Cell mediated immunity in Chagas' disease. Trypanosoma cruzi antigens induce suppression of the in vitro proliferative response of mononuclear cells.

The partial suppression of the cell-mediated immune response by Trypanosoma cruzi antigens in patients with Chagas' disease is demonstrated in a costimulation assay with T. cruzi antigens and Mycobacterium tuberculosis purified protein derivative (PPD) or Tetanus toxoid (TT). Mononuclear cells from 13 patients with chagasic infection without evidence of heart disease, 10 patients with chagasic cardiomyopathy and 7 healthy blood bank donors were stimulated with antigen A (autoclaved epimastigotes), PPD, TT, PPD + A, PPD + TT and TT + A. The average percentage of suppression induced by costimulation of mononuclear cells with PPD and antigen A was 47.1% in patients with chagasic infection without heart disease (INF), 38.8% in patients with chagasic cardiomyopathy (CDM) and 23.3% in healthy controls. Similar values were observed when living trypomastigotes were used. A costimulatory study with PPD and TT, PPD and A and TT and A was carried out in 8 patients with chagasic infection, in order to evaluate the possibility that this difference could be due to a nonspecific inhibitory effect. The mean suppression induced by TT + PPD was -8.9, with TT + A was 52.7 and with PPD + A was 50.1. The data reported show that T. cruzi antigens induce a specific suppression of the proliferative response of mononuclear cells, that might be relevant to the persistence of the parasite in the host.     

Direct stimulation of monocyte release of interleukin 1 by mycobacterial protein antigens

We examined stimulation of monocyte (MN) release of interleukin 1 (IL 1) by soluble microbial products. MN from tuberculin skin test nonreactive donors incubated with PPD (100 micrograms/ml) released IL 1 activity of 80.5 +/- 33.9 U/ml (mean +/- SD, n = 6), similar to that induced by optimal concentrations of LPS (76.4 U/ml). OKT3-reactive cells were not required for this process. PPD-stimulated IL 1 release by MN did not appear to be due to endotoxin contamination, as 1) PPD contained 0.01% endotoxin, 2) MN incubated in LPS (0.1 micrograms/ml) produced 19.5 +/- 13.9 U/ml, significantly less than PPD (p = 0.03), and 3) addition of polymyxin B (12.5 micrograms/ml) abrogated IL 1 production in response to LPS (0.1 microgram/ml) but had no significant effect on PPD induction of IL 1. Antigen 5, a partially purified cytoplasmic antigen of Mycobacterium tuberculosis, had similar IL 1-inducing effects. Arabinogalactan (a mycobacterial polysaccharide), streptolysin O, and tetanus toxoid did not. Thus, mycobacterial protein antigens directly stimulate MN to release IL 1. This property may be central to the response of the naive host to mycobacterial infection and may play a pathophysiologic role in tuberculosis.     

Th2-type immune response observed in healthy individuals to sonicate antigen prepared from the most prevalent Mycobacterium tuberculosis strain with single copy of IS6110

Different Mycobacterium tuberculosis strains operate different immune evasion strategies for their survival in the host. This mainly depends on the virulence of the strain and the host immune responses. The most virulent strains are actively involved in the transmission, widely spread in the community and induce differential immune responses. We evaluated the immune response of a sonicate antigen prepared from one predominant strain (S7) from M. tuberculosis harbouring a single copy of IS6110. Significant lymphoproliferative response against purified protein derivative from tubercle bacillus (PPD) and H37Rv antigens was observed in PPD positive normal individuals and tuberculosis patients. Interferon-gamma (IFN-gamma) levels against these antigens were significantly increased in normal individuals but not in tuberculosis patients. The antigen S7 showed marginal T-cell proliferation but did not induce IFN-gamma secretion in both groups. Conversely, it induced significantly high levels of cytokine interleukin 4 (IL-4) in normal individuals. The macrophage cytokines, IL-12 and tumour necrosis factor alpha (TNF-alpha), did not show S7 antigen specific stimulation. The intracellular cytokine further confirmed an increase in IL-4(+)/CD4+ T-cells and a decrease in IFN-gamma(+)/CD4+ T-cells upon stimulation. The antibody response showed an increase in IgG and IgA levels against this antigen in normal individuals. These observations suggest that antigen S7 modulates the immune response towards T helper cell type 2 by suppressing T helper cell type 1 protective immune response in PPD positive normal individuals. We speculate that some components of this sonicate antigen are associated with immunosuppressive response.     

