Polyfunctional Mycobacterium tuberculosis-specific effector memory CD4+ T cells at sites of pleural TB.

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.

[Diagnosis of pulmonary tuberculosis: evaluation of the TB IgA EIA assay in Morocco]. / Diagnostic de la tuberculose pulmonaire: evaluation du test "TB IgA EIA" au Maroc.

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.

[Low prevalence of anti-centromere antibodies in scleroderma in Morocco (about 272 cases)]. / Faible prévalence des anticorps anti-centromère dans la sclérodermie au Maroc (à propos de 272 cas).

PURPOSE: assessment of autoantibodies prevalence during scleroderma within a Moroccan population by a retrospective survey. MATERIAL AND METHODS: 272 patient (220 cases of systemic sclerosis, 45 cases localised scleroderma and 7 cases of mixed connective tissue disease (MCTD)) underwent a screening for antinuclear antibodies (ANA) by indirect immunofluorescence (IFI) on Hep-2 cells, followed, in 127 cases, by anti-extractable nuclear antigen (ENA) antibodies identification using a double immunodiffusion (IDD) method. RESULTS: sixty eight for percent of patients presenting with a systemic sclerosis had positive ANA whose identification revealed: 23 cases (15.3%) of anti-topoisomerase I, 8 cases (5.3%) of anti-centromere (ACA) and 5 cases (3.3%) of anti-U1-RNP antibodies. Out of the 8 cases of ACA, 3 corresponded to a CREST syndrome. Anti-topoisomerase I antibodies were observed in 2 of the 4 patients having an interstitial pulmonary syndrome. Anti-U1-RNP antibodies were present in 3/38 patients (7.8%) having a systemic sclerosis associated to arthritis. 4/45 patients (9%), presenting with a localised scleroderma, had positive ANA, of which 2 were ACA. All patients admitted for MCTD had anti-U1-RNP antibodies, coexisting with anti-Sm antibody in 2 cases. CONCLUSION: the low prevalence of ACA observed in this survey, when compared to American, European and Japanese studies, is probably due to ethnic variation in frequency of ANA. Indeed, low rates or absence of ACA have been reported in south-African, Afro-American, Indian, and Thai studies. The IDD, method of reference for detecting of anti-ENA antibodies, identify a small fraction of anti-nucleolar aspects of scleroderma. Thus, other methods such as ELISA and/or immunoblotting are required to complete their identification.

[Diagnosis of pulmonary tuberculosis: evaluation of the TB IgA EIA assay in Morroco]

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