RESUMO
Se evaluaron las poblaciones y subpoblaciones linfocitarias en pacientes con tuberculosis pulmonar antes y durante la terapia relacionando estos valores con la incidencia y evolucion de la enfermedad. Pacientes en sus diversas manifestaciones clinicas, virgenes de tratamiento, se estudiaron por baciloscopia (BAAR), radiologia, i.d.r. Mantoux y analisis complementarios. Se cuantificaron mediante la prueba de Rosetas espontaneas (RE) linfocitos T totales y activos (RE a 4 graus Celsius y 37 graus Celsius), T colaboradores (RE Teofilina Resistentes: RETR) y supressores (RE Teofilina Sensibles: RETS). Los examenes se repitieron en los mismos sujetos iniciado el tratamiento y en testigos sanos (TS). Se demostro en los pacientes en todas sus formas clinicas un descenso significativo en los valores relativos y absolutos de celulas T y en la relacion RETR/RETS (menor de 1). Existe asociacion entre la forma clinica y el numero de linfocitos T colaboradores. Los pacientes en tratamiento con evolucion favorable, evidenciaron un incremento significativo en los linfocitos T totales, activos, colaboradores y en la relacion RETR/RETS. Los enfermos con baciloscopia altemente positiva presentaron i.d.r. Mantoux baja o negativa y marcado descenso de celulas inmunocompetentes...
Assuntos
Adolescente , Adulto , Masculino , Feminino , Pessoa de Meia-Idade , Humanos , Subpopulações de Linfócitos T/efeitos dos fármacos , Teofilina/farmacologia , Tuberculose Pulmonar/imunologia , Estado Nutricional , Subpopulações de Linfócitos T/químicaRESUMO
T cells and T cells subsets in peripheral blood of patients with different forms of pulmonary tuberculosis were evaluated to explain some aspects of the immunocompromised state of these subjects. Diagnosis was made by baciloscopy (BAAR), chest roentgenography i.d.r. Mantoux, and other clinical analysis. Spontaneous E-Rosette test (RE) was used to quantify Total (RET 4 degrees C) and Active T cells (REA 37 degrees C) and the same test after incubation with Theophylline (The) for helper cells (The-resistant cells: RETR) and suppressor cells (The-sensitive cells: RETS). Patients were followed for at least 4 months after therapy. The data demonstrate a significant decrease of relative and absolute numbers of Total T-cells and a diminished T helper/T suppressor subset ratio (RETR/RETS) which dropped to less than 1 in untreated patients. Treated patients with a favourable evolution showed a restoration of Total active and helper T cells. RETR/RETS ratio was also significantly increased. In patients with highly positive BAAR, low on negative i.d.r. Mantoux, a decreased level of immunocompetent cells was observed. The 3 aspects were associated. Nutritional condition of the patients was also associated with the predisposition to acquire this disease.