Ratcliffe L T, Lukey P T, MacKenzie C R, Ress S R
Department of Medicine, University of Cape Town, South Africa.
Clin Exp Immunol. 1994 Sep;97(3):373-9. doi: 10.1111/j.1365-2249.1994.tb06097.x.
There has been a global increase in the incidence of multidrug-resistant pulmonary tuberculosis (TB). As there are no previous reports of immune function in HIV- patients with multidrug-resistant pulmonary TB, a comprehensive assessment of cellular immunity in this setting was undertaken. This involved a prospective, case-controlled study which included five patients with active multidrug-resistant pulmonary TB and five matched controls with active non-resistant infection, and documented the changes in immune parameters which occurred upon clinical resolution. Patients with multidrug-resistant TB had significantly lower fresh natural killer (NK) cell activity than matched controls with non-resistant pulmonary TB (P < 0.05). This was a specific abnormality, as there were no significant differences in antigen-specific cytotoxicity or lymphocyte proliferation in the case-controlled study. Follow-up assessment of the patients with multidrug-resistant infections indicated that clinical improvement correlated with a moderate increase in NK cell activity. Impaired NK cell function may be involved in the pathogenesis of multidrug-resistant TB.
全球耐多药肺结核（TB）的发病率呈上升趋势。由于此前尚无关于HIV感染且患有耐多药肺结核患者免疫功能的报道，因此对该情况下的细胞免疫进行了全面评估。这涉及一项前瞻性病例对照研究，其中包括5例活动性耐多药肺结核患者和5例匹配的活动性非耐药感染对照，并记录了临床缓解时免疫参数的变化。耐多药肺结核患者的新鲜自然杀伤（NK）细胞活性明显低于匹配的非耐药肺结核对照（P < 0.05）。这是一种特异性异常，因为在病例对照研究中抗原特异性细胞毒性或淋巴细胞增殖没有显著差异。对耐多药感染患者的随访评估表明，临床改善与NK细胞活性的适度增加相关。NK细胞功能受损可能参与了耐多药肺结核的发病机制。