Enhancement of nitroblue tetrazolium dye reduction by leucocytes exposed to a factor released from sensitised lymphocytes.

Leucocytes from purified protein derivative (PPD) skin test positive individuals, after exposure to PPD in vitro, show a significant increase in nitroblue tetrazolium (NBT) dye reduction when compared to leucocytes from PPD negative donors. The active principle was shown to be soluble, and was released from lymphocytes after a rapid, immunologically specific interaction with the sensitising antigen.     

Nonspecificity of the Anda A60-tb ELISA test for serodiagnosis of mycobacterial disease.

The conventional methods for the laboratory diagnosis of tuberculosis and other mycobacterial diseases are time consuming and beyond the scope of most of the small and medium-sized hospital facilities. Therefore, there has been considerable interest in the development of a serological method for the detection of antibodies against mycobacteria. We recently evaluated a commercially available ELISA test (Anda Biologicals, Strasbourg, France) that measures antibody levels to A60 antigen, a membrane glycoprotein that is found in most mycobacteria. Of the 123 patients with positive pulmonary cultures for Mycobacterium tuberculosis, 82% had detectable antibodies against the kit antigen. Of the 68 patients with extrapulmonary tuberculosis, 59% yielded positive results. Specimens from 2 of the 12 patients that grew Mycobacterium avium-intracellulare complex, and one each with Mycobacterium fortuitum and Mycobacterium chelonei, were considered significant on the basis of medical history and repeated isolation of the bacterium from clinical specimens, and these patients yielded positive serology. Of the healthy, normal PPD positive and PPD negative controls, 24% gave false positive results.     

Isolation of a 19-kDa mycobacterium,bovis-specific antigen,different from MPB70/80, by chromatofocusing

Two antigens, 19-kDa each, were purified from Mycobacterium bovis culture filtrate protein extract by chromatofocusing. Antigen I had a 4.5 pI, and its amino terminal (DPVDAVINTTCNYGQVVAALNATDP) showed a 100% homology with the hypothetical protein Rv1174c. Antigen II had a pI of 6.0 pI and its amino terminal (GDLVGPGCAEYAAANPTGPASVQGM) showed a 100% homology with M. bovis MPB70/80. Antigen I is a hetero-dimer formed by a glycosylated, 10.5-kDa, monomer and a non-glycosylated 8-kDa monomer with identical amino terminal sequences. Both antigens were recognized by the sera of PPD+ animals, but antigen I did not crossreact with sera of human PPD+ individuals. Antigen I was a weak inducer of lymphocyte proliferation and IFN-gamma production. Our results show that M. bovis expresses a 19 kDa glycoprotein, homologue to the product of M. tuberculosis gen Rv1174c, which may prove useful for bovine TB diagnostic assays.     

