Induction of cell-mediated immunity to Mycobacterium lepraemurium in susceptible mice.

A mouse strain (CB6) that is highly susceptible to Mycobacterium lepraemurium was infected with 10(8) bacilli into the hind footpad. These mice developed cell-mediated immunity to M. lepraemurium, as expressed by the development of a granulomatous lesion at the site of inoculation in normal but not in T-lymphocyte-depleted mice, a proliferative response in the paracortical zone of the draining lymph node, delayed-type hypersensitivity to a sonic extract of M. lepraemurium, and immunopotentiation of the delayed hypersensitivity response to sheep erythrocytes. Resistance to a second challenge infection with M. lepraemurium was not demonstrated.     

Suppression of immunity to Mycobacterium lepraemurium infection.

After injection of 10(8) live Mycobacterium lepraemurium (MLM) into the left hind footpad of mice, there is development of local swelling attributable to a granuloma of the cell-mediated immunity type. Concomitant intravenous inoculation of live MLM delays and may even suppress footpad swelling, the effects being proportional to the intravenous dose of organisms. Concomitant footpad infection and intravenous inoculation of 10(9) dead MLM also delays footpad swelling, but over a period of months the feet become excessively swollen. The excessive swelling is due to local enhancement of infection as evidenced by an increase in the number of MLM per footpad. Attempts were made to prevent such immunosuppression by splenectomy or treatment with BCG. Splenectomy was entirely without effect, but 10(7) live BCG administered intravenously 2 to 4 weeks before dead MLM prevented enhancement of infection. The mediator of the immunosuppressive mechanism that results in enhanced infection remains to be elucidated, but it is unlikely to be antibody or immune complexes.     

Survival of Mycobacterium lepraemurium in C57BL mice after acquired protective immunity

The protective immune response against Mycobacterium lepraemurium (MLM) in C57BL mice has been shown to stop the increase in bacillary numbers and the dissemination of bacilli, but the acid fast bacilli are not cleared from the tissues. Persistence of viable bacilli was indicated by a significant increase in the number of acid fast bacilli in the footpad of C57BL mice that were treated with cortisone acetate several weeks after the onset of the immune response. Bacilli harvested 9 and 16 days after inoculation into immune C57BL mice showed only a marginally detectable loss of viability as determined by bacillary multiplication after transfer into susceptible C3H mice. Twenty-six weeks after being inoculated into immune C57BL mice a small proportion of the bacilli was found still to be alive. A similar finding was done 15 weeks after primary inoculation of MLM into mice that developed an apparently effective protective immune response 4 weeks after being inoculated. Sixty-seven weeks after inoculation of immunized C57BL mice with MLM, bacillary numbers in the footpad were as with patent immunity, but the bacilli were found to be fully viable, suggesting incipient reactivation of the infection. When bacillary numbers were followed over a period of 52 weeks in the organs of normal C57BL mice inoculated with a low dose of bacilli it was found that after a plateau phase bacillary numbers started to increase again. Thus, in all experiments part of the bacillary population had survived the protective immune response against MLM in C57BL mice.     

Development of delayed-type hypersensitivity during Mycobacterium lepraemurium infection in mice.

Various preparations of Mycobacterium lepraemurium were used to elicit delayed-type hypersensitivity in the footpad of mice infected with this organism. With a sonicated preparation of the mycobacterium, a significant increase in footpad swelling was elicited in mice infected with M. lepraemurium 5 weeks previously, but not in BCG-infected animals or uninfected controls. This footpad reaction was shown to peak at 24 h and to be associated with an infiltration of mononuclear cells. The kinetics of footpad swelling, its association with lymphoproliferation, and its dependence on T lymphocytes were each examined. The results support the hypothesis that this is a delayed-type hypersensitivity reaction. The ability to transfer this reactivity to normal mice with cells but not serum offers further confirmation that this hypersensitivity is dependent on cell-mediated immunological mechanisms rather than humoral antibody. The relevance of this to the study of the immunological response of mice to murine leprosy is discussed.     

Mycobacterium lepraemurium infection of nude athymic (nu/nu) mice.

