Cha Seung Bin, Jeon Bo Young, Kim Woo Sik, Kim Jong-Seok, Kim Hong Min, Kwon Kee Woong, Cho Sang-Nae, Shin Sung Jae, Koh Won-Jung
Department of Microbiology, Institute for Immunology and Immunological Diseases, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea.
Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju, South Korea.
PLoS One. 2015 Sep 25;10(9):e0139251. doi: 10.1371/journal.pone.0139251. eCollection 2015.
The latency and reactivation of Mycobacterium tuberculosis infection has been well studied. However, there have been few studies of the latency and reactivation of Mycobacterium avium complex (MAC), the most common etiological non-tuberculous Mycobacterium species next to M. tuberculosis in humans worldwide. We hypothesized that latent MAC infections can be reactivated following immunosuppression after combination chemotherapy with clarithromycin and rifampicin under experimental conditions. To this end, we employed a modified Cornell-like murine model of tuberculosis and investigated six strains consisting of two type strains and four clinical isolates of M. avium and M. intracellulare. After aerosol infection of each MAC strain, five to six mice per group were euthanized at 2, 4, 10, 18, 28 and 35 weeks post-infection, and lungs were sampled to analyze bacterial burden and histopathology. One strain of each species maintained a culture-negative state for 10 weeks after completion of 6 weeks of chemotherapy, but was reactivated after 5 weeks of immunosuppression in the lungs with dexamethasone (three out of six mice in M. avium infection) or sulfasalazine (four out of six mice in both M. avium and M. intracellulare infection). The four remaining MAC strains exhibited decreased bacterial loads in response to chemotherapy; however, they remained at detectable levels and underwent regrowth after immunosuppression. In addition, the exacerbated lung pathology demonstrated a correlation with bacterial burden after reactivation. In conclusion, our results suggest the possibility of MAC reactivation in an experimental mouse model, and experimentally demonstrate that a compromised immune status can induce reactivation and/or regrowth of MAC infection.
结核分枝杆菌感染的潜伏期和再激活已得到充分研究。然而,对于鸟分枝杆菌复合群(MAC)的潜伏期和再激活的研究却很少,MAC是全球人类中仅次于结核分枝杆菌的最常见的非结核分枝杆菌病原体。我们假设在实验条件下,克拉霉素和利福平联合化疗后免疫抑制可导致潜伏的MAC感染再激活。为此,我们采用了一种改良的类似康奈尔的小鼠结核病模型,并研究了由两株标准菌株和四株鸟分枝杆菌及胞内分枝杆菌临床分离株组成的六个菌株。在对每个MAC菌株进行气溶胶感染后,每组五到六只小鼠在感染后2、4、10、18、28和35周时安乐死,并采集肺部样本分析细菌载量和组织病理学。每种菌株中的一株在完成6周化疗后10周保持培养阴性状态,但在肺部用 dexamethasone(鸟分枝杆菌感染的六只小鼠中有三只)或柳氮磺胺吡啶(鸟分枝杆菌和胞内分枝杆菌感染的六只小鼠中均有四只)免疫抑制5周后被再激活。其余四株MAC菌株对化疗的反应是细菌载量降低;然而,它们仍处于可检测水平,并在免疫抑制后重新生长。此外,肺部病理学加重与再激活后的细菌载量相关。总之,我们的结果表明在实验小鼠模型中MAC有再激活的可能性,并通过实验证明免疫状态受损可诱导MAC感染的再激活和/或重新生长。