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1.
Sci Rep ; 11(1): 14162, 2021 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-34238943

RESUMO

The prevalence of atopic diseases has been steadily increasing since the mid twentieth century, a rise that has been linked to modern hygienic lifestyles that limit exposure to microbes and immune system maturation. Overactive type 2 CD4+ helper T (Th2) cells are known to be closely associated with atopy and represent a key target for treatment. In this study, we present an initial characterization of ammonia oxidizing bacteria (AOB) Nitrosomonas eutropha D23, an environmental microbe that is not associated with human pathology, and show AOB effectively suppress the polarization of Th2 cells and production of Th2-associated cytokines (IL-5, IL-13, and IL-4) by human peripheral blood mononuclear cells (PBMC). We show that AOB inhibit Th2 cell polarization not through Th1-mediated suppression, but rather through mechanisms involving the anti-inflammatory cytokine IL-10 and the potential inhibition of dendritic cells, as evidenced by a reduction in Major Histocompatibility Complex Class II (MHC II) and CD86 expression following AOB treatment. This is the first report of immunomodulatory properties of AOB, and provides initial support for the development of AOB as a potential therapeutic for atopic diseases.


Assuntos
Amônia/metabolismo , Anti-Inflamatórios/metabolismo , Polaridade Celular , Interleucina-10/metabolismo , Nitrosomonas/metabolismo , Células Th2/citologia , Células Th2/microbiologia , Células Dendríticas/metabolismo , Humanos , Leucócitos Mononucleares/imunologia , Leucócitos Mononucleares/microbiologia , Metaboloma , Oxirredução , Transdução de Sinais , Células Th1/imunologia
2.
Toxicol Appl Pharmacol ; 415: 115441, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33556388

RESUMO

The immunotoxicity of zearalenone (ZEA) and deoxynivalenol (DON), two of the most common environmental mycotoxins, has been well investigated. However, due to the complexity of the immune system, especially during bacterial infection, many types of immune cells are involved in invasion resistance and bacterial clearance. Of these, T helper 2 (Th2) cells, which are members of the helper T cell family, assist B cells to activate and differentiate into antibody-secreting cells, participate in humoral immune response, and, ultimately, eliminate pathogens. Thus, it is important to identify the stage at which these toxins affect the immune function, and to clarity the underlying mechanisms. In this study, mice infected with Listeria monocytogenes (Listeria) were used to study the effects of ZEA, DON, and ZEA + DON on Th2 differentiation, Interleukin-4 Receptor (IL-4R) expression, costimulatory molecules expression and cytokine secretion after Listeria infection. Naive CD4+ T cells, isolated from mice, were used to verify the in vivo effects and the associated mechanisms. In vivo experiments showed that these toxins aggravated spleen damage after Listeria infection and reduced the differentiation of Th2 cells by affecting the synthesis of IL-4R of CD4+ T cells. In addition, the level of the costimulatory molecule CD154 decreased. Consistent with this, in vitro studies showed that these toxins inhibited the differentiation of mouse naive CD4+ T cell into Th2 subtype and decreased IL-4R levels. In addition, the levels of costimulatory molecules CD154, CD278 and the Th2 cells secrete cytokines IL-4, IL-6, and IL-10 decreased. Based on our in vivo and in vitro experiments, we suggest that ZEA, DON, and ZEA + DON inhibit the expression of costimulatory molecules on CD4+ T cell, and inhibit the IL-4R-mediated Th2 cell differentiation. This may indicate that the body cannot normally resist or clear the pathogen after mycotoxin poisoning.


Assuntos
Diferenciação Celular/efeitos dos fármacos , Listeria monocytogenes/patogenicidade , Listeriose/induzido quimicamente , Ativação Linfocitária/efeitos dos fármacos , Receptores de Interleucina-4/metabolismo , Baço/efeitos dos fármacos , Células Th2/efeitos dos fármacos , Tricotecenos/toxicidade , Zearalenona/toxicidade , Animais , Ligante de CD40/metabolismo , Células Cultivadas , Citocinas/metabolismo , Modelos Animais de Doenças , Feminino , Interações Hospedeiro-Patógeno , Proteína Coestimuladora de Linfócitos T Induzíveis/metabolismo , Listeria monocytogenes/imunologia , Listeriose/imunologia , Listeriose/metabolismo , Listeriose/microbiologia , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Transdução de Sinais , Baço/imunologia , Baço/metabolismo , Baço/microbiologia , Células Th2/imunologia , Células Th2/metabolismo , Células Th2/microbiologia
3.
Int Immunopharmacol ; 90: 107148, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33189614

RESUMO

The prime human and animal safety issues accentuate the search of promising newer alternative vaccine candidates to resolve complications associated with the live attenuated Brucella abortus strain19 (S19) vaccine. Outer membrane vesicles (OMVs S19 Δper) extracted from Brucella abortus S19Δper (S19Δper) as an alternative subunit vaccine candidate has been explored in the present study as OMVs are endowed with immunogenic molecules, including LPS and outer membrane proteins (OMPs) and do not cause infection by virtue of being an acellular entity. The LPS defective S19Δper released a higher amount of OMVs than its parent strain S19. Under transmission electron microscopy (TEM), OMVs were seen as nano-sized outward bulge from the surface of Brucella. Dynamic light scattering analysis of OMVs revealed that OMVs S19Δper showed the less polydispersity index (PDI) than OMVs S19 pointing towards relatively more homogenous OMVs populations. Both OMVs S19Δper and OMVs S19 with or without booster dose and S19 vaccine were used for immunization of mice and subsequently challenged with 2 × 105 CFU virulent Brucella abortus strain 544 (S544) to assess protective efficacy of vaccines. The less splenic weight index and less S544 count in OMVs immunized mice in comparison to unimmunized mice after S544 challenge clearly indicated good protective efficacy of OMVs. OMVs S19 Δper induced relatively high titer of IgG than OMVs S19 but conferred nearly equal protection against brucellosis. An ELISA based determination of IgG and its isotype response, Cytometric Bead Array (CBA) based quantitation of serum cytokines and FACS based enumeration of CD4+ and CD8+ T cells revealed high titer of IgG, production of both Th1 (IgG2a) and Th2 (IgG1) related antibodies, stimulation of IL-2, TNF (Th1) and IL-4, IL-6, IL-10 (Th2) cytokines, and induced T cell response suggested that OMVs S19Δper elicited Th1 and Th2 type immune response and ensured protection against S544 challenge in murine model.


