IMMUNE RESPONSIVENESS AND LYMPHOKINE PRODUCTION IN PATIENTS WITH TUBERCULOSIS AND WEALTHY CONTROLS

The aim of the present study was to determine the profile of immune re sponsiveness that differentiates patients with tuberculosis (TB) from healthy tuberculin-positive controls. Forty-five patients with pulmona ry TB and 16 healthy tuberculin-positive controls, all human immunodef iciency virus negative, were studied, Patients had decreased reactivit y to tuberculin, diminished proliferative response to purified protein derivative (PPD), lower concentrations of interleukin-2 (II-2) and ga mma interferon in PPD-stimulated cultures, no increase in the percenta ge of gamma/delta cells in PPD-stimulated cultures, and higher immunog lobulin G antimycobacterial antibodies compared with control subjects. Furthermore, controls exhibited decreased production of IL-4 by PPI-s timulated cells. Multivariate discriminant and factor analyses demonst rated divergent patterns of immune reactivity against mycobacterial an tigens. The association of IL-4 and immunoglobulin G antibody levels i n patients, in contrast to the high reactivity to tuberculin, increase d proliferation to PPD, and higher levels of IL-2 and gamma interferon observed in healthy controls suggested that most TB patients exhibit a TH2 pattern of immune responsiveness while tuberculin-positive healt hy individuals have a TH1 pattern.