Reactive oxygen species-mediated endoplasmic reticulum stress response induces apoptosis of Mycobacterium avium-infected macrophages by activating regulated IRE1-dependent decay pathway.

Mycobacterium avium, a slow-growing nontuberculous mycobacterium, causes fever, diarrhoea, loss of appetite, and weight loss in immunocompromised people. We have proposed that endoplasmic reticulum (ER) stress-mediated apoptosis plays a critical role in removing intracellular mycobacteria. In the present study, we investigated the role of the regulated IRE1-dependent decay (RIDD) pathway in macrophages during M. avium infection based on its role in the regulation of gene expression. The inositol-requiring enzyme 1 (IRE1)/apoptosis signal-regulating kinase 1 (ASK1)/c-Jun N-terminal kinase (JNK) signalling pathway was activated in macrophages after infection with M. avium. The expression of RIDD-associated genes, such as Bloc1s1 and St3gal5, was decreased in M. avium-infected macrophages. Interestingly, M. avium-induced apoptosis was significantly suppressed by pretreatment with irestatin (inhibitor of IRE1α) and 4µ8c (RIDD blocker). Macrophages pretreated with N-acetyl cysteine (NAC) showed decreased levels of reactive oxygen species (ROS), IRE1α, and apoptosis after M. avium infection. The expression of Bloc1s1 and St3gal5 was increased in NAC-pretreated macrophages following infection with M. avium. Growth of M. avium was significantly increased in irestatin-, 4µ8c-, and NAC-treated macrophages compared with the control. The data indicate that the ROS-mediated ER stress response induces apoptosis of M. avium-infected macrophages by activating IRE1α-RIDD. Thus, activation of IRE1α suppresses the intracellular survival of M. avium in macrophages.

Amyloid A amyloidosis secondary to avian tuberculosis in naturally infected domestic pekin ducks (Anas platyrhynchos domestica).

To investigate the correlation between avian tuberculosis and duck amyloidosis, the liver, lung, spleen, kidney, duodenum and pectoralis muscle of ducks naturally infected with Mycobacterium avium subsp. avium were used to detect amyloidosis by Congo red staining and potassium permanganate-Congo red staining. The expression level of IL-1ß, IL-6, IL-10, TNF-α and SAA2 were detected by quantitative real-time RT-PCR (qRT-PCR). The results showed that the liver, lung, spleen, kidney, duodenum and pectoralis muscle of the infected ducks exhibited amyloid proteins under ordinary light microscopy and the polarization light under polarized light microscopy. However, no amyloid deposition in potassium permanganate-Congo red staining sections indicated that the amyloidosis was AA amyloidosis. In addition, the expression level of IL-1ß, IL-6, IL-10, TNF-α and SAA2 increased from 4 to 43. This study showed that avian tuberculosis could induce secondary amyloidosis in naturally infected ducks.

Small-Cell Lung Cancer Comorbid with Pulmonary Mycobacterium avium Infection: A Case Report.

BACKGROUND: Small-cell lung cancer (SCLC) rarely coexists with pulmonary Mycobacterium avium intracellular complex (MAC) infection. The key drug for SCLC treatment is etoposide, which is metabolized by cytochrome P-450 (CYP) 3A4. Meanwhile, the key drugs for pulmonary MAC infection are clarithromycin (CAM) and rifampicin (RFP), and their metabolism influences CYP3A4. Therefore, treatment of concurrent SCLC and pulmonary MAC infection is difficult, and to the best of our knowledge, no report of treatments for concurrent SCLC and pulmonary MAC infection has been published. Patient Concerns and Diagnoses: A 65-year-old man presented to our hospital with abnormal findings of chest computed tomography: (1) a hilar region nodule in the left lung and mediastinal lymphadenopathy and (2) a thick-walled cavity lesion in the right upper lobe of the lung. After further examinations, the former lesions were diagnosed as SCLC, cT4N3M0, stage IIIC and the latter as pulmonary MAC infection, fibrocavitary disease. INTERVENTIONS AND OUTCOMES: Concurrent treatment was conducted with discontinuation of CAM and RFP before and after etoposide administration. Specifically, intravenous cisplatin and etoposide were administered on day 1 and days 1-3, respectively, and CAM, RFP, and ethambutol (EB) were administered orally on days 6-22 every 4 weeks. Concurrent radiotherapy was added to the drug administration on days 1-27 of the first cycle. The chemotherapy was continued for 4 cycles, followed by continuation of CAM and RFP administration. EB was discontinued because of optic nerve disorder. The treatments were conducted completely and safely, and both of the SCLC lesions and the MAC lesion were improved. CONCLUSIONS: Treatments for concurrent SCLC and pulmonary MAC infection may be successfully conducted with discontinuation of CAM and RFP before and after etoposide administration.

