Tuberculin Skin Test and Plasma Prostaglandin E2 in Patients of New and Intractable Pulmonary Tuberculosis

Abstract

Background: The cell-mediated immunity is needed for eradicating the tubercle bacilli. Prostaglandin(PG), especially PG , is involved in cellular immunosuppression. It is known that the PG is suppressed by indomethacin. For using indomethacin as a immunomodulator of intractable pulmonary tuberculosis(Tbc) patients, we measured the tuberculin skin test(TST) and the plasma PG levels. Method: The forty-eight inpatients with sputum positive acid-fast stain bacilli were classified into 6 groups according to antiTbc chemotherapy history(new and intractable cases), plain chest roetgenogram(minimal and far advanced cases), and TST reaction(nagative and positive cases). Except for one group(n=2; new, minimal, and negative cases of TST reaction) of the 6 groups, all subjects(n=46) were measured for the plasma PG , levels with radioimmunoassay. Results: 1) There was no significant difference in the plasma PG levels among A group(far advanced and positive TST reaction cases, n=10, ), B group(minimal and negative TST reaction cases, n=9, ) and C group(far advanced and positive TST reaction cases, n=7, ) in the new cases(p>0.05). 2) There was no significant difference in the plasma PG levels between positive(n=10, ) and negative(n=10, ) groups by TST in the intractable cases(p>0.05). 3) Comparing the plasma PG levels between new(n=26, ) and intractable(n=20, ) groups, the intractable group had significi- andy lower plasma PG levels(p levels between negative(n=19, ) and positive(n=27, ) groups by TST(p>0.05). 5) There was no significant difference in the plasma PG levels between male(n=32, ) and female(n=14, )(p>0.05). 6) There was no significant difference in the plasma PG levels among 2nd(n=5, ), 3rd(n=9, ), 4th(n=13, ) and 5th(n=19, ) decades(p>0.05). 7) There was no significant correlation between the induration sizes of the TST and the plasma PG levels(r=0.054, p>0.05). Conclusion: From the above results, the plasma PG levels of intractable group are not higher as the authors had expected. There was no significant difference in the plasma PG levels by the lesion sizes of plain chest roentgenogram and the induration sizes of TST, so more study will be needed to use the indomethacin as a immunomodulator for intractable pulmonary tuberculosis patients.