FUNCTIONAL AND METABOLIC FEATURES OF BLOOD PHAGOCYTES AT DIFFERENT FORMS OF TUBERCULAR INFLAMMATORY PROCESS OF LUNGS

Abstract

A leading role of phagocytes in prevention of M. tuberculosis infection is well established. Various clinical variants of tubercular inflammatory process necessitate further studies of functional and metabolic features of blood phagocytes in the patients with different forms of lung tuberculosis, being the main goal of this study. We have observed a total of 124 persons including 25 healthy subjects, and 99 patients with tuberculosis who manifested with different types of tubercular inflammatory process, i.e., 31 patients had a limited specific process (tuberculoma); in 44 patients, an infiltrative lung tuberculosis was diagnosed, and 24 patients had fibro-cavernous tuberculosis of lungs. We studied activation markers of neutrophils and monocytes (phagotest, burst-test, CD11b+, CD11c+, HLA-DR-Ag), as well as main indicators of cellular immunity (CD45+CD3+, CD45+CD19+, CD45+CD3- CD16+56+). Statistical evaluation was carried out in the «Microsoft Office Excel 2007» and «Statistica for Windows v. 6.1» environment.

A considerable decrease in proportion of superoxide anion-producing monocytes was found in 10% of the patients with fibro-cavernous tuberculosis as compared to the patients with tuberculoma and infiltrative tuberculosis. Similarly, the fibro-cavernous tuberculosis was characterized by higher expression of adhesion markers, e.g., CD11b, by 49%, and CD11c, by 73.5%, when compared with the two other groups of patients. A considerable decrease of absorbing granulocyte function was found in the patients with active forms of tuberculosis, as compared with limited clinical forms (tuberculoma). Fibro-cavernous tuberculosis was associated with increased absolute numbers of granulocyte that produce both superoxide anion, and express surface CD11b+ and CD11c+. We have revealed a relative decrease in lymphocyte quantities in the patients from tuberculoma which corresponded to increased granulocyte quantities of granulocytes and monocytes in the patients’ blood. The conducted study allowed us to make a conclusion that each clinical form of tuberculosis id characterized by a specific immunological pattern.

In the patients with tuberculoma, we have revealed a decrease of phagocytic, functional and metabolic activities of monocytes is noted, along with increased quantities of CD11b+ and CD11c+ adhesion molecules on granulocytes, increased numbers of T-lymphocytes, and decreased amounts of NK-cells. Infiltrative tuberculosis is characterized by increased contents and higher HLA-DR expression of the monocytes, with enhanced expression of CD11b+ and CD11c+ adhesion molecules on the granulocytes, and decreased number of T-lymphocytes. In the fibro-cavernous tuberculosis we observed leukocytosis, monocytosis, granulocytosis. The main functional feature of this clinical form is an increased amount of CD 11b+ and CD 11с+-bearing leukocytes, higher functional and metabolic activity of granulocytes, as well as expansion of CD11b+ expressing cell population and increased numbers of B-cells in peripheral blood.