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Study of DTH and resistance in Mycobacterium lepraemurium infection using a T-cell line isolated from mice infected with Mycobacterium bovis (BCG).

A T-cell line of mixed phenotype (60% L3T4+, 40% Lyt-2+) was isolated from mice infected with Mycobacterium bovis (BCG). This line responded to M. lepraemurium and BCG but not to M. leprae and produced TCGF spontaneously. It also produced factors which stimulated macrophages to secrete hydrogen peroxide and superoxide anion. In vivo studies showed that only L3T4+ cells were required to transfer DTH responses and that Lyt-2+ cells suppressed this response. Both L3T4+ and Lyt-2+ cells were required to inhibit M. lepraemurium multiplication in vivo.

Animals↗

Mycobacterium infection directly observed in a surgical outpatient centre.

BACKGROUND: This study aims to check the presence and the role of the Mycobacterium tuberculosis infection, in an Ambulatory and Day Surgery Out-Patient Centre. METHODS: Two periods of activity in this Centre are evaluated corresponding separately to the years 1989-1993 and 1994-1998 and the total number of patients, coming for examination, ambulatory or day surgery, hospitalization, postoperative follow-up, is considered, in order to identify the number of cases and the clinical signs of this disease. All cases were examined by the same team and the checks were completed, in the selected cases in which it was advisable, with radiological, bacteriological, bioptical, radiometrical exams and with the Elisa test (after informed consent). RESULTS: In the first period 1989-1993, 21,220 patients were examined and no case of tubercular infection was observed. In 1994-1998, 24,347 patients were examined and 4 cases of tubercular infection detected, which represent 0.016% of the patients attending the service. The clinical cases are as follows. Case 1: right sub-mammary lump, diameter 7 x 5 cm, smooth, oval, firm. Case 2: right breast swelling, diameter 5 cm, not sore, with deep attachments. The mammography and ultrasound scan indicate: the opacity is compatible with mali moris breast lesion. Case 3: coloured, immigrant, who presents back swelling, diameter 8 cm, with fluctuation. CT of the chest indicates opacity near left latissimus dorsi muscle, diameter 10 cm, without bronchopleural connections. Case 4: bleeding neoplastic ulcer of the wrist. At physical exam a right subclavear amphoric breath sound is noticed, corresponding at chest X-ray to an opacity including cavitation. In the 4 cases no lymph node in the regional effusion areas is detected. In the 4 cases surgical therapy is integrated with antituberculous chemotherapy till 6 months after operation. CONCLUSIONS: Mycobacterium tuberculosis infection has been increasing in the second group of years considered, as it is observed in European industrialized countries and North America. This increase corresponds to 0.016% in 24,374 patients examined in the period 1994-98. This infection must not be connected with the classic sites and traditional primary and post-primary symptons, but must be considered and identified in a surgical hospital out-patient centre, in unusual sites, sometimes masquerading as a false positive carcinoma, in patients with predisposition, because of old age, race, immunodepression (also if HIV negatives), resistance to treatment, previous tuberculous infection. In the cases identified deep diagnostic definition, the surgical treatment and a prolonged antituberculous chemotherapy are necessary.

Abscess↗

[Prevention of atypical mycobacterium infections in immunocompromised patients].

Unusual before AIDS epidemic, non tuberculosis mycobacterial infections were observed in HIV-infected patients with CD4 cells count less than 75/mm3. Primary prophylaxis with rifabutin, clarithromycin or azythromycin may be used. Secondary prophylaxis are necessary with association of two or three drugs among clarithromycin, azythromycin, ethambutol and rifabutin. In immunocompromised patients, without HIV infection, risk of disseminated infection seems lower, but no study evaluate it.

AIDS-Related Opportunistic Infections↗

Role of type I cytokines in host defense against Mycobacterium avium infection.

Mycobacterium avium is a human pathogen that causes infection in immunocompetent as well as immunocompromised patients. Infection is acquired both by the respiratory and gastrointestinal routes, and bacterial invasion of mucosal epithelial cells is characteristic. M. avium crosses the mucosal barrier without triggering substantial inflammatory response. Once in the intestinal submucosa or in the alveolar space M. avium infects macrophages. Intracellular bacteria block the production of cytokines involved in the host response against the infection, such as TNF-alpha and IL-12, and suppress antigen presentation by the macrophage. Innate response against the infection is effective to certain extent but the ability of the bacterium to remain "silent" for a period of time prevents neutrophil and NK cells from effectively controlling the establishing of the infection. CD4+ T cells as well as CD8+ T cells are activated, although only CD4+ T cells appear to be effective in inducing anti-M. avium activity in macrophages. M. avium-specific CD8+ T cells undergo apoptosis early in the infection. Therefore, the immune mechanisms of the host and bacterial strategies for survival are complex and fascinating.

