Decrease in CD4+ CD25+ FoxP3+ Treg cells after pulmonary resection in the treatment of cavity multidrug-resistant tuberculosis

• Published in: International journal of infectious diseases 2010-09, Vol.14 (9), p.e815-e822
• Main Authors: Wu, Ying E, Peng, Wen Guang, Cai, Ying Mu, Zheng, Gao Zhe, Zheng, Geng Long, Lin, Jing Hua, Zhang, Su Wei, Li, Ke
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; CD4 Antigens - metabolism; Female; Flow Cytometry; Forkhead Transcription Factors - metabolism; Humans; Infectious Disease; Interleukin-2 Receptor alpha Subunit - metabolism; Lung - diagnostic imaging; Lung - immunology; Lung - surgery; Male; Middle Aged; Mycobacterium tuberculosis - immunology; Pneumonectomy - methods; Pulmonary/Respiratory; Radiography; T-Lymphocytes, Regulatory - cytology; T-Lymphocytes, Regulatory - immunology; Tomography Scanners, X-Ray Computed; Tuberculosis, Multidrug-Resistant - diagnostic imaging; Tuberculosis, Multidrug-Resistant - immunology; Tuberculosis, Multidrug-Resistant - microbiology; Tuberculosis, Multidrug-Resistant - surgery; Tuberculosis, Pulmonary - diagnostic imaging; Tuberculosis, Pulmonary - immunology; Tuberculosis, Pulmonary - microbiology; Tuberculosis, Pulmonary - surgery; Young Adult
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2010.04.005

Summary Objectives Immune regulatory mechanisms may limit the immunopathologic condition of infection with Mycobacterium tuberculosis and suppress cellular immune responses in the host. We investigated the CD4+ CD25+ FoxP3+ circulating regulatory T cells (Treg ) in patients with cavity multidrug-resistant tuberculosis (MDR-TB) before and after surgery. Methods We compared the proportion of Treg cells in 13 patients with cavity MDR-TB pre- and postoperatively and in 10 healthy control subjects by flow cytometry using three specific markers in peripheral blood lymphocytes: cell-surface CD4 and CD25 expression and intracellular FoxP3 expression. Results The proportion of CD4+ CD25high and CD4+ CD25+ FoxP3+ Treg was significantly higher in patients with cavity MDR-TB and at 1-month postoperatively than in healthy controls ( p < 0.001). The proportion of CD4+ and CD4+ CD25− cells was significantly lower in patients with cavity MDR-TB than in controls ( p < 0.001). Pre- and postoperative proportions of CD4+ CD25high and CD4+ CD25+ FoxP3+ Treg cells showed a positive correlation ( r = 0.878, p < 0.001). Conclusion Circulating Treg cells are increased in proportion in patients with cavity MDR-TB and decreased after surgery. Infection with M. tuberculosis may induce Treg cell-surface molecular changes with increased numbers of cells.