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Reactivation of persistant tuberculosis

Bibliography: leaves 122-138.

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Main Author: Botha, Tania
Other Authors: Ryffel, Bernhard
Format: Thesis
Language:English
Published: Division of Immunology 2014
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access_status_str Open Access
author Botha, Tania
author2 Ryffel, Bernhard
author_browse Botha, Tania
Ryffel, Bernhard
author_facet Ryffel, Bernhard
Botha, Tania
author_sort Botha, Tania
collection Thesis
description Bibliography: leaves 122-138.
format Thesis
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institution University of Cape Town (South Africa)
language eng
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2014
publishDateRange 2014
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publisherStr Division of Immunology
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/8598 Reactivation of persistant tuberculosis Botha, Tania Ryffel, Bernhard Immunology Bibliography: leaves 122-138. Exposure to Mycobacterium tuberculosis results in clinical tuberculosis only in a small percentage of immunocompetent individuals. In most instances mycobacteria are controlled by the host immune system and survive in a dormant state within granuloma. lmmunosuppression, however, may result in reactivation of active tuberculosis resulting in clinical disease. Using low dose aerosol infection of M. tuberculosis in mice, a short-duration model of rifampicin-isoniazid (RMP-INH)-induced persistent tuberculosis is described. This persistent infection is characterised by undetectable levels of colony-forming units (CFU) in mouse organs and mice being clinically asymptomatic for prolonged periods. Reactivation of persistent tuberculosis can occur spontaneously following short-course chemotherapy or can be achieved by immunosuppression, specifically inhibition of macrophage- specific nitric oxide synthase (NOS2) by a chemical inhibitor, aminoguanidine. This model can therefore be used to characterise spontaneous or drug-induced reactivation of murine tuberculosis, as this is not feasible to study in human subjects. Additionally, this model may serve as a valuable tool for testing novel vaccines and antituberculous drugs, especially those designed to combat persistent infection. Mycobacterial genome copy enumeration and assessment of 168 ribosomal RNA (168 rRNA) and sigma factor A (sigA) gene expression revealed that large numbers of dormant bacilli are present in lung tissue during the persistent phase of infection in this model. This finding opens up the possibility that additional gene expression profiles can be analysed with current technology, unravelling the exact metabolic status of these dormant mycobacteria. Moreover, this model facilitates characterisation of another poorly understood aspect, namely reinfection. Preliminary aerosol reinfection during the persistent phase of tuberculosis revealed that the primary- infected dormant M. tuberculosis strain may be reactivated and may outgrow the primary strain during reinfection. Tumour necrosis factor (TNF) deficient mice are known to be highly susceptible to M. tuberculosis infection. In this study it was asked whether TNF is required for post-infectious immunity in aerosol-infected mice. This model was applied and mice were treated with RlV|P-INH for 4 weeks to reduce the CFU to undetectable levels. While wild-type control mice spontaneously reactivated but controlled the infection upon cessation of chemotherapy, TNF deficient mice developed fatal reactivation of infection. The increased susceptibility of TNF deficient mice was accompanied by diminished recruitment and activation of T cells and macrophages into the lung with defective granuloma formation and reduced inducible nitric oxide synthase expression. Reduced chemokine production in the lung might explain sub-optimal recruitment and activation of T cells and uncontrolled infection. Therefore, despite a massive reduction of the mycobacterial load by chemotherapy, TNF deficient mice were unable to compensate and mount a protective immune response. In conclusion, endogenous TNF is critical to maintain latent tuberculosis infection and in its absence no specific immunity is generated. 2014-10-18T05:58:33Z 2014-10-18T05:58:33Z 2003 Doctoral Thesis Doctoral PhD http://hdl.handle.net/11427/8598 eng application/pdf Division of Immunology Faculty of Health Sciences University of Cape Town
spellingShingle Immunology
Botha, Tania
Reactivation of persistant tuberculosis
thesis_degree_str Doctoral
title Reactivation of persistant tuberculosis
title_full Reactivation of persistant tuberculosis
title_fullStr Reactivation of persistant tuberculosis
title_full_unstemmed Reactivation of persistant tuberculosis
title_short Reactivation of persistant tuberculosis
title_sort reactivation of persistant tuberculosis
topic Immunology
url http://hdl.handle.net/11427/8598
work_keys_str_mv AT bothatania reactivationofpersistanttuberculosis