Antigen Presentation↗

Antibodies to 68, 52, and 48 kd proteins of Mycobacterium avium in serum samples from patients with Mycobacterium avium infection.

Mycobacterium avium complex (MAC) is responsible for the highest incidence of disseminated bacterial infection in patients with AIDS. Disease caused by this organism was originally thought to be rare in nonimmunocompromised individuals, but it is now being encountered more frequently. Relatively little is known about the components that play a role in the immunopathology of infection caused by MAC. To identify the immunoreactive antigens of this organism that are important targets of the humoral immune response in MAC infection, serum samples from MAC-infected and non-MAC-infected patients were analyzed by Western Blot analysis with sonic extracts of M. avium (MA) as the antigen. The MAC-infected population included patients who were HIV-negative as well as patients with AIDS, and the non-MAC-infected population included non-AIDS, HIV-positive patients and normal, purified protein derivative-negative individuals. The immunodominant antigens recognized by the MAC-infected patients were the 68, 52, and 48 kd proteins of MA. These antigens were also recognized by a few of the non-MAC-infected patients. However, significant differences were observed between the number of MAC-infected and non-MAC-infected patients reacting with these antigens. Sixty-nine percent of the MAC-infected patient serum samples were found to react with the 68 kd antigen, whereas only 24% of the serum samples from patients without MAC infection recognized this antigen (p < 0.001). Of the MAC-infected serum samples, 53.1% were found to react with the 52 kd antigen, whereas only 22% of the non-MAC-infected patient serum samples reacted with this antigen (p = 0.008).(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗

Mycobacterium marinum infections.

Mycobacterium marinum is a saprophytic mycobacteria capable of causing soft tissue infection in humans, usually acquired by inoculation. As with other mycobacterial infections, diagnosis may be difficult and recent developments in molecular biology are also being applied to atypical mycobacteria such as Mycobacterium marinum.

Journal Article↗

[Therapeutic efficacy of a benzoxazinorifamycin, KRM-1648, administered at the different periods of infection in Mycobacterium intracellulare--infected mice].

Therapeutic efficacy of a newly synthesized benzoxazinorifamycin, KRM-1648, administered at the different periods of infection in Mycobacterium intracellulare-infected mice was studied. Mice were infected intravenously with M. intracellulare (9.8 x 10(6) CFU/mouse) and then were given 0.4 mg of KRM-1648 emulsified in 2.5% gum arabic-0.2% Tween 80 by gavage, once daily six times per week, from day 1 to week 4, week 2 to week 6, week 4 to week 8, and week 8 to the end of experiment (week 12). Judgement of the therapeutic efficacy of the drug against the infection was done on the basis of incidence and degree of gross lung lesions, % organ weight (organ weight/body weight x 100), and bacterial loads in the lungs and spleen. The lung lesions were not observed in the control and KRM-treated mice at 4 weeks after infection (KRM treatment: day 1 to week 4). At 6 weeks after infection (KRM treatment: week 2 to week 6), the lung lesions were observed in all control mice, whereas 3 of the 5 mice given KRM-1648 did not show the lesions. At 8 weeks after infection (KRM treatment: week 4 to week 8), the lung lesions were observed in all control and KRM-1648-treated mice, but the degree of the lung lesions was much more slight in mice given KRM-1648 than in control mice. The incidence and the degree of the lung lesions at 12 weeks after infection (KRM treatment: week 8 to week 12) was not different in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Serum antibody reactivity to recombinant mig and whole cell antigens in Mycobacterium avium infection.

Mycobacterium avium is a significant opportunistic pathogen in immunocompromised patients. Moreover, the prevalence of infections in patients without known predisposing conditions has also been increasing in recent years. Patients would greatly benefit from early diagnosis of disseminated infection. Serodiagnostic tests have already been promising in tuberculosis and immunocompetent patients but studies in HIV-infected patients and humoral response to M. avium antigens resulted in conflicting data. We have evaluated the use of the phagocytosis-induced MIG protein of M. avium as a diagnostic antigen. Serum antibody levels of M. avium-infected, HIV-negative patients were significantly elevated for the recombinant MIG (p < 0.001) and also for M. avium whole-cell antigens (p < 0.025) as compared to controls. In contrast, HIV-infected patients with disseminated M. avium infection demonstrated also elevated levels of antibody for the whole-cell antigen (p < 0.00001) but a decreased reactivity for the MIG antigen (p < 0.007). The recombinant antigen proved to have no cross-reactivity with M. tuberculosis antigens as antibody levels were decreased in tuberculosis patients (p < 0.001). Therefore, a simultaneous serological test using recombinant MIG and the whole cell antigens might be helpful in the sometimes problematic diagnosis of M. avium infections in patients without predisposing conditions.

Antibodies, Bacterial↗