title: T cell responses to tuberculin purified protein derivative in primary biliary cirrhosis: evidence for defective T cell function.
abstract: BACKGROUND
  Primary biliary cirrhosis (PBC) has an autoimmune aetiology, although little is known regarding the mechanisms of breakdown of self tolerance. One postulated mechanism of control of self tolerance is through interacting T cell subsets, a phenomenon explored in this study.
  
  
  OBJECTIVE
  To characterise and compare T cell subset responses to an antigen (tuberculin purified protein derivative derived from mycobacteria) in PBC patients and controls. Cross reactive responses to mycobacteria have recently been implicated in the aetiology of PBC.
  
  
  METHODS
  58 PBC patients, 25 normal controls, and 34 chronic liver disease controls.
  
  
  METHODS
  Responses to antigen were measured in terms of primary T cell proliferation and cytokine secretion (by ELISA). Responding cells were phenotyped by FACS analysis.
  
  
  RESULTS
  Similar CD4+ T cell proliferative responses were seen in PBC patients (mean (SD) stimulation index (SI) 22.6 (27.2), 42 of 58 (72.4%) positive response), normal controls (46.5 (88.0), 17 of 25 (68%) positive), and chronic liver disease controls (24.8 (49.8), 27 of 34 (79.4%) positive)). Secretion of both interferon gamma and IL10 was significantly lower in PBC patients than controls (IFN gamma: PBC 822.7 (1100) pg/ml, controls 2929 (3402) pg/ml, p < 0.05: IL10: PBC 11.1 (15.6) pg/ml, controls 34.7 (63.4) pg/ml, p < 0.05).
  
  
  CONCLUSIONS
  In PBC unimpaired T cell proliferation is seen with reduced secretion of both Th-1 (interferon gamma) and Th-2 type (IL10) cytokines. These findings may result from differential subset responses and may help explain the defects of functional immunity seen in PBC.
authors.affiliation: Department of Medicine, University of Newcastle, Newcastle upon Tyne.
authors.forename: D E
authors.initials: DE
authors.lastname: Jones
authors.forename: J M
authors.initials: JM
authors.lastname: Palmer
authors.forename: M P
authors.initials: MP
authors.lastname: Leon
authors.forename: S J
authors.initials: SJ
authors.lastname: Yeaman
authors.forename: M F
authors.initials: MF
authors.lastname: Bassendine
authors.forename: A G
authors.initials: AG
authors.lastname: Diamond
mesh_terms: D000942:Antigens, Bacterial / Q000494:pharmacology*; D017252:CD3 Complex / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D002908:Chronic Disease; D016207:Cytokines / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D005455:Fluorescent Antibody Technique; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D016753:Interleukin-10 / Q000378:metabolism; D008105:Liver Cirrhosis, Biliary / Q000276:immunology*; D008107:Liver Diseases / Q000276:immunology; D008213:Lymphocyte Activation / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology*; D014373:Tuberculin
chemical_list: D000942:Antigens, Bacterial; D017252:CD3 Complex; D016207:Cytokines; D014373:Tuberculin; D016753:Interleukin-10; D007371:Interferon-gamma