T cells mediate protection against tuberculosis, but little is known about
their role during chemotherapy of patients with active disease. Here we exa
mined the cytokine profile of CD4 T cells before and after four months of c
hemotherapy in six initial skin test anergic cases. Purified protein deriva
tive (PPD) and 16-kDa antigen-reactive CD4 T-cell clones prior to therapy r
esided mostly in disease-associated body fluids and were of the Th0 (interf
eron (IFN)-gamma + interleukin (IL)-4) secreting profile. In contrast, the
majority of postchemotherapy CD4 T-cell clones originated from blood and we
re of the IFN-gamma secreting Th1 type. However, the recognition of several
peptides derived from the 16-kDa antigen was not significantly different b
etween the Th1 and Th0 clones. We conclude that chemotherapy shifts CD4 T c
ells from the affected body fluids to the blood circulation, accompanied by
a change from Th0 to Th1 cytokine profile.