Nude athymic (nu/nu) mice on a BALB/c background and their heterozygous euthymic litter mates (nu/+) were infected with either 10(8) or 10(6) Mycobacterium lepraemurium organisms intravenously or in the left hind footpad (LHF). After LHF infection with 10(8) M. lepraemurium organisms, nu/+ mice slowly developed a response that consisted of LHF swelling and local resistance to Listeria monocytogenes. The lower inoculum induced a proportionately lower response in nu/+ mice, but the nu/nu mice developed neither LHF swelling nor resistance to L. monocytogenes in response to either dose of M. lepraemurium. Counts of M. lepraemurium in the LHF revealed no difference between the nu/+ mice and nu/nu mice. After intravenous infection the nu/+ mice developed splenomegaly, but did not otherwise differ from nu/nu mice with respect to resistance to intravenous challenge with L. monocytogenes or growth of M. lepraemurium in the spleen. In light of the poor responsiveness of nu/+ mice in this experiment, they were then compared with CB6 and B6D2 mice, which are genetically susceptible and resistant to M. lepraemurium, respectively. These mice were infected with either 10(8) or 10(6) M. lepraemurium cells or 10(6) Mycobacterium bovis BCG cells in the LHF. Once again the nu/+ mice responded poorly to M. lepraemurium, the CB6 mice responded very strongly, and the B6D2 mice gave an intermediate response with respect to LHF swelling and resistance to L. monocytogenes. However, M. lepraemurium grew to higher numbers in the LHF of nu/+ and CB6 mice than in B6D2 mice, revealing, in CB6 mice, a dissociation between resistance to L. monocytogenes and M. lepraemurium. All three mouse strains responded strongly to M. bovis BCG, but there was a suggestion that nu/+ mice might be more susceptible to this agent than the other two strains. I concluded that the failure of nu/+ mice to restrict the growth of M. lepraemurium more than nu/nu mice was due to the intrinsic genetic susceptibility of both types of mice. In effect, the nu/+ mice behaved like nu/nu mice, as if they too were deficient in T lymphocytes that were responsive to M. lepraemurium.     

Protective immunity and delayed-type hypersensitivity in C57BL mice after immunization with live Mycobacterium lepraemurium and sonicated bacilli.

The importance of the mode of antigen presentation (intravenous, oral, or enteral restricted to the lower ileum) in the development of a local immune response and immunological memory for such a response in different parts of the intestine was studied in mice. Cholera toxin was used as antigen and the immune response was assayed by determining both the number of specific antitoxin-containing cells in the lamina propria and protection against experimental cholera. The results showed that all of these routes of antigen presentation could induce significant memory along the entire small intestine. In contrast, the actual production of antitoxin-containing cells or protective immune response elicited by booster immunization was restricted to those parts of the intestine that were directly exposed to antigen; i.e., lower ileum boosting resulted in immunity in the distal ileum but not in the proximal jejunum, whereas oral or intravenous boosting gave a response in both jejunum and ileum. Protection correlated closely with the number of antitoxin-containing cells in the lamina propria (correlation coefficient, 0.88); ≥4,000 antitoxin-containing cells per mm³ conferred solid immunity to cholera toxin-induced diarrhea. The total number of immunoglobulin-containing cells in intestines was not significantly influenced by the specific immunizations. There were four times as many of these cells in the upper jejunum (167,000 cells per mm³) as in the lower ileum, but the proportions of immunoglobulin A-containing cells (80 to 85%), immunoglobulin M-containing cells (14 to 20%), and immunoglobulin G-containing cells (0.4 to 0.9%) were similar in various parts of the intestine. The results indicate a differential dependence on local tissue antigen for the intestinal antibody-secreting cells and their memory cell precursors.     

A histopathological study of pulmonary infection of mice with Mycobacterium lepraemurium

Intranasal instillation of Mycobacterium lepraemurium (MLM) into mice produced pulmonary infection. MLM multiplied rapidly in the lung tissue during the first few weeks without involvement of other organs. The increase in number, size and confluence of lung granulomas paralleled the multiplication of MLM which could be found both intracellularly and extracellularly. It is postulated that extracellular bacteria may find their way to the bloodstream and thus spread to other visceral organs. Extensive destruction of alveoli and occupation of airspaces by lepra-like cells invariably occurred as the disease progressed.     

