Immune responses in the lungs of patients with tuberculous pleural effusion without pulmonary tuberculosis.
BACKGROUND
Tuberculous pleural effusion (TPE) is one of the most common forms of extrapulmonary tuberculosis. Because most studies of TPE focused on the pleural space, little information regarding lung parenchyma is available. We therefore aimed to investigate immune responses in the lung parenchyma of TPE patients without pulmonary tuberculosis.


METHODS
Patients with any evidence of pulmonary tuberculosis, either from radiologic or bacteriologic evaluation, were excluded. Bronchoalveolar lavage fluid (BALF) was collected from 10 newly diagnosed, untreated, HIV-negative TPE patients and 10 healthy controls. We analyzed T-lymphocyte subpopulations and measured 10 cytokines in BALF. Cytokine levels in BALF were standardised using urea.


RESULTS
The concentrations of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF), and the CD4+/CD8+ ratio of T-lymphocytes were significantly higher in TPE patients without pulmonary tuberculosis than in the controls. Of the cytokines measured in BALF, VEGF showed the highest concentration. No difference was observed in T-helper type 2 cytokines between the 2 groups.


CONCLUSIONS
There were significant immune responses and increases in IFN-γ, TNF-α, and VEGF in the lung parenchyma of TPE patients without pulmonary tuberculosis. This result suggests that TPE may induce a significant immune response in lung parenchyma.
Department of Internal Medicine, Dongsan Hospital, Keimyung University School of Medicine, Dalseong-ro 56, Jung-gu, Daegu 700-712, Republic of Korea.
Diana
D
Qama
Won-Il
WI
Choi
Kun Young
KY
Kwon
D000328:Adult; D016516:CD4-CD8 Ratio; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006801:Humans; D007109:Immunity; D008168:Lung / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000276:immunology* / Q000473:pathology; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology*; D058408:Th1-Th2 Balance; D014397:Tuberculosis, Pulmonary / Q000276:immunology* / Q000473:pathology
D016207:Cytokines