Depressed T-cell interferon-γ responses in pulmonary tuberculosis:: Analysis of underlying mechanisms and modulation with therapy
Depressed T-cell interferon-γ responses in pulmonary tuberculosis:: Analysis of underlying mechanisms and modulation with therapy
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DOI：
10.1086/315114
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发表时间：
1999-12-01
影响因子：
6.4
通讯作者：
Ellner, JJ
中科院分区：
文献类型：
--
作者：
Hirsch, CS;Toossi, Z;Ellner, JJ
对人类免疫缺陷病毒(HIV)未感染和HIV感染的患者、新诊断的肺结核(TB)患者和结核菌素皮试反应的健康对照组的免疫学和临床特征进行了评估。对未感染HIV的结核病患者在化疗期间和化疗后进行纵向随访，确诊时，结核病患者外周血单个核细胞经PPD刺激产生干扰素-γ的水平低于健康对照组，而转化生长因子-β和白介素10的水平高于健康对照组。在纵向研究中，PPD刺激IL-10和转化生长因子-β的产生在3个月后恢复到基线水平，而干扰素-γ的产生至少在12个月内保持抑制。这些数据表明，在结核分枝杆菌感染早期，结核病的免疫抑制不仅是直接的，明显地(至少部分地)依赖于免疫抑制细胞因子，而且是长期的，可能与T细胞功能的初级异常有关。
Immunological and clinical profiles were evaluated in 2 groups: human immunodeficiency virus (HIV)-uninfected and HIV-infected patients, with newly diagnosed pulmonary tuberculosis (TB), and tuberculin-skin-test-reactive healthy control subjects. HIV-uninfected patients with TB were also followed up longitudinally during and after chemotherapy, At the time of diagnosis, purified protein derivative (PPD)-stimulated production of interferon (IFN)-gamma by peripheral blood mononuclear cells from TB patients was depressed, compared with that of healthy control subjects, whereas levels of transforming growth factor (TGF)-beta and interleukin (IL)-10 were increased. In longitudinal studies, PPD stimulated production of IL-10 and TGF-beta returned to baseline by 3 months, whereas IFN-gamma production remained depressed for at least 12 months. These data indicate that the immunosuppression of TB is not only immediate and apparently dependent (at least in part) on immunosuppressive cytokines early during the course of Mycobacterium TB infection but is also long lasting, presumably relating to a primary abnormality in T-cell function.