An in vitro assessment of cellular and humoral immune function in pulmonary tuberculosis: correction of defective neutrophil motility by ascorbate, levamisole, metoprolol and propranolol.
Fifty-six tuberculosis patients and twenty-eight control subjects were evaluated in a comprehensive investigation of cellular and humoral immune function in pulmonary TB. The patient group showed significantly higher levels of secretory IgA and serum IgG, IgA and IgM than did the control group but 7% of patients displayed a selective secretory IgA deficiency. Levels of alpha-1-antitrypsin were also significantly higher in the patient group. There were no significant differences in levels of total haemolytic complement, C'3 and C'4. In moderate to moderately advanced TB patients there were no significant differences in T and B cell numbers nor in mitogen-induced lymphocyte transformation and lymphokine production, when compared with the control group. The range of PPD-induced lymphocyte transformation and lymphokine production levels encountered was similar in both groups although certain patients did not respond to the PPD antigen. Neutrophils from TB patients showed increased random motility in vitro but eight out of ten patients showed impaired directed motility (chemotaxis). Phagocytic and anti-microbial functions were normal in the patient group. The neutrophil chemotactic defect was reversible and could be corrected in vitro when the patients' cells were treated with sodium and calcium ascorbate, levamisole, metoprolol and propranolol.