Active tuberculosis in Africa is associated with reduced Th1 and increased Th2 activity in vivo


Lienhardt, C; Azzurri, A; Amedei, A; Fielding, K; Sillah, J; Sow, OY; Bah, B; Benagiano, M; Diallo, A; Manetti, R; Manneh, K; Gustafson, P; Bennett, S; D'Elios, MM; McAdam, K; del Prete, G; (2002) Active tuberculosis in Africa is associated with reduced Th1 and increased Th2 activity in vivo. European journal of immunology, 32 (6). pp. 1605-1613. ISSN 0014-2980 DOI: 10.1002/1521-4141(200206)32:6<1605::AID-IMMU1605>3.0.CO;2-6

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Abstract

Activation of Th1 lymphocytes, IFN-gamma production and macrophage activation are crucial in defense against Mycobacteria. In developing countries, Th2 activation and IL-4 production have been associated in vitro with tuberculosis and with poor clinical outcome after treatment. Serological markers of Th1 [soluble lymphocyte activation gene (LAG)-3] and Th2 (IgE, soluble CD30, and CCL22/macrophage-derived chemokine) activity were measured in 414 HIV-negative tuberculosis patients from The Gambia and Guinee and in 414 healthy household and community controls. Measurements were repeated during treatment to assess the effect of therapy on Th1/Th2 ratio. At diagnosis, sLAG-3 levels were lower in patients than in community controls (p<0.0001), but were higher in household controls exposed to contact with patients than in community controls (p<0.0001). In comparison with community controls, patients had consistently higher levels of IgE, sCD30, and CCL22 (p<0.0001), whereas household controls had lower levels of indicators of Th2 activity (P<0.0001). After treatment, cured patients had higher levels of Th1 (p<0.0001) and lower levels of Th2 (p<0.0001) activity than patients who were not successfully treated or interrupted therapy. In Africa, tuberculosis is associated with low Th1 and high Th2 activity in vivo, whereas close exposure to tuberculosis is associated with a high Th1/Th2 ratio. Patients with favorable outcome after treatment exhibit a higher Th1/Th2 ratio compared to patients with poor clinical outcome.

Item Type: Article
Keywords: tuberculosis, Th1/Th2 activity, lymphocyte activation gene-3, (LAG-3), IgE, soluble CD30, Cd4(+) t-cells, ifn-gamma production, interferon-gamma, mycobacterium-tuberculosis, chemokine production, cd30, expression, serum ige, in-vitro, responses, helper, Adolescence, Adult, Africa, Aged, Antigens, CD30, blood, Chemokines, CC, analysis, Female, Human, Immunoglobulin E, blood, Male, Membrane Proteins, blood, Middle Age, Support, Non-U.S. Gov't, Th1 Cells, immunology, Th2 Cells, immunology, Tuberculosis, Pulmonary, immunology
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Public Health and Policy > Dept of Global Health and Development
Research Centre: TB Centre
Tropical Epidemiology Group
PubMed ID: 12115643
Web of Science ID: 176269000011
URI: http://researchonline.lshtm.ac.uk/id/eprint/16439

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