Preparation, Purification, and Stability of Tuberculin

The method used to produce “Connaught” tuberculin purified protein derivative (PPD) is described. The tuberculin PPD for the multiple-puncture method was shown to be stable for at least 24 months at 5 C; tuberculin PPD for the intracutaneous method was shown to be stable at 5 C and 24 C for a period of 18 months in the presence of Tween 80. Evans blue or brillant vital red was added to tuberculin PPD for improved testing by the multiple-puncture method. These tinted tuberculin preparations were found to be as stable as the Connaught tuberculin PPD preparations without dye at 5 C. Freeze-dried tuberculin PPD with Plasdone as an inert base was found to be remarkably stable for a period of at least 24 months at 5, 24, and 37 C.     

Transfer factor—Transfer of tuberculin cutaneous sensitivity in an allogeneic and xenogeneic monkey model

Tuberculin cutaneous sensitivity can be transferred from rhesus monkeys, sensitized to tuberculin using BCG, to rhesus and cynomolgus recipients with viable or disrupted leucocytes, and with a dialysed lysate preparation from 3 × 10⁸ leucocytes. Dialysable transfer factor (TF) using the lyophilized aqueous dialysate of a leucocyte lysate prepared by the freeze-thaw method did not give an active material. Modifications to the preparative method, in that leucocytes from fresh blood were disrupted gently by mechanical shearing forces, the lysate dialysed against a balanced salt solution and injected without lyophilization, yielded an active preparation. Transferred tuberculin (PPD) skin reactivity, confirmed by biopsy, was always less than the reactivity of the donor monkey and lasted for approximately 2–3 months. Although donor monkeys showed good in vitro lymphocyte transformation response to antigen stimulation, recipient monkeys which became skin test positive did not have a concomitant blastogenic response to PPD.     

Preparation of 14C-labeled tuberculin purified protein derivative

(14)C-labeled tuberculin purified protein derivative ((14)C-tuberculin PPD) has been prepared from culture filtrates of Mycobacterium tuberculosis var. hominis grown in a culture medium containing uniformly labeled (14)C-amino acids. With a mixture of (14)C-amino acids (an acid hydrolysate of (14)C-Chlorella protein) in the medium, the recoveries of (14)C in the final product were higher than with (14)C-labeled-l-glutamic acid. (14)C-tuberculin PPD was separated into tuberculoprotein and nucleic acid by paper electrophoresis. The specific radioactivity of tuberculoprotein was substantially greater than that of the nucleic acid. (14)C-tuberculin PPD is advocated as a means to measure the adsorption of tuberculin to glass or other surfaces. It could also prove useful as a means to study the structure and mode of action of tuberculin.     

Proteomic analysis of purified protein derivative of Mycobacterium tuberculosis

Background

Purified protein derivative (PPD) has been used for more than half a century as an antigen for the diagnosis of tuberculosis infection based on delayed type hypersensitivity. Although designated as “purified,” in reality, the composition of PPD is highly complex and remains ill-defined. In this report, high resolution mass spectrometry was applied to understand the complexity of its constituent components. A comparative proteomic analysis of various PPD preparations and their functional characterization is likely to help in short-listing the relevant antigens required to prepare a less complex and more potent reagent for diagnostic purposes.

Results

Proteomic analysis of Connaught Tuberculin 68 (PPD-CT68), a tuberculin preparation generated from M. tuberculosis, was carried out in this study. PPD-CT68 is the protein component of a commercially available tuberculin preparation, Tubersol, which is used for tuberculin skin testing. Using a high resolution LTQ-Orbitrap Velos mass spectrometer, we identified 265 different proteins. The identified proteins were compared with those identified from PPD M. bovis, PPD M. avium and PPD-S2 from previous mass spectrometry-based studies. In all, 142 proteins were found to be shared between PPD-CT68 and PPD-S2 preparations. Out of the 354 proteins from M. tuberculosis–derived PPDs (i.e. proteins in either PPD-CT68 or PPD-S2), 37 proteins were found to be shared with M. avium PPD and 80 were shared with M. bovis PPD. Alignment of PPD-CT68 proteins with proteins encoded by 24 lung infecting bacteria revealed a number of similar proteins (206 bacterial proteins shared epitopes with 47 PPD-CT68 proteins), which could potentially be involved in causing cross-reactivity. The data have been deposited to the ProteomeXchange with identifier PXD000377.

