Wilkinson Katalin A, Kon Onn M, Newton Sandra M, Meintjes Graeme, Davidson Robert N, Pasvol Geoffrey, Wilkinson Robert J
Wellcome Trust Center for Research in Clinical Tropical Medicine, Division of Medicine, Imperial College London, Wright Fleming Institute, UK.
J Infect Dis. 2006 Feb 1;193(3):354-9. doi: 10.1086/499311. Epub 2005 Dec 29.
Most cases of latent tuberculosis infection (LTBI) do not cause symptoms during the lifetime of the infected person. Longitudinal analysis of the immune response of healthy Mycobacterium tuberculosis-infected people might, therefore, give insight into the basis of protective immunity. In a longitudinal study, we documented the effect that treatment had on the T cell response to M. tuberculosis antigens in 33 healthy people with LTBI. Preventive treatment of LTBI resulted in a 1.8-fold average increase in the numbers of interferon (IFN)- gamma -producing T cells within 26 +/- 4 days (P = .006), followed by a decrease by the end of the treatment period (82 +/- 6 days; P = .004). There was no significant overall change in the T cell response to any antigen in a control group (n = 8) of patients who elected radiological follow-up. Using live M. tuberculosis strain H37Rv as a stimulant in an enzyme-linked immunospot assay in sensitized individuals, we showed that isoniazid, but not rifampin, led to an increase in the number of IFN- gamma -producing cells. These results suggest that the integrity of the bacterial cell wall is important for M. tuberculosis in avoiding immune recognition by T cells and favor a dynamic model of LTBI.
大多数潜伏性结核感染（LTBI）病例在感染者的一生中不会引发症状。因此，对健康的结核分枝杆菌感染者的免疫反应进行纵向分析，可能有助于深入了解保护性免疫的基础。在一项纵向研究中，我们记录了治疗对33名LTBI健康者的结核分枝杆菌抗原T细胞反应的影响。LTBI预防性治疗导致在26±4天内产生干扰素（IFN）-γ的T细胞数量平均增加1.8倍（P = 0.006），随后在治疗期结束时（82±6天；P = 0.004）下降。选择进行影像学随访的患者对照组（n = 8）对任何抗原的T细胞反应没有显著的总体变化。在致敏个体中使用活的结核分枝杆菌菌株H37Rv作为酶联免疫斑点试验中的刺激物，我们发现异烟肼而非利福平会导致产生IFN-γ的细胞数量增加。这些结果表明，细菌细胞壁的完整性对于结核分枝杆菌避免被T细胞免疫识别很重要，并支持LTBI的动态模型。
