[The TRH stimulation test in children].
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Biomedical subjects
Publications and source records attributed to J Skvor.
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The inhibition of migration of leucocytes (stimulated by PPD) and the concentration of serum-immunoglobulin A had been controlled in 50 patients with bacteriologically verified tuberculosis of the respiratory system. All patients showed a clear hypersensitivity of delayed type with inhibition of migration of leucocytes and high concentrations of serum IgA before the therapy run. In patients with effective therapy there resulted a decline of hypersensitivity of delayed type and of the concentration of IgA. All patients, who still had mycobacterium tuberculosae in the sputa in spite of a correct therapy for 3 months no changes of controlled parameters could be recognized. These results will be interpreted that the effect of an antimycobacterial therapy is accompanied by a clear decline of hypersensitivity of delayed type and parallel decline of protective immunity at least of humoral character, likely not very favourable for the patients.
In 32 patients with newly detected pulmonary tuberculosis positive on smear and culture, included in a controlled clinical trial, a significant correlation between diminishing inhibition of leukocyte migration (induced by PPD) and reduction of mycobacterial population in the sputum during the course of chemotherapy has been demonstrated. The changes of mycobacterial population in the host have been assessed in two ways: an indirect assessment was made from the time taken to achieve sputum smear and culture negativity; a direct assessment was based on repeated quantitative determinations of tubercle bacilli in the sputum. The direct migration inhibition test with peripheral buff-coated leukocytes, is an easy and reliable correlate of delayed hypersensitivity to mycobacterial antigens in the human body. It is suggested that its use in individual patients could indicate changes in mycobacterial population, particularly after microbiological negativity has been obtained, and thus could be helpful in estimating the optimum duration of chemotherapy.
Humoral immune response of patients with newly detected, bacteriologically confirmed pulmonary tuberculosis was determined prior to initiation of chemotherapy. Correlation with the extent of the disease was studied. A significant rise in the IgA and IgG levels in the serum was observed, the increase in the IgA levels correlated with the extent of the disease. In tuberculous patients elevated levels of anti-OT (ppd) antibodies were found by haemaggluination, but no marked correlation was observed with the extent of the disease. There was no interrelationship between the IgA or IgG increase and that of specific anti-OT (PPD) antibodies. The importance of the mentioned findings is discussed.
Cell immunity profiles were determined in 46 patients with previously untreated pulmonary tuberculosis, confirmed bacteriologically, and in 21 blood donors. Evaluations were made of T-lymphocytes, blastic transformation of lymphocytes after stimulation with phytohaemagglutinin or tuberculoprotein, and migration inhibition of blood leukocytes stimulated by tuberculo-protein. The average proportion of T-lymphocytes in the peripheral blood was significantly diminished in the group of tuberculous patients, and the intensity of the decline correlated both with age and extent of the disease. Similarly, migration of leukocytes in tuberculous patients was, in the presence of tuberculoprotein, markedly inhibited. The inhibition was correlated to the extent of the disease, expressed as the number of bacilli excreted. It can be concluded that, despite the depression of immunocompetent cells, active daughter clones under the influence of a specific antigen are capable of producing a factor conditioning migration inhibition.
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The total level of haemolytic complement in serum, and the phagocytic activity of blood neutrophils were found to be significantly increased in patients with active pulmonary tuberculosis prior to treatment. A relationship could not, however, be demonstrated between the elevation in the two studied values and the extent of tuberculous changes in the lungs of the patients.
Study of the relationship existing between in vivo and in vitro correlates of cell immunity has revealed that there is no marked correlation between the magnitude of skin induration of the tuberculin skin test and the degree of inhibition of migration of blood leukocytes stimulated by PPD in patients with newly detected, bacteriologically confirmed pulmonary tuberculosis.