Covelli H D, Wilson R T
Am J Obstet Gynecol. 1978 Oct 1;132(3):256-9. doi: 10.1016/0002-9378(78)90889-x.
One-hundred and seventy-two pregnant patients were identified as tuberculin sensitive in the first trimester. These patients were followed throughout pregnancy for any signs or symptoms of active tuberculosis which were discovered only in the index case. Post partum, patients were again re-evaluated for tuberculosis and prophylactically treated with isoniazid if they met established criteria. The tuberculous host also represented a model for the study of cell-mediated immunity, which presumably is altered in pregnancy. This investigation revealed a progressive depression of lymphocyte function to a specific antigen, purified protein derivative, obtaining significance at 36 weeks' gestation and continuing through delivery (p is less than 0.001). Nonspecific cell-mediated immunity, however, was not depressed when monitored throughout the gestation by the mitogen, phytohemagglutinin, which would stimulate all lymphocyte clones. This discrepancy in the alteration of specific clones of lymphocytes compared to all noncommitted lymphocytes may account for varying reports of the immune status of the pregnant woman.
172名孕妇在孕早期被确定为结核菌素敏感。这些患者在整个孕期都接受随访，以观察活动性结核病的任何体征或症状，仅在该索引病例中发现了此类症状。产后，对患者再次进行结核病评估，若符合既定标准，则用异烟肼进行预防性治疗。结核宿主也是细胞介导免疫研究的一个模型，而细胞介导免疫在孕期可能会发生改变。这项研究揭示了淋巴细胞对特异性抗原（纯化蛋白衍生物）的功能呈进行性抑制，在妊娠36周时具有统计学意义，并持续至分娩（p<0.001）。然而，在整个孕期通过有丝分裂原植物血凝素监测时，非特异性细胞介导免疫并未受到抑制，植物血凝素会刺激所有淋巴细胞克隆。与所有未分化淋巴细胞相比，淋巴细胞特异性克隆的改变存在差异，这可能解释了关于孕妇免疫状态的不同报道。