Mycobacterium tuberculosis recall antigens suppress HIV-1 replication in anergic donor cells via CD8+ T cell expansion and increased IL-10 levels

Mycobacterium tuberculosis (MTb) is the leading cause of death in the setting of AIDS. MTb enhances the pathogenicity and accelerates the course of HIV disease and, furthermore, infection with HIV-1 increases the risk of reactivation or reinfection with MTb. In this study, we show that host-specific recall responses to one pathogen, MTb, has a direct effect upon the regulation of a second pathogen, HIV-1. Using cells from immunocompetent former tuberculosis (TB) patients who displayed either a persistently positive (responsive) or negative (anergic), delayed-type hypersensitivity (DTH) reaction to intradermal injection of purified protein derivative (PPD), we investigated the effect of recall Ags to MTb upon the replication of HIV-1 primary isolates in vitro. We show that HIV-1 replication of a T cell-tropic isolate was significantly impaired in MTb-stimulated PBMC from PPD-anergic donors. Furthermore, these donors displayed a significant increase in CD8(+) T cells and IL-10 levels and lower levels of IL-2 and TNF-alpha relative to PPD-responsive donors in response to PPD stimulation. Strikingly, CD8(+) T cell depletion and blocking of IL-10 significantly increased HIV-1 replication in these PPD-anergic donors, indicating that an immunosuppressive response to MTb recall Ags inhibits HIV-1 replication in PPD-anergic individuals. Therefore, immunotherapeutic approaches aimed at recapitulating Ag-specific MTb anergy in vivo could result in novel and effective approaches to inhibit HIV-1 disease progression in MTb/HIV-1 coinfection.     

Tuberculin purified protein derivative up-regulates the telomerase activity of peripheral blood mononuclear cells from patients with pulmonary tuberculosis.

Telomerase activity was detectable in cells of tuberculous pleural effusions at high percentage. To investigate the possible role of telomerase in the immune function, we examined the proliferating state and the expression of telomerase activity in peripheral blood mononuclear cells (PBMC) from 13 patients with pulmonary tuberculosis (TB) and 13 healthy volunteers in response to tuberculin purified protein derivative (PPD) challenge. Exposure of cells to phytohemagglutinin (PHA) significantly promoted PBMC proliferation during a 6 day-period in both TB patient and healthy volunteer groups. PPD treatment also significantly promoted PBMC proliferation during a 6 day-period in TB patient group, but had no significant effect in healthy volunteer group. During the same period, telomerase activity was detected in every PHA- and PPD-treated samples of the TB patient group. However, the telomerase activity was not detected in PPD-treated samples from healthy donors and all the untreated samples. Our results indicate that the telomerase activity in PBMC could be induced by PPD stimulation in TB patients. Telomerase activity may thus play a permissive role in cell division and clonal expansion of the immune cells in response to TB.     

Identification of mycobacterial HSP70 reactive human T cell clones discriminating between M. tuberculosis and M. leprae

M. tuberculosis reactive CD4⁺ T cell clones were established from a BCG vaccinated donor and tested for proliferative responses against complex mycobacterial antigens like M. tuberculosis , M. leprae , and PPD, as well as the recombinant M. tuberculosis HSP70 and HSP65 antigens from both M. tuberculosis and M. leprae . This screening permitted the identification of T cell clones specifically recognizing the mycobacterial HSP70 or HSP65 antigen. All HSP65 reactive T cell clones were cross-reactive for M. tuberculosis and M. leprae , whereas three HSP70 reactive T cell clones only recognized M. tuberculosis . In addition, HLA typing and blocking experiments with anti-HLA antibodies revealed that antigen presentation to all M. tuberculosis reactive T cell clones was restricted by HLA-DR3 molecules. We have thereby demonstrated the presence of human T cell specificities directed against the mycobacterial HSP70 antigen that are able to discriminate between M. tuberculosis and M. leprae .     

Trace elements incorporated into the culture medium of Mycobacterium tuberculosis promote the presence of tuberculoprotein C in the preparation of purified protein derivatives

Two purified protein derivatives (PPDs) were prepared from Mycobacterium tuberculosis, H37Ra. One of the PPDs was prepared from the culture filtrate of organisms grown on Proskauer-Beck medium to which trace elements had been added. The other PPD was prepared from the culture filtrate of organisms grown on the same medium but without trace elements, and was used as the control. Comparative skin reactions in sensitized rabbits showed that the PPD prepared from organisms grown in the presence of trace elements was less potent than the control. Since it has long been recognized that of the many tuberculoproteins present in PPD, the C protein (a 44 to 66 kDa protein) was always the least potent fraction when tested in equivalent concentrations in both serological and skin test assays, the possibility existed that the PPD obtained from organisms grown in trace element medium had more of the C protein complex than the control. Comparative studies of these two PPDs in terms of their chemical composition, skin test responses, and electrophoretic profiles obtained by SDS-polyacrylamide gel electrophoresis provide support for this assumption.     

Leukocyte procoagulant activity in man: an in vitro correlate of delayed-type hypersensitivity

Human mononuclear leukocytes generate cell-bound procoagulant activity (LPCA) after incubation with an antigen (mumps or tuberculin) to which the donor was previously sensitized. An inhibitor of coagulation appears to be liberated into the extracellular culture fluid during incubation of leukocytes with the sensitizing antigen. Removal of this activity before measuring LPCA resulted in a reliable test that correlated directly with delayed skin reactivity. The assay was particularly sensitive in that cells from weakly sensitized donors who reacted only to high doses of tuberculin (100 TU) in the delayed skin tests produced detectable LPCA in vitro. By contrast cells from weakly sensitized donors did not react to PPD in the lymphocyte blast transformation test or the direct macrophage migration inhibition factor test. The LPCA assay correlated closely with the blast transformation and MIF tests in which cells were used from more strongly sensitized donors who reacted in skin tests with lower doses of tuberculin (1 or 10 TU). The assays were antigen-specific in that cells from donors sensitive to mumps antigen but not to tuberculin reacted only to mumps antigen in vitro. The assay was extremely reproducible; cells from individual donors reacted to the same extent over a period of 8 mo). We propose that the assay system reported here represents an improved method for the measurement of cell-mediated immunity in vitro because it requires fewer donor cells, is technically simpler, and is more sensitive than previously described methods.     

Long-Lived Memory B-Cell Responses following BCG Vaccination

The role of T-cells in immunity against Mycobacterium tuberculosis (M. tuberculosis) infection has been extensively studied, however, that of B-cells still remains comparatively unexplored. In this study, we determined the presence and frequencies of mycobacteria-specific memory B-cells (MBCs) in peripheral blood from clinically healthy, Bacillus Calmette Guerin (BCG) vaccinated (n = 79) and unvaccinated (n = 14) donors. Purified protein derivative (PPD)-specific MBCs were present in most donors (both vaccinated and unvaccinated) but their frequencies were significantly higher in vaccinated than in unvaccinated donors. MBCs specific for other mycobacterial antigens [antigen-85A (Ag85A), antigen-85B (Ag85B), 6 kDalton early secretory antigenic target (ESAT-6) and the 10 kDalton-culture filtrate protein (CFP-10)] were less prevalent than those recognising PPD. Furthermore, PPD-specific MBCs were detected in BCG vaccinated donors without ESAT-6 and CFP-10 specific responses. Together, these results indicate that BCG vaccination induces long-lived MBC responses. Similar patterns of response were seen when we examined mycobacteria-specific antibody and T-cell responses in these donors. Our data show for the first time that BCG vaccination elicits long-lived mycobacteria-specific MBC responses in healthy individuals, suggesting a more substantial role of B-cells in the response to BCG and other mycobacterial infections than previously thought.     

Murine transfer factor. I. Description of the model and evidence for specificity

A model for studying transfer of delayed-type sensitivity to mice with cellfree materials is described. The results with a particulate antigen (Candida) and 4 soluble protein antigens (PPD, ferritin, cytochrome c, and horseradish peroxidase) suggest that the phenomenon is antigen specific. Identical preparations from the spleens of insensitive donors were not active. This murine model should facilitate characterization of the immunologic and chemical properties of transfer factor.     

Interferon and the cellular immune response: separation of interferon-producing cells from DNA-synthetic cells

Spleen cells from mice were separated by albumin discontinuous density gradient centrifugation into six fractions. Cells from each fraction were cultured with a variety of general mitogens and a specific antigen PPD. The cultures then were assayed for mitogenesis and interferon production. The fraction of cells producing interferon were found to belong to a different population of cells from those undergoing a DNA synthetic response. Treatment of the interferon-producing fraction of cells with anti-theta serum and complement eliminated the interferon-producing capabilities of the remaining cells after exposure to PHA, Con A, and PPD but not after exposure to PWM. The results suggest at least a two-cell requirement for the production of interferon in response to PHA, Con A or PPD stimulation. They also suggest that the interferon-producing cells do not belong to the thymus-dependent lymphocyte subpopulation.     

Detection of a factor suppressing leukocyte migration in the sera of allergy patients following antigen administration]

The effect on donor leukocyte migration of serum obtained from the patients with tuberculosis of the lungs, chronic pneumonia and healthy persons was studied after subcutaneous or intradermal injection of the microbial antigen (PPD, streptococcus and staphylococcus antigen). A factor inhibiting donor leukocyte migration appeared in the blood serum of sensitized individuals after the antigen injection. This factor proved to be localized in the serum fraction III obtained after the gel-filtration of sephadex G-200, and is sorbed by leukocytes.     

Multiplicity of molecules carrying blood-group-I antigen on erythrocyte membranes.

A human serum containing a monoclonal anti-(blood-group I) antibody was used to investigate the distribution of blood-group-I antigen on erythrocyte membrane components. Sodium dodecyl sulphate/polyacrylamide-gel-electrophoresis profiles of immuneprecipitates by using 3H-labelled (by the galactose oxidase/NaB3H4 method) and 125I-labelled solubilized stroma were compared. Different radioactive profiles were revealed by the two radiolabelling methods. In the immunoprecipitates the predominant 125I radioactivity within the gel had the electrophoretic mobility of Band-3 protein (apparent mol.wt. 90 000--100 000), whereas the 3H radioactivity revealed a diffusely migrating component(s) (apparent mol.wt. range 40 000--70 000) in addition to radioactivity compatible with glycolipids at the dye front. The diffusely migrating 3H-labelled component was shown to have a similar electrophoretic mobility to a subpopulation of erythrocyte poly(glycosyl)ceramides with blood-group-I activity.     

BCG—PPD的制备及应用

用三氯醋酸(TCA)和硫酸铵(AS)综合法,由卡介菌苗(BCG)培养滤液中提纯制得卡介菌素纯蛋白衍生物(BCG—PPD)。BCG—PPD的纯度和结核菌素纯蛋白衍生物国际标准(PPD-S)及中国标准(PPD—C)相近,高于加拿大标准(PPD—CT68)和丹麦标准(PPD—RT23)。在BCG免疫豚鼠中,BCG—PPD的皮肤迟发型变态反应(DTH)大于结核菌素纯蛋白衍生物(PPD)的DTH反应。在结核菌感染豚鼠组中,BCG—PPD的DTH反应小于PPD的DTH反应.在检查333名新生儿接种BCG12周后的免疫     

M. leprae and PPD-triggered T cell lines in tuberculoid and lepromatous leprosy

Proliferative responses of peripheral blood mononuclear cells (PBMC) to Mycobacterium leprae and bacillus Calmette Guerin-derived purified protein derivative (PPD) were studied in the presence or absence of interleukin 2 (IL 2) in high M. leprae responders (tuberculoid leprosy patients and healthy subjects) and low M. leprae responders (lepromatous leprosy patients). High responders in most cases developed a strong proliferative response to both antigens in the absence of IL 2. Additional IL 2 and restimulation with antigen plus autologous antigen-presenting cells (APC) allowed the derivation of antigen-specific T cell lines. The lines were assayed for proliferative responses to several mycobacterial antigens. Both PPD and M. leprae-triggered T cell lines exhibited a good proliferative response to either antigen and showed in addition a broad cross-reactivity with other mycobacteria, suggesting a preferential T cell response to epitopes shared by several mycobacterial species. Within the lepromatous group, 50% of the patients studied could mount a proliferative response to PPD antigen in the absence of IL 2, but none of them was able to do so with M. leprae antigen. The addition of IL 2 increased the number of positive responders to PPD in this group, and in some patients IL 2 was able to restore M. leprae reactivity as well, suggesting that IL 2 had overcome a suppressor mechanism. PPD and M. leprae-triggered T cell lines were obtained from these subjects (with IL 2 added from the beginning of the culture when required). M. leprae lines exhibited variable and unstable pattern of specificity, most lines exhibiting, at least transiently, a cross-reactive response to other mycobacteria, but some displaying only M. leprae-specific response. In contrast, PPD lines from these subjects consistently exhibited a good response to PPD, a lesser response to various other mycobacteria and no response to M. leprae, a pattern differing from that obtained with PPD lines of high M. leprae responders. Co-cultures of irradiated lepromatous PPD triggered T cell lines with fresh autologous PBMC non-specifically reduced the proliferative response of the latter to PPD, as well as to unrelated antigens. A similar suppression was also observed when PPD lines from one of the tuberculoid patients were assayed. PPD and M. leprae T cell lines from both high and low responders initially exhibited the same CD4+ CD8- phenotype. In all cases, antigenic specificity declined and could not be maintained after 5 to 8 wk of continuous culture, a change associated with the progressive appearance of CD8+ and Leu8+ cells.     

Loss of cellular immune reactivity during acute Plasmodium falciparum malaria

Sixteen patients suffering from acute Plasmodium falciparum malaria were studied. All were residents of an area of unstable malaria-transmission in Eastern Sudan. Blood-samples were drawn at diagnosis, and 7 and 30 days later. Blood-samples from thirteen donors, drawn outside the malaria transmission season 5 months prior to the attack, were included in the study. Lymphoproliferative responsiveness to purified soluble malarial antigens and to the unrelated antigen PPD was lost during the acute phase of the disease in most donors, but was regained during convalescence, except in four donors recrudescing or reinfected by day 30. In contrast to the suppression of antigenic responses, cellular responses to phytohaemagglutinin (PHA) remained virtually unaffected. All donors showed elevated plasma-levels of soluble IL-2 receptor during the acute phase of the disease which normalized during convalescence. Five donors examined by fluorescence-activated cell sorting (FACS) showed no increase in surface expression of IL-2 receptor on peripheral lymphocytes. The data indicate that acute P. falciparum malaria causes a depletion of antigen-reactive T-cells from the peripheral circulation, probably due to homing of this cell-population to lymphoid tissues. It was also found that acute-phase plasma was suppressive to PPD-induced proliferative responses, indicating an additional suppressive mechanism operating in vivo.     

Inhibition of in vitro lymphocyte proliferation by brain glycoprotein (NSA3) and mesenchyme-associated antigen (MAA)

Summary Two cross-reacting antigens, one (NSA₃) associated with nervous system and the other (MAA) present in mesenchyme and different types of tumors, were shown to inhibit the mitogenic effect of PHA, Con-A, and PPD on normal peripheral human lymphocytes. They do not affect the response to allogeneic cells in the one-way mixed lymphocyte reaction. The two antigens also suppress in vitro response to PPD obtained with lymphocytes isolated from BCG-treated patients. The lack of effect on unstimulated lymphocytes and on MLR allows the exclusion of cytotoxic action by our antigen preparations. These data, taken in conjunction with previously obtained results concerning inhibition of E active rosette formation, give rise to the hypothesis of an antigen action directed against a T cell subpopulation. These results also suggest that MAA, in association with other tissue and tumor factors, could play a role in tumor-induced immunosuppression.