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Eur Respir J 2007, doi:10.1183/09031936.00096707
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ORIGINAL ARTICLE |
Local immunodiagnosis of pulmonary tuberculosis by enzyme-linked immunospot
1 Division of Clinical Infectious Diseases and
2 Division of Immune Cell Analytics, Research Center Borstel
3 Hospital Großhansdorf, Center for Pulmonary Medicine and Thoracic Surgery
* To whom correspondence should be addressed. E-mail: clange{at}fz-borstel.de.
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Abstract |
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Lymphocytes are crucial in the immune defense against Mycobacterium tuberculosis (MTB) infection. We ascertained whether MTB-specific lymphocytes are selectively compartmentalised in the lungs of patients with minimal active pulmonary tuberculosis (pTB).
We prospectively recruited patients with smear-negative, MTB culture-confirmed pTB. Differential cell counts, immunophenotyping with monoclonal antibodies against cell surface markers CD4, CD8, CD4CD45RA, CD4CD45R0, CD38, HLADR, CD19, CD3, CD57, CD16 and MTB-specific enzyme linked immunospot assays (ELISPOT) with early-secretory-antigenic-target-6 (ESAT-6) and culture-filtrate-protein-10 (CFP-10) of peripheral blood mononuclear cells (PBMCs) and broncho-alveolar lavage mononuclear cells (BALMCs) were performed.
Among 12 patients with culture-confirmed smear-negative pTB, no differences were found in the distribution of total CD4 or CD8 T cells in peripheral blood or BAL. Activated HLA DR+ cells as well as memory CD4CD45R0+ T cells were expanded among cells of the BAL. Compared with a group of control patients with alternative pulmonary pathologies, there was no significant difference in lymphocyte subpopulations. However, ESAT-6 and CFP-10 specific lymphocytes were concentrated with a median of 9.9 and 8.9 times more in BAL compared to peripheral blood in patients with pTB.
MTB-specific T cells are highly selectively compartmentalised at the site of infection in active pTB
Keywords: Broncho-alveolar lavage, CFP-10, ELISPOT, ESAT-6, lymphocytes, tuberculosis
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