Identification and genetic characterization of polyomaviruses in estrildid and fringillid finches.

Polyomavirus infections were detected in 40 companion bird individuals belonging to a broad species range of estrildid and fringillid finches and originating from 21 different bird aviaries. Based on partial virus protein 1 (VP1) sequences, the viruses were identified as Serinus canaria polyomavirus 1 and Pyrrhula pyrrhula polyomavirus 1. Serinus canaria polyomavirus 1 was found in 18 birds belonging to one estrildid and four fringillid species. Pyrrhula pyrrhula polyomavirus 1 was detected in 22 birds of six estrildid and three fringillid species. There was a large overlap in host range. Increased mortality was frequently found in the affected bird aviaries while clinical signs were diverse. Co-infections with other viruses, bacteria or fungal pathogens were common and might have influenced the clinical signs. Sequence analyses, including partial VP1 sequences of the 40 virus strains, and full genome sequences of selected strains revealed a high genetic heterogeneity among virus subgroups of Serinus canaria polyomavirus 1 and Pyrrhula pyrrhula polyomavirus 1, indicating the existence of two virus variants for both virus species. For Pyrrhula pyrrhula polyomavirus 1, two genotypes were found that associated with the family of the finches, Estrildidae or Fringillidae.

Outbreak of Avian Tuberculosis in Commercial Domestic Pekin Ducks ( Anas platyrhynchos domestica).

Avian tuberculosis is a contagious disease affecting various domestic and wild bird species, and is caused by Mycobacterium avium . It is reported extremely rarely in commercial poultry flocks and has not been reported in commercial domestic ducks to date, with domestic ducks reported to be moderately resistant to M. avium infection. Here, we report the outbreak of avian tuberculosis in commercial Pekin duck ( Anas platyrhynchos domestica) flocks. Postmortem and histopathologic findings included nodules presenting in the visceral organs of ducks, and granulomas with central caseous necrosis surrounded by infiltrating lymphocytes. The M. avium pathogen was isolated and further identified by Ziehl-Neelsen staining and PCR based on insert sequence IS901 and the 16S rRNA gene. We highlight that avian tuberculosis not only has economic significance for the duck industry, but also presents a potential zoonotic hazard to humans.

Multifocal respiratory and vertebral mycobacteriosis in a red-tailed hawk (Buteo jamaicensis).

An adult, female, free-ranging red-tailed hawk (Buteo jamaicensis) was presented to a rehabilitation facility for an inability to stand. On examination, it displayed bilateral exaggeration of the pelvic limb reflexes with extensor muscle rigidity, intact superficial pain response, and positive withdrawal reflexes. A complete blood count identified moderate leukocytosis characterized by moderate heterophilia. No abnormalities were appreciable on radiographic evaluation. After initial improvement, it regressed and was euthanized 27 days after presentation. Necropsy and histologic investigation identified reduction in the diameter of the vertebral canal and spinal cord at cervical segments 8-9 with coalescing granulomas and intralesional acid-fast bacilli within the intertrabecular space, left side of the clavicular air sac, and cranial left lung. Bacterial culture and genetic sequencing from respiratory lesions identified Mycobacterium avium avium. Real time-polymerase chain reaction of paraffin-fixed spinal tissue tested positive for M. avium complex. Mycobacteriosis should be considered when peripheral neurologic deficits are present in raptors.

Genetic IS901 RFLP diversity among Mycobacterium avium subsp. avium isolates from four pheasant flocks.

IS901 RFLP analysis of 36 Mycobacterium avium subsp. avium (MAA) isolates from 15 pheasants (Phasianus colchicus) and two goshawks (Accipiter gentilis) from four pheasant farms was performed. Using this method, six different IS901 RFLP types (E, F, G, M, Q, and V) were identified. The distribution of IS901 RFLP profiles was tightly linked to individual flocks. Matching IS901 RFLP profiles observed in the present study indicate MAA transmission between pheasants and goshawks in the same locality. In two flocks, different pheasants within a flock as well as in various organs of five individual pheasants were found to have two distinct IS901 RFLP profiles.

