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Shifts of T4/T8 T Lymphocytes From BAL Fluid and Peripheral Blood by Clinical Grade in Patients With Pulmonary Tuberculosis*
Objectives: We investigated the shifts of T4/T8 lymphocytes from BAL fluid (BALF) and peripheral blood by the clinical grade of pulmonary tuberculosis (TB), which is determined by factors such as extent of pulmonary involvement, fever, and loss of body weight.
Materials and methods: In order to explore these questions, BALF was collected from 45 patients presenting with active pulmonary TB and 14 healthy control subjects. The percentages for T-lymphocyte subpopulations, including CD4^sup +^, CD8^sup +^, and CD3^sup +^ T cells, were measured using two-color flow cytometry.
Results: A higher percentage of CD3^sup +^CD4^sup +^ T lymphocytes, with a relatively lower percentage of CD3^sup +^CD8^sup +^ T lymphocytes, was revealed for the patients with a higher grade of pulmonary TB, compared to patients with a lower grade of pulmonary TB, resulting in an increased BALF C4^sup +^/CD8^sup +^ ratio. By contrast, a higher percentage of CD3^sup +^CD8^sup +^ T lymphocytes with a relatively low percentage of CD3^sup +^CD4^sup +^ T lymphocytes was demonstrated for these patients with a higher grade of pulmonary TB, resulting in a decreased peripheral blood CD4^suph +^/CDB^sup +^ ratio.
Conclusions: Our findings suggest that compartmentalization of the CD4^sup +^ T lymphocytes in the infected lungs may occur for patients with higher grades of pulmonary TB.
(CHEST 2002; 122:1285-1291)
Key words: BAL fluid; pulmonary tuberculosis; T-lymphocyte subpopulation
Abbreviations: BALF = BAL fluid; IFN = interferon; PBS = phosphate-buffered saline solution; TB = tuberculosis
The clinical manifestations for pulmonary tuberculosis (TB) are determined by host immune factors in response to mycobacterial infection. T cell-mediated immunity, especially from CD4^sup +^ T-- lymphac,te function, plays an important role in eliminating mycobacteria.1-3 In advanced or disseminated TB, numbers of circulating T lymphocytes (especially CD4^sup +^ cells) are reduced, while numbers of CD8^sup +^ cells are increased.4-6 We have previously reported increased lymphocyte and neutrophil percentages for BAL fluid (BALF) from patients with active pulmonary TB.7 There have been relatively few reports, however, investigating T-lymphocyte subpopulations for BALF from infected lungs; and the results were contradictory due to different patient populations.
For patients with active pulmonary TB, the TB bacilli infect and invade cells in the bronchiolar...