Assuntos
Proteínas da Membrana Bacteriana Externa/administração & dosagem , Vacina contra Brucelose/administração & dosagem , Brucella abortus/imunologia , Brucelose/prevenção & controle , Animais , Anticorpos Antibacterianos/sangue , Proteínas da Membrana Bacteriana Externa/imunologia , Vacina contra Brucelose/imunologia , Brucella abortus/patogenicidade , Brucelose/sangue , Brucelose/imunologia , Brucelose/microbiologia , Citocinas/sangue , Modelos Animais de Doenças , Feminino , Imunização , Imunogenicidade da Vacina , Imunoglobulina G/sangue , Camundongos , Células Th1/efeitos dos fármacos , Células Th1/imunologia , Células Th1/metabolismo , Células Th1/microbiologia , Células Th2/efeitos dos fármacos , Células Th2/imunologia , Células Th2/metabolismo , Células Th2/microbiologia , Vacinas de Subunidades Antigênicas/administração & dosagem , Virulência
4.
Infect Immun ; 88(8)2020 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-32423915

RESUMO

Cryptococcus neoformans is a fungal pathogen that kills almost 200,000 people each year and is distinguished by abundant and unique surface glycan structures that are rich in xylose. A mutant strain of C. neoformans that cannot transport xylose precursors into the secretory compartment is severely attenuated in virulence in mice yet surprisingly is not cleared. We found that this strain failed to induce the nonprotective T helper cell type 2 (Th2) responses characteristic of wild-type infection, instead promoting sustained interleukin 12p40 (IL-12p40) induction and increased IL-17A (IL-17) production. It also stimulated dendritic cells to release high levels of proinflammatory cytokines, a behavior we linked to xylose expression. We further discovered that inducible bronchus-associated lymphoid tissue (iBALT) forms in response to infection with either wild-type cryptococci or the mutant strain with reduced surface xylose; although iBALT formation is slowed in the latter case, the tissue is better organized. Finally, our temporal studies suggest that lymphoid structures in the lung restrict the spread of mutant fungi for at least 18 weeks after infection, which is in contrast to ineffective control of the pathogen after infection with wild-type cells. These studies demonstrate the role of xylose in modulation of host response to a fungal pathogen and show that cryptococcal infection triggers iBALT formation.


Assuntos
Criptococose/imunologia , Cryptococcus neoformans/imunologia , Evasão da Resposta Imune , Imunidade nas Mucosas , Pneumopatias Fúngicas/imunologia , Proteínas de Transporte de Monossacarídeos/imunologia , Xilose/metabolismo , Animais , Transporte Biológico , Criptococose/genética , Criptococose/microbiologia , Criptococose/mortalidade , Cryptococcus neoformans/patogenicidade , Células Dendríticas/imunologia , Células Dendríticas/microbiologia , Modelos Animais de Doenças , Regulação da Expressão Gênica , Proteínas de Homeodomínio/genética , Proteínas de Homeodomínio/imunologia , Humanos , Subunidade p40 da Interleucina-12/genética , Subunidade p40 da Interleucina-12/imunologia , Interleucina-17/genética , Interleucina-17/imunologia , Pulmão/imunologia , Pulmão/microbiologia , Pneumopatias Fúngicas/genética , Pneumopatias Fúngicas/microbiologia , Pneumopatias Fúngicas/mortalidade , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Proteínas de Transporte de Monossacarídeos/genética , Receptores de Antígenos de Linfócitos T alfa-beta/genética , Receptores de Antígenos de Linfócitos T alfa-beta/imunologia , Transdução de Sinais , Análise de Sobrevida , Células Th2/imunologia , Células Th2/microbiologia , Xilose/imunologia
5.
Inflammation ; 43(1): 32-43, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31894450

RESUMO

Air pollution events frequently occur in China during the winter. Most investigations of pollution studies have focused on the physical and chemical properties of PM2.5. Many of these studies have indicated that PM2.5 exacerbates asthma or eosinophil inflammation. However, few studies have evaluated the relationship between bacterial loads in PM2.5, and especially pathogenic bacteria and childhood asthma. Airborne PM2.5 samples from heavily polluted air were collected in Hangzhou, China between December 2014 and January 2015. PM2.5 and ovalbumin (OVA) were intratracheally administered twice in 4-week intervals to induce the allergic pulmonary inflammation in adolescent C57/BL6 mice. PM2.5 exposure caused neutrophilic alveolitis and bronchitis. In the presence of OVA, the levels of the Th2 cytokines IL-4, IL-12, and IL-17 were significantly increased in bronchoalveolar lavage fluids (BALF) after PM2.5 exposure, while eosinophil infiltration and mucin secretion were also induced. In addition to adjuvant effects on OVA-induced allergic inflammation, PM2.5 exposure also led to the maturation of dendritic cells. These results suggest that PM2.5 exposure may aggravate lung eosinophilia and that PM2.5-bound microbial can exacerbate allergic and inflammatory lung diseases.


