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Abstract

Mycobacterium tuberculosis has a penetrance of its host population that would be the envy of most human pathogens. About one-third of the human population would have a positive skin test for the infection and is thus thought to harbor the bacterium. Globally, 22 “high-burden” countries account for more than 80% of the active tuberculosis cases in the world, which shows the inequitable distribution of the disease. There is no effective vaccine against infection, and current drug therapies are fraught with problems, predominantly because of the protracted nature of the treatment and the increasing occurrence of drug resistance. Here we focus on the biology of the host-pathogen interaction and discuss new and evolving strategies for intervention.

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References and Notes

1
Flynn J. L., Chan J., What’s good for the host is good for the bug. Trends Microbiol. 13, 98 (2005).
2
Russell D. G., Who puts the tubercle in tuberculosis? Nat. Rev. Microbiol. 5, 39 (2007).
3
Russell D. G., Cardona P. J., Kim M. J., Allain S., Altare F., Foamy macrophages and the progression of the human tuberculosis granuloma. Nat. Immunol. 10, 943 (2009).
4
Via L. E., et al., Tuberculous granulomas are hypoxic in guinea pigs, rabbits, and nonhuman primates. Infect. Immun. 76, 2333 (2008).
5
Kaplan G., et al., Mycobacterium tuberculosis growth at the cavity surface: A microenvironment with failed immunity. Infect. Immun. 71, 7099 (2003).
6
Eum S. Y., et al., Neutrophils are the predominant infected phagocytic cells in the airways of patients with active pulmonary TB. Chest 137, 122 (2010).
7
Barry C. E., et al., The spectrum of latent tuberculosis: Rethinking the biology and intervention strategies. Nat. Rev. Microbiol. 7, 845 (2009).
8
Dietrich J., Doherty T. M., Interaction of Mycobacterium tuberculosis with the host: Consequences for vaccine development. APMIS 117, 440 (2009).
9
MacMicking J. D., et al., Altered responses to bacterial infection and endotoxic shock in mice lacking inducible nitric oxide synthase. Cell 81, 641 (1995).
10
Nathan C., Role of iNOS in human host defense. Science 312, 1874 (2006).
11
Bekker L. G., et al., Immunopathologic effects of tumor necrosis factor alpha in murine mycobacterial infection are dose dependent. Infect. Immun. 68, 6954 (2000).
12
Lin P. L., et al., Tumor necrosis factor neutralization results in disseminated disease in acute and latent Mycobacterium tuberculosis infection with normal granuloma structure in a cynomolgus macaque model. Arthritis Rheum. 62, 340 (2010).
13
Plessner H. L., et al., Neutralization of tumor necrosis factor (TNF) by antibody but not TNF receptor fusion molecule exacerbates chronic murine tuberculosis. J. Infect. Dis. 195, 1643 (2007).
14
Tsenova L., Bergtold A., Freedman V. H., Young R. A., Kaplan G., Tumor necrosis factor alpha is a determinant of pathogenesis and disease progression in mycobacterial infection in the central nervous system. Proc. Natl. Acad. Sci. U.S.A. 96, 5657 (1999).
15
Fortin A., Abel L., Casanova J. L., Gros P., Host genetics of mycobacterial diseases in mice and men: Forward genetic studies of BCG-osis and tuberculosis. Annu. Rev. Genomics Hum. Genet. 8, 163 (2007).
16
Black G. F., et al., BCG-induced increase in interferon-gamma response to mycobacterial antigens and efficacy of BCG vaccination in Malawi and the UK: Two randomised controlled studies. Lancet 359, 1393 (2002).
17
Verma I., Grover A., Antituberculous vaccine development: A perspective for the endemic world. Expert Rev. Vaccines 8, 1547 (2009).
18
Behr M. A., Small P. M., Has BCG attenuated to impotence? Nature 389, 133 (1997).
19
Brandt L., et al., Failure of the Mycobacterium bovis BCG vaccine: Some species of environmental mycobacteria block multiplication of BCG and induction of protective immunity to tuberculosis. Infect. Immun. 70, 672 (2002).
20
Lozes E., et al., Cross-reactive immune responses against Mycobacterium bovis BCG in mice infected with non-tuberculous mycobacteria belonging to the MAIS-Group. Scand. J. Immunol. 46, 16 (1997).
21
