BACKGROUND: Pulmonary tuberculosis is one of the diseases characterized granuloma formation which was controlled by cellular immune reactions. In the process of granulomatous changes, activated alveolar macrophages and T lymphocytes secrete many cytokines including interleukin-1 (IL-1), tumor necrosis factor-alpha(TNF-alpha), interferon-gamma (INF-gamma) which mediate inflammatory reactions. Intercelluar adhesion molecule-1(ICAM-1) also known to major role player in inflammatory processes, and increased cellular expressions when endothelial cell was stimulated by IL-1, TNF and IFN. METHOD: To evaluate relationships among cellular immune reactions and clinical stages, pulmonary tuberculosis patients were classifed into three groups according to their clinical stages including minimal, moderate and far advance tuberculosis. TNF-alpha, INF-gamma, sICAM-1 (soluble form of ICAM-1) were measured at the time of diagnosis and after 6-months anti-tuberculosis medications by radioimmuno assay or enzyme linked immunosolvent assay. RESULTS: TNF-alpha, INF-gamma, sICAM-1 were singificantly increased in moderate and far advanced pulmonary tuberculosis patients but no meaningful changes in minimal staged patients. 6-months anti-tuberculosis medications reduced serum sICAM-1 levels significantly, related to clinical improvement but no significnat changes were found in the serum levels of TNF-alpha and INF-gamma. In the point of correlations, positive ones revealed between TNF-alpha and sICAM-1, also between IFN-gamma and sICAM-1 but no correlation between TNF-alpha and IFN-gamma. CONCLUSION: Measurement of serum sICAM-1 could be usuful parameter to evaluate the severity of pulmonary tuberculosis and to monitor disease activities durig anti-tubercoulsis medications.