Assuntos
Microbiologia do Ar , Pulmão/microbiologia , Material Particulado/toxicidade , Pneumonia/microbiologia , Eosinofilia Pulmonar/microbiologia , Hipersensibilidade Respiratória/microbiologia , Fatores Etários , Animais , Carga Bacteriana , Células Cultivadas , Técnicas de Cocultura , Citocinas/metabolismo , Células Dendríticas/metabolismo , Células Dendríticas/microbiologia , Modelos Animais de Doenças , Pulmão/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos ICR , Ovalbumina , Tamanho da Partícula , Pneumonia/induzido quimicamente , Pneumonia/metabolismo , Eosinofilia Pulmonar/induzido quimicamente , Eosinofilia Pulmonar/metabolismo , Hipersensibilidade Respiratória/induzido quimicamente , Hipersensibilidade Respiratória/metabolismo , Células Th2/metabolismo , Células Th2/microbiologia
6.
Eur J Immunol ; 49(9): 1380-1390, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31365119

RESUMO

CD200 receptor 1(CD200R1) signalling limits myeloid cell responses and reduces autoimmunity, alloimmunity and viral-mediated immunopathology, but has never been examined in the context of eosinophilic inflammation. Susceptibility to lung fungal infection is associated with T-helper 2 (Th2) cytokine dominated responses and strong eosinophilic pathology. Blockade of CD200R1 enhances type I cytokine responses in many infectious and non-infectious settings and so may promote a more protective response to fungal infection. By contrast, we demonstrate that, rather than promoting type I cytokine responses, CD200R1 blockade enhanced eosinophilia in a mouse model of Cryptococcus neoformans infection, whereas CD200R1 agonism reduced lung eosinophilia - with neither strategy completely altering fungal burden. Thus, we reveal a surprising disconnect between pulmonary eosinophilia and cryptococcal burden and dissemination. This research has 2 important implications. Firstly, a lack of CD200R1 signalling enhances immune responses regardless of cytokine polarisation, and secondly reducing eosinophils does not allow protective immunity to develop in susceptible fungal system. Therefore, agonists of CD200R1 may be beneficial for eosinophilic pathologies.


Assuntos
Pneumopatias Fúngicas/imunologia , Receptores de Orexina/imunologia , Eosinofilia Pulmonar/imunologia , Animais , Criptococose/imunologia , Criptococose/microbiologia , Cryptococcus neoformans/imunologia , Citocinas/imunologia , Modelos Animais de Doenças , Inflamação/imunologia , Inflamação/microbiologia , Pulmão , Pneumopatias Fúngicas/microbiologia , Camundongos , Células Mieloides/imunologia , Células Mieloides/microbiologia , Eosinofilia Pulmonar/microbiologia , Células Th2/imunologia , Células Th2/microbiologia
7.
Front Immunol ; 10: 1465, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31316513

RESUMO

Background: Chronic periodontitis (CP), caused by bacteria and fungi, appears in up to 66% of HIV-patients. The impact and association of HIV-treatment (HAART) and Candida itself has not been properly evaluated in the development and progression of CP. The immunopathogenesis is characterized by CD4+ T-cells activation and the balance between the T-helper 1 (Th1) and T-helper 2 (Th2) or a mixed cytokine profile. Currently, the associated causes of an immune response in HIV-patients with CP is controversial. Our aims were the determination of Candida spp. and cytokine profile in oral samples from HIV-positive patients with CP, considering the CD4+ T cells levels and HAART use. Methods: From 500 HIV-positive patients evaluated, 228 patients were enrolled. Patients were separated in groups: (A) n = 53 (≤200 CD4+ T-cells on HAART); (B) n = 57 (≤200 CD4+ T-cells without HAART); (C) n = 50 (>200 CD4+ T-cells without HAART); (D) n = 68 (>200 CD4+ T-cells on HAART). Candida spp. were isolated from the oral biofilm and crevicular fluid in CHROMagar and confirmed by endpoint PCR. Cytokine levels were measured by beads-based immunoassay in saliva by flow cytometry. Results: 147 patients (64.5%) were positive to Candida spp. and 204 strains were isolated; 138 (67.6%) were C. albicans and the remaining C. non-albicans species (C. glabrata>C. tropicalis>C. krusei>C. dubliniensis). In this study, CHROMagar showed good sensitivity (95%) but poor specificity (68%); since of the 152 samples identified as C. albicans, only 131 were confirmed by PCR; from the 10 samples identified as C. glabrata, only six were confirmed. Finally, of the 42 samples detected as C. tropicalis, only five were confirmed. When evaluating Candida spp. presence, group A and D had higher isolation, while group B had the highest species diversity. Whereas, group C had a significant reduction of Candida spp. Despite the presence of Candida and HAART, we found a Th1/Th2 hybrid profile in the saliva of patients with low CD4+ T-cell count (group A). Conclusion: Abundance and diversity of the Candida spp. detected in HIV-patients with CP could be related to HAART and low CD4+ T-cells levels. Also, the immunosuppression might promote a local Th1/Th2 hybrid cytokine profile.


Assuntos
Candida/imunologia , Candidíase Bucal/imunologia , Periodontite Crônica/imunologia , Citocinas/imunologia , Infecções por HIV/imunologia , Células Th1/imunologia , Células Th2/imunologia , Adulto , Terapia Antirretroviral de Alta Atividade , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD4-Positivos/virologia , Candida/classificação , Candida/fisiologia , Candidíase Bucal/microbiologia , Periodontite Crônica/microbiologia , Periodontite Crônica/virologia , Citocinas/metabolismo , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Saliva/efeitos dos fármacos , Saliva/imunologia , Saliva/metabolismo , Especificidade da Espécie , Células Th1/microbiologia , Células Th1/virologia , Células Th2/microbiologia , Células Th2/virologia
8.
Infect Immun ; 87(10)2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31308083

RESUMO

Bordetella bronchiseptica is an etiologic agent of respiratory diseases in animals and humans. Despite the widespread use of veterinary B. bronchiseptica vaccines, there is limited information on their composition and relative efficacy and on the immune responses that they elicit. Furthermore, human B. bronchiseptica vaccines are not available. We leveraged the dual antigenic and adjuvant functions of Bordetella colonization factor A (BcfA) to develop acellular B. bronchiseptica vaccines in the absence of an additional adjuvant. BALB/c mice immunized with BcfA alone or a trivalent vaccine containing BcfA and the Bordetella antigens FHA and Prn were equally protected against challenge with a prototype B. bronchiseptica strain. The trivalent vaccine protected mice significantly better than the canine vaccine Bronchicine and provided protection against a B. bronchiseptica strain isolated from a dog with kennel cough. Th1/17-polarized immune responses correlate with long-lasting protection against bordetellae and other respiratory pathogens. Notably, BcfA strongly attenuated the Th2 responses elicited by FHA and Prn, resulting in Th1/17-skewed responses in inherently Th2-skewed BALB/c mice. Thus, BcfA functions as both an antigen and an adjuvant, providing protection as a single-component vaccine. BcfA-adjuvanted vaccines may improve the efficacy and durability of vaccines against bordetellae and other pathogens.


Assuntos
Adesinas Bacterianas/administração & dosagem , Adjuvantes Imunológicos/administração & dosagem , Antígenos de Bactérias/administração & dosagem , Proteínas da Membrana Bacteriana Externa/administração & dosagem , Vacinas Bacterianas/administração & dosagem , Infecções por Bordetella/prevenção & controle , Bordetella bronchiseptica/efeitos dos fármacos , Fatores de Virulência de Bordetella/administração & dosagem , Animais , Infecções por Bordetella/imunologia , Infecções por Bordetella/microbiologia , Bordetella bronchiseptica/imunologia , Bordetella bronchiseptica/patogenicidade , Cães , Feminino , Humanos , Imunização , Imunogenicidade da Vacina , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Células Th1/efeitos dos fármacos , Células Th1/imunologia , Células Th1/microbiologia , Equilíbrio Th1-Th2/efeitos dos fármacos , Células Th17/efeitos dos fármacos , Células Th17/imunologia , Células Th17/microbiologia , Células Th2/efeitos dos fármacos , Células Th2/imunologia , Células Th2/microbiologia
9.
Scand J Immunol ; 90(3): e12799, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31211854

RESUMO

Pemphigus vulgaris (PV) is an autoimmune disease characterized by the production of IgG autoantibodies owing to an imbalance in the Th1/Th2 and Th17/Tregs cell pathways. The role of gut microbiota in the development of immune system and autoimmune diseases has been unraveled in the last two decades. However, data pertaining to gut microbiota of PV patients is largely lacking. We aimed to compare the gut microbiota of PV patients and healthy controls and assessed potential correlation with circulating cytokines of Th1/Th2/Th17 cell. Faecal bacterial diversity was analysed in 18 PV patients and 14 age- and gender-matched healthy individuals using hypervariable tag sequencing of the V3-V4 region of the 16S rRNA gene. Plasma levels of 20 inflammatory cytokines were assessed using the Luminex screening system. As a result, we identified 10 differentially abundant taxa between patients and controls. At the genera level, Lachnospiracea_incertae_sedis and Coprococcus decreased, while Granulicatella, Flavonifractor enriched in PV. Plasma levels of C5a, interleukin (IL)-2R, IL-6, IL-8, IL-7, IL-1ß, IL17A, IL-5 and IL-21 were significantly increased in PV Flavonifractor exhibited a positive correlation with C5a, IL-6, IL-8, IL-7, IL-1ß, IL17A and IL-21. Lachnospiracea_incertae_sedis and Coprococcus showed a negative correlation with IL-17A. Our results are consistent with the hypothesis that PV patients have gut microbial dysbiosis which might contribute to the immune disorder and the development of PV.


Assuntos
Doenças Autoimunes/imunologia , Citocinas/imunologia , Microbioma Gastrointestinal/imunologia , Inflamação/imunologia , Pênfigo/imunologia , Plasma/imunologia , Adulto , Autoanticorpos/imunologia , Doenças Autoimunes/microbiologia , Fezes/microbiologia , Feminino , Humanos , Inflamação/microbiologia , Masculino , Pessoa de Meia-Idade , Pênfigo/microbiologia , Plasma/microbiologia , Linfócitos T Reguladores/imunologia , Linfócitos T Reguladores/microbiologia , Células Th1/imunologia , Células Th1/microbiologia , Células Th17/imunologia , Células Th17/microbiologia , Células Th2/imunologia , Células Th2/microbiologia
10.
Eur Respir J ; 54(2)2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31097521

RESUMO

Protective immunity against Mycobacterium tuberculosis is poorly understood. The role of interleukin (IL)-4, the archetypal T-helper type 2 (Th2) cytokine, in the immunopathogenesis of human tuberculosis remains unclear.Blood and/or bronchoalveolar lavage fluid (BAL) were obtained from participants with pulmonary tuberculosis (TB) (n=23) and presumed latent TB infection (LTBI) (n=22). Messenger RNA expression levels of interferon (IFN)-γ, IL-4 and its splice variant IL-4δ2 were determined by real-time PCR. The effect of human recombinant (hr)IL-4 on mycobacterial survival/containment (CFU·mL-1) was evaluated in M. tuberculosis-infected macrophages co-cultured with mycobacterial antigen-primed effector T-cells. Regulatory T-cell (Treg) and Th1 cytokine levels were evaluated using flow cytometry.In blood, but not BAL, IL-4 mRNA levels (p=0.02) and the IL-4/IFN-γ ratio (p=0.01) was higher in TB versus LTBI. hrIL-4 reduced mycobacterial containment in infected macrophages (p<0.008) in a dose-dependent manner and was associated with an increase in Tregs (p<0.001), but decreased CD4+Th1 cytokine levels (CD4+IFN-γ+ p<0.001; CD4+TNFα+ p=0.01). Blocking IL-4 significantly neutralised mycobacterial containment (p=0.03), CD4+IFNγ+ levels (p=0.03) and Treg expression (p=0.03).IL-4 can subvert mycobacterial containment in human macrophages, probably via perturbations in Treg and Th1-linked pathways. These data may have implications for the design of effective TB vaccines and host-directed therapies.


Assuntos
Interleucina-4/farmacologia , Tuberculose Latente/microbiologia , Macrófagos/citologia , Mycobacterium tuberculosis/imunologia , Antígenos de Bactérias/imunologia , Líquido da Lavagem Broncoalveolar , Linfócitos T CD4-Positivos/citologia , Linfócitos T CD4-Positivos/imunologia , Células Cultivadas , Técnicas de Cocultura , Citocinas/imunologia , Humanos , Imunoterapia , Inflamação , Interferon gama/metabolismo , Tuberculose Latente/metabolismo , Macrófagos/microbiologia , RNA Mensageiro/metabolismo , Proteínas Recombinantes/farmacologia , Linfócitos T Reguladores/citologia , Linfócitos T Reguladores/microbiologia , Células Th1/citologia , Células Th1/microbiologia , Células Th2/citologia , Células Th2/microbiologia , Tuberculose Pulmonar/imunologia
11.
Tuberculosis (Edinb) ; 116S: S11-S18, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31072689

RESUMO

TB is a catastrophic infectious disease, affecting roughly one third of the world's population. Mucosal-associated invariant T (MAIT) cells are innate-like T cells that recognize vitamin B metabolites produced by bacteria, possess effector memory phenotype, and express tissue-homing markers driving migration to sites of infection. Previous research in both Mtb and HIV infections has shown that MAIT cells are depleted in the human periphery, possibly migrating to the tissue sites of infection. We investigated this hypothesis using rhesus macaques (RMs) with active TB, latent TB (LTBI), and SIV-coinfection to explore the effects of different disease states on the MAIT cell populations in vivo. Early in infection, we observed that MAIT cells increased in the blood and bronchoalveolar lavage fluid (BAL) of all infected RMs, irrespective of clinical outcome. However, the frequency of MAIT cells rapidly normalized such that they had returned to baseline levels prior to endpoint. Furthermore, following infection, the chemokines expressed on MAIT cells reflected a strong shift towards a Th1 phenotype from a shared Th1/Th17 phenotype. In conclusion, MAIT cells with enhanced Th1 functions migrating to the site of Mtb-infection. The anti-mycobacterial effector functions of MAIT cells, particularly during the early stages of Mtb infection, had been of interest in promoting protective long-term TB immunity. Our research shows, however, that they have relatively short-acting responses in the host.


Assuntos
Movimento Celular , Proliferação de Células , Imunidade nas Mucosas , Tuberculose Latente/microbiologia , Pulmão/microbiologia , Ativação Linfocitária , Células T Invariantes Associadas à Mucosa/microbiologia , Mycobacterium tuberculosis/patogenicidade , Tuberculose Pulmonar/microbiologia , Animais , Coinfecção , Modelos Animais de Doenças , Interações Hospedeiro-Patógeno , Tuberculose Latente/imunologia , Pulmão/imunologia , Macaca mulatta , Células T Invariantes Associadas à Mucosa/imunologia , Células T Invariantes Associadas à Mucosa/virologia , Mycobacterium tuberculosis/imunologia , Fenótipo , Síndrome de Imunodeficiência Adquirida dos Símios/imunologia , Síndrome de Imunodeficiência Adquirida dos Símios/virologia , Vírus 40 dos Símios/imunologia , Vírus 40 dos Símios/patogenicidade , Células Th1/imunologia , Células Th1/microbiologia , Células Th2/imunologia , Células Th2/microbiologia , Fatores de Tempo , Tuberculose Pulmonar/imunologia
12.
Semin Immunol ; 39: 4-13, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30396811

RESUMO

The development of the CAF family adjuvant was initiated around 20 years ago when Statens Serum Institut was preparing its first generation protein based recombinant subunit vaccine against tuberculosis for clinical testing, but realized that there were no clinically relevant adjuvants available that would support the strong CMI response needed. Since then the aim for the adjuvant research at Statens Serum Institut has been to provide adjuvants with distinct immunogenicity profiles correlating with protection for any given infectious disease. Two of the adjuvants CAF01 and CAF09 are currently being evaluated in human clinical trials. The purpose of this review is to give an overview of the immunocorrelates of those CAF adjuvants furthest in development. We further aim at giving an overview of the mechanism of action of the CAF adjuvants.


Assuntos
Adjuvantes Imunológicos/farmacologia , Glicolipídeos/farmacologia , Imunidade Celular/efeitos dos fármacos , Imunogenicidade da Vacina , Lipídeo A/análogos & derivados , Compostos de Amônio Quaternário/farmacologia , Tuberculose Pulmonar/prevenção & controle , Adjuvantes Imunológicos/química , Animais , Glicolipídeos/química , Humanos , Imunidade Humoral/efeitos dos fármacos , Lipídeo A/química , Lipídeo A/farmacologia , Lipossomos/administração & dosagem , Lipossomos/química , Lipossomos/imunologia , Camundongos , Compostos de Amônio Quaternário/química , Células Th1/efeitos dos fármacos , Células Th1/imunologia , Células Th1/microbiologia , Células Th17/efeitos dos fármacos , Células Th17/imunologia , Células Th17/microbiologia , Células Th2/efeitos dos fármacos , Células Th2/imunologia , Células Th2/microbiologia , Vacinas contra a Tuberculose/administração & dosagem , Vacinas contra a Tuberculose/química , Vacinas contra a Tuberculose/imunologia , Tuberculose Pulmonar/imunologia , Tuberculose Pulmonar/microbiologia
13.
Sci Rep ; 8(1): 7242, 2018 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-29740033

RESUMO

Anthrax infection is primarily initiated by B. anthracis endospores that on entry into the host germinate to vegetative cells and cause severe bacteremia and toxaemia employing an array of host colonisation factors and the lethal tripartite toxin. The protective efficacy of conventional protective antigen (PA) based anthrax vaccines is improved by co-administration with inactivated spores or its components. In the present study, using structural vaccinology rationale we synthesized a bivalent protein r-PB encompassing toxin (PAIV) and spore components (BclACTD) and characterized its protective efficacy against B. anthracis infection. Active immunization of mice with r-PB generated high titer circulating antibodies which facilitated the phagocytic uptake of spores, inhibited their germination to vegetative cells and completely neutralized anthrax toxins in vivo resulting in 100 % survival against anthrax toxin challenge. Proliferation of CD4+ T cell subsets with up-regulation of Th1 (IFN-γ, IL-2, and IL-12), Th2 (IL-5, IL-10) cytokines and balanced expression of IgG1:IgG2a antibody isotypes indicated the stimulation of both Th1 and Th2 subsets. The immunized mice exhibited 100 % survival upon challenge with B. anthracis spores or toxin indicating the ability of r-PB to provide comprehensive protection against anthrax. Our results thus demonstrate r-PB an efficient vaccine candidate against anthrax infection.


Assuntos
Antraz/prevenção & controle , Anticorpos Antibacterianos/biossíntese , Antígenos de Bactérias/imunologia , Bacillus anthracis/efeitos dos fármacos , Toxinas Bacterianas/imunologia , Glicoproteínas de Membrana/imunologia , Proteínas Recombinantes de Fusão/imunologia , Esporos Bacterianos/efeitos dos fármacos , Animais , Antraz/imunologia , Antraz/microbiologia , Antraz/mortalidade , Antígenos de Bactérias/genética , Bacillus anthracis/crescimento & desenvolvimento , Bacillus anthracis/imunologia , Bacillus anthracis/patogenicidade , Toxinas Bacterianas/genética , Proliferação de Células/efeitos dos fármacos , Clonagem Molecular , Escherichia coli/genética , Escherichia coli/metabolismo , Feminino , Expressão Gênica , Soros Imunes/farmacologia , Imunização , Interferon gama/biossíntese , Interferon gama/imunologia , Interleucinas/biossíntese , Interleucinas/imunologia , Glicoproteínas de Membrana/genética , Camundongos , Camundongos Endogâmicos BALB C , Fagocitose/efeitos dos fármacos , Células RAW 264.7 , Proteínas Recombinantes de Fusão/administração & dosagem , Proteínas Recombinantes de Fusão/genética , Esporos Bacterianos/crescimento & desenvolvimento , Esporos Bacterianos/imunologia , Esporos Bacterianos/patogenicidade , Análise de Sobrevida , Células Th1/efeitos dos fármacos , Células Th1/imunologia , Células Th1/microbiologia , Equilíbrio Th1-Th2 , Células Th2/efeitos dos fármacos , Células Th2/imunologia , Células Th2/microbiologia
14.
Semin Immunol ; 39: 14-21, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29801750

RESUMO

After decades of slow progress, the last years have seen a rapid acceleration of the development of adjuvanted vaccines which have lately been approved for human use. These adjuvants consist of different components, e.g. aluminium salts, emulsions such as MF59 and AS03, Toll-like receptor (TLR) agonists (CpG ormonophosphoryl lipid A (MPL) adsorbed on aluminium salts as in AS04) or combination of immunopotentiators (QS-21 and MPL in AS01). Despite their distinctive features, most of these adjuvants share some key characteristics. For example, they induce early activation (although at different levels) of innate immunity which then translates into higher antibody and cellular responses to the vaccine antigens. In addition, most of these adjuvants (e.g. MF59, AS03, AS04) clearly induce a wider breadth of adaptive responses able to confer protection against, for example, heterovariants of the influenza viruses (MF59, AS03) or against human papillomavirus strains not contained in the vaccine (AS04). Finally, the use of some of these adjuvants has contributed to significantly enhance the immune response and the efficacy and effectiveness of vaccines in the elderly who experience a waning of the immune responsiveness to infection and vaccination, as shown for MF59- or AS03-adjuvanted influenza vaccines and AS01-adjuvanted herpes zoster vaccine. These results, together with the track record of acceptable safety profiles of the adjuvanted vaccines, pave the way for the development of novel vaccines at the extremes of age and against infections with a high toll of morbidity and mortality. Here, we review the mechanisms associated with the performance of those adjuvanted vaccines in animal models and in humans through recent advances in systems vaccinology and biomarker discovery. We also provide some perspectives on remaining knowledge gaps but also on opportunities that could accelerate the development of new vaccines.


Assuntos
Adjuvantes Imunológicos/farmacologia , Herpes Zoster/prevenção & controle , Imunidade Celular/efeitos dos fármacos , Imunogenicidade da Vacina , Influenza Humana/prevenção & controle , Infecções por Papillomavirus/prevenção & controle , Adjuvantes Imunológicos/química , Idoso , Animais , Combinação de Medicamentos , Herpes Zoster/imunologia , Herpes Zoster/virologia , Humanos , Imunidade Humoral/efeitos dos fármacos , Influenza Humana/imunologia , Influenza Humana/virologia , Lipossomos/administração & dosagem , Lipossomos/química , Lipossomos/imunologia , Infecções por Papillomavirus/imunologia , Infecções por Papillomavirus/virologia , Polissorbatos/química , Polissorbatos/farmacologia , Esqualeno/química , Esqualeno/farmacologia , Células Th1/efeitos dos fármacos , Células Th1/imunologia , Células Th1/microbiologia , Células Th2/efeitos dos fármacos , Células Th2/imunologia , Células Th2/microbiologia , Vacinas Virais/administração & dosagem , Vacinas Virais/química , Vacinas Virais/imunologia , alfa-Tocoferol/química , alfa-Tocoferol/farmacologia
15.
Pathog Dis ; 76(3)2018 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-29718176

RESUMO

Many of the deadliest bacterial diseases that plague humanity in the modern age are caused by bacterial biofilms that produce chronic infections. However, most of our knowledge of the host immune response comes from the study of planktonic pathogens. While there are similarities in the host response to planktonic and biofilm bacteria, specific immune responses toward biofilms have not been well studied; the only apparent difference is the inability to clear the bacteria allowing the biofilm infection to become chronic. In some cases, the biofilms skew T-cell response toward a balance that allows a stalemate between the host and the pathogen, in which the infection can become persistent. In this minireview, we will summarize well-known examples of this phenomena as well as some emerging studies that may indicate that this situation is much more common than initially thought.


Assuntos
Biofilmes/crescimento & desenvolvimento , Fibrose Cística/imunologia , Interações Hospedeiro-Patógeno/imunologia , Periodontite/imunologia , Infecções por Pseudomonas/imunologia , Pseudomonas aeruginosa/imunologia , Animais , Doença Crônica , Fibrose Cística/microbiologia , Fibrose Cística/patologia , Citocinas/biossíntese , Citocinas/imunologia , Humanos , Imunidade Inata , Camundongos , Periodontite/microbiologia , Periodontite/patologia , Plâncton/crescimento & desenvolvimento , Infecções por Pseudomonas/microbiologia , Infecções por Pseudomonas/patologia , Pseudomonas aeruginosa/patogenicidade , Células Th1/imunologia , Células Th1/microbiologia , Equilíbrio Th1-Th2 , Células Th2/imunologia , Células Th2/microbiologia
16.
Ann Allergy Asthma Immunol ; 121(1): 90-97, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29555351

RESUMO

BACKGROUND: Our previous study found that most Mycoplasma pneumoniae (MP) pneumonia (MPP)patients had elevated serum total immunoglobulin E (IgE) levels. OBJECTIVE: To determine components of MP that can cause an IgE increase in children, and to clarify its specific mechanism. METHODS: The components of MP cells were isolated by serum IgE from patients with MP pneumonia. These components obtained through the prokaryotic expression were used as allergens to detect the proportion of allergen-specific IgE produced in MPP patients, and the clinical characteristics and related immune parameters of these patients who produced this allergen-specific IgE were also analyzed. In addition, a cell experiment was used to verify the biological effect of these components in vitro. RESULTS: P1-specific IgE was detected in serum of MPP children. An approximately 24-kDa polypeptide of P1 protein was obtained through prokaryotic expression purified by nickel agarose affinity chromatography. Approximately 9.2% of MPP patients produced IgE against this polypeptide of P1 protein, which was more likely to be produced in MPP patients with no history of allergies or family history of allergy-related diseases. P1-specific IgE-positive MPP patients had more severe clinical symptoms, with excessive secretion of interleukin (IL)-4 and IL-5 and overdifferentiation of Th0 cells into Th2 cells. Tests also demonstrated that the P1 protein stimulated excessive secretion of IL-4 and IL-5 in peripheral blood mononuclear cells from the peripheral blood of healthy donors. CONCLUSION: Mycoplasma pneumoniae is not only an infectious agent but also an allergen for certain individuals. The P1 protein of MP can induce the production of P1-specific IgE.


Assuntos
Alérgenos/imunologia , Proteínas de Bactérias/imunologia , Imunoglobulina E/biossíntese , Mycoplasma pneumoniae/imunologia , Pneumonia por Mycoplasma/imunologia , Alérgenos/genética , Proteínas de Bactérias/genética , Criança , Pré-Escolar , Clonagem Molecular , Escherichia coli/genética , Escherichia coli/metabolismo , Feminino , Expressão Gênica , Vetores Genéticos/química , Vetores Genéticos/metabolismo , Humanos , Imunoglobulina E/sangue , Lactente , Interleucina-4/genética , Interleucina-4/imunologia , Interleucina-5/genética , Interleucina-5/imunologia , Masculino , Mycoplasma pneumoniae/química , Mycoplasma pneumoniae/patogenicidade , Pneumonia por Mycoplasma/microbiologia , Pneumonia por Mycoplasma/patologia , Estudos Prospectivos , Proteínas Recombinantes/genética , Proteínas Recombinantes/imunologia , Células Th1/imunologia , Células Th1/microbiologia , Células Th2/imunologia , Células Th2/microbiologia
17.
Cell Microbiol ; 20(5): e12826, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29392836

RESUMO

Helicobacter pylori (H. pylori) causes chronic inflammation which is a key precursor to gastric carcinogenesis. It has been suggested that H. pylori may limit this immunopathology by inducing the production of interleukin 33 (IL-33) in gastric epithelial cells, thus promoting T helper 2 immune responses. The molecular mechanism underlying IL-33 production in response to H. pylori infection, however, remains unknown. In this study, we demonstrate that H. pylori activates signalling via the pathogen recognition molecule Nucleotide-Binding Oligomerisation Domain-Containing Protein 1 (NOD1) and its adaptor protein receptor-interacting serine-threonine Kinase 2, to promote production of both full-length and processed IL-33 in gastric epithelial cells. Furthermore, IL-33 responses were dependent on the actions of the H. pylori Type IV secretion system, required for activation of the NOD1 pathway, as well as on the Type IV secretion system effector protein, CagA. Importantly, Nod1+/+ mice with chronic H. pylori infection exhibited significantly increased gastric IL-33 and splenic IL-13 responses, but decreased IFN-γ responses, when compared with Nod1-/- animals. Collectively, our data identify NOD1 as an important regulator of mucosal IL-33 responses in H. pylori infection. We suggest that NOD1 may play a role in protection against excessive inflammation.


Assuntos
Infecções por Helicobacter/genética , Helicobacter pylori/patogenicidade , Interleucina-33/genética , Proteína Adaptadora de Sinalização NOD1/genética , Receptores de Interleucina-13/genética , Animais , Linhagem Celular , Células Epiteliais/microbiologia , Células Epiteliais/patologia , Mucosa Gástrica/imunologia , Mucosa Gástrica/microbiologia , Infecções por Helicobacter/imunologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/genética , Helicobacter pylori/imunologia , Humanos , Imunidade nas Mucosas/genética , Inflamação/genética , Inflamação/imunologia , Inflamação/microbiologia , Interferon gama/genética , Camundongos , Células Th2/imunologia , Células Th2/microbiologia
18.
Nutrients ; 9(10)2017 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-29023393

RESUMO

Consumption of the probiotic bacteria LactobacillusrhamnosusLGG and flavanol-rich cocoa have purported immune modulating effects. This study compared the host response to infection with Ascaris suum in three-month-old pigs fed a standard growth diet supplemented with a vehicle control: LGG, cocoa powder (CP) or LGG + CP. Pigs were inoculated with infective A. suum eggs during Week 5 of dietary treatment and euthanized 17 days later. Lactobacillus abundance was increased in pigs fed LGG or LGG + CP. Specific anti-A. suum IgG2 antibodies were decreased (p < 0.05) in LGG + CP-fed pigs compared to pigs fed CP alone. Pigs fed LGG had significantly reduced expression (p < 0.05) of Eosinophil peroxidase (EPX), Interleukin 13 (IL-13), Eotaxin 3 (CCL26), Toll-like receptor 2 (TLR2), TLR4, and TLR9 and Interleukin-1Beta (IL1B) in the tracheal-bronchial lymph node (TBLN) independent of CP treatment. These results suggested that feeding LGG significantly reduced the localized prototypical Th2-related markers of infection with A. suum in the TBLN. Although feeding CP does not appear to affect the A. suum-induced Th2-associated cytokine response, feeding LGG + CP reduced anti-A. suum antibodies and delayed intestinal expulsion of parasitic larvae from the intestine.


Assuntos
Anticorpos Anti-Helmínticos/sangue , Antinematódeos/farmacologia , Ascaríase/prevenção & controle , Ascaris suum/imunologia , Cacau , Chocolate , Flavonóis/farmacologia , Intestinos/efeitos dos fármacos , Lacticaseibacillus rhamnosus/fisiologia , Probióticos , Células Th2/efeitos dos fármacos , Ração Animal , Animais , Antinematódeos/isolamento & purificação , Ascaríase/imunologia , Ascaríase/microbiologia , Ascaríase/parasitologia , Cacau/química , Células Cultivadas , Modelos Animais de Doenças , Fezes/microbiologia , Fezes/parasitologia , Flavonóis/isolamento & purificação , Microbioma Gastrointestinal , Interações Hospedeiro-Patógeno , Intestinos/imunologia , Intestinos/microbiologia , Intestinos/parasitologia , Linfonodos/efeitos dos fármacos , Linfonodos/imunologia , Linfonodos/microbiologia , Linfonodos/parasitologia , Macrófagos Alveolares/efeitos dos fármacos , Macrófagos Alveolares/imunologia , Macrófagos Alveolares/microbiologia , Macrófagos Alveolares/parasitologia , Contagem de Ovos de Parasitas , Sus scrofa , Células Th2/imunologia , Células Th2/microbiologia , Células Th2/parasitologia , Fatores de Tempo
19.
Microb Pathog ; 110: 7-13, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28629726

RESUMO

Brucellosis is an important zoonotic disease caused by Brucella species. The disease is difficult to control due to the intracellular survival of the bacterium and the lack of precise understanding of pathogenesis. Despite of continuous researches on the pathogenesis of Brucella spp. infection, there is still question on the pathogenesis, especially earlier immune response in the bacterial infection. Malate dehydrogenase (MDH), elongation factor (Tsf), and arginase (RocF), which showed serological reactivity, were purified after gene cloning, and their immune modulating activities were then analyzed in a murine model. Cytokine production profiles were investigated by stimulating RAW 264.7 cells and naïve splenocytes with the three recombinant proteins. Also, immune responses were analyzed by ELISA and an ELIspot assay after immunizing mice with the three proteins. Only TNF-α was produced in stimulated RAW 264.7 cells, whereas Th1-related cytokines, IFN-γ and IL-2, were induced in naïve splenocytes. In contrast, Th2-type immune response was more strongly induced in antigen-secreting cells in the splenocytes obtained 28 days after immunizing mice with the three proteins, as were IgM and IgG. The induction of Th2-related antibody, IgG1, was higher than the Th1-related antibody, IgG2a, in immunized mice. These results suggest that the three proteins strongly induce Th2-type immune response in vivo, even though Th1-related cytokines were produced in vitro.


Assuntos
Antígenos de Bactérias/imunologia , Arginase/imunologia , Brucella abortus/imunologia , Brucelose/imunologia , Imunidade Celular , Malato Desidrogenase/imunologia , Fatores de Alongamento de Peptídeos/imunologia , Células Th2/microbiologia , Animais , Anticorpos Antibacterianos/imunologia , Antígenos de Bactérias/genética , Arginase/genética , Linfócitos B , Proteínas de Bactérias/genética , Proteínas de Bactérias/imunologia , Brucella abortus/química , Brucella abortus/genética , Brucelose/microbiologia , Citocinas/imunologia , Citocinas/metabolismo , DNA Bacteriano , Ensaio de Imunoadsorção Enzimática , Feminino , Regulação Bacteriana da Expressão Gênica , Genes Bacterianos/genética , Vetores Genéticos , Imunização , Imunoglobulina G , Imunoglobulina M , Interferon gama/metabolismo , Interleucina-2/metabolismo , Malato Desidrogenase/genética , Camundongos , Camundongos Endogâmicos BALB C , Óxido Nítrico/metabolismo , Fatores de Alongamento de Peptídeos/genética , Células RAW 264.7/imunologia , Proteínas Recombinantes/imunologia , Proteínas Recombinantes/isolamento & purificação , Células Th1/imunologia , Fator de Necrose Tumoral alfa/imunologia , Fator de Necrose Tumoral alfa/metabolismo
20.
Immunology ; 152(1): 13-24, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28543817

RESUMO

Type 2 diabetes mellitus(DM) is a major risk factor for the development of active pulmonary tuberculosis (TB), with development of DM pandemic in countries where TB is also endemic. Understanding the impact of DM on TB and the determinants of co-morbidity is essential in responding to this growing public health problem with improved therapeutic approaches. Despite the clinical and public health significance posed by the dual burden of TB and DM, little is known about the immunological and biochemical mechanisms of susceptibility. One possible mechanism is that an impaired immune response in patients with DM facilitates either primary infection with Mycobacterium tuberculosis or reactivation of latent TB. Diabetes is associated with immune dysfunction and alterations in the components of the immune system, including altered levels of specific cytokines and chemokines. Some effects of DM on adaptive immunity that are potentially relevant to TB defence have been identified in humans. In this review, we summarize current findings regarding the alterations in the innate and adaptive immune responses and immunological mechanisms of susceptibility of patients with DM to M. tuberculosis infection and disease.


Assuntos
Imunidade Adaptativa , Antígenos de Bactérias/imunologia , Linfócitos T CD4-Positivos/imunologia , Diabetes Mellitus Tipo 2/imunologia , Imunidade Inata , Mycobacterium tuberculosis/imunologia , Estado Pré-Diabético/imunologia , Tuberculose/imunologia , Animais , Linfócitos T CD4-Positivos/microbiologia , Comorbidade , Diabetes Mellitus Tipo 2/epidemiologia , Modelos Animais de Doenças , Humanos , Estado Pré-Diabético/epidemiologia , Prognóstico , Fatores de Risco , Linfócitos T Reguladores/imunologia , Linfócitos T Reguladores/microbiologia , Células Th1/imunologia , Células Th1/microbiologia , Células Th17/imunologia , Células Th17/microbiologia , Células Th2/imunologia , Células Th2/microbiologia , Tuberculose/epidemiologia
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