| Change of T Cell Immunity in Patients with Tuberculosis |
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Dae Soo Kim, Wan Dong Kim, Sang Bok Lim, Yun Tae Jung, Jun Hee Woo, Yong Hun Kim, Choon Sik Park, Hi Bahl Lee |
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Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, Korea |
| 결핵 환자에서 T 세포 매개성 면역의 변화 |
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김대수, 김완동, 임상복, 정연태, 우준희, 김용훈, 박춘식, 이희발 |
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| Abstract |
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Purified protein derivative (PPD) skin test is one of the in vivo methods to evaluate the cell-mediated immunity in patients with tuberculosis. Positive reaction indicates prior mycobacterial infection, but some patients with newly acquired pulmonary tuberculosis, one half of the patients with miliary tuberculosis and one-third of the patients with tuberculous pleurisy may show negative reaction. Lymphoblast transformation to PPD antigen is an in vitro method of evaluating cell-mediated immunity.
To search for the changes in cell-mediated immunity and for the mechanisms behind the attenuated immunity in patients with tuberculosis, we performed the tuberculin skin test and lymphoblast transformation to antigen (PPD) and mitogen (PHA and Con-A) in 35 patients with pulmonary tuberculosis (minimal 6, moderate 19 and far advanced 10), 18 patients with tuberculous pleurisy and 19 healthy individuals The results were as follows;
1) Tuberculin skin tests in patients with pulmonary tuberculosis and tuberculous pleurisy were not significantly different from that of healthy control groups (p>0.05) , but in vitro lymphoblast transformation to PPD antigen was significantly lower in patients with pulmonary tuberculosis and tuberculous pleurisy when compared to that in healthy control groups (p<0.05 ).
2) In vitro lymphoblast transformation to PHA (p<0.005) and Con-A (p<0.05) was significantly lower in patients with tuberculous pleurisy when compared to those with pulmonary tuberculosis. 3) Size of tuberculin skin test tended to be correlated with absolute CPM of Iymphoblast transformation to PPD in patients with pulmonary tuberculosis (r = 0.63. p < 0.05). 4) Cells from plellral fluid had a higher tendency to spontaneous blast transformation as compared to peripheral blood lymphocytes. We conclude that cell.mediated immunity is depressed in patients with tuberculosis in terms of lymphoblast transformation to antigen and/ or mitogens and the attenuation of cell-mediated immunity might be specific to PPD-antigen in pulmonary tuberculosis and nonspecific in tuberculous pleurisy |
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