| The relationship between cell-mediated immunity and subtypes of lymphocyte in BAL fluid and peripheral blood in patients with pulmonary tuberculosis. |
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Soo Taek Uh, Mi Kyung Cha, Sang Moo Lee, Hyun Tae Kim, Yeon Tae Chung, Jun Hee Woo, Yong Hun Kim, Choonsik Park |
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Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea |
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| Abstract |
Background
The activated T lymphocyte by inhaled mycobacterial antigen may evoke cellmediated immunity in patients with active pulmonary tuberculosis. These activated lymphocytes may influence the response of tuberculin-purified protein derivative (PPD) in skin test. But occasionally, anergy to PPD appear in patients with pulmonary tuberculosis in spite of active stage. Thus we evaluated the effect of change of subtypes of lymphocyte in bronchoalveolar lavage fluid (BAL) and peripheral blood on anergy to PPD in patients with active pulmonary tuberculosis.
Method: We performed tuberculin skin test and flow-cytometry analysis of lymphocytes obtained from BAL fluid and peripheral blood in 11 healthy normal volunteers and 20 patients with active pulmonary tuberculosis.
Results
1) The composition of lymphocyte significant1y increased in patients with active pulmonary tuberculosis when compared with that in healthy control (25.2 ± 4.8 vs 6.5 ± 1.3% , p<0.01), but composition of monocyte significant1y decreased (69.6 ± 5.7 vs 89.2 ± 1.4%, p < 0.05) in analysis of BAL fIuid.
2) There were no differences in compositions of cells in BAL f1uid between responders and no-responders to PPD.
3) The compositions of CD3 (+), CD4 (+), CD3 (+) IL-2R (+), CD3 (+) HLA-DR (+) significantly increased in BAL fluid when compared with those in peripheral blood in patients with active pulmonary tuberculosis. But the composition of CD8 ( + ), CD4/ CD8 were not different between BAL fluid and peripheral blood 4) There were no correlations between response to PPD and compositions of cells and lymphocyte subtypes in BAL fluid and peripheral blood in all patients with tuberculosis, responders, and noresponders, respectively .
Conclusion
From these results, we suggest no direct relationship between compositions of inflammatory cells in bronchoalveolar lavage fluid and we could not rule out the possibility of compartmentalization of activated lymphocyte involving in anergy to PPD in skin test in patients with active pulmonary tuberculosis. |
| Key Words:
Tuberculosis, Cell-mediated immunity, Lymphocyte |
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