Conclusions

Proteomic and bioinformatics analysis of different PPD preparations revealed commonly and differentially represented proteins. This information could help in delineating the relevant antigens represented in various PPDs, which could further lead to development of a lesser complex and better defined skin test antigen with a higher specificity and sensitivity.     

Antibody response to a sterile filtered PPD tuberculin in <Emphasis Type="Italic">M. bovis</Emphasis> infected and <Emphasis Type="Italic">M. bovis</Emphasis> sensitized cattle

Background  

Bovine tuberculosis, caused by Mycobacterium bovis, afflicts approximately 50 million cattle worldwide and is detected by the tuberculin skin test (TST). While it has long been recognized that purified protein derivative (PPD) tuberculin is composed of a mixture of M. bovis derived protein components, little is known about the quality, relative quantity and identity of the proteins that make up PPD tuberculin. We manufactured a sterile filtered PPD tuberculin (SF-PPD) from a nine-week-old M. bovis culture supernatant in order to characterise the culture filtrate proteins (CFP) which make up M. bovis PPD tuberculin and to compare the antibody response of M. bovis infected versus M. bovis sensitized cattle.     

Tuberculin response of lymphocytes from human skin test nonreactors; evidence for in vitro primary sensitization of T lymphocytes.

Tuberculin-purified protein derivative (PPD) is a B-lymphocyte mitogen in a variety of experimental animals. Although peripheral blood mononuclear cells (PB MNC) from healthy human tuberculin responders consistently responded to PPD by increased incorporation of [³H]thymidine, cell fractionation studies showed this to be due to T-lymphocyte rather than B-cell blastogenesis. Moreover, utilizing thymidine suicide experiments, the T-lymphocyte response could be categorized as antigenic rather than nonspecific mitogenic reactivity. Kinetic studies revealed a delayed peak of PPD-induced thymidine incorporation in PB MNC from tuberculin skin test-negative as compared to skin test-positive donors. This suggested in vitro primary sensitization of T lymphocytes to PPD, which was corroborated in experiments demonstrating tuberculin reactivity of human umbilical-cord blood lymphocytes.     

Retention of 14C-Labeled Tuberculin Purified Protein Derivative in the Skin of Sensitized and Nonsensitized Animals

Tuberculin purified protein derivative labeled with (14)C ([(14)C]PPD) with a biological potency equivalent to the International Standard for tuberculin PPD was used to study the retention of tuberculin PPD in the skin of sensitized and nonsensitized animals. We found that [(14)C]PPD was almost entirely cleared from the skin test site during the first 18 to 24 h after injection and that when approximately 5% of the initial concentration of [(14)C]PPD was present in the skin test site, the size of the tuberculin skin reaction in sensitized guinea pigs was at its maximum. Furthermore, the addition of 5 or 50 mug of Tween 80 per ml to a solution of PPD did not change either the rate of clearance of PPD from the skin test sites of sensitized guinea pigs or the size of the tuberculin skin reactions. There was no difference in the rate of clearance of [(14)C]PPD from the skin test sites between sensitized and nonsensitized guinea pigs and between guinea pigs of different age. However, there was a significant difference in the rate of clearance of [(14)C]PPD between the guinea pig and the mouse. Finally, the percentage of [(14)C]PPD retained in the site of injection at 24 h was in the neighborhood of 5% of the initial concentration of the solution of PPD injected. The significance of these phenomena is discussed.     

