RESUMEN
BACKGROUND: Chronic helminth infections induce a Th2 immune shift and establish an immunoregulatory milieu. As both of these responses can suppress Th1 immunity, which is necessary for control of Mycobacterium tuberculosis (MTB) infection, we hypothesized that chronic helminth infections may exacerbate the course of MTB. METHODOLOGY/PRINCIPAL FINDINGS: Co-infection studies were conducted in cotton rats as they are the natural host for the filarial nematode Litomosoides sigmodontis and are an excellent model for human MTB. Immunogical responses, histological studies, and quantitative mycobacterial cultures were assessed two months after MTB challenge in cotton rats with and without chronic L. sigmodontis infection. Spleen cell proliferation and interferon gamma production in response to purified protein derivative were similar between co-infected and MTB-only infected animals. In contrast to our hypothesis, MTB loads and occurrence and size of lung granulomas were not increased in co-infected animals. CONCLUSIONS/SIGNIFICANCE: These findings suggest that chronic filaria infections do not exacerbate MTB infection in the cotton rat model. While these results suggest that filaria eradication programs may not facilitate MTB control, they indicate that it may be possible to develop worm-derived therapies for autoimmune diseases that do not substantially increase the risk for infections.
Asunto(s)
Filariasis/complicaciones , Tuberculosis/complicaciones , Tuberculosis/patología , Animales , Carga Bacteriana , Proliferación Celular , Enfermedad Crónica , Coinfección/inmunología , Coinfección/microbiología , Coinfección/parasitología , Coinfección/patología , Modelos Animales de Enfermedad , Femenino , Filariasis/inmunología , Filarioidea/inmunología , Filarioidea/patogenicidad , Histocitoquímica , Interferón gamma/metabolismo , Leucocitos Mononucleares/inmunología , Pulmón/microbiología , Pulmón/patología , Mycobacterium tuberculosis/inmunología , Mycobacterium tuberculosis/patogenicidad , Sigmodontinae , Bazo/inmunología , Tuberculosis/inmunologíaRESUMEN
Respiratory syncytial virus (RSV) causes significant morbidity in very young children, preterm infants with and without chronic lung disease, and children with hemodynamically significant congenital heart disease. In the absence of a safe and effective vaccine, alternative means of protecting high-risk infants and young children from serious RSV illness have been studied. Clinical observations and animal model data over the past 30 years suggested that RSV immunoglobulin G (IgG) neutralizing antibodies might offer protection from severe RSV lower respiratory tract disease. Transfer of adequate amounts of IgG to the fetus does not occur efficiently until the third trimester of pregnancy, which helps to explain why premature infants are at high risk of serious RSV illness. Efforts shifted toward the prophylactic monthly administration of standard immunoglobulins and, later, of RSV-enriched immunoglobulin in selected high-risk infants and young children. Although this approach proved effective, RSV-enriched immune globulin was not suitable for all patients and administration was labor intensive. The development of palivizumab, a monoclonal antibody that can bind to a specific antigenic site on the virus and prevent cell-to-cell spread of infection has since become the mainstay of RSV illness prevention in preterm infants and those with significant congenital heart disease. Palivizumab, the only monoclonal antibody approved for the prevention of RSV lower respiratory tract disease must be administered monthly throughout the RSV season and does not always prevent serious RSV illness. Further research to develop more effective and less labor-intensive immunoprophylactic agents is ongoing.
Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Esquemas de Inmunización , Inmunoglobulinas Intravenosas/uso terapéutico , Infecciones por Virus Sincitial Respiratorio , Virus Sincitial Respiratorio Humano , Anticuerpos Monoclonales Humanizados , Antivirales/uso terapéutico , Niño , Ensayos Clínicos como Asunto , Femenino , Cardiopatías Congénitas/complicaciones , Humanos , Inmunidad Materno-Adquirida , Inmunoglobulina G/metabolismo , Lactante , Recién Nacido , Recien Nacido Prematuro/inmunología , Palivizumab , Embarazo , Tercer Trimestre del Embarazo/inmunología , Infecciones por Virus Sincitial Respiratorio/complicaciones , Infecciones por Virus Sincitial Respiratorio/inmunología , Infecciones por Virus Sincitial Respiratorio/fisiopatología , Infecciones por Virus Sincitial Respiratorio/prevención & control , Virus Sincitial Respiratorio Humano/efectos de los fármacos , Virus Sincitial Respiratorio Humano/inmunología , Enfermedades Respiratorias/complicaciones , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
We previously described primary tuberculosis in Sigmodon hispidus cotton rats up to 6 months following a pulmonary challenge. At that time, we observed fewer animals demonstrating disease as time from exposure progressed. We hypothesized that some cotton rats may control a primary infection to latency in a similar fashion to humans. The current experiment was designed to examine the natural progression of disease in S. hispidus at a later timepoint following a respiratory challenge with Mycobacterium tuberculosis (Mtb). An additional objective was to test whether cotton rats may become latently infected, and to determine whether latent disease might be activated by cyclophosphamide induced immune suppression. Thirty-four percent of the inoculated cotton rats died prior to 9 months following the challenge. However, 50% of immunocompetent animals surviving past 9 months demonstrated positive lung tissue cultures for Mtb without histologic evidence of disease. None of the immunosuppressed animals demonstrated this pattern. These findings are consistent with the development of latent tuberculosis infection in some cotton rats. Furthermore, it appears reactivation of disease occurs with cyclophosphamide induced immunosuppression. Cotton rats may serve as a model for latent as well as active tuberculosis infection.
Asunto(s)
Modelos Animales de Enfermedad , Tuberculosis Latente/patología , Tuberculosis Pulmonar/patología , Animales , Ciclofosfamida , Progresión de la Enfermedad , Femenino , Huésped Inmunocomprometido , Inmunosupresores , Tuberculosis Latente/inmunología , Tuberculosis Latente/microbiología , Mycobacterium tuberculosis/aislamiento & purificación , Técnicas de Cultivo de Órganos , Sigmodontinae , Tuberculosis Pulmonar/inmunología , Tuberculosis Pulmonar/microbiologíaRESUMEN
Respiratory syncytial virus (RSV) is a leading cause of infant mortality worldwide. Although anti-RSV Ab prophylaxis has greatly reduced infant mortality in the United States, there is currently no vaccine or effective antiviral therapy. RSV fusion (F) protein activates cells through TLR4. Two single nucleotide polymorphisms (SNPs) encoding Asp299Gly and Thr399Ile substitutions in the TLR4 ectodomain were previously associated with TLR4 hyporesponsiveness and increased susceptibility to bacterial infection. Prevalence of these SNPs was analyzed in a case series of 105 DNA samples extracted from archived nasal lavage samples from high-risk infants/young children with confirmed RSV disease who participated in two seminal clinical trials for anti-RSV prophylaxis. Frequencies of TLR4 SNPs in the case series were compared with those of literature controls, healthy adults, infants, and young children who presented with symptoms of respiratory infections (but not preselected for high risk for RSV). Both SNPs were highly associated with symptomatic RSV disease in this largely premature population (p < 0.0001), with 89.5% and 87.6% of cases being heterozygous for Asp299Gly and Thr399Ile polymorphisms versus published control frequencies of 10.5% and 6.5%, respectively. The other two control groups had similarly low frequencies. Our data suggest that heterozygosity of these two extracellular TLR4 polymorphisms is highly associated with symptomatic RSV disease in high-risk infants and support a dual role for TLR4 SNPs in prematurity and increased susceptibility to RSV not revealed by analysis of either alone.
Asunto(s)
Predisposición Genética a la Enfermedad , Polimorfismo de Nucleótido Simple , Infecciones por Virus Sincitial Respiratorio/genética , Virus Sincitiales Respiratorios , Receptor Toll-Like 4/genética , Sustitución de Aminoácidos , Ácido Aspártico/química , Ácido Aspártico/genética , Niño , Preescolar , Femenino , Heterocigoto , Humanos , Lactante , Masculino , Treonina/química , Treonina/genéticaRESUMEN
Several animal models are used to study Mycobacterium tuberculosis (MTB) infections, but none is a fully ideal model of human disease. The American cotton rat is an excellent model for the study of several human viral and bacterial respiratory infectious diseases, but until now has not been reported to be a model with MTB infection. Preliminary experiments were designed in which two species of cotton rats (Sigmodon hispidus and Sigmodon fulviventer) received respiratory challenges with M. tuberculosis via either intranasal or aerosol inoculation. Granulomatous disease, often with central necrosis, developed in the lungs, spleen, and lymph nodes of infected animals. The number of MTB bacilli in the lungs increased logarithmically until reaching a plateau in the second month after aerosol inoculation. There were differences in response to infection between the two species, with S. fulviventer demonstrating greater mortality than S. hispidus. Cytokine gene expression analysis by reverse transcriptase polymerase chain reaction (RT-PCR) was performed on both normal appearing and granulomatous lung tissue from infected animals. Many cytokine genes were more highly expressed in the focal areas of inflammation. Cotton rats provide another valuable tool in future research with tuberculosis.
