title: Reduced NK activity correlates with active disease in HIV- patients with multidrug-resistant pulmonary tuberculosis.
abstract: There has been a global increase in the incidence of multidrug-resistant pulmonary tuberculosis (TB). As there are no previous reports of immune function in HIV- patients with multidrug-resistant pulmonary TB, a comprehensive assessment of cellular immunity in this setting was undertaken. This involved a prospective, case-controlled study which included five patients with active multidrug-resistant pulmonary TB and five matched controls with active non-resistant infection, and documented the changes in immune parameters which occurred upon clinical resolution. Patients with multidrug-resistant TB had significantly lower fresh natural killer (NK) cell activity than matched controls with non-resistant pulmonary TB (P < 0.05). This was a specific abnormality, as there were no significant differences in antigen-specific cytotoxicity or lymphocyte proliferation in the case-controlled study. Follow-up assessment of the patients with multidrug-resistant infections indicated that clinical improvement correlated with a moderate increase in NK cell activity. Impaired NK cell function may be involved in the pathogenesis of multidrug-resistant TB.
authors.affiliation: Department of Medicine, University of Cape Town, South Africa.
authors.forename: L T
authors.initials: LT
authors.lastname: Ratcliffe
authors.forename: P T
authors.initials: PT
authors.lastname: Lukey
authors.forename: C R
authors.initials: CR
authors.lastname: MacKenzie
authors.forename: S R
authors.initials: SR
authors.lastname: Ress
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003602:Cytotoxicity, Immunologic / Q000276:immunology; D005260:Female; D018023:HIV Seronegativity / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular; D016130:Immunophenotyping; D007376:Interleukin-2; D015979:Killer Cells, Lymphokine-Activated / Q000276:immunology; D007694:Killer Cells, Natural / Q000276:immunology*; D008213:Lymphocyte Activation / Q000276:immunology; D016131:Lymphocyte Subsets; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011446:Prospective Studies; D012882:Skin Tests; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000276:immunology*; D014397:Tuberculosis, Pulmonary / Q000276:immunology*
chemical_list: D007376:Interleukin-2