Physicochemical and Biological Studies on Various Preparations of Tuberculin Purifield Protein Derivative

Tuberculin purified protein derivative (PPD) has been prepared by seven different precipitation methods from culture filtrate of Mycobacterium tuberculosis var. hominis. It was found to contain 48 to 99% tuberculoprotein, depending on the method of precipitation. The remaining percentage is represented by nucleic acid, polysaccharide, and ash. Activation analysis on tuberculin PPD and on tubercle bacilli has revealed the presence of trace elements. The molecular weight of tuberculin PPD has been found to be of the order of 14,800 to 27,800. The biological activity of tuberculin PPD varies from lot to lot and from method to method. A correlation between its molecular weight and its biological activity seems to exist.     

The utility of the macrophage migration inhibition test for in vitro titration of tuberculins

The purpose of this study was to explore the fundamental principle of the potency estimation of tuberculins, as applied in vitro by the macrophage migration inhibition test (MIT) under agarose. The MIT was performed using specifically sensitized mouse and guinea-pig peritoneal macrophages and serial dilutions of the analogous PPD (purified protein derivatives of tuberculin) tuberculins as antigen. Statistical studies performed included (a) the standard deviation of the mean migration areas, (b) the analysis of variance, (c) the regression analysis, (d) its corresponding linearity test and (e) the determination of the related correlation coefficient. It was shown for the first time and in both animal species under study that there is correspondence between the log dose-response relationship of the tuberculin PPD in MIT under agarose and the well known in tuberculin cutaneous reaction. The MIT may therefore successfully replace the in vivo titration of tuberculins.     

Interpretation of the PPD skin test in BCG-vaccinated children.

Skin testing with 5 tuberculin units (TU) of purified protein derivative (PPD) of tuberculin stabilized with polysorbate (Tween) 80 was done 3 months and 1 year after immunization with bacille Calmette-Guérin (BCG) vaccine in two groups of children: one group vaccinated at birth and another group at age 6 years. Interpretation of the PPD skin test with 5 TU is possible in children 1 year and older vaccinated with BCG at birth: if the diameter of induration is more than 10 to 12 mm the reaction cannot be ascribed to BCG vaccination and is highly suggestive of supervening infection with Mycobacterium tuberculosis or occasionally atypical mycobacteria. In contrast, the interpretation of a PPD test in children vaccinated at age 6 years is extremely difficult.     

Tuberculin Activity of Mycobacterial Fractions Obtained by Chromatography

Commercial purified protein derivatives (PPD), old tuberculin (OT), the bacillary extract, and the culture filtrate of Mycobacterium tuberculosis H37Ra were submitted to Sephadex G-25 and diethylaminoethyl (DEAE)-cellulose chromatography. The ability of the fractions obtained to elicit delayed dermal hypersensitivity in M. tuberculosis H37Ra-infected guinea pigs was studied. Skin tests with Sephadex fractions in M. tuberculosis H37Ra-infected guinea pigs showed that the tuberculin activity was localized in the first fraction. All other Sephadex fractions were nonessential and nonspecifically irritating. Fractions from chromatography of Sephadex G-25 fraction 1 on DEAE-cellulose columns showed that all but the first were able to elicit delayed hypersensitivity reactions. There was a variability in the capacity to elicit the tuberculin reaction according to the fraction injected and the stage of tuberculous infection in guinea pigs. Compared to the others, the seven lots of commercial PPD were variable in composition and content. They contained both essential and nonessential materials for the tuberculin reaction. Sephadex fraction 1 would appear to be a better tuberculin as it excludes nonessential nonspecifically irritating elements and contains the complement able to elicit the tuberculin reaction. Its methodological simplicity would be economically advantageous.     

Cell-mediated response to BCG investigated by leukocyte migration test from an agarose droplet

The modified leukocyte migration test (LMT) from an agarose droplet with the antigen stimulation (by BCG) is proposed in the present work. The BCG concentrations ranging from 1.25 up to 130 mg/l were used to examine 20 tuberculin (PPD) skin test negative and 10 PPD positive patients, which suffered from lung diseases. The optimal concentrations were 6.25 and 25.0 mg/l. The mean index values of a 20 membered control group ranged from 0.7 up to 0.88 when stimulated with the lower BCG concentration, and they were of 0.53 up to 0.69 at higher BCG concentration. In spite of its suitable indicatory properties as to ascertain cell mediated immunity state, the LMT with the BCG were of no use as a tuberculin skin test correlate.     

