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Changes in cell-mediated immune response after lung resection surgery for MDR-TB patients

 Seung-Kyu Park  ;  Sunghee Hong  ;  Seok-Yong Eum  ;  In Hee Lee  ;  Donk Ok Shin  ;  Jang Eun Cho  ;  Sungae Cho  ;  Sang-Nae Cho 
 TUBERCULOSIS, Vol.91(4) : 300-307, 2011 
Journal Title
Issue Date
Adolescent ; Adult ; Antitubercular Agents/adverse effects ; Antitubercular Agents/therapeutic use* ; Cell Proliferation ; Cytokines/metabolism* ; Drug Therapy, Combination ; Female ; Humans ; Immunity, Cellular* ; Interferon-gamma/metabolism ; Interleukin-10/metabolism ; Lymphocyte Activation ; Male ; Middle Aged ; Practice Guidelines as Topic ; Tuberculosis, Multidrug-Resistant/drug therapy ; Tuberculosis, Multidrug-Resistant/immunology* ; Tuberculosis, Multidrug-Resistant/surgery ; Young Adult
Mycobacterium tuberculosis(Mtb) ; MDR-TB (Multidrug-resistant tuberculosis) ; IFN-γ ; IL-10 ; Lung resection surgery
The immune responses of multidrug-resistant tuberculosis (MDR-TB) patients undergoing lung resection surgery were investigated in order to understand the mechanism of strong immune suppression in MDR-TB. We examined changes in cell-mediated immune response (CMI) of a total of sixteen MDR-TB patients, three of them extensively drug-resistant tuberculosis (XDR-TB) patients, after the removal of the heavily diseased lung section. The IFN-γ response to Mycobacterium tuberculosis culture filtrate proteins (Mtb-CFP), one of the most important CMI to defend TB, showed a statistically significant elevation in 2-4 months after operation when compared to the preoperative CMI in patients who were converted into AFB negative and cured in two years' follow-up, suggesting that the recovery of CMI may be one of the key factors in the successful treatment of MDR-TB. Interestingly, IL-10 response to Mtb-CFP was also elevated in 2-4 months after surgery in cured patients although both proliferative response and PBMC composition were not significantly changed. Infection with first- or second-line drugs resistant Mtb reduces the efficiency of chemotherapeutic treatment of MDR-TB to about 50%. Thus, this study suggests that chemotherapeutic treatment of MDR-TB may be more effective when combined with accompanying therapy that increases CMI, includes lung resection surgery.
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1. College of Medicine (의과대학) > Dept. of Microbiology (미생물학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Cho, Sang Nae(조상래)
Cho, Sung Ae(조성애)
Hong, Sung Hee(홍성희)
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