ABSTRACT
BACKGROUND: The poor prognostic factors of far-advanced pulmonary tuberculosis(FAPTB) are lymphocytopenia in the peripheral blood(PB)( or =65years), cachexia or a low body weight, shock, hematologic diseases, or BM involvement of tuberculosis. The distributions of cells in PB and BM were analyzed and compared to the control group. The interleukin(IL)-2, IL-7, IL-10, TNF-alpha, Interferon-gamma, and TGF-beta levels in the BM were measured by ELISA. RESULTS: Thirteen patients(male : female=9:4) were included and the mean age was 42+/-12years. The proportion and count of the lymphocytes in the PB were significantly lower in the FAPTB group (7.4+/- 3.0%, 694+/-255/mm3 vs. 17.5+/-5.8%, 1,377+/-436/mm3, each p=0.0001 and 0.002). The proportion of immature lymphocyte in the BM showed a decreasing trend in the FAPTB group(9+/-4% vs. 12+/-3%, p=0.138). The IL-2(26.0+/-29.1 vs. 112.2+/-42.4pg/mL, p=0.001) and IL-10(3.4+/-4.7 vs. 12.0+/-8.0pg/mL, p=0.031) levels in the BM were significantly lower in the FAPTB group than those in control. The levels of the other cytokines in FAPTB group and control were similar. CONCLUSION: These results suggest that the cause of lymphocytopenia in PB is associated with a abnormality IL-2 and IL-10 production in the BM. More study will be needed to define the mechanism of a decreased reservoir in BM.