Tuberc Respir Dis.  1999 Jul;47(1):13-25. 10.4046/trd.1999.47.1.13.

Evaluation of the Cell-Mediated Immunity in Treatment Failure Pulmonary Tuberculosis

• Park JK
• Park JS
• Kim HJ
• Jo EG
• Min D
• Lim JH
• Suhr JW
• Paik TH

• KMID: 2050155
• DOI: http://doi.org/10.4046/trd.1999.47.1.13

Abstract

BACKGROUND: Ineffective cell-mediated immune response in human tuberculosis is associated with a depressed Th1 cytokine response and reduced production of IFN-gamma. Most persons infected with Mycobacterium tuberculosis are healthy tuberculin reactors with protective immunity, but a minority with ineffective immunity develop extensive pulmonary tuberculosis. The cell-mediated immune response is an important aspect of host resistance to mycobacterial infection and is believed to be tightly regulated by a balance between Th1 cytokines including IFN-gamma IL-12, IL-18, regulated on activation, normal T cell expressed and secreted (RANTES) and Th2 counterparts such as IL-4, monocyte chemoattractant protein-1 (MCP-1).
METHODS
Proliferation and mRNA expression of IFN-gamma RANTES and MCP-1 by RT-PCR in peripheral blood mononuclear cells (PBMCs) in response to in vitro stimulation with mycobacterial antigens were compared in pulmonary tuberculosis patients with cured and treatment failure and in tuberculin-positive and tuberculin-negative healthy subjects.
RESULTS
Defective proliferative responsiveness to aqueous TSP antigen was involved with treatment failure tuberculosis patients. Aqueous TSP antigen-induced IFN-gamma and RANTES mRNA expression was decreased in treatment failure tuberculosis patients compared with healthy tuberculin reactors and cured tuberculosis patients (23.1% versus 90.0% for IFN-gamma and 46.2% versus 70.0% versus 46.2% for RANTES). The frequency of MCP-1 mRNA expression to aqueous TSP antigen in treatment failure tuberculosis patients was greater than in healthy tuberculin reactors and cured tuberculosis patients (76.9% versus 40.0%).
CONCLUSION
The increasing expression of MCP-1 mRNA in response to aqueous TSP antigen might be predicted to favor Th2 responses and restricted Th1 responses in treatment failure of pulmonary tuberculosis.

Keyword

Pulmonary tuberculosis; IFN-gamma; Monocyte chemoattractant protein-1

MeSH Terms

Chemokine CCL2
Chemokine CCL5
Cytokines
Humans
Immunity, Cellular*
Interleukin-12
Interleukin-18
Interleukin-4
Mycobacterium tuberculosis
RNA, Messenger
Treatment Failure*
Tuberculin
Tuberculosis
Tuberculosis, Pulmonary*
Chemokine CCL2
Chemokine CCL5
Cytokines
Interleukin-12
Interleukin-18
Interleukin-4
RNA, Messenger
Tuberculin