Phenotypic modulation in Mycobacterium tuberculosis infected neutrophil during tuberculosis.

Background & objectives: Polymorphonuclear leucocytes (PMN) or neutrophils infiltrate to the inflammatory sites and phagocytose mycobacteria thereby inhibiting the bacillary spread initially until the accumulated macrophages get activated. The present study was carried out to highlight the interaction of neutrophils with the two clinical isolates (S7 and S10) of Mycobacterium tuberculosis and the subsequent morphological changes. Methods: Dextran purified neutrophils from normal and TB patients infected with M. tuberculosis isolates were cultured for 3 and 18 h time points. At the end of termination, the cell surface expression of CD16, CD69, CXCR2 and induction of apoptosis were analyzed using flow cytometry. Cytokines and chemokines were estimated in supernatants by ELISA. Results: All infected PMN showed decrease in CD16 at both time points in normals while at 18 h in TB group. Interestingly, CD69 expression was significantly high at early time point in TB-PMN compared to normals. The high expression of CXCR2 was sustained in infected TB-PMN at both the time points. S7 and S10 infected neutrophils showed high phagocytic indices compared to H37Rv in both the groups. A significant increase in apoptosis was observed at both the time points in infected TB-PMN but only at 18 h in normals. Increased pro-inflammatory cytokine (TNF-α) and chemokine (IL-8) response was observed in infected neutrophils at 3 h in both the groups. Interpretation & conclusions: This study demonstrates the varying degree of modulation of neutrophil functions in both the groups. TB-PMN was more competent in amplifying the innate immune response and conferring protection at the early phase of infection. However, the response was not strain specific in either of these groups.

Leptin response in patients with tuberculous pleuritis.

BACKGROUND & OBJECTIVES: Tuberculous pleuritis is used as a model to understand the protective immune response in tuberculosis. It is predominated by Th1 response at the site of infection, where a possible role for the leptin, a known enhancer of Th1 response, could be speculated. Hence, we investigated leptin levels in pleural effusions in patients with both tuberculous (TP) and non-tuberculous (NTP) pleural effusion. METHODS: Leptin and cytokine levels were assessed in serum and pleural fluid of TP and NTP patients (N = 20 each) by ELISA. Multivariate regression analysis were performed to find the possible determinants of leptin taking leptin as the dependent and body mass index (BMI), gender, source of leptin [i.e., serum or pleural fluid (PF)], age and disease status as independent variables. RESULTS: PF leptin levels were significantly higher than serum leptin levels in both the groups however the PF leptin levels were significantly lower in TP subjects compared to NTP. The results showed that the leptin was found to be dependent on BMI but not on the other parameters. However, regression analysis based on the source of leptin showed males to be a better predictor of leptin. No correlation was observed between leptin and measured immune parameters. INTERPRETATION & CONCLUSION: Our findings demonstrated that the decreased leptin levels were associated with reduction in BMI but not with the disease status in tuberculous pleuritis.

Expression of co-stimulatory molecules B7.1 & B7.2 on macrophages infected with various strains of Mycobacterium tuberculosis & its influence on T-cell apoptosis.

BACKGROUND & OBJECTIVE: Activation of T cells is mediated through two critical signals provided by activated macrophages. The first signal is triggered when T cell receptor (TCR) binds to the major histocompatibility antigen (MHC/Ag) complex. The second signal is the interaction of co-stimulatory molecules with their respective ligands on T cells for their activation and proliferation. We undertook this study to observe the modulation in B7.1 (CD80) and B7.2 (CD86) co-stimulatory molecules on Mycobacterium tuberculosis infected monocyte derived macrophages (MDM) and their role in T helper (Th1) cell apoptosis. METHODS: M. tuberculosis clinical strains (S7 and S10) and laboratory strains (H37Ra and H37Rv) were used to infect the MDMs. The modulation of apoptosis was assessed by treating T cells with anti-CD3 and anti-CD28 antibodies. The infected MDMs were co-cultured with autologous PPD pulsed T cells to ascertain the role of co-stimulatory molecules during infection. RESULTS: In infected MDMs, all strains on day 1 but only S7 on day 2 showed significant decrease (P<0.05) in B7.1 expression compared to uninfected. The expression levels of B7.2 were also low on day 1 in S7, S10 and H37Ra infected MDMs. The anit-CD3 induced apoptosis in PPD pulsed Tcells showed further reduction with anti-CD28 antibodies. However, the modulation observed in B7.1 expression in infected MDMs was not reflected in T cell apoptosis in co-culture experiments. INTERPRETATION & CONCLUSION: Our results confirmed the role of B7.1 in rescuing the activated Tcells from undergoing apoptosis. During infection when the expression of B7.1 is downregulated, other co-stimulatory molecules may take over its crucial role to confer protective immune response against M. tuberculosis.