Dysregulated production of interferon-gamma, interleukin-4 and interleukin-6 in early tuberculosis patients in response to antigen 85B of Mycobacterium tuberculosis.

Both interferon-gamma (IFN-gamma) and interleukin (IL)-4 expression in T cells and IL-6 expression in cells of the monocyte/macrophage lineage were monitored using antigen 85B (Ag85B) protein and purified protein derivative (PPD) antigen in the early stages of tuberculosis (TB). We showed that the levels of cell-associated IFN-gamma and IL-4 (mRNA and intracellular cytokine) in Ag85B-stimulated T cells were significantly depressed in TB patients compared with those in healthy tuberculin reactors. On the other hand, the capacity of peripheral blood mononuclear cells (PBMC) to produce IL-6 spontaneously ex vivo was enhanced in patients (P < 0. 001), but their corresponding capacities to respond to Ag85B were not significantly different from those of normal donors. After 2 months of antituberculosis therapy, the mean blastogenic responses of Ag85B-stimulated PBMC from seven TB patients were increased 6. 1-fold (P = 0.011). Furthermore, the proportions of both IFN-gamma- (P < 0.01) and IL-4- (P = 0.05) producing T cells were significantly increased. However, those of IL-6-producing cells were diminished in response to Ag85B (P = 0.05). Our results suggest that there may be an altered regulation of IFN-gamma, IL-4 and IL-6 to Ag85B in the early stages of TB.