title: Decreased in vitro interferon-gamma production in patients with cavitary tuberculosis on chest radiography.
abstract: Interferon (IFN)-gamma expression is altered in pulmonary lesions, such as cavities and granulomas. However, the exact association between patterns on chest radiography and IFN-gamma responses are unclear. The purpose of this study was to determine the IFN-gamma response in patients with tuberculosis and to correlate the pulmonary lesions with the IFN-gamma responses. We enrolled 78 patients with tuberculosis, as diagnosed with initial positive results for acid-fast bacilli in the sputum and final positive cultures for Mycobacterium tuberculosis. Cell cultures of stimulated peripheral blood mononuclear cells were performed. The supernatants were analyzed for the IFN-gamma response and the results statistically analyzed. The patients' chest radiographs were examined for fibronodules, masses, pleural effusion, cavities, and the severity of parenchymal involvement. IFN-gamma responses were lower in patients with cavities on chest radiography than in those without cavities (403.306+/-397.048 vs 698.154+/-593.436 pg/ml, P<0.05). IFN-gamma responses were also lower in patients with masses on chest radiography than in those without masses (186.345+/-200.724 vs 583.950+/-528.295 pg/ml, P<0.05). After regression analysis, the presence of a cavity was the only factor predictive of a decreased IFN-gamma response. We conclude that only chest radiographic pattern correlated with the IFN-gamma response was cavity formation. The administration of pharmacological IFN-gamma in tuberculosis patients with cavity may be considered.
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC. whanpyng@cgmh.org.tw
authors.forename: Huang-Pin
authors.initials: HP
authors.lastname: Wu
authors.forename: Chung-Ching
authors.initials: CC
authors.lastname: Hua
authors.forename: Duen-Yau
authors.initials: DY
authors.lastname: Chuang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism*; D007963:Leukocytes, Mononuclear / Q000276:immunology*; D016014:Linear Models; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D011859:Radiography; D012737:Sex Factors; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000276:immunology*
chemical_list: D007371:Interferon-gamma