RESUMO
Clinical and immunological studies were conducted in 62 patients with infiltrative pulmonary tuberculosis and 53 with disseminated one. As drug resistance and viability of mycobacteria increased, an immune response was found to develop as the humoral type and cellular immunity was suppressed. A more marked reduction in the activity of T helper cells type 1 of an immune response and the neutrophilic granulocytic system was revealed in patients with disseminated pulmonary tuberculosis. The maximum suppression of cell immunity was found in patients with multidrug-resistant mycobacterial strains. The observed changes in an immune response and in the production of cytokines (IL-2, IL-8) are informative signs correlating with deterioration of a specific process. Mycobacterial drug resistance and its suppressed cell immunity make chemotherapy policy difficult. The findings identify patients with mycobacterial drug resistance and high viability as a group of priority in the context of immunomodulator therapy.
