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-Defensins in Plasma and BAL Fluid of Patients With Active Pulmonary Tuberculosis*
* From the National Sanatorium Miyazakihigashi Hospital (Drs. Ashitani and Kumamoto), and Third Department of Internal Medicine (Drs. Mukae, Hiratsuka, Nakazato, and Matsukura), Miyazaki Medical College, Miyazaki, Japan.
Correspondence to: Hiroshi Mukae, MD, Second Department of Internal Medicine, Nagasaki University School of Medicine, Sakamoto 1–7-1, Nagasaki, Nagasaki 852-8501, Japan; e-mail: hmukae{at}post.miyazaki-med.ac.jp
Study objectives: To investigate the role of neutrophil
peptides named 
-defensins in patients with pulmonary tuberculosis
(TB).
Patients: Thirty-seven patients with TB and 25 healthy subjects.
Measurements and results:
Concentrations of -defensins (human neutrophil peptide [HNP]-1,
HNP-2, and HNP-3) were measured by radioimmunoassay in plasma and BAL
fluid (BALF). Concentrations of -defensins were significantly higher
in plasma and BALF of patients with TB than in healthy subjects. In
BALF of patients with TB, the concentration of -defensins correlated
positively with the levels of interleukin 8, and higher concentrations
of -defensins in BALF were also detected in patients with cavitary
lesions. There was an inverse relationship between plasma -defensins
and FEV1/FVC ratio before treatment, and between plasma
concentrations of -defensins before treatment and the improvement in
percentage of vital capacity after treatment. Plasma -defensin
concentrations returned to the normal range after treatment.
Conclusion: Our data suggest that -defensins released
from neutrophils may play an important role in the pathogenesis of TB,
and that plasma -defensin concentration may be a useful marker of
disease severity and deterioration of pulmonary
function.
Key Words: -defensins • BAL fluid • human neutrophil peptides • pulmonary tuberculosis
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