Figure 4.

Immunopathology in paradoxical tuberculosis immune reconstitution inflammatory syndrome (TB-IRIS) is associated with increased matrix metalloproteinase (MMP) activity. Plasma procollagen III N-terminal propeptide (PIIINP) was elevated in TB-IRIS patients compared to non-IRIS control patients at the time of TB diagnosis and also at IRIS onset (A). Plasma MMPs were elevated in TB-IRIS compared to non-IRIS controls, including MMP-1 (B), MMP-3 (C), and, most consistently, MMP-8 (D). Plasma MMP-8 positively correlated with plasma PIIINP (E) and also with neutrophil count (F). In A–D, boxes represent the first and third quartiles; horizontal bars within median values and whiskers minimum and maximum values. Comparisons are by Mann-Whitney U test. *P < .05, **P < .01, ***P < .001. In E and F, individual data points are plotted by filled circles. Spearman rank-order correlation coefficient r and P values are reported for correlations.