Potentiation of the in vitro specific cytotoxic response to syngeneic lymphoma cells by PPD-stimulated tuberculin sensitive cells.

Spleen cells from rats immunized with the syngeneic (C58NT)D Gross virus-induced lymphoma have been shown to differentiate into cytotoxic effector cells following secondary in vitro stimulation with tumor cells. In the studies presented here, we evaluated whether cells specifically responding to PPD would increase the development of specific cytotoxic reactivity by a second cell population primed to lymphoma antigen. Mixtures of (C58NT)D-primed and BCG-primed responding cells generated cytotoxic activity to syngeneic lymphoma cells following cocultivation with mitomycin C-treated stimulating (C58NT)D cells; the addition of PPD to these mixtures produced a significant increase in cytotoxicity. The increased antitumor response resulted from an increase in specific cytotoxic activity from primed precursor cells. Responding cells activated with PPD alone in the absence of lymphoma antigen showed no lytic activity. Optimal numbers of tuberculin sensitive cells and concentration of PPD were determined. Evaluation of the kinetics of the generation of the cytotoxic response indicated that the addition of BCG-primed ceils and PPD increased the magnitude of cytotoxicity but did not alter the time course of the generation of cytotoxic activity. The addition of tuberculin sensitive cells and PPD to the in vitro secondary immune response also led to augmentation of generation of cells with antitumor activity detectable in vivo.     

Vaccination with Freeze-Dried BCG

Sixty first-year medical students, negative to 1:2000 and 1:100 dilutions of old tuberculin (OT), were vaccinated with freezedried BCG vaccine. At six months, 98.3% were found to be positive reactors as ascertained by the intracutaneous (Mantoux) method, using 1:2000 and 1:100 dilutions of OT, and 73.7% as ascertained by the Heaf test, using a tuberculin PPD solution containing 100,000 T.U. per ml.     

Isolation of tuberculin peptides from tuberculin purified protein derivative (PPD).

Tuberculin purified protein derivative (PPD) obtained from the filtrate of Mycobacterium tuberculosis was hydrolysed with proteinase, trypsin, or chymotrypsin. Each hydrolysate consisted of a tuberculin peptides mixture (TPM). From each TPM 16 fractions were obtained by ion-exchange chromatography on Dowex 50W-X8 but only one fraction was isolated from each of the 16 fractions which showed tuberculin activity in guinea pigs sensitized with M. bovis (bcg) or M. tuberculosis. This fraction was designated "purified tuberculin peptide" (PTP). The PTP fraction from the proteinase hydrolysate (PTP-proteinase) was rechromatographed on Dowex 1-X2 and two tuberculin peptide fractions having molecular weights of 3200 and 12,000 were isolated. The potency of these two fractions was assessed in guinea pigs sensitized with M. bovis (BCG) and with M. tuberculosis and they were approximately 4 to 7 times more potent than either the international standaCG and of at least equal potency to either PPD-S or Connaught PPD in guinea pigs sensitized with either M. kansasii, M. scrofulaceum, M. intracellulare, or M. avium whereas very little if any cross-reactivity was elicited by these two fractions. This lack of response indicates that either fraction could be used as an aid to differentiate between sensitization due to M. tuberculosis or M. bovis and sensitization attributed to other mycobacteria.     

