Peripheral blood lymphocyte subsets have been evaluated in patients with pulmonary tuberculosis using combination of monoclonal antibodies and two color flow cytometry. Pleural effusion lymphocytes were also examined in patients with tuberculosis.
Patients with pulmonary tuberculosis were divided into three groups.
1) Active early stage Newly detected, bacteriologically confirmed patients treated with antituberculous treatment for less than 2 months.
2) Convalescent stage: Patients converted to negative by culture with antituberculous treatment for about 6 months.
3) Chronic bacillary excreter for more than 2 years.
The results obtained were as follows:
1. Patients under 69 years of age.
At the active early stage, there was a decrease in total lymphocytes, pan T cells, inducer T cells and suppressor/cytotoxic T cells as compared to normal controls. The numbers of lymphocytes and almost all T cell subsets were restored to the normal level at the convalescent stage, however, decrease in suppressor T cells was observed. Among the natural killer cell subsets, we observed a significant increase in Leu 11+7- cells at both stages active early and convalescent. In chronic excreters we found a decrease in total lymphocytes, pan T cells, inducer T cells and an increase in helper T cells, activated T cells. There was an increase in Leu 11+7+ cells and Leu 7+2+ cells. The ratio of T4/T8 cells tended to be high in all three groups as compared to normal.
2. Patients over 70 years of age.
The number of lymphocytes tended to decrease at the active early stage and the chronic excreters and to be restored to normal at the convalescent stage. We observed a remarkable decrease in suppressor T cells at the active early stage. At the convalescent stage, we found a decrease in helper T cells and an increase in cytotoxic T cells. Among the natural killer cell subsets, we found a decrease in Leu 11+7- cells and Leu 11+7+ cells at the active early stage and their restoration to the normal level at the convalescent stage.Furthermore, there was a significant increase in Leu 11-7+ cells and Leu 7+2+ cells at the convalescent stage. In chronic excreters, we observed an increase in helper T cells, cytotoxic T cells, Leu 11-7+ cells and Leu 7+2+ cells. The ratio of T4/T8 cells tended to be low compared to normal in all tuberculous groups over 70 years.
3. Patients with tuberculous pleurisy.
Comparing pleural effusion lymphocytes to peripheral blood lymphocytes, we found a significant increase in both proportion and absolute number of pan T cells, helper T cells and inducer T cells in pleural effusion. The ratio of T4/T8 cells was markedly high in pleural effusion. In contrast, we observed a remarkable decrease in all subsets of natural killer cells in pleural effusion.
