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Effect of maturation of T helper lymphocytes into Th1 and Th2 types on immune response in tuberculosis. Immunity requires a Th1 response, and tumour necrosis factor (TNFα) is needed as an additional, macrophage activating factor. With a mixed Th1-Th2 cytokine response, TNFα becomes toxic and mediates the gross tissue destruction characteristic of active, progressive tuberculosis. Stress and corticosteroids tend to drive newly recruited T cells towards Th2 responses
