title: Changes in leucocyte and lymphocyte subsets during tuberculosis treatment; prominence of CD3dimCD56+ natural killer T cells in fast treatment responders.
abstract: The immune responses against pulmonary tuberculosis are still poorly defined. This study describes changes in leucocyte and lymphocyte subsets during treatment to find reliable immunological markers for the disease and treatment response. Flow cytometric peripheral blood immune phenotyping, routine haematology and sputum microbiology were performed on 21 HIV-negative adult tuberculosis (TB) patients with positive sputum cultures during therapy in comparison with 14 healthy purified protein derivative (PPD)-positive volunteers. Patients at diagnosis showed high absolute neutrophil and monocyte counts which fell during treatment but low lymphocyte subset counts which increased [except natural killer (NK) and NK T cells]. High counts of a population of CD3(dim)/CD56+ NK T cells at diagnosis correlated significantly with negative sputum culture after 8 weeks of treatment. A multivariate classification technique showed improved correlation when NK cells were taken into account. In conclusion, peripheral blood white cell counts change significantly during treatment and counts at diagnosis, especially CD3(dim)/CD56+ NK T cells, hold promise in predictive models of TB treatment response.
authors.affiliation: Division of Molecular Biology and Genetics and MRC Centre for Molecular and Cellular Biology, University of Stellenbosch, PO Box 19063, Tygerberg 7505, South Africa. hveen@sun.ac.za
authors.forename: H
authors.initials: H
authors.lastname: Veenstra
authors.forename: R
authors.initials: R
authors.lastname: Baumann
authors.forename: N M
authors.initials: NM
authors.lastname: Carroll
authors.forename: P T
authors.initials: PT
authors.lastname: Lukey
authors.forename: M
authors.initials: M
authors.lastname: Kidd
authors.forename: N
authors.initials: N
authors.lastname: Beyers
authors.forename: C T
authors.initials: CT
authors.lastname: Bolliger
authors.forename: P D
authors.initials: PD
authors.lastname: van Helden
authors.forename: G
authors.initials: G
authors.lastname: Walzl
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D017252:CD3 Complex / Q000032:analysis; D019002:CD56 Antigen / Q000032:analysis; D004351:Drug Resistance; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D007694:Killer Cells, Natural / Q000276:immunology; D007958:Leukocyte Count; D016131:Lymphocyte Subsets / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology; D015999:Multivariate Analysis; D009504:Neutrophils / Q000276:immunology; D011379:Prognosis; D013183:Sputum / Q000276:immunology*; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy / Q000276:immunology*
chemical_list: D000995:Antitubercular Agents; D017252:CD3 Complex; D019002:CD56 Antigen; D007538:Isoniazid