T Lymphocytes in Human Tuberculosis

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Abstract
The manifestations of tuberculous infection reflect the immune response to infection. Most healthy tuberculin reactors develop protective immunity; tuberculous pleuritis reflects a resistant response manifest by mild disease, whereas advanced pulmonary and miliary tuberculosis reflect ineffective immunity. The role of γδ T cells was assessed in tuberculous infection by evaluating expansion of these cells from blood mononuclear cells after stimulation with Mycobacterium tuberculosis. After culture in vitro, the percentages of γδ+ cells were significantly greater in patients with protective and resistant immunity (tuberculin reactors, 25% ± 4%; tuberculous pleuritis, 30% ± 7%) than in those with ineffective immunity (advanced pulmonary tuberculosis, 9% ± 3%; miliary tuberculosis, 2% ± 1%). In leprosy, expansion of γδ+ cells was greater in immunologically resistant tuberculoid patients (32% ± 4%) than in Mycobacterium leprae-unresponsive lepromatous patients (9% ± 2%). M. tuberculosis-reactive γδ T cell lines produced interferon-γ, granulocyte-macrophage colony-stimulating factor, interleukin-3, and tumor necrosis factor-α, cytokines that activate macrophages and may contribute to mycobacterial elimination. These findings suggest that γδ T cells contribute to immune resistance against M. tuberculosis.

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