Induction of immunity against live Mycobacterium lepraemurium: a requirement for viable bacilli?

Live Mycobacterium lepraemurium (MLM) bacilli, bacilli killed by irradiation or heat, and the water-soluble components of ultrasonicated bacilli (MLMSon) were compared as immunizing and eliciting antigens in C57BL mice which are high-responders to live MLM. The latency period preceding the development of a local granulomatous reaction in normal mice inoculated subcutaneously in the footpad with live MLM was reduced, and the reaction became larger when the dose of bacilli was increased. Immunization with MLMSon induced only weak initial reactivity against an inoculum with live bacilli, but the development of stronger reactivity was accelerated and the magnitude of the local reaction that then developed was increased. MLMSon-immunized mice showed some reactivity also against heat-killed bacilli. Killed bacilli caused the development of a small, late local reaction in normal mice, but no local reactivity was detected upon challenge with live and killed MLM in mice immunized with killed bacilli. However, a local reaction was elicited by MLMSon, which was thus a more potent eliciting antigen than intact bacilli, and MLMSon and whole killed bacilli appeared to induce immune reactivity with overlapping antigen specificities. Subcutaneous inoculation with live bacilli induced reactivity against live MLM but not against MLMSon and not against whole killed MLM, except for a transient early (24 hr) reaction elicited only with a large dose of killed bacilli. The development of a lasting local reaction against killed bacilli was found to be suppressed in mice immunized with live bacilli. Live bacilli and dead MLM antigen appeared to have largely different specificities as inducing as well as eliciting antigens.     

Effect of Mycobacterium bovis BCG vaccination upon Mycobacterium lepraemurium infection.

Mice were infected with 10(8) Mycobacterium lepraemurium in the footpad (unsuppressed mice), and some of these animals were concurrently given 10(9) heat-killed M. lepraemurium intravenously (suppressed mice). These groups of mice were preimmunized with 10(7) viable organisms of Mycobacterium bovis BCG by several routes. BCG inhibited the proliferation of M. lepraemurium in the unsuppressed mice, but not in the suppressed mice. In effect, the intravenous administration of heat-killed M. lepraemurium suppressed the immunity to M. lepraemurium that BCG vaccination had engendered. BCG did not protect normal mice against intravenous infection with M. lepraemurium. It appears that normal mice against intravenous infection with M. lepraemurium. It appears that the inhibitory effect of BCG vaccination upon M. lepraemurium infection is due to cross-reactive immunity rather than to nonspecific immunity or immunopotentiation. Thus, the route of BCG vaccination was immaterial, and vaccination 12 weeks before M. lepraemurium infection was as beneficial as vaccination 4 weeks before infection. Moreover, spleen cells from M. lepraemurium-immunized mice conferred adoptive immunity to BCG. The implications of this study for the use of BCG as a prophylactic and therapeutic agent in human leprosy are discussed.     

Antibody-mediated immunity in CFW mice infected with Mycobacterium lepraemurium. Humoral immune response in murine leprosy.

A depression in antibody-mediated immunity (AMI) measured both in terms of circulating antibody and plaque-forming cells in the spleen was observed in CFW mice infected with M. lepraemurium when sheep red blood cells (SRBC) and human gammaglobulin (HGG) were used as antigens. The impairment in AMI was evident only after 75 days of infection thereafter the antibody response to SRBC antigen progressively decreased until the last day of experimentation (135 days). Within the first 60 days of infection no alteration in AMI was observed with the HGG antigen while the response to the SRBC antigen was significantly higher in the infected animals than in uninfected controls.     

Antibacterial resistance in mice infected with Mycobacterium lepraemurium.

The differences in susceptibility among C57Bl/6, DBA/2 mice and their F1 hybrids to infections with M. lepraemurium were shown to depend upon the route of infection and size of the inoculum. A method was developed to measure the ability of lymphocytes obtained from M. lepraemurium-infected donors to effect adoptive immunization of syngeneic naive mice against infection with M. tuberculosis. This required sublethal irradiation of recipient mice prior to cell transfer and bacterial challenge. Using this method, it was found that mice infected subcutaneously generated antituberculous immune mechanisms concordantly with the development of delayed-hypersensitivity to antigens of M. lepraemurium. In contrast, intravenously infected mice demonstrated only a transient from of delayed hypersensitivity and little or no antimycobacterial immunity in that progression of infection was associated with a rapid decay of both these functions. Moreover, during the terminal stage, M. lepraemurium-infected mice lost the ability to control the growth of a sublethal intravenous inoculum of the antigenically unrelated bacterium. Listeria monocytogenes.     

