ABSTRACT
Pleural tuberculosis (TB) is a common presentation of Mycobacterium tuberculosis (MTB) infection, and despite spontaneous resolution remains a strong risk factor for reactivation pulmonary TB in a majority of individuals. This study was undertaken to further understand the characteristics of immune cells at sites of pleural TB. A significant shift toward memory CD4+ T cells with an effector phenotype and away from naïve CD4+ T cells in pleural fluid as compared to blood mononuclear cells was found. These data suggest that effector T cells are capable of migrating to sites of active TB infection and/or the differentiation to effector phenotype T cells in situ is highly amplified. Using multi-parameter flow cytometry analysis, a significant portion of MTB-specific CD4+ T cells in the pleural space were polyfunctional demonstrating two, three or four simultaneous functions including IFN-gamma, IL-2, TNF-alpha, and or MIP-1 alpha production. A greater proportion of these polyfunctional cells were of effector memory rather than central memory phenotype. The role of these polyfunctional MTB-specific CD4+ T cells at sites of pleural TB requires further study.
Subject(s)
CD4-Positive T-Lymphocytes/immunology , Mycobacterium tuberculosis/immunology , Tuberculosis, Pleural/immunology , Adolescent , Adult , Aged , CD4-Positive T-Lymphocytes/metabolism , Chemokine CCL3/biosynthesis , Female , Flow Cytometry , Humans , Interferon-gamma/biosynthesis , Interleukin-2/biosynthesis , Male , Middle Aged , Morocco/epidemiology , Mycobacterium tuberculosis/cytology , Phenotype , Tuberculosis, Pleural/epidemiology , Tuberculosis, Pleural/genetics , Tumor Necrosis Factor-alpha/biosynthesis , Uganda/epidemiology , Young AdultABSTRACT
We analysed 2 evaluation lots of the TB IgA EIA test in pulmonary tuberculosis patients (TBp). Sera were obtained from 345 TBp, 18 healthy subjects (HS), 28 subjects in contact with tuberculous patients (CS) and 16 non-tuberculous lung disease patients (N-TB) for the first evaluation lots and 302 TBp, 60 HS, 21 CS and 18 N-TB for the second. IgA titres against p-90 antigen with the second evaluation lot were significantly higher than the first evaluation lot. With the second evaluation lots, the sensitivity was 78.8% whereas with the first evaluation lot, the sensitivity was 75.9%. Specificity for the first and second evaluation lots was 50% and 70.7% respectively. The sensitivity of this test is still not satisfactory to establish pulmonary tuberculosis diagnosis.
Subject(s)
Antibodies, Bacterial/blood , Enzyme-Linked Immunosorbent Assay/methods , Immunoglobulin A/blood , Mycobacterium tuberculosis/immunology , Tuberculosis, Pulmonary/diagnosis , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Analysis of Variance , Case-Control Studies , Child , Enzyme-Linked Immunosorbent Assay/standards , Female , Humans , Male , Middle Aged , Morocco/epidemiology , ROC Curve , Sensitivity and Specificity , Sex Distribution , Statistics, Nonparametric , Tuberculosis, Pulmonary/blood , Tuberculosis, Pulmonary/epidemiology , Tuberculosis, Pulmonary/immunologyABSTRACT
We analysed 2 evaluation lots of the TB IgA EIA test in pulmonary tuberculosis patients [TBp]. Sera were obtained from 345 TBp, 18 healthy subjects [HS], 28 subjects in contact with tuberculous patients [CS] and 16 non-tuberculous lung disease patients [N-TB] for the first evaluation lots and 302 TBp, 60 HS, 21 CS and 18 N-TB for the second. IgA titres against p-90 antigen with the second evaluation lot were significantly higher than the first evaluation lot. With the second evaluation lots, the sensitivity was 78.8% whereas with the first evaluation lot, the sensitivity was 75.9%. Specificity for the first and second evaluation lots was 50% and 70.7% respectively. The sensitivity of this test is still not satisfactory to establish pulmonary tuberculosis diagnosis
