T-cell recognition of iron-regulated culture filtrate proteins of Mycobacterium tuberculosis in tuberculosis patients and endemic normal controls.

Background: Culture filtrate proteins (CFPs) of Mycobacterium tuberculosis are potential vaccine candidates. Objective: The aim was to study the influence of iron levels on CFPs and assess the immuno-protective potential of defined antigenic fractions from high (8 μg Fe/mL) and low iron (0.02 μg Fe / mL) cultures of M. tuberculosis. Materials and Methods: The CFPs of M. tuberculosis from high (CFP-high) and low (CFP-low) iron conditions were first compared to identify iron-regulated proteins and then fractionated to obtain ten antigen pools (CF-Ags H1- H5 and L1-L5) that were used to assess the immune response of TB patients and normal healthy controls. Results: Iron limitation resulted in the up-regulation of two novel iron-regulated low-molecular-weight proteins Irp-1 (in CF-Ag L4) and Irp-2 (in CF-Ag L5) and repression of two ESAT proteins (identified with monoclonal antibody HYB 76.8). The median stimulation indices (SIs) against most of the CF-Ags were high in pulmonary TB patients. The CF-Ags L1 and L2 showed statistically significant SI (P values of 0.0027 and 0.0029 respectively); the % case recognition was high with these antigens as well as with L4 ( P = 0.0275). IFN-γ in response to these CF-Ags was significantly high in the endemic normals; maximal expression was seen with CF-Ag L5 (median value of 233 pg mL -1 ) that was higher than the corresponding H5 (140 pg mL -1 ) and H3 and L3 (205 and 206 pg mL -1 respectively). Conclusions: CF-Ags L5, H3 and L3 showed immuno-protective potential in this geographical location.

A profile of lung cancer patients in Hyderabad.

One hundred and sixty cases of bronchogenic carcinoma were retrospectively analysed. Male to female ratio was 8.4:1, common age group being 40-60 years. The most common (38%) radiological presentation was mass lesion. The predominant histological cell type was squamous cell carcinoma (67%). Most of the patients presented in an advanced stage of the disease of inoperability. The study underlines the various diagnostic madalities in diagnosing lung cancer and emphasises the need for practising doctors to keep in mind the possibilities of bronchogenic carcinoma in all cases of unresolved pneumonia and mass lesion on chest x-ray especially in high risk patients.

Carcinoid tumour: laser therapy.

A 31-year-old female, pregnant (I trimester), presented with symptoms and signs of bronchial asthma. Chest roentgenogram and computerized tomography of the chest revealed right mid and lower zone opacity (collapse). Bronchoscopic examination revealed intrabronchial growth in the right middle and lower lobe bronchus. Biopsy and histopathological examination confirmed carcinoid tumour. These symptoms and signs disappeared after laser therapy. The lesion, however, recurred two years later.