Transformation of the T-lymphocyte profile in peripheral blood upon resection of tuberculous lung granuloma

It is known that subpopulations of peripheral blood T-lymphocytes in patients with tuberculous lung granuloma may be used for determining patient's condition and monitoring pathological process. The aim of this study was to monitor the number and functional state of peripheral blood T-lymphocytes upon resection of tuberculous granuloma of the lungs. Twenty-two patients with tuberculous lung granuloma were examined, including 12 men (54.5%) and 10 women (45.5%). The patients with immune-dependent diseases and HIV were not eligible for the study. All these patients underwent resection of the granuloma by minimally invasive method. The blood samples were examined twice: before and 5-7 days after surgery, i.e., total T-cell numbers, (CD45+CD3+), their subpopulations were also determined (CD3⁺CD4⁺, CD3⁺CD8⁺, CD3⁺CD4-CD8-, CD3⁺CD4⁺CD8⁺, CD3^brightCD4-, CD3⁺CD16⁺CD56⁺, CD3⁺HLA-DR⁺, CD3⁺CD25⁺, CD3⁺CD25⁺HLA-DR⁺), as well as CD3⁺CD25⁺/CD3⁺HLA-DR⁺ ratio, performed by means of Coulter Epicx XL instrument (Beckman Coulter, USA). In addition, the changes in B- and NK-cell numbers were studied. Due to small size of the groups, distribution was considered abnormal, and the Wilcoxon Matched-Pair Test was used. The differences were considered significant at pw < 0.05. The statistical programs Statistica v. 12.5.192.7 (StatSoft, USA) and GraphPad Prism v. 8.0.2 (GraphPad Software, USA) were used in the work. Resection of tuberculous granuloma of the lungs was followed by redistribution of T-, B-, and NK-cell numbers, as compared with preoperative level. The B-cell population increased by 35.8%, whereas the number of NK-cells decreased by 18.9% (p_w < 0.05). Despite such significant changes in two other populations, total number of T-lymphocytes decreased only slightly: the changes ranged within 3.2% for absolute counts, and 3.8% (p_w < 0.05) for relative values. The changes of T-cell subpopulation profile were different. During the postsurgical period, a 4.8% decrease in the CD3⁺CD4⁺-cell number was observed, whereas reduction in CD3⁺CD8⁺ subpopulation was more significant, and amounted to 26.2% (p_w < 0.05). The number of doublepositive cells increased by 13.6% (p_w < 0.05); γσT-cell counts decreased by 20.8% (p_w < 0.05), and absolute number of TNK-cells increased by 32.4%. A decreased number of γσT-cells in early postoperative period could be considered a favorable criterion for assessing the patient's condition, since some previous studies provide information about increased number of these cells in patients with tuberculous granuloma. Increased HLA-DR expression on T-lymphocytes may be another favorable factor, since the patients with tuberculous granuloma are known to have lesser amounts of such cells in peripheral blood than healthy persons. In general, a search for expression of activation molecules showed that there is a decrease of T-cells expressing CD25⁺, and an increased number of CD3⁺HLA-DR⁺-cells. The T-lymphocyte population co-expressing both CD25⁺ and HLA-DR⁺ shifts to the normal ranges after the surgery. The obtained data are supposed for monitoring results of treatment in the patients.