Asunto(s)
Modelos Animales de Enfermedad , Sigmodontinae , Tuberculosis Pulmonar/inmunología , Aerosoles , Animales , Quimiocinas/análisis , Recuento de Colonia Microbiana , Citocinas/análisis , Femenino , Expresión Génica , Inyecciones , Pulmón/inmunología , Pulmón/microbiología , Pulmón/patología , Ganglios Linfáticos/inmunología , Ganglios Linfáticos/microbiología , Ganglios Linfáticos/patología , Mycobacterium tuberculosis/inmunología , Bazo/inmunología , Bazo/microbiología , Bazo/patología , Factores de Tiempo , Prueba de TuberculinaRESUMEN
TLR4 is the signal-transducing receptor for structurally diverse microbial molecules such as bacterial LPS, respiratory syncytial virus fusion (F) protein, and chlamydial heat shock protein 60. Previous studies associated two polymorphic mutations in the extracellular domain of TLR4 (Asp(299)Gly and Thr(399)Ile) with decreased LPS responsiveness. To analyze the molecular basis for diminished responsiveness, site-specific mutations (singly or coexpressed) were introduced into untagged and epitope (Flag)-tagged wild-type (WT) TLR4 expression vectors to permit a direct comparison of WT and mutant signal transduction. Coexpression of WT TLR4, CD14, and MD-2 expression vectors in HEK293T cells was first optimized to achieve optimal LPS-induced NF-kappaB reporter gene expression. Surprisingly, transfection of cells with MD-2 at high input levels often used in the literature suppressed LPS-induced signaling, whereas supraoptimal CD14 levels did not. Under conditions where WT and polymorphic variants were comparably expressed, significant differences in NF-kappaB activation were observed in response to LPS and two structurally unrelated TLR4 agonists, chlamydial heat shock protein 60 and RSV F protein, with the double, cosegregating mutant TLR4 exhibiting the greatest deficiency. Overexpression of Flag-tagged WT and mutant vectors at input levels resulting in agonist-independent signaling led to equivalent NF-kappaB signaling, suggesting that these mutations in TLR4 affect appropriate interaction with agonist or coreceptor. These data provide new insights into the importance of stoichiometry among the components of the TLR4/MD-2/CD14 complex. A structural model that accounts for the diminished responsiveness of mutant TLR4 polymorphisms to structurally unrelated TLR4 agonists is proposed.
Asunto(s)
Receptores de Lipopolisacáridos/química , Receptores de Lipopolisacáridos/genética , Antígeno 96 de los Linfocitos/química , Antígeno 96 de los Linfocitos/genética , Polimorfismo Genético , Transducción de Señal/inmunología , Receptor Toll-Like 4/química , Receptor Toll-Like 4/genética , Sustitución de Aminoácidos/genética , Ácido Aspártico/genética , Línea Celular , Espacio Extracelular/genética , Espacio Extracelular/inmunología , Variación Genética , Glicina/genética , Humanos , Isoleucina/genética , Receptores de Lipopolisacáridos/fisiología , Lipopolisacáridos/farmacología , Antígeno 96 de los Linfocitos/fisiología , Oligopéptidos , Péptidos/genética , Unión Proteica/genética , Unión Proteica/inmunología , Estructura Terciaria de Proteína/genética , Transducción de Señal/genética , Treonina/genética , Receptor Toll-Like 4/agonistas , Receptor Toll-Like 4/antagonistas & inhibidores , TransfecciónRESUMEN
Triamcinolone acetonide, methylprednisolone, and dexamethasone were each evaluated in combination with palivizumab (Synagis) for the therapy of established respiratory syncytial virus infection in the cotton rat. Triamcinolone and methylprednisolone proved to be more effective than dexamethasone in reducing lung pathology. No recurrence of viral replication or pulmonary pathology followed the cessation of therapy.