Med Sci Monit 1997; 3(6): RA956-960
Recent data provided by WHO and epidemiological analysis of Poland stress the decline in the regression rate of tuberculosis morbidity. It was found beyond any doubts that the cellular response is essential in the disease. Constant recirculation of T lymphocytes enables the repeated contacts of sensitised CD4+ T cells with specific antigen. Th1 and Th2 cells are activated by antigen what leads to the secretion of many cytokines. The optimal development of cellular response is usually accompanied by the lack of humoral response and vice versa. The constant stimulation by M. tuberculosis antigens leads not only to the T lymphocytes differentiation towards Th1 - Th2 population but also cause the activation of cells forming tuberculous granulation due to the lack of M. tuberculosis elimination. Under the stimulation of Mycobacterium antigens and cytokines secreted by monocytes, macrophages and Th2 lymphocytes, the plasmocytes clones able to antibodies production are formed by B lymphocytes. The concentration of immunoglobulins of differebt classes is not normal in patients suffering from tuberculosis which has been stressed by many authors. The increase of antibodies concentration in blood serum of patients is regulated by MHC. Immunoglobulins of A and G class form immunological complexes. There is also a correlation between the increased level of immunocomplexes in severe tuberculosis and the decrease of T cell activity and tissue damage. The storage of immunocomplexes in renal glomerules has been observed in severe tuberculosis. It is known that immunological complexes are able to activate the complement by classical or alternative pathway. The measurements and evaluation of particular complement fragments which has been performed by many authors, has revealed the increased concentration of C3 and C4 in active tuberculosis. In spite of this the role of the humoral response in the development and course of tuberculosis is not yet known.
Keywords: Tuberculosis, humoral response