A lack of correlation between antigen-specific cellular reactions and resistance to Mycobacterium lepraemurium infection in mice.

Following infection subcutaneously in the footpad with 10(7) Mycobacterium lepraemurium organisms C57BL mice were able to limit multiplication of organisms at the infection site for the 6 months studied and to limit organism spread to the draining lymph node. Large numbers of organisms were present in the footpad and draining lymph node of BALB/c mice at 6 months. In spite of this difference in local immunity the changes in cellular reactivity to specific antigen as assessed by the delayed footpad response and the in vitro proliferative response of draining lymph node cells were similar in the two strains over the time studied.     

Experimental murine leprosy: induction of immunity and immune paralysis to Mycobacterium lepraemurium in C57BL mice.

Two series of reinfection experiments were carried out using C57BL mice. In the first series, the mice were inoculated with Mycobacterium lepraemurium (MLM) in one hind footpad and reinoculated in the contralateral footpad, two or four weeks later. Compared with normal mice of the same strain, the mice reinoculated after four weeks showed an increased local reaction to the bacilli and the bacilli did not multiply at the injection site. The responses of mice reinoculated after two weeks were intermediate to those of the other two groups. In the second series, a systemic infection was established by intraperitoneal innoculation of either a large or small dose of MLM. Twenty-two weeks later the mice were reinoculated in one of the hind footpads. Upon reinoculation, mice receiving the small intraperitoneal dose reacted more strongly than normal mice to MLM, whereas mice receiving the large dose were unable to mount any local reaction to the mycobacterium. The experiments have shown that the local reaction which develops in the C57BL strain of mice approximately four weeks after subcutaneous injection of MLM is accompanied by the onset of systemic immunity. Such systemic immunity lasted for more than 20 weeks after intraperitoneal injection of a small dose of bacilli, but was completely abolished during the course of a heavy systemic MLM infection.     

Evaluation of phagocytic function in Mycobacterium lepraemurium infection

Infection of mice with Mycobacterium lepraemurium caused significant functional alterations of the mononuclear phagocyte system. Accelerated clearance of sheep red blood cells was consistently demonstrated throughout the infection and the infected mice showed progressive anaemia. Infected mice showed an enhanced ability to limit growth of phagocytosed Listeria monocytogenes in spleens during the early stages of infection, whereas moribund leprous mice lost this ability. Autoradiography showed that uninfected Kupffer cells and splenic macrophages of moribund mice could still phagocytose Listeria, suggesting that MLM infection did not affect the capacity of Listeria to localize to macrophages but interfered in some way with subsequent killing of such bacteria. The possible mechanisms underlying these observations are discussed.     

Relationship between delayed-type hypersensitivity and the progression of Mycobacterium lepraemurium infection.

The relationship between the level of delayed-type hypersensitivity (DTH) and the progression of Mycobacterium lepraemurium infection was examined after inoculation of mice with 10(8) M. lepraemurium in the left hind footpad. The expression of DTH developed over the first 4 weeks of infection, remained high up to week 8, and then dropped to a low level at which it remained for 12 more weeks. The development of DTH was concordant with an initial swelling of the inoculated foot, the appearance of a mononuclear infiltrate at this site, and a prevention of any increase in the number of mycobacteria in this foot and in other tissues studied. A decay of DTH reactivity was associated with a progressive increase in the number of M. lepraemurium initially at the original site of inoculation and subsequently in all other tissues. Although the expression of DTH was lost, adoptive immunization experiments showed that a population of sensitized lymphocytes persisted within host. Further experimentation offered evidence to suggest that the level of systemic antigen may be in part responsible for the loss of DTH reactivity.     

Impairment of cell-mediated immune responses by infection with Mycobacterium lepraemurium.

