[T-cellular energy deficiency in the pathogenesis of immunodeficiency in pulmonary tuberculosis]. / T-kletochnaia anergiia v patogeneze immunnoi nedostatochnosti pri tuberkuleze legkikh.

The phenotypic and functional properties of T cells were evaluated in patients with tuberculin anergy and a possible role of anergic T cells in the development of immune deficiency in pulmonary tuberculosis (PT) was studied. The profound decrease (more than 50%) depressed T-cell proliferation in PPD-stimulated cultures was shown to be recorded in 44% (59/134) patients with PT. PPD hyporesponsiveness was associated with the low proliferation of anti-CD3 and SEB-stimulated proliferation of a healthy donor's mononuclear cells evidencing the enlargement of anergic T cells with a suppressive activity in PT. A PPD-stimulated response in healthy donors was under the negative control of CG25-positive cells. In the PPD-anergic patients, there was a significant increase in CD4+CD25+ T cells that were inversely correlated with the PPD-induced proliferative response. The development of tuberculin anergy was more pronounced in patients with drug resistance. The intensity of a PPD-stimulated response in patients with tuberculin anergy may be restored in the presence of exogenous interleukin-2.

[Involvement of nitric oxide in the development of tuberculin anergy in patients with pulmonary tuberculosis]. / Uchastie oksida azota v razvitii tuberkulinovoi anergii u bol'nykh tuberkulezom legkikh.

The production of nitric oxide (NO) and the magnitude of an antigen-specific proliferative response of the human lymphocytes stimulated by M. tuberculosis antigen [a purified protein derivative (PPD)] were investigated. PPD-reactive T lymphocytes were found in the peripheral blood of healthy donors. Normal values (mean values, the range of the minimum and maximum values) of PPD-induced proliferation and NO production were determined. Patients with pulmonary tuberculosis were found to have different levels of PPD-stimulated proliferation and NO production. The lymphocytes are shown to preserve their PPD reactivity in patients with normal NO production whereas the PPD-induced proliferative response was significantly decreased in those with high NO production. Patients with reduced tuberculin reactivities and high NO production were less responsive to treatment. The findings suggest that nitric oxide is involved in the development of tuberculin anergy with pulmonary tuberculosis.