title: Purified protein derivative-activated type 1 cytokine-producing CD4+ T lymphocytes in the lung: a characteristic feature of active pulmonary and nonpulmonary tuberculosis.
abstract: Because tuberculosis (TB) is primarily a pulmonary disease, we examined the cytokine responses of CD4(+) T lymphocytes in bronchoalveolar lavage (BAL) fluid after incubation with purified protein derivative (PPD) in human immunodeficiency virus-negative patients with TB and control subjects with nontuberculous respiratory disease. Parallel blood and BAL fluid samples from each subject were incubated with or without PPD, and the proportions of CD4(+) T lymphocytes producing interferon (IFN)-gamma or tumor necrosis factor (TNF)-alpha were measured by flow cytometry. The proportions of PPD-activated IFN-gamma- and TNF-alpha-producing CD4(+) cells were low among control subjects (median, 0.33% and 0.78%, respectively). By contrast, among patients with TB, strong IFN-gamma and TNF-alpha responses were demonstrated (median, 24.0% and 32.4%, respectively), regardless of whether the TB was pulmonary or nonpulmonary. Measurement of type 1 cytokine production by CD4(+) T lymphocytes in response to PPD in BAL fluid is a promising new diagnostic test for active TB in immunocompetent individuals.
authors.affiliation: Department of HIV Immunology, Royal Free Hospital, London, United Kingdom. sbarry@doctors.org.uk
authors.forename: Simon M
authors.initials: SM
authors.lastname: Barry
authors.forename: Marc C
authors.initials: MC
authors.lastname: Lipman
authors.forename: Barbara
authors.initials: B
authors.lastname: Bannister
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Johnson
authors.forename: George
authors.initials: G
authors.lastname: Janossy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000276:immunology; D016516:CD4-CD8 Ratio; D018414:CD8-Positive T-Lymphocytes / Q000166:cytology / Q000276:immunology; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000276:immunology; D008168:Lung / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009163:Mycobacterium bovis / Q000276:immunology; D018417:Th1 Cells / Q000276:immunology* / Q000378:metabolism; D014373:Tuberculin / Q000276:immunology*; D014376:Tuberculosis / Q000175:diagnosis* / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
chemical_list: D014373:Tuberculin; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma