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Clinical Investigations: INFECTION |

Elevated Levels of α-Defensins in Plasma and BAL Fluid of Patients With Active Pulmonary Tuberculosis*

Jun-ichi Ashitani, MD; Hiroshi Mukae, MD; Takeaki Hiratsuka, MD; Masamitsu Nakazato, MD; Kenshi Kumamoto, MD; Shigeru Matsukura, MD
Author and Funding Information

*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@post.miyazaki-med.ac.jp



Chest. 2002;121(2):519-526. doi:10.1378/chest.121.2.519
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Study objectives: To investigate the role of neutrophil peptides named α-defensins in patients with pulmonary tuberculosis (TB).

Patients: Thirty-seven patients with TB and 25 healthy subjects.

Measurements and results: Concentrations of α-defensins (human neutrophil peptide [HNP]-1, HNP-2, and HNP-3) were measured by radioimmunoassay in plasma and BAL fluid (BALF). Concentrations of α-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 α-defensins correlated positively with the levels of interleukin 8, and higher concentrations of α-defensins in BALF were also detected in patients with cavitary lesions. There was an inverse relationship between plasma α-defensins and FEV1/FVC ratio before treatment, and between plasma concentrations of α-defensins before treatment and the improvement in percentage of vital capacity after treatment. Plasma α-defensin concentrations returned to the normal range after treatment.

Conclusion: Our data suggest that α-defensins released from neutrophils may play an important role in the pathogenesis of TB, and that plasma α-defensin concentration may be a useful marker of disease severity and deterioration of pulmonary function.

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