Lack of T-Helper Lymphocytes in BAL Fluid from a HIV-negative Patient with Recurrent Non-tuberculous Mycobacterial Lung Infections

Abstract

We describe here a previously healthy, 42 year old, HIV-negative woman. Following a seemingly successful 2-year antimycobacterial regimen for a lung infection caused by Mycobacterium avium/intracellulare she acquired a lung infection caused by M. chelonei. Characterization of alveolar cells from bronchoalveolar lavage fluid using flow cytometry revealed a total lack of T-cell subset CD4⁺ helper lymphocytes in spite of a normal proportion of the CD3⁺ and CD4⁺ T-cells in peripheral blood. The levels of Th2 cytokines such as IL-4, TGF-β and G-CSF were higher in the patient's alveolar cells than in the cells of 4 healthy controls. This imbalance of cells and cell cytokines may contribute to the patient's susceptibility for non-tuberculous mycobacteria and her failure to eradicate these microorganisms