title: Abnormal production of transforming growth factor beta and interferon gamma by peripheral blood cells of patients with multidrug-resistant pulmonary tuberculosis in Brazil.
abstract: OBJECTIVE
  The aim of the present study was to determine the immune response profile that differentiates patients with newly diagnosed (non-treated) pulmonary tuberculosis from multidrug-resistant (MDR) ones, as well as from healthy, tuberculin positive individuals.
  
  
  METHODS
  Lymphocytes proliferative response to non-specific mitogen (PHA) and PPD were evaluated by 3H thymidine incorporation and cytokines were quantified using an ELISA assay.
  
  
  RESULTS
  Patients with active disease showed a diminished proliferative response to PHA and PPD, while multidrug-resistant patients showed a diminished proliferative response to PHA, but a normal response to PPD. The cytokine production of newly diagnosed patients was characterized by a diminished production of IFNgamma and normal production of transforming growth factor (TGFbeta), while MDR patients revealed a normal production of IFNgamma accompanied by an increase in TGFbeta.
  
  
  CONCLUSIONS
  The production of significant amounts of TGFbeta in MDR patients leads to a poor immune response and may contribute to the resistance of tuberculosis patients to drugs.
authors.affiliation: Department of Microbiology and Immunology, University of Campinas, UNICAMP, Campinas, CEP 13083 970 São Paulo, SP, Brazil.
authors.forename: Analia Z
authors.initials: AZ
authors.lastname: Castro
authors.forename: Blanca M
authors.initials: BM
authors.lastname: Diaz-Bardalez
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Oliveira
authors.forename: Reinaldo C
authors.initials: RC
authors.lastname: Garcia
authors.forename: Jorge Barros
authors.initials: JB
authors.lastname: Afiune
authors.forename: Ilma A
authors.initials: IA
authors.lastname: Paschoal
authors.forename: Leonilda M B
authors.initials: LM
authors.lastname: Santos
mesh_terms: D000328:Adult; D001938:Brazil; D016022:Case-Control Studies; D018432:Drug Resistance, Multiple; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D007371:Interferon-gamma / Q000032:analysis / Q000096:biosynthesis* / Q000276:immunology; D007963:Leukocytes, Mononuclear / Q000276:immunology*; D008213:Lymphocyte Activation; D008214:Lymphocytes / Q000187:drug effects / Q000276:immunology* / Q000382:microbiology / Q000502:physiology; D008297:Male; D008875:Middle Aged; D008934:Mitogens / Q000494:pharmacology; D009169:Mycobacterium tuberculosis / Q000276:immunology / Q000302:isolation & purification; D016212:Transforming Growth Factor beta / Q000032:analysis / Q000096:biosynthesis* / Q000276:immunology; D014373:Tuberculin / Q000494:pharmacology; D014397:Tuberculosis, Pulmonary / Q000276:immunology*
chemical_list: D008934:Mitogens; D016212:Transforming Growth Factor beta; D014373:Tuberculin; D007371:Interferon-gamma