PEPTIDE-SPECIFIC T-CELL RESPONSE TO MYCOBACTERIUM-TUBERCULOSIS - CLINICAL SPECTRUM, COMPARTMENTALIZATION, AND EFFECT OF CHEMOTHERAPY

The T cell repertoire of 59 patients with untreated tuberculosis was c ompared with that of 46 bacille Calmette-Guerin-vaccinated controls by assaying the proliferative responses to six permissively recognized p eptides from the 16-, 19-, and 38-kDa molecules of Mycobacterium tuber culosis. A trend from higher to lower reactivity following this order: vaccinated controls > lymph node disease > localized extrapulmonary > pulmonary > pleural was seen for 4 of the peptides (P <.03), The decr eased response of blood lymphocytes from patients with pleural tubercu losis was partially accounted for by sequestration of peptide-responsi ve cells within the pleural fluid, Chemotherapy ''reversed'' the depre ssed proliferative responses of patients with pulmonary and pleural tu berculosis depending on the peptide origin, being greatest for peptide s of 16 kDa, transient for those of 19 kDa, and least for those of 38 kDa, These data demonstrate antigen specificity in the decreased respo nsiveness of patients with tuberculosis.