Humoral Immune Response in Tuberculous Pleuritis

Tuberculous pleuritis is a good human model to understand the local and protective immune response against tuberculosis, due to the self-limitedness of the disease. Although the cellular immune response has been well characterised in tuberculous pleurisy, much less is known about the humoral immune response operating at the site of infection. To understand the humoral immune response, B cells were enumerated in peripheral blood mononuclear cells (PBMC) and pleural fluid mononuclear cells (PFMC) of tuberculous (TP) and non-tuberculous pleuritis patients (NTP). The levels of IgG, IgA and IgM antibodies for PPD, culture filtrate (CF) and sonicate antigens (Son Ag) were assessed in plasma (BL) and pleural fluid (PF) and a western blot was carried out with the CF antigen. The percentage of CD19+B-cells was similar in PBMC and PFMC of TP patients but was significantly lower in PFMCs of NTP patients. The IgG levels for PPD and CF antigens were higher in PF of TP than NTP patients. The antigen recognition patterns did not differ in plasma and pleural fluid of the same patient in both groups pointing out the passive diffusion of the plasma to the pleura. The antigens 25, 31, 33, 70, 110, 124 and 132 kDa were recognized exclusively by the TP patients. Thus our study showed that the local humoral response in TP did not differ from the systemic response. However, the humoral response differed in TP patients when compared to NTP patients.