Mycobacteriosis in ostriches (Struthio camelus) due to infection with Mycobacterium bovis and Mycobacterium avium complex.

Avian tuberculosis rarely affects ratites compared to other bird species and is typically caused by Mycobacterium avium species. This study describes the pathological and microbiological findings in three adult ostriches with mycobacteriosis, in one of which Mycobacterium bovis was isolated from the lesions. Post mortem examinations on ostriches from two different zoological collections in Ireland revealed multifocal caseous granulomas affecting the spleen and liver in all cases, with additional involvement of intestines in two cases. In one case, granulomas were present within the pharynx, at the thoracic inlet and multifocally on the pleural surface. Acid-fast bacilli were observed in all lesions. Mycobacterium sp. of the M. avium complex was isolated from the intestinal lesions in the two cases with intestinal involvement, and M. bovis sp. oligotype SB0140 was cultured from the liver of the third ostrich. This represents the first reported case of M. bovis infection in an ostrich. Avian tuberculosis due to M. bovis is rare and to date has been reported in only parrots and experimentally inoculated birds. Mycobacterium bovis needs to be considered as a possible cause of tuberculosis in ostriches because the lesions are similar to those observed with M. avium complex infection.

Avian tuberculosis of zoonotic importance at a zoo on the Bogotá Andean plateau (Sabana), Colombia.

Given that exposure to captive wild animals at circuses or zoos can be a source of zoonotic infection, a case and control study was carried out with a collection of exotic fowl at a zoo in Bogotá, Colombia. The presence of Mycobacterium avium-II was directly related to the death of birds kept in the original enclosure, and of 50% of a group of sentinel birds. Failure to detect the organism in a control group of birds outside the enclosure indicated that the infection was limited to the original enclosed area. We demonstrated that M. gordonae-IV was disseminated in all organs from 1 bird with macroscopic granulomatous lesion, a finding which has not been reported previously. We emphasize the importance of establishing handling norms to reduce the risk of zoonotic transmission.

Humoral response to Mycobacterium avium subsp. avium in naturally infected ring-neck doves (Streptopelia risoria).

Creation of a reliable and easy to use serologic test would greatly improve ante mortem diagnosis of Mycobacterium avium subsp. avium and aid in the control of avian mycobacteriosis, particularly in captive birds. In order to determine whether serodiagnostics could be of value in testing ring-neck doves (Streptopelia risoria) for M. a. avium infection, Western blot analysis was used to assess the humoral response of ring-neck doves exposed to M. a. avium, and to evaluate whether an association could be made between the humoral response and necropsy findings, histopathology, culture, and PCR testing. Western blot results were examined for reactivity patterns associating humoral response with infection status, severity and type of lesions (diffuse vs. multifocal granulomatous inflammation) and phenotype (white vs. non-white). A sensitivity of 88.24% and a specificity of 100% were achieved utilizing Western blot analysis to detect M. a. avium infection in ring-neck doves, offering a negative predictive value of 93% and a positive predictive value of 100%. While Western blot analysis results did not reflect lesion severity, lesion type did partially correspond with the humoral response. The findings of the present study indicate that serologic testing can be used as a valuable ante mortem screening tool for identifying ring-neck doves infected with M. a. avium.

Mycobacteriosis in naturally infected ring-neck doves (Streptopelia risoria): investigation of the association between feather colour and susceptibility to infection, disease and lesions type.

Prevalence of infection and disease, the degree of organ involvement and the nature of the lesions were investigated in 11 white and 18 non-white ring-neck doves coming from a flock naturally infected with Mycobacterium avium subsp. avium. Lesions were common in the liver, spleen, lung, kidney, intestines, ovary and bone marrow. Overall, 18 out of 29 (62%) birds were considered infected with a sequevar of M. avium subsp. avium that contains serotypes 2, 3, 4 and 9. The prevalence of infection in the white doves (36.4%) was significantly lower than in the non-white morphs (77.7%). White doves had on average fewer organs affected (mean =3.1) than the non-white doves (mean =5.9). A diffuse pattern of inflammation in the liver and spleen was observed mainly in non-white doves. Focal or multifocal granulomatous inflammation of the liver and spleen was predominant in white doves. Genetic mechanisms of immunity to mycobacteriosis may be contributing or determining these differences. There are three basic colour morphs in ring-neck doves--dark or wild type, blond and white--and the alleles coding for colour are sex-linked and located on the sex (Z) chromosome. Female's single sexual chromosomed (ZW) and homozygous males (ZZ) can be white if they carry the white alleles. It is very probable that the gene or genes modulating the immune response to M. avium subsp. avium infection in these doves could be associated to these loci or at least located in the same (Z) chromosome, as the association with white colour suggests.

