Ospanov Medical University”, Aktobe, Kazakhstan
2FSBEI of HE “Kemerovo State Medical University” of the Ministry of Health of the Russian Federation, Kemerovo, Russia
3SCE on REM “Aktobe Regional Phthisiopulmonology Center”, Aktobe, Kazakhstan
Introduction. Tuberculosis remains a major global public health problem, with pulmonary tuberculosis representing the principal transmissible form of the disease. Host-response biomarkers may complement microbiological testing by providing information on disease activity and treatment-related immune changes. CXCL10/IP-10 and interleukin-18 participate in interferon-mediated and inflammasome-associated immune responses, but their clinical roles remain incompletely defined.
Objective. To summarize evidence on the diagnostic and prognostic significance of CXCL10/IP-10 and interleukin-18 and their potential value for treatment monitoring in adults with newly diagnosed pulmonary tuberculosis.
Materials and Methods. A structured narrative review was conducted using English-language publications indexed in Scopus and the Web of Science Core Collection from January 2016 to August 2026. A total of 373 records were identified, of which 129 duplicates were removed. Following relevance assessment and full-text evaluation, 37 publications were included: 33 original clinical studies and four systematic reviews/meta-analyses.
Results. Circulating CXCL10/IP-10 was commonly elevated in active pulmonary tuberculosis and was associated in several cohorts with mycobacterial burden, radiological extent, and systemic inflammation. Diagnostic performance varied according to comparator group, HIV status, biological specimen, assay method, and antigen stimulation. Pooled sensitivity/specificity for differentiating active from latent tuberculosis infection were 72%/78% for unstimulated IP-10 and 82%/85% after stimulation with Mycobacterium tuberculosis-specific antigens. During effective treatment, circulating CXCL10/IP-10 generally declined, particularly during the first one to two months, and contributed to multivariable models of microbiological conversion and unfavorable outcomes. Evidence for interleukin-18 was more limited and heterogeneous. Elevated IL-18 was reported in active or more extensive disease; decreases during treatment were observed in selected longitudinal studies, and higher baseline IL-18 was associated with delayed sputum-smear conversion.
Discussion. The overall evidence base is more consistent for CXCL10/IP-10 than for IL-18. CXCL10/IP-10 appears most promising as an adjunctive marker of disease activity and treatment-related change, whereas IL-18 may have greater value as part of multibiomarker inflammatory panels. Substantial heterogeneity in specimens, assay methods, comparator groups, and comorbid conditions currently limits the establishment of universal diagnostic or prognostic thresholds.
Conclusion. Current evidence supports further evaluation of CXCL10/IP-10 as an adjunctive marker of pulmonary tuberculosis activity and treatment-related change. IL-18 may provide complementary information in selected inflammatory or multibiomarker models but requires additional validation. Standardized prospective studies are needed to determine the incremental clinical value of combined CXCL10/IP-10 and IL-18 measurement for treatment monitoring and outcome prediction.
Keywords: pulmonary tuberculosis, CXCL10/IP-10, interleukin-18, immunological biomarkers, treatment monitoring, prognosis.
