title: [Longitudinal assessment of IFN-gamma production in patients with pulmonary tuberculosis complicated with diabetes mellitus].
abstract: Patients with diabetes mellitus (DM) are more susceptible to bacterial infection including pulmonary tuberculosis. To define the immunopathologic mechanisms underlying pulmonary tuberculosis in patients with DM, the production of IFN-gamma by CD4+ T cells or PBMC were followed up longitudinally during antituberculous chemotherapy. At the time of diagnosis, IFN-gamma production by CD4+ T cells in either tuberculosis patients without DM (TB) or with DM was significantly lower than that in the healthy control. CD4+ T cells in tuberculosis patients with DM under poor control (DM(p)TB) produced significantly less IFN-gamma than did patients with DM under good control (DM(g)TB). In longitudinal studies, IFN-gamma production in both TB and DM(g)TB patients returned to the control level by 6 months, whereas the production in DM(p)TB patients remained depressed. There was no significant relation between regimens of antituberculous chemotherapy and the production of IFN-gamma by PBMC in all subject groups. IFN-gamma production was depressed in DM(p)TB patients treated with HREZ for 6 months. These results indicate that depressed production of IFN-gamma in DM(p)TB patients is prolonged not due to tuberculous infection but intrinsic defect presumably induced by poorly controlled DM.
authors.affiliation: Department of Internal Medicine, National Nishinara Hospital, 2-789, Shichijo, Nara-shi, Nara 630-8053, Japan. katsuka@wnara.hosp.go.jp
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Tsukaguchi
authors.forename: Hideo
authors.initials: H
authors.lastname: Okamura
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Matsuzawa
authors.forename: Mouka
authors.initials: M
authors.lastname: Tamura
authors.forename: Ryuji
authors.initials: R
authors.lastname: Miyazaki
authors.forename: Shinji
authors.initials: S
authors.lastname: Tamaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kimura
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000276:immunology*; D004198:Disease Susceptibility; D006801:Humans; D007371:Interferon-gamma / Q000096:biosynthesis*; D008137:Longitudinal Studies; D008875:Middle Aged; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000188:drug therapy / Q000276:immunology*
chemical_list: D000995:Antitubercular Agents; D007371:Interferon-gamma