Disseminated mycobacteriosis in a bald eagle (Haliaeetus leucocephalus).

A mature bald eagle (Haliaeetus leucocephalus) was diagnosed with mycobacterial infection after being presented for an inability to fly, emaciation, and a swelling of the left tibiotarsal-tarso metatarsal joint. Results of a complete blood cell count revealed a persistent, marked leukocytosis, with heterophilia, monocytosis, and anemia. Radiographs revealed lysis of the left distal tibiotarsus and soft-tissue swelling around the left tibiotarsal-tarsometatarsal joint, multiple pulmonary opacities, and an enlarged liver. Endoscopic evaluation and biopsy of caseated material within the left caudal coelom revealed acid-fast organisms. The eagle was euthanatized, and results of necropsy and histologic evaluation revealed caseated granulomas of the intestine, lungs, air sacs, and subcutaneous regions of the hock. Results of culture, a polymerase chain reaction testing, and direct deoxyribonucleic acid (DNA) sequencing for mycobacterial 16S ribosomal ribonucleic acid DNA determined this organism most likely to be Mycobacterium avium.

Observed differences in virulence-associated phenotypes between a human clinical isolate and a veterinary isolate of Mycobacterium avium.

Mycobacterium avium, the most common opportunistic pathogen in patients with AIDS, is frequently isolated from a variety of environmental sources, but rarely can these environmental isolates be epidemiologically linked with isolates known to cause human disease. Using a number of in vitro tissue culture assays, we found significant pathogenic differences between a serotype 4 human clinical M. avium isolate and a serotype 2 veterinary isolate. Cell association of the patient strain with a human intestinal cell line was 1.7 times that of the veterinary strain. Growth of this clinical strain in human peripheral blood mononuclear cell-derived macrophages increased from 12-fold higher than that of the veterinary isolate after 2 days to 200-fold higher after 4 days. By the conclusion of each experiment, lysis of all examined host cell types and accumulation of cell debris were observed in infections with the human isolate, but monolayers remained relatively intact in the presence of the animal isolate. The two strains also differed in the ability to stimulate human immunodeficiency virus replication in coinfected host cells, with p24 antigen levels after 6 days threefold higher in the cells coinfected with the clinical strain than in those infected with the veterinary strain. If the genetic differences responsible for the phenotypes observed in these assays can be identified and characterized, it may be possible to determine which M. avium strains in the environment are potential human pathogens.

Formulation and efficacy of liposome-encapsulated antibiotics for therapy of intracellular Mycobacterium avium infection.

Mycobacterium avium is an intracellular pathogen that can invade and multiply within macrophages of the reticuloendothelial system. Current therapy is not highly effective. Particulate drug carriers that are targeted to the reticuloendothelial system may provide a means to deliver antibiotics more efficiently to M. avium-infected cells. We investigated the formulation of the antibiotics ciprofloxacin and azithromycin in liposomes and tested their antibacterial activities in vitro against M. avium residing within J774, a murine macrophage-like cell line. A conventional passive-entrapment method yielded an encapsulation efficiency of 9% for ciprofloxacin and because of aggregation mediated by the cationic drug, was useful only with liposomes containing < or = 50 mol% negatively charged phospholipid. In contrast, ciprofloxacin was encapsulated with > 90% efficiency, regardless of the content of negatively charged lipids, by a remote-loading technique that utilized both pH and potential gradients to drive drug into preformed liposomes. Both the cellular accumulation and the antimycobacterial activity of ciprofloxacin increased in proportion to the liposome negative charge; the maximal enhancement of potency was 43-fold in liposomes of distearoylphosphatidylglycerol-cholesterol (DSPG-Chol) (10:5). Azithromycin liposomes were prepared as a freeze-dried preparation to avoid chemical instability during storage, and drug could be incorporated at 33 mol% (with respect to phospholipid). Azithromycin also showed enhanced antimycobacterial effect in liposomes, and the potency increased in parallel to the moles percent of negatively charged lipids; azithromycin in DSPG-Chol (10:5) liposomes inhibited intracellular M. avium growth 41-fold more effectively than did free azithromycin. Thus, ciprofloxacin or azithromycin encapsulated in stable liposomes having substantial negative surface charge is superior to nonencapsulated drug in inhibition of M.avium growth within cultured macrophages and may provide more effective therapy of M.avium infections.

