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Delayed hypersensitivity and HLA in smear-positive pulmonary tuberculosis
G H Bothamley1, J H Gibbs, J S Beck
1MRC Tuberculosis and Related Infections Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.
International Archives of Allergy and Immunology
|January 1, 1995
Summary
Human leukocyte antigen DR15 (HLA-DR15) influences tuberculosis skin test responses. Certain HLA-DR15 positive patients show distinct immune cell patterns and blood flow, potentially explaining tuberculosis severity.
Area of Science:
- Immunology
- Tuberculosis Research
- Human Genetics
Background:
- Tuberculosis (TB) is a significant global health challenge.
- Host genetics, including human leukocyte antigen (HLA) types, play a role in TB susceptibility and disease presentation.
- The association between HLA-DR15 and pulmonary TB requires further elucidation.
Purpose of the Study:
- To investigate the relationship between HLA-DR15 status and the immunological response to tuberculin skin testing.
- To explore how HLA-DR15 influences dermal microcirculation and cellular infiltrate composition in TB patients.
Main Methods:
- Quantification of tuberculin responses via skin induration, dermal microcirculation blood flow velocity, and cellular infiltrate composition.
- Analysis of 125 TB patients and 39 healthy controls.
- Comparison of immune responses between HLA-DR15-positive and HLA-DR15-negative individuals.
Main Results:
- Tuberculin response diameters were larger in HLA-DR15-positive patients.
- CD4+ cell density correlated positively with induration in HLA-DR15-negative subjects.
- A subset of HLA-DR15-positive patients exhibited large responses with low CD4+ cell counts, altered infiltrate distribution, modified blood flow, and higher antibody levels.
Conclusions:
- HLA-DR15 influences the nature of the tuberculin immune response.
- Specific patterns in HLA-DR15-positive patients, including reduced immunocompetent cells and altered blood flow, may contribute to pulmonary cavitation.
- These findings suggest a mechanism linking HLA-DR15 to smear-positive pulmonary tuberculosis.