Ribeiro-Rodrigues Rodrigo, Resende Co Tatiana, Johnson John L, Ribeiro Fabiola, Palaci Moises, Sá Ricardo T, Maciel Ethel L, Pereira Lima Fausto E, Dettoni Valderio, Toossi Zahra, Boom W Henry, Dietze Reynaldo, Ellner Jerrold J, Hirsch Christina S
Universidade Federal do Espírito Santo, Núcleo Doenças Infecciosas, Vitória, ES, Brazil.
Clin Diagn Lab Immunol. 2002 Jul;9(4):818-23. doi: 10.1128/cdli.9.4.818-823.2002.
Sputum and serum from patients with active pulmonary tuberculosis (TB), healthy purified protein derivative-positive adults, and patients with bacterial pneumonia were collected to simultaneously assess local immunity in the lungs and peripheral blood. To determine whether cytokine profiles in sputum from TB patients and control subjects were a reflection of its cellular composition, cytospin slides were prepared in parallel and assessed for the presence of relative proportions of epithelial cells, neutrophils, macrophages, and T cells. Gamma interferon (IFN-gamma) in sputum from TB patients was markedly elevated over levels for both control groups. With anti-TB therapy, IFN-gamma levels in sputum from TB patients decreased rapidly and by week 4 of treatment were comparable to those in sputum from controls. Further, IFN-gamma levels in sputum closely followed mycobacterial clearance. Although detected at fourfold-lower levels, IFN-gamma immunoreactivities in serum followed kinetics in sputum. TNF-alpha, interleukin 8 (IL-8) and IL-6 also were readily detected in sputum from TB patients at baseline and responded to anti-TB therapy. In contrast to IFN-gamma, however, TNF-alpha and IL-8 levels also were elevated in sputum from pneumonia controls. These data indicate that sputum cytokines correlate with disease activity during active TB of the lung and may serve as potential early markers for sputum conversion and response to anti-TB therapy.
收集活动性肺结核（TB）患者、健康的纯化蛋白衍生物阳性成年人以及细菌性肺炎患者的痰液和血清，以同时评估肺部局部免疫和外周血情况。为了确定结核病患者和对照受试者痰液中的细胞因子谱是否反映其细胞组成，同时制备了细胞涂片玻片，并评估上皮细胞、中性粒细胞、巨噬细胞和T细胞的相对比例。结核病患者痰液中的γ干扰素（IFN-γ）水平明显高于两个对照组。随着抗结核治疗的进行，结核病患者痰液中的IFN-γ水平迅速下降，到治疗第4周时与对照组痰液中的水平相当。此外，痰液中的IFN-γ水平与分枝杆菌清除情况密切相关。虽然血清中的IFN-γ免疫反应性检测水平比痰液中低四倍，但血清中的IFN-γ免疫反应性与痰液中的动力学情况相似。在基线时，结核病患者的痰液中也很容易检测到肿瘤坏死因子-α（TNF-α）、白细胞介素8（IL-8）和IL-6，并且这些细胞因子对抗结核治疗有反应。然而，与IFN-γ不同的是，肺炎对照组患者的痰液中TNF-α和IL-8水平也有所升高。这些数据表明，痰液中的细胞因子与肺部活动性结核病的疾病活动相关，可能作为痰菌转阴和抗结核治疗反应的潜在早期标志物。