Isolation of Mycobacterium avium from ringneck pheasants (Phasianus colchicus).

Tuberculous lesions were observed at necropsy in the liver, spleen, and intestine of five 10-month-old ringneck pheasants (Phasianus colchicus) from a flock of birds raised in captivity for breeding. Histological examination of the tissues revealed granulomas with associated acid-fast bacilli. The history and lesions are unusual in that very few bacteria were found in any given lesion, the birds were all in good flesh when necropsied, and five birds from this same group at 6 months of age were observed to have acid-fast bacteria in the small intestine. Mycobacterium avium was isolated and serotyping was attempted, but the colonies were too dry to serotype.

Therapeutic efficacy of the benzoxazinorifamycin KRM-1648 against experimental Mycobacterium avium infection induced in rabbits.

The therapeutic efficacy of the benzoxazinorifamycin KRM-1648 was studied in an experimental rabbit infection system with avian Mycobacterium avium. The infected rabbits died from Yersin type infections, a peculiar type of experimental bovine tuberculosis characterized by a very rapid course, enlargement of the spleen and liver, and septic infection, 14 to 20 days after bacterial challenge, as evidenced by bacteremia and severe bacterial loads in the visceral organs. Histopathologic studies of the visceral organs of the infected rabbits revealed the development of numerous typical granulomatous lesions. This experimental rabbit infection system, features of which resemble certain features of disseminated M. avium complex infections in AIDS patients, was used to evaluate the therapeutic efficacy of KRM-1648, a newly synthesized benzoxazinorifamycin. KRM-1648 given orally at 25 and 50 mg/kg of body weight reduced the incidence and degree of bacteremia in infected rabbits and protected against subsequent death. Moreover, the drug allowed almost complete recovery of infected rabbits by week 7. KRM-1648 cleared infections in the lungs, liver, spleen, and kidneys and restored histopathologic features of healthy tissue in the visceral organs. KRM-1648 exhibited a more potent therapeutic effect against M. avium infection than rifampin and clarithromycin.

Effect of environmental-genetic interactions on Mycobacterium avium challenge infection.

Chickens from lines selectively bred for either a high-antibody (HA) or low-antibody (LA) response to sheep erythrocytes were injected intravenously with Mycobacterium avium while being held in low, medium, or high levels of social stress for 5 days (first environment). During the remaining 6 weeks, they were held under either low or medium levels of social stress (second environment). Infection led to lesions consisting of granulomas, some of which had necrotic centers. There was a positive correlation between numbers of lesions with necrotic centers and M. avium cells recovered from livers. The numbers and nature of lesions were influenced by both genetic and environmental factors. Numbers of necrotizing lesions increased with stressfulness of the first environment. Total numbers of lesions were reduced by the medium-stress second environment, and the total number of necrotizing lesions was reduced among LA chickens in the low-stress second environment.

Isolation of Mycobacterium avium from waterfowl with polycystic livers.

An unusual gross appearance of avian tuberculosis, where fluid-filled thin-walled cysts are produced and grossly apparent in preference to granulomas, is presented. Histopathology confirmed the granulomatous nature of the lesions and the presence of intracellular acid-fast organisms. Mycobacterium avium complex was cultured from affected organs. The unusual gross presentation in these cases indicates the need to consider tuberculosis in the differential of cystic diseases of avian livers.

Mycobacterium avium serotype 1 infection in a sandhill crane (Grus canadensis).

Tuberculous lesions were observed in the liver of an adult sandhill crane (Grus canadensis); Mycobacterium avium serotype 1 was isolated. Chickens inoculated intravenously with the culture had granulomas in the liver and spleen at necropsy 62 days after inoculation.

Isolation of Mycobacterium avium serotype 3 from a white-headed tree duck (Dendrocygna viduata).

Tuberculous lesions were observed at necropsy in the liver of 1 of 10 White-headed Tree ducks (Dendrocygna viduata) imported from Nigeria. Microscopic examination revealed granulomas with acid-fast bacilli; Mycobacterium avium serotype 3 was isolated. Two chickens inoculated intraperitoneally with the isolant had gross and microscopic granulomas in the liver at necropsy 62 days after inoculation. Isolants from chickens were serologically similar to the strain isolated from the duck.