非定型抗酸菌(Mycobacterium avium-intracellulare complex)症患者における末梢血単核球サイトカイン産生能に関する研究

Abstract

Cytokine productions of peripheral blood lymphocytes (PBLs) and monocytes (PBMs) from patients with Mycobacterium avium-intracellulare complex (MAC) infection were assessed. PPD-S prepared from M. tuberculosis, PPD-B from M. intracellulare, and PPD-Y from M. kansasii, were used as stimulants. PBLs from patients with active MAC did not produce IFN-γ to a significant extent upon stimulation with any of three PPDs, while PBLs from patients with inactive MAC showed higher responses to each PPD with the maximal response to PPD-B antigens. On the other hand, PBLs from healthy controls produced IFN-γ with the maximal response to PPD-S. Spontaneous release of both TNFα and IL-6 by PBMs from patients at the active stage was higher than those by the cells of the inactive stage patients or healthy controls. When PBMs were stimulated with MAC-derived PPD (PPD-B), increased TNFα production was obtained for PBMs of the active stage and decreased IL-6 production was seen for the cells of both the active and inactive stages. Moreover, the in vitro increased production of TNFα upon stimulation with PPD-B seems to be related to persistent MAC infection, resulting in exhausted nutritional status. These results suggest that in vitro ability of both PBLs to produce IFN-γ and that of PBMs to produce TNFα and IL-6 are closely related to the clinical stage of MAC infection.