Features of immunoregulation in patients with pulmonary tuberculosis with blood eosinophilia

• Published in: Bi͡u︡lletenʹ Sibirskoĭ medit͡s︡iny Vol. 17; no. 3; pp. 168 - 179
• Main Authors: Urazova, O. I., Churina, E. G., Kolobovnikova, Yu. V., Novitskiy, V. V., Karaulov, A. V., Nikulina, E. L., Poletika, V. S.
• Format: Journal Article
• Language: English
• Published: Siberian State Medical University (Tomsk) 29-09-2018
• Subjects: регуляторные т-клетки; регуляция иммунного ответа; туберкулез легких; эозинофилия
• ISSN: 1682-0363; 1819-3684
• DOI: 10.20538/1682-0363-2018-3-168-179

The aim
of the investigation was to determine the characteristics of the immune response regulation for pulmonary tuberculosis (TB) and to analyze the role of regulatory T cells in the immunopathogenesis of TB with eosinophilia in the blood, depending on the clinical form of the disease and sensitivity of Micobacterium tuberculosis to anti-TB drugs.
Materials and methods.
157 patients who were initially diagnosed with infiltrative and disseminated TB were examined. The material of the study was venous blood and culture of mononuclear leukocytes isolated from venous blood. The content of interleukin (IL) 4, IL-10 and transforming factor beta (TGFβ) in culture suspensions of mononuclear leukocytes in vitro and IL-5 in the blood was determined by enzyme-linked immunosorbent assay (ELISA) test. The expression of surface molecules CD4, CD20, CD25 and intracellular transcription factor Foxp3 by lymphocytes of the blood was evaluated by flow cytometry. The obtained results were analyzed by statistical methods.
Results.
It is shown that excessive generation of regulatory T cells in patients with TB is associated with eosinophilia of the blood and imbalance of immune response regulation mechanisms. In TB with eosinophilia, an increase in the number of Foxp3-positive regulatory T cells in the blood is combined with in vitro hypersecretion of anti-inflammatory cytokines TGFβ, IL-10, IL-4 and an increase in the content of CD20+ B lymphocytes and IL-5 in the blood. These changes are most pronounced in the disseminated form of TB in combination with drug resistance.
Conclusion.
Characteristics of immunoregulation at TB with blood eosinophilia are associated with activation of immunosuppression mechanisms and polarization of immune response towards Th2-dependent pathway.