Immunohistochemical study of lungs with focal tuberculosis
Objective. Assessment of the number and ratio of CD4+ and CD8+ lymphocytes in lungs affected by focal tuberculosis.Gimaldinova N.E., Lyubovtseva L.A., Guryanova E.A.
Materials and methods. The study was performed on autopsy lung material from 40 deceased men aged 30–55 years with focal tuberculosis diagnosed during their lifetime. Immunohistochemical methods were used to assess the immune response.
Results. When studying the expression localization of the studied markers in the lungs in the «conditionally healthy» group, the majority of CD4+ and CD8+ lymphocytes were determined predominantly in the interstitial space, with single ones near blood vessels and in the lamina propria of the bronchial mucosa. In focal tuberculosis, the highest number of CD4+ lymphocytes was found in the granulation tissue (12.2 ± 1.9 in the field of view) surrounding the caseous necrosis focus. In areas without signs of inflammation, the number of cells decreased (4.2±1.3 in the field of view). CD8+ lymphocytes predominated over CD4+ lymphocytes both in the area around the necrosis (48.8 ± 5.8 in the field of view) and in distant areas (12.3 ± 0.3 in the field of view). The immunoregulatory index (CD4+/CD8+) in the tuberculous lesion and in the area without signs of specific inflammation was 0.25 and 0.34, respectively, indicating suppression of local cellular immunity.
Conclusion. In focal tuberculosis, the balance between T-helper (CD4+) and T-suppressor (CD8+) cells is disrupted in the area of specific inflammation. The identified quantitative changes and decrease in the immunoregulatory index in the studied areas can serve as objective criteria for the development of local immunodeficiency and can be considered markers for refining the prognosis of the disease course and choosing immunocorrection tactics.
Keywords
tuberculosis
mycobacterium
lymphocytes
immune system
immunoregulatory index
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About the Authors
Natalia E. Gimaldinova, Cand. Med. Sci., Associate Professor, Department of General and Clinical Morphology and Forensic Medicine, I.N. Ulyanov Chuvash State University, Cheboksary, Russia; ngimaldinova@yandex.ru; http://orcid.org/0000-0003-2475-3392Professor Lyubov A. Lyubovtseva, Corresponding Member Russian Academy of Natural Sciences. BD, Professor, Department of General and Clinical Morphology and Forensic Medicine, I.N. Ulyanov Chuvash State University, Cheboksary, Russia; lybovceva@mail.ru; http://orcid.org/0000-0002-2818-568X
Professor Evgeniya A, Guryanova, MD, Rector, Institute for Advanced Medical Training, Ministry of Health of the Chuvash Republic; Professor, Department of Internal Medicine; Professor, Department of Surgery, I.N. Ulyanov Chuvash State University, Cheboksary, Russia; rufer06@rambler.ru; https://orcid.org/0000-0003-1519-2319
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