Campbell P B
J Infect Dis. 1979 Apr;139(4):409-17. doi: 10.1093/infdis/139.4.409.
Because the accumulation of macrophages and their precursors, peripheral blood monocytes, in foci of infection is an important feature of the host reponse to mycobacterial challenge, the leukotactic responsiveness of monocytes from patients with active tuberculosis was evaluated. With a double-filter, in vitro technique, defective leukotaxis was demonstrated in monocytes from 19 of 20 untreated patients, whereas normal leukotactic responses were found in monocytes from 11 of 15 patients with chronic, nontuberculous pulmonary inflammatory diseases. This defect may be related to increased activity of a naturally occurring, heat-stable plasma substance with a molecular mass of approximately 2.3 x 10(5) daltons that inhibited leukotactic responsiveness. Monocyte leukotaxis improved and the leukotactic inhibitory activity of plasma disappeared in most patients while they were on therapy; these phenomena were unrelated to bacteriologic conversion or resolution of symptoms. In vitro studies with isoniazid, ethambutol, and rifampin excluded a direct effect of these drugs or their metabolites on monocytes or on the leukotactic inhibitor in plasma. Thus, defective leukotaxis of monocytes in patients with pulmonary tuberculosis may be an epiphenomenon of the local tissue reaction.
由于巨噬细胞及其前体（外周血单核细胞）在感染灶中的聚集是宿主对分枝杆菌攻击反应的一个重要特征，因此对活动性肺结核患者单核细胞的趋化反应性进行了评估。采用双滤器体外技术，在20例未经治疗的患者中，有19例患者的单核细胞表现出趋化功能缺陷，而在15例患有慢性非结核性肺部炎症疾病的患者中，有11例患者的单核细胞表现出正常的趋化反应。这种缺陷可能与一种天然存在的、热稳定的血浆物质活性增加有关，该物质分子量约为2.3×10⁵道尔顿，可抑制趋化反应性。大多数患者在接受治疗时，单核细胞趋化功能改善，血浆的趋化抑制活性消失；这些现象与细菌学转阴或症状缓解无关。用异烟肼、乙胺丁醇和利福平进行的体外研究排除了这些药物或其代谢产物对单核细胞或血浆中趋化抑制剂的直接作用。因此，肺结核患者单核细胞趋化功能缺陷可能是局部组织反应的一种附带现象。
