title: Changes in cell-mediated immune response after lung resection surgery for MDR-TB patients.
abstract: The immune responses of multidrug-resistant tuberculosis (MDR-TB) patients undergoing lung resection surgery were investigated in order to understand the mechanism of strong immune suppression in MDR-TB. We examined changes in cell-mediated immune response (CMI) of a total of sixteen MDR-TB patients, three of them extensively drug-resistant tuberculosis (XDR-TB) patients, after the removal of the heavily diseased lung section. The IFN-γ response to Mycobacterium tuberculosis culture filtrate proteins (Mtb-CFP), one of the most important CMI to defend TB, showed a statistically significant elevation in 2-4 months after operation when compared to the preoperative CMI in patients who were converted into AFB negative and cured in two years' follow-up, suggesting that the recovery of CMI may be one of the key factors in the successful treatment of MDR-TB. Interestingly, IL-10 response to Mtb-CFP was also elevated in 2-4 months after surgery in cured patients although both proliferative response and PBMC composition were not significantly changed. Infection with first- or second-line drugs resistant Mtb reduces the efficiency of chemotherapeutic treatment of MDR-TB to about 50%. Thus, this study suggests that chemotherapeutic treatment of MDR-TB may be more effective when combined with accompanying therapy that increases CMI, includes lung resection surgery.
authors.affiliation: National Masan Tuberculosis Hospital, 486 Gapo-dong, Masan 631-710, Republic of Korea. pulmo116@korea.kr
authors.forename: Seung-Kyu
authors.initials: SK
authors.lastname: Park
authors.forename: Sunghee
authors.initials: S
authors.lastname: Hong
authors.forename: Seok-Yong
authors.initials: SY
authors.lastname: Eum
authors.forename: In Hee
authors.initials: IH
authors.lastname: Lee
authors.forename: Donk Ok
authors.initials: DO
authors.lastname: Shin
authors.forename: Jang Eun
authors.initials: JE
authors.lastname: Cho
authors.forename: Sungae
authors.initials: S
authors.lastname: Cho
authors.forename: Sang-Nae
authors.initials: SN
authors.lastname: Cho
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D049109:Cell Proliferation; D016207:Cytokines / Q000378:metabolism*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D007371:Interferon-gamma / Q000378:metabolism; D016753:Interleukin-10 / Q000378:metabolism; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000276:immunology* / Q000601:surgery; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D016207:Cytokines; D016753:Interleukin-10; D007371:Interferon-gamma