Oğuzhan OKUTAN, Tayfun ÇALIŞKAN, Esin ÇETİN AKTAŞ, Günnur DENİZ, Zafer KARTALOĞLU, Faruk ÇİFTÇİ, Hatice KAYA

The effect of Bacille Calmette-Guerin on the immunopathogenesis of tuberculous pleurisy

Amaç: Bu çalışmada tüberküloz plörezi immünopatogenezinde CD4+ ve CD8+ T hücrelerinin rolü ve T helper (Th)1/Th2 lenfosit hücre dengesi ve Bacille Calmette Guerin’in (BCG) neden olduğu immünomodülasyon incelendi. Çalışma planı: Çalışmaya patolojik olarak tüberküloz plörezi tanısı konulmuş, 10’u BCG aşısız ve 16’sı BCG aşılı olmak üzere toplam 26 hasta dahil edildi. Total CD3+, CD4+, CD8+ T hücreleri, total C D19+ B hücreleri ve doğal katil hücre oranı ve yanı sıra plevra sıvısı lenfositlerinden hücre içi interferon-gama (IFN-γ), interlökin (IL)-2, IL-4, IL-5 ve IL-10 düzeyleri analiz edildi.Bulgular: BCG pozitif grupta, CD8+ T lenfositler anlamlı düzeyde arttı. Bu kişilerde plevra sıvısındaki lenfositlerin hücre içi IL-4 düzeyleri, BCG negatif kişilerle kıyaslandığında, anlamlı düzeyde azaldı.Sonuç: BCG aşısı, Th2 tipinde immün yanıtı baskılayabilir ve ayrıca CD8+ T hücre düzeylerinin artmasına neden olabilir. CD8+ T hücreleri, t überküloz plörezi i mmünopatogenezinde önemli bir rol oynayabilir.

Tüberküloz plörezi immünopatogenezine Bacille Calmette Guerin’in etkisi

The effect of Bacille Calmette-Guerin on the immunopathogenesis of tuberculous pleurisyTayfun Çalışkan, 1 Esin Aktaş Çetin, 2 Oğuzhan Okutan, 1 Faruk Çiftçi, 1 Günnur Deniz, 2 Hatice Kaya, 3 Zafer Kartaloğlu11Department of Pulmonary Diseases, GATA Haydarpaşa Training Hospital, İstanbul, Turkey 2Department of Immunology, Institute of Experimental Medicine (DETAE), İstanbul University, İstanbul, Turkey 3Department of Pulmonary Diseases, Gulhane Military Medical Academy, Ankara, TurkeyKeywords (Turkish): Bacille Calmette Guerin; immünopatogenez; tüberküloz plöreziKeywords (English): Bacille Calmette Guerin; immunopathogenesis; tuberculous pleurisySummary Background: This study aims to investigate the role of CD4+ a nd CD8+ T cells and T helper (Th)1/Th2 lymphocyte cell balance in the immunopathogenesis of tuberculous pleurisy and the immunomodulation resulting from Bacille Calmette-Guerin (BCG) were investigated. Methods: A total of 26 patients, who were pathologically diagnosed as tuberculous pleurisy, including 10 of whom had no BCG vaccine and 16 of whom had BCG vaccine, were included. Total CD3+, CD4+, CD8+ T cells, total CD19+ B cells and natural killer cell ratio as well as intracellular interferon-gamma (IFN-γ), interleukin (IL)-2, IL-4, IL-5 and IL-10 expression in pleural fluid lymphocytes were analyzed.Results: In BCG positive group, CD8+ T lymphocytes were significantly increased. Intracellular IL-4 levels of lymphocytes in pleural fluid were significantly reduced in these subjects, compared to BCG negative subjects.Conclusion: BCG vaccine may suppress Th2 type immune response and also lead to increased levels of CD8+ T cells. CD8+ T cells may play an important role in the immunopathogenesis of tuberculous pleurisy.

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