利用结核分枝杆菌抗原特异性γ-IFN体外释放测定评估抗结核治疗疗效的临床应用价值

探讨利用结核分枝杆菌抗原特异性γ-IFN体外释放测定评估抗结核治疗疗效的临床应用价值。研究了66例培养阳性肺结核病人抗结核治疗过程中抗原特异性γ-IFN体外释放测定结果的变化,并与结核菌素皮试结果的变化相比较。结果,抗原特异性γ-IFN体外释放测定于抗结核治疗前期(满2个月)的阳性率显著高于后期(疗程满6个月)[55/66(83.3%)vs12/66(18.2%);P≤0.01],而PPD结素皮试于抗结核治疗前期及后期的阳性率分别为[50/66(75.8%)vs38/66(57.6%);P>0.05]。结论:结核分枝杆菌抗原特异性γ-IFN体外释放测定评估抗结核治疗疗效较PPD结素皮试临床应用价值更大。     

Interspecies transfer by "immune" RNA of lymphocyte proliferative response to specific antigen

Ribonucleic acid (RNA) extracted from the lymph nodes of BCG sensitized cattle transferred tuberculin sensitivity to normal guinea pig lymphocytes as indicated by increased incorporation in vitro of ³H-thymidine in response to Purified Protein Derivative (PPD). The RNA treated lymphocytes were unresponsive to a nonspecific antigen, histoplasmin. Ribonuclease treatment of the RNA abolished its ability to transfer tuberculin reactivity and RNA extracted from the lymph nodes of normal cattle was also ineffective.     

Interferon and cytotoxic factor (cytotoxin) released in the blood of mice infected with Mycobacterium bovis BCG. III. Interferon and cytotoxin induced by the specific antigen as compared with those induced by bacterial lipopolysaccharide

The time course of development and decline of the ability of BCG-infected mice to produce interferon in the serum in response to the intravenous infection of purified protein derivative of tuberculin (PPD) was very similar to that of their systemic hypersensitivity to PPD. A cytotoxic factor (cytotoxin) was produced in parallel with interferon in the serum of BCG-infected mice after stimulation with PPD. The duration of the period in which cytotoxin-production responsiveness to PPD was definitely detectable was much shorter than that for interferon-production responsiveness although the periods for the maximum production of interferon and cytotoxin coincided. The kinetics of release of interferon in the serum of BCG-infected mice after stimulation with PPD did not parallel that of release of cytotoxin. The four kinds of activities, interferons and cytotoxins induced by PPD and lipopolysaccharide (LPS) in the serum of BCG-infected mice, were compared for their stability to heating at 56 C and to treatment at pH 2. The kinetics of inactivation of these four activities differed significantly, when the serum was either heated at 56 C or treated at pH 2. Interferon produced in response to LPS could be neutralized by anti-L cell(NDV) interferon rabbit serum as easily as L cell (NDV) interferon, 16 times as much antiserum was required to neutralize the same amount of interferon in response to PPD, but cytotoxins induced by PPD and LPS were not neutralized at all by the antiserum. From these findings it is thought likely that interferons and cytotoxins induced by PPD and LPS in the serum of BCG-infected mice are different substances, although the antigenic relationship between cytotoxins induced by PPD and LPS remains unknown.     

Statistical analysis of distribution of antibody level against Mycobacterium bovis antigens for bovine tuberculosis diagnostics

Antibody responses to purified protein derivate PPD of tuberculin and to antigens MPB63 and MPB83 of Mycobacterium bovis were determined in bovine herd (94 adult animals). Statistical approach based on approximation by multiple Gaussians with Levenberg-Marquardt algorithm for analysis of antibody level distribution against antigens examined was provided. Our results confirm that indirect ELISA with recombinant MPB83 and MPB63 as well as conventional PPD could be used for test-systems development for detection of cow tuberculosis infection at the herd level.     

Low molecular mass protein patterns in mycobacterial culture filtrates and purified protein derivatives

Mycobacterial polypeptides from 2 kDa to 14 kDa may be involved in host response to infection and be useful for new diagnostics and vaccines. Tris-tricine SDS-polyacrylamide gel electrophoresis separation of proteins in tuberculin purified protein derivative (PPD) and in 6-8-week culture filtrates of Mycobacterium tuberculosis, Mycobacterium bovis BCG, and other Mycobacterium species demonstrated as many as 10 low molecular mass bands. Common and distinct bands were observed among different species and PPD. These low molecular mass culture filtrate proteins may represent potential diagnostic reagents and vaccines for Mycobacterium tuberculosis.