T Cell Responses and Regulation and the Impact of In Vitro IL ‐10 and TGF ‐β Modulation During Treatment of Active Tuberculosis

Abstract Mycobacterium tuberculosis (Mtb) is particularly challenging for the immune system being an intracellular pathogen, and a variety of T cell subpopulations are activated by the host defence mechanism. In this study, we investigated T cell responses and regulation in active TB patients with drug‐sensitive Mtb (N = 18) during 24 weeks of efficient anti‐TB therapy. T cell activation, differentiation, regulatory T cell (Treg) subsets, Mtb‐induced T cell proliferation and in vitro IL‐10 and TGF‐β modulation were analysed by flow cytometry at baseline and after 8 and 24 weeks of therapy, while soluble cytokines in culture supernatants were analysed by a 9‐plex Luminex assay. Successful treatment resulted in significantly reduced co‐expression of HLA‐DR/CD38 and PD‐1/CD38 on both CD4+ and CD8+ T cells, while the fraction of CD4+CD25highCD127low Tregs (P = 0.017) and CD4+CD25highCD127low CD147+ Tregs (P = 0.029) showed significant transient increase at week 8. In vitro blockade of IL‐10/TGF‐β upon Mtb antigen stimulation significantly lowered the fraction of ESAT‐6‐specific CD4+CD25highCD127low Tregs at baseline (P = 0.047), while T cell proliferation and cytokine production were unaffected. Phenotypical and Mtb‐specific T cell signatures may serve as markers of effective therapy, while the IL‐10/TGF‐β pathway could be a target for early inhibition to facilitate Mtb clearance. However, larger clinical studies are needed for verification before concluding.