Demangel C., Garnier T., Rosenkrands I., Cole S. T., Differential effects of prior exposure to environmental mycobacteria on vaccination with Mycobacterium bovis BCG or a recombinant BCG strain expressing RD1 antigens. Infect. Immun. 73, 2190 (2005).
22
Horwitz M. A., Recombinant BCG expressing Mycobacterium tuberculosis major extracellular proteins. Microbes Infect. 7, 947 (2005).
23
Williams A., et al., Evaluation of vaccines in the EU TB Vaccine Cluster using a guinea pig aerosol infection model of tuberculosis. Tuberculosis (Edinb.) 85, 29 (2005).
24
Grode L., et al., Increased vaccine efficacy against tuberculosis of recombinant Mycobacterium bovis Bacille Calmette-Guérin mutants that secrete listeriolysin. J. Clin. Invest. 115, 2472 (2005).
25
Aguilar D., et al., Immunological responses and protective immunity against tuberculosis conferred by vaccination of BALB/C mice with the attenuated Mycobacterium tuberculosis (phoP) SO2 strain. Clin. Exp. Immunol. 147, 330 (2007).
26
Hinchey J., et al., Enhanced priming of adaptive immunity by a proapoptotic mutant of Mycobacterium tuberculosis.J. Clin. Invest. 117, 2279 (2007).
27
Waters W. R., et al., Failure of a Mycobacterium tuberculosis DeltaRD1 DeltapanCD double deletion mutant in a neonatal calf aerosol M. bovis challenge model: Comparisons to responses elicited by M. bovis bacille Calmette Guerin.Vaccine 25, 7832 (2007).
28
Elvang T., et al., CD4 and CD8 T cell responses to the M. tuberculosis Ag85B-TB10.4 promoted by adjuvanted subunit, adenovector or heterologous prime boost vaccination.PLoS ONE 4, e5139 (2009).
29
Skeiky Y. A., et al., Non-clinical efficacy and safety of HyVac4:IC31 vaccine administered in a BCG prime-boost regimen.Vaccine 28, 1084 (2010).
30
Tchilian E. Z., et al., Immunogenicity and protective efficacy of prime-boost regimens with recombinant (delta)ureC hly+ Mycobacterium bovis BCG and modified vaccinia virus Ankara expressing M. tuberculosis antigen 85A against murine tuberculosis.Infect. Immun. 77, 622 (2009).
31
Vordermeier H. M., et al., Viral booster vaccines improve Mycobacterium bovis BCG-induced protection against bovine tuberculosis.Infect. Immun. 77, 3364 (2009).
32
Whelan K. T., et al., Safety and immunogenicity of boosting BCG vaccinated subjects with BCG: Comparison with boosting with a new TB vaccine, MVA85A.PLoS ONE 4, e5934 (2009).
33
Reed S. G., et al., Defined tuberculosis vaccine, Mtb72F/AS02A, evidence of protection in cynomolgus monkeys.Proc. Natl. Acad. Sci. U.S.A. 106, 2301 (2009).
34
de Noronha A. L., Báfica A., Nogueira L., Barral A., Barral-Netto M., Lung granulomas from Mycobacterium tuberculosis/HIV-1 co-infected patients display decreased in situ TNF production.Pathol. Res. Pract. 204, 155 (2008).
35
Doenhoff M. J., Granulomatous inflammation and the transmission of infection: Schistosomiasis—and TB too? Immunol. Today 19, 462 (1998).
36
Ledru E., Ledru S., Zoubga A., Granuloma formation and tuberculosis transmission in HIV-infected patients.Immunol. Today 20, 336 (1999).
37
Parwati I., van Crevel R., van Soolingen D., Possible underlying mechanisms for successful emergence of the Mycobacterium tuberculosis Beijing genotype strains.Lancet Infect. Dis. 10, 103 (2010).
38
Shamputa I. C., et al., Genetic diversity of Mycobacterium tuberculosis isolates from a tertiary care tuberculosis hospital in South Korea.J. Clin. Microbiol. 48, 387 (2010).
39
Muñoz-Elías E. J., et al., Replication dynamics of Mycobacterium tuberculosis in chronically infected mice.Infect. Immun. 73, 546 (2005).
40
Rees R. J., Hart P. D., Analysis of the host-parasite equilibrium in chronic murine tuberculosis by total and viable bacillary counts.Br. J. Exp. Pathol. 42, 83 (1961).
41
Gill W. P., et al., A replication clock for Mycobacterium tuberculosis.Nat. Med. 15, 211 (2009).
42
Sassetti C. M., Boyd D. H., Rubin E. J., Comprehensive identification of conditionally essential genes in mycobacteria.Proc. Natl. Acad. Sci. U.S.A. 98, 12712 (2001).
43
Sassetti C. M., Rubin E. J., Genetic requirements for mycobacterial survival during infection.Proc. Natl. Acad. Sci. U.S.A. 100, 12989 (2003).
44
McKinney J. D., et al., Persistence of Mycobacterium tuberculosis in macrophages and mice requires the glyoxylate shunt enzyme isocitrate lyase.Nature 406, 735 (2000).
