Lack of T-helper lymphocytes in BAL fluid from a HIV-negative patient with recurrent non-tuberculous mycobacterial lung infections.
We describe here a previously healthy, 42 year old, HIV-negative woman. Following a seemingly successful 2-year antimycobacterial regimen for a lung infection caused by Mycobacterium avium/intracellulare she acquired a lung infection caused by M. chelonei. Characterization of alveolar cells from bronchoalveolar lavage fluid using flow cytometry revealed a total lack of T-cell subset CD4+ helper lymphocytes in spite of a normal proportion of the CD3+ and CD4+ T-cells in peripheral blood. The levels of Th2 cytokines such as IL-4, TGF-beta and G-CSF were higher in the patient's alveolar cells than in the cells of 4 healthy controls. This imbalance of cells and cell cytokines may contribute to the patient's susceptibility for non-tuberculous mycobacteria and her failure to eradicate these microorganisms.
Heurlin
N
N
Department of Medicine, Karolinska Institute, Huddinge University Hospital, Sweden.
Bratel
T
T
Andersson
J
J
Christensson
M
M
Christensson
B
B
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D018791:CD4 Lymphocyte Count; D016207:Cytokines / Q000096:biosynthesis; D005260:Female; D005434:Flow Cytometry; D018023:HIV Seronegativity; D006801:Humans; D007371:Interferon-gamma / Q000627:therapeutic use*; D009165:Mycobacterium Infections, Nontuberculous / Q000276:immunology* / Q000628:therapy; D009162:Mycobacterium avium / Q000187:drug effects*; D015270:Mycobacterium avium-intracellulare Infection / Q000276:immunology* / Q000628:therapy; D016926:Mycobacterium chelonae / Q000187:drug effects*; D010641:Phenotype; D012008:Recurrence; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology; D014397:Tuberculosis, Pulmonary / Q000276:immunology* / Q000628:therapy
D000995:Antitubercular Agents; D016207:Cytokines; D007371:Interferon-gamma