title: Immune response to Mycobacterium tuberculosis infection in the parietal pleura of patients with tuberculous pleurisy.
abstract: The T lymphocyte-mediated immune response to Mycobacterium tuberculosis infection in the parietal pleura of patients with tuberculous pleurisy is unknown. The aim of this study was to investigate the immune response in the parietal pleura of tuberculous pleurisy compared with nonspecific pleuritis. We have measured the numbers of inflammatory cells particularly T-cell subsets (Th1/Th2/Th17/Treg cells) in biopsies of parietal pleura obtained from 14 subjects with proven tuberculous pleurisy compared with a control group of 12 subjects with nonspecific pleuritis. The number of CD3+, CD4+ and CCR4+ cells and the expression of RORC2 mRNA were significantly increased in the tuberculous pleurisy patients compared with the nonspecific pleuritis subjects. The number of toluidine blue+ cells, tryptase+ cells and GATA-3+ cells was significantly decreased in the parietal pleura of patients with tuberculous pleurisy compared with the control group of nonspecific pleuritis subjects. Logistic regression with receiver operator characteristic (ROC) analysis for the three single markers was performed and showed a better performance for GATA-3 with a sensitivity of 75%, a specificity of 100% and an AUC of 0.88. There was no significant difference between the two groups of subjects in the number of CD8, CD68, neutrophil elastase, interferon (IFN)-γ, STAT4, T-bet, CCR5, CXCR3, CRTH2, STAT6 and FOXP3 positive cells. Elevated CD3, CD4, CCR4 and Th17 cells and decreased mast cells and GATA-3+ cells in the parietal pleura distinguish patients with untreated tuberculous pleurisy from those with nonspecific pleuritis.
authors.affiliation: Section of Respiratory Diseases, University of Ferrara, Ferrara, Italy. gaetano.caramori@unife.it
authors.forename: Gaetano
authors.initials: G
authors.lastname: Caramori
authors.forename: Lisa
authors.initials: L
authors.lastname: Lasagna
authors.forename: Angelo G
authors.initials: AG
authors.lastname: Casalini
authors.forename: Ian M
authors.initials: IM
authors.lastname: Adcock
authors.forename: Paolo
authors.initials: P
authors.lastname: Casolari
authors.forename: Marco
authors.initials: M
authors.lastname: Contoli
authors.forename: Federica
authors.initials: F
authors.lastname: Tafuro
authors.forename: Anna
authors.initials: A
authors.lastname: Padovani
authors.forename: Kian Fan
authors.initials: KF
authors.lastname: Chung
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Barnes
authors.forename: Alberto
authors.initials: A
authors.lastname: Papi
authors.forename: Guido
authors.initials: G
authors.lastname: Rindi
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Bertorelli
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D004804:Eosinophils / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D005260:Female; D006098:Granulocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007124:Immunoenzyme Techniques; D007371:Interferon-gamma / Q000235:genetics; D008297:Male; D008407:Mast Cells / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology; D057132:Nuclear Receptor Subfamily 1, Group F, Member 3 / Q000235:genetics; D010994:Pleura / Q000276:immunology* / Q000378:metabolism / Q000382:microbiology; D010996:Pleural Effusion / Q000276:immunology* / Q000378:metabolism / Q000382:microbiology; D012333:RNA, Messenger / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016176:T-Lymphocyte Subsets / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology* / Q000378:metabolism; D014376:Tuberculosis / Q000276:immunology* / Q000378:metabolism / Q000382:microbiology; D014396:Tuberculosis, Pleural / Q000276:immunology* / Q000378:metabolism / Q000382:microbiology
chemical_list: D015415:Biomarkers; D057132:Nuclear Receptor Subfamily 1, Group F, Member 3; D012333:RNA, Messenger; C539900:RORC protein, human; D007371:Interferon-gamma