45
Muñoz-Elías E. J., Upton A. M., Cherian J., McKinney J. D., Role of the methylcitrate cycle in Mycobacterium tuberculosis metabolism, intracellular growth, and virulence.Mol. Microbiol. 60, 1109 (2006).
46
Pandey A. K., Sassetti C. M., Mycobacterial persistence requires the utilization of host cholesterol.Proc. Natl. Acad. Sci. U.S.A. 105, 4376 (2008).
47
Upton A. M., McKinney J. D., Role of the methylcitrate cycle in propionate metabolism and detoxification in Mycobacterium smegmatis.Microbiology 153, 3973 (2007).
48
Van der Geize R., et al., A gene cluster encoding cholesterol catabolism in a soil actinomycete provides insight into Mycobacterium tuberculosis survival in macrophages.Proc. Natl. Acad. Sci. U.S.A. 104, 1947 (2007).
49
Yang X., Nesbitt N. M., Dubnau E., Smith I., Sampson N. S., Cholesterol metabolism increases the metabolic pool of propionate in Mycobacterium tuberculosis.Biochemistry 48, 3819 (2009).
50
Peyron P., et al., Foamy macrophages from tuberculous patients’ granulomas constitute a nutrient-rich reservoir for M. tuberculosis persistence.PLoS Pathog. 4, e1000204 (2008).
51
Rustad T. R., Sherrid A. M., Minch K. J., Sherman D. R., Hypoxia: A window into Mycobacterium tuberculosis latency.Cell. Microbiol. 11, 1151 (2009).
52
Christophe T., et al., High content screening identifies decaprenyl-phosphoribose 2′ epimerase as a target for intracellular antimycobacterial inhibitors.PLoS Pathog. 5, e1000645 (2009).
53
Lin P. L., et al., Early events in Mycobacterium tuberculosis infection in cynomolgus macaques.Infect. Immun. 74, 3790 (2006).
54
Lin P. L., et al., Quantitative comparison of active and latent tuberculosis in the cynomolgus macaque model.Infect. Immun. 77, 4631 (2009).
55
Ly L. H., McMurray D. N., The Yin-Yang of TNFalpha in the guinea pig model of tuberculosis.Indian J. Exp. Biol. 47, 432 (2009).
56
Manabe Y. C., et al., The aerosol rabbit model of TB latency, reactivation and immune reconstitution inflammatory syndrome.Tuberculosis (Edinb.) 88, 187 (2008).
57
Doherty M., Wallis R. S., Zumla A., ; WHO-Tropical Disease Research/European Commission joint expert consultation group, Biomarkers for tuberculosis disease status and diagnosis.Curr. Opin. Pulm. Med. 15, 181 (2009).
58
Doherty T. M., Wallis R. S., Zumla A., Biomarkers of disease activity, cure, and relapse in tuberculosis.Clin. Chest Med. 30, 783– (2009).
59
Loveday M., Thomson L., Chopra M., Ndlela Z., A health systems assessment of the KwaZulu-Natal tuberculosis programme in the context of increasing drug resistance.Int. J. Tuberc. Lung Dis. 12, 1042 (2008).
60
Jones K. D., Hesketh T., Yudkin J., Extensively drug-resistant tuberculosis in sub-Saharan Africa: An emerging public-health concern.Trans. R. Soc. Trop. Med. Hyg. 102, 219 (2008).
61
Pillay M., Sturm A. W., Evolution of the extensively drug-resistant F15/LAM4/KZN strain of Mycobacterium tuberculosis in KwaZulu-Natal, South Africa.Clin. Infect. Dis. 45, 1409 (2007).

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Published In

Science
Volume 328 | Issue 5980
14 May 2010

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Published in print: 14 May 2010

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Acknowledgments

Research in the authors’ laboratories is supported by NIH grants AI067027, AI057086, AI080651, HL055936, and HL100928 (D.G.R.) and AI50732, HL71241, HL092883, and HL075845 (J.L.F.) and by the Intramural Research Program of the NIAID, NIH (C.E.B.). All three authors receive support from the Bill and Melinda Gates Foundation.

Authors

Affiliations

David G. Russell* [email protected]
Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
Clifton E. Barry, 3rd
Tuberculosis Research Section, Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 33 North Drive, Building 33, Room 2W20D, Bethesda, MD 20892, USA.
JoAnne L. Flynn
Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, W1144 Biomedical Science Tower, Pittsburgh, PA 15261, USA.

Notes

*
To whom correspondence should be addressed. E-mail: [email protected]

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