The effect of chronic infection with Mycobacterium lepraemurium upon cell-mediated immune responses was studied in Lewis rats. Rats infected for 40 to 175 days were completely protected from attempted induction of experimental adjuvant disease, and the severity of experimental allergic encephalomyelitis in leprous rats was markedly attenuated. Full manifestations of each autoimmune disease were expressed in littermate control groups. Skin homograft rejection by infected rats was significantly impaired (P less than 0.001) as was the delayed-type hypersensitivity response to sheep erythrocytes (P less than 0.02). It is suggested that chronic infection with M. lepraemurium exerts a nonspecific inhibitory effect on cell-mediated immunity by perturbation of normal lymphocyte recirculation and by induction of immuno-suppressor cell activity.     

Detection of immune complexes in mice infected with Mycobacterium lepraemurium.

A specific binding test was used to detect immune complexes containing antigens of Mycobacterium lepraemurium in the serum and tissues of infected mice. Complexes were precipitated by antiserum against immunoglogulin, free antigen removed by washing and the presence of bound antigen demonstrated by measurement of uptake of radioactively labelled specific antibody by the precipitate. Tests were done both with 125I-labelled FAB prepared from an immune from rabbit antiserum against M. Lepraemurium and with 125I-labelled IgG precipitate. Out of seventy-nine serum samples taken monthly up to the 5th month after infection, only there were positive (one at 2 months and two at 3 months). Kidneys taken from infected mice were also examined for immune complexes. Although deposits of IgM and sometimes of IgG were observed by immunoflourescence in glomeruli of normal mice, deposits of IgG were more frequent later on in infected mice. Nevertheless, binding tests done on acid eluates were positive in only one out of fifty-three infected mice.     

Recombinant interleukin-2 limits the replication of Mycobacterium lepraemurium and Mycobacterium bovis BCG in mice.

BALB/c mice were infected with Mycobacterium lepraemurium in the footpad or with Mycobacterium bovis BCG intravenously with 5 x 10(7) bacilli. Recombinant interleukin-2 (IL-2) was injected intraperitoneally as a single dose (20,000 U), as a single course of five injections (400 U each), or as a 6-month course starting 3 days after the M. lepraemurium infection. BCG-infected mice received a single dose (1,000 U) or five daily injections of 100 or 1,000 U each. IL-2 significantly reduced the total bacterial counts in the footpad, lymph nodes, and liver of M. lepraemurium-infected mice (50 to 85%) by 6 months and viable counts in the spleen (30 to 50%) by 60 days after BCG infection. The courses of IL-2 started at 60 days were more effective than those started at 3 days after M. lepraemurium infection (P less than 0.05 to 0.001), and for BCG, 100 U of IL-2 was better than 1,000 U (P less than 0.05 to 0.01). These results indicate that IL-2 limits mycobacterial infections in mice and raise the question of its possible use in humans.     

Induction of delayed type hypersensitivity against ultrasonicated Mycobacterium lepraemurium bacilli without simultaneous local reactivity against live bacilli or protective immunity.

Delayed type hypersensitivity (DTH) was induced in C3H mice by subcutaneous immunization with Mycobacterium lepraemurium (MLM) antigens in Freund's complete (FCA) or Freund's incomplete (FIA) adjuvant. The total ultrasonicate (MLMSon-P) of MLM bacilli as well as the water soluble fraction (MLMSon-S) of this ultrasonicate was found effective. MLMSon-S was used as the test antigen. Specific DTH also developed after immunization with heat-killed MLM bacilli in FIA, but not with heat-killed bacilli in saline. Some mice were pre-treated with cyclophosphamide (CY) or splenectomized to augment the effect of immunization. In no instance was DTH to MLMSon-S accompanied by detectable local reactivity to live MLM bacilli measured as swelling of the infected footpad or by reduced multiplication or dissemination of the bacilli during the first 11 weeks after inoculation. As determined by testing in the infected footpad 8 weeks after inoculation, MLM infection did not induce DTH to MLMSon-S in non-immunized mice, and MLM infection was found to neither augment nor suppress established DTH to MLMSon-S. The experiments thus demonstrated a clear dissociation between DTH to MLMSon-S and local reactivity to live MLM bacilli, as well as between DTH to MLMSon-S and protective immunity to MLM infection.