Tuberculin Skin Test and Plasma Prostaglandin E2 in Patients of New and Intractable Pulmonary Tuberculosis / 결핵

ABSTRACT

BACKGROUND: The cell-mediated immunity is needed for eradicating the tubercle bacilli. Prosta- glandin(PG), especially PG E2, is involved in cellular immunosuppression. It is known that the PG E2 is suppressed by indo- methacin. For using indomethacin as a immunomodulator of intractable pulmonary tuberculosis(Tbc) patients, we measured the tuberculin skin test(TST) and the plasma PG E2 levels. METHOD: The forty-eight inpatients with sputum positive acid-fast stain bacilli were classified into 6 groups according to antiTbc chemotherapy history(new and intractable cases), plain chest roetgenogram(minimal and far advanced cases), and TST reaction(nagative and positive cases). Except for one group(n=2; new, minimal, and negative cases of TST reaction) of the 6 groups, all subjects(n=46) were measured for the plasma PG E2 levels with radioimmunoassay. RESULTS: 1) There was no significiant difference in the plasma PG E2 levels among A group(far advanced and positive TST reaction cases, n=10, 11.22 +/-2.86 pg/ml), B group(minimal and negative TST reaction cases, n=9, 11.35 +/-2.20) and C group(far advanced and positive TST reaction cases, n=7, 11.11+/-2.30) in the new cases(p >0.05). 2) There was no significiant difference in the plasma PG E2 levels between positive(n=10, 9.25 +/- 2.21) and negative(n=10, 8.25 +/- 1.13) groups by TST in the intractable cases(p>0.05). 3) Comparing the plasma PG E2 levels between new(n=26, 11.35 +/-2.41) and intractable(n=20, 8.75 1.78) groups, the intractable group had significi- antly lower plasma PG E2 levels(p0.05). 5) There was no significiant difference in the plasma PG E2 levels between male(n=32, 10.07 +/- 2.44) and female(n=14, 10.56 +/-2.70)(p >0.05). 6) There was no significiant difference in the plasma PG E2 levels among 2nd(n=5, 10.21 +/-2.86), 3rd(n=9, 9.97+/-2.47), 4th(n=13, 11.35+/-2.33) and 5th(n=19, 9.57+/-2.48) decades(p>0.05). 7) There was no significiant correlation between the induration sizes of the TST and the plasma PG E2 levels(r=0.054, p>0.05). CONCLUSION: From the above results, the plasma PG E2 levels of intract- able group are not higher as the authors had expected. There was no significiant difference in the plasma PG E2 levels by the lesion sizes of plain chest roetgengram and the induration sizes of TST, so more study will be needed to use the indomethacin as a immunomodulator for intractable pulmonary thberculosis patients.