title: MTB-specific lymphocyte responses are impaired in tuberculosis patients with pulmonary cavities.
abstract: OBJECTIVE
  Tuberculosis (TB), an infectious disease caused by the bacillus Mycobacterium tuberculosis (MTB), is a global health problem. Because the failing immune response in the lung can lead to formation of a pulmonary cavity, this study was designed to clarify MTB-specific lymphocyte responses in TB patients with pulmonary cavities.
  
  
  METHODS
  We utilized culture filtrate protein 10 (CFP-10) and early secretory antigenic target 6 (ESAT-6) as immunogenic MTB antigens following overnight stimulation of peripheral blood mononuclear cells (PBMCs). By flow cytometry, we then dissected CD4+ and CD8+ T lymphocytes secreting intracellular cytokines of IFN-γ and TNF-α to assess the local immune response of TB patients with pulmonary cavities compared with those having other radiological infiltrates.
  
  
  RESULTS
  As expected, after 16 h of ex vivo activation using both ESAT-6 and CFP-10, the proportions of CD4+IFN-γ, CD4+TNF-α, CD8+TNF-α, and CD8+IFN-γ cells were all markedly increased in 46 patients with TB when compared with 23 household contacts. However, the IFN-γ and TNF-α responses of both CD4+ and CD8+ T lymphocytes were found to be relatively lower in 18 patients who had pulmonary cavities when compared with 28 patients who had radiological infiltrates. Moreover, patients with cavities had higher absolute numbers of neutrophils than patients with infiltrates. Further analysis indicated an inverse correlation between neutrophil counts and the proportions of IFN-γ-secreting T cells.
  
  
  CONCLUSIONS
  MTB-specific lymphocyte responses are impaired in TB patients with pulmonary cavities that are likely to play an important role in the pathogenesis of cavitary TB.
authors.affiliation: Center of Clinical Laboratory, The Fifth People's Hospital of Wuxi, Affiliated to Jiangnan University, Wuxi, 214005, Jiangsu, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Center of Clinical Laboratory, The Fifth People's Hospital of Wuxi, Affiliated to Jiangnan University, Wuxi, 214005, Jiangsu, China.
authors.forename: Yaping
authors.initials: Y
authors.lastname: Dai
authors.affiliation: Center of Clinical Laboratory, The Fifth People's Hospital of Wuxi, Affiliated to Jiangnan University, Wuxi, 214005, Jiangsu, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.affiliation: Radiology Department, The Fifth People's Hospital of Wuxi, Affiliated to Jiangnan University, Wuxi, 214005, Jiangsu, China.
authors.forename: Yongmei
authors.initials: Y
authors.lastname: Yin
authors.affiliation: Center of Clinical Laboratory, The Fifth People's Hospital of Wuxi, Affiliated to Jiangnan University, Wuxi, 214005, Jiangsu, China. peihao1008@126.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Pei
mesh_terms: D016207:Cytokines / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D007963:Leukocytes, Mononuclear / Q000276:immunology* / Q000382:microbiology; D008169:Lung Abscess / Q000276:immunology* / Q000382:microbiology; D008214:Lymphocytes / Q000276:immunology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D014376:Tuberculosis / Q000276:immunology* / Q000382:microbiology
chemical_list: D016207:Cytokines
keywords: Cavity; IFN-γ; TNF-α; Tuberculosis