Yoshikawa M, Yoneda T, Maegawa J, Tsukaguchi K, Tokuyama T, Fu A, Fukuoka K, Tomoda K, Nakaya M, Fukuoka A
Second Department of Internal Medicine, Nara Medical University, Japan.
Kekkaku. 1994 Apr;69(4):307-16.
A survey on the nutritional status and cell-mediated immune function of 47 hospitalized patients with active pulmonary tuberculosis and healthy controls was conducted. In the patients group: 1) Anthropometric measurements, such as %ideal body weight (%IBW), %arm circumference (%AC), %arm muscle circumference (%AMC) and %triceps skin fold (%TSF), were significantly reduced. 2) Visceral proteins including serum albumin (Alb), transferrin (Tf), prealbumin (PA) and retinol binding protein (RBP) were significantly reduced. 3) The imbalance of plasma amino acids, which was characterized by the depression of Fischer ratio, a molar ratio of branched chain amino acids (BCAA) to aromatic amino acids (AAA), was observed. Fischer ratio was significantly correlated with anthropometric measurements (%IBW, %AC and %AMC). Delayed-type hypersensitivity to DNCB (2,4-dinitrochlorobenzene) and lymphocyte transformation to phytohemagglutinin (PHA) and concanavalin A (Con A) were significantly impaired in the patients group, whereas NK cell activity was higher than that of controls. Alb, PA, RBP and Fischer ratio were significantly lower in the patients with reduced DNCB reaction than in those with normal responses. Lymphocyte transformation was significantly correlated with Fischer ratio, and NK cell activity was significantly correlated with Alb, PA, RBP. These data may suggest that the imbalance of plasma amino acids represented by the reduction of Fischer ratio and the depletion of visceral proteins are closely related to the impairment of lymphocyte function in the patients with active pulmonary tuberculosis.
对47例活动性肺结核住院患者和健康对照者的营养状况及细胞介导免疫功能进行了一项调查。在患者组中：1）人体测量指标，如理想体重百分比（%IBW）、上臂围百分比（%AC）、上臂肌肉围百分比（%AMC）和肱三头肌皮褶厚度百分比（%TSF），均显著降低。2）内脏蛋白，包括血清白蛋白（Alb）、转铁蛋白（Tf）、前白蛋白（PA）和视黄醇结合蛋白（RBP），均显著降低。3）观察到血浆氨基酸失衡，其特征为费希尔比率降低，即支链氨基酸（BCAA）与芳香族氨基酸（AAA）的摩尔比降低。费希尔比率与人体测量指标（%IBW、%AC和%AMC）显著相关。患者组对二硝基氯苯（DNCB）的迟发型超敏反应以及对植物血凝素（PHA）和刀豆蛋白A（Con A）的淋巴细胞转化均显著受损，而自然杀伤细胞（NK）活性高于对照组。DNCB反应降低的患者中，Alb、PA、RBP和费希尔比率显著低于反应正常的患者。淋巴细胞转化与费希尔比率显著相关，NK细胞活性与Alb、PA、RBP显著相关。这些数据可能表明，以费希尔比率降低为代表的血浆氨基酸失衡和内脏蛋白耗竭与活动性肺结核患者淋巴细胞功能受损密切相关。
