Department of Internal Medicine, Dongsan Hospital, Keimyung University School of Medicine, Dalseong-ro 56, Jung-gu, Daegu 700-712, Republic of Korea.
BMC Immunol. 2012 Aug 13;13:45. doi: 10.1186/1471-2172-13-45.
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.
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.
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.
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.
结核性胸腔积液（TPE）是最常见的肺外结核形式之一。由于大多数 TPE 研究都集中在胸腔，因此有关肺实质的信息很少。因此，我们旨在研究无肺结核的 TPE 患者肺实质中的免疫反应。
排除任何有肺部结核证据的患者，包括影像学或细菌学评估。从 10 名新诊断、未经治疗、HIV 阴性的 TPE 患者和 10 名健康对照者中采集支气管肺泡灌洗液（BALF）。我们分析了 T 淋巴细胞亚群并测量了 BALF 中的 10 种细胞因子。用尿素对 BALF 中的细胞因子水平进行标准化。
无肺结核的 TPE 患者的干扰素-γ（IFN-γ）、肿瘤坏死因子-α（TNF-α）、血管内皮生长因子（VEGF）浓度和 CD4+/CD8+比值明显高于对照组。在 BALF 中测量的细胞因子中，VEGF 浓度最高。两组间辅助性 T 细胞 2 型细胞因子无差异。
无肺结核的 TPE 患者的肺实质中存在明显的免疫反应和 IFN-γ、TNF-α 和 VEGF 增加。这一结果表明，TPE 可能会在肺实质中引起明显的免疫反应。
