Lack of T-helper lymphocytes in BAL fluid from a HIV-negative patient with recurrent non-tuberculous mycobacterial lung infections

Scand J Infect Dis. 1996;28(6):625-8. doi: 10.3109/00365549609037972.

Abstract

We describe here a previously healthy, 42 year old, HIV-negative woman. Following a seemingly successful 2-year antimycobacterial regimen for a lung infection caused by Mycobacterium avium/intracellulare she acquired a lung infection caused by M. chelonei. Characterization of alveolar cells from bronchoalveolar lavage fluid using flow cytometry revealed a total lack of T-cell subset CD4+ helper lymphocytes in spite of a normal proportion of the CD3+ and CD4+ T-cells in peripheral blood. The levels of Th2 cytokines such as IL-4, TGF-beta and G-CSF were higher in the patient's alveolar cells than in the cells of 4 healthy controls. This imbalance of cells and cell cytokines may contribute to the patient's susceptibility for non-tuberculous mycobacteria and her failure to eradicate these microorganisms.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antitubercular Agents / therapeutic use
  • Bronchoalveolar Lavage Fluid / microbiology
  • CD4 Lymphocyte Count
  • Cytokines / biosynthesis
  • Female
  • Flow Cytometry
  • HIV Seronegativity
  • Humans
  • Interferon-gamma / therapeutic use*
  • Mycobacterium Infections, Nontuberculous / immunology*
  • Mycobacterium Infections, Nontuberculous / therapy
  • Mycobacterium avium / drug effects*
  • Mycobacterium avium-intracellulare Infection / immunology*
  • Mycobacterium avium-intracellulare Infection / therapy
  • Mycobacterium chelonae / drug effects*
  • Phenotype
  • Recurrence
  • T-Lymphocytes, Helper-Inducer* / immunology
  • Tuberculosis, Pulmonary / immunology*
  • Tuberculosis, Pulmonary / therapy

Substances

  • Antitubercular Agents
  • Cytokines
  • Interferon-gamma