Biology of the mycobacterioses. Chemical and immunological studies on peptides and polysaccharides from tubercle bacilli

Strategies for Using Muramyl Peptides - Modulators of Innate Immunity of Bacterial Origin - in Medicine

The spread of infectious diseases is rampant. The emergence of new infections, the irrational use of antibiotics in medicine and their widespread use in agriculture contribute to the emergence of microorganisms that are resistant to antimicrobial drugs. By 2050, mortality from antibiotic-resistant strains of bacteria is projected to increase up to 10 million people per year, which will exceed mortality from cancer. Mutations in bacteria and viruses are occurring faster than new drugs and vaccines are being introduced to the market. In search of effective protection against infections, new strategies and approaches are being developed, one of which is the use of innate immunity activators in combination with etiotropic chemotherapy drugs. Muramyl peptides, which are part of peptidoglycan of cell walls of all known bacteria, regularly formed in the body during the breakdown of microflora and considered to be natural regulators of immunity. Their interaction with intracellular receptors launches a sequence of processes that ultimately leads to the increased expression of genes of MHC molecules, pro-inflammatory mediators, cytokines and their soluble and membrane-associated receptors. As a result, all subpopulations of immunocompetent cells are activated: macrophages and dendritic cells, neutrophils, T-, B- lymphocytes and natural killer cells for an adequate response to foreign or transformed antigens, manifested both in the regulation of the inflammatory response and in providing immunological tolerance. Muramyl peptides take part in the process of hematopoiesis, stimulating production of colony-stimulating factors, which is the basis for their use in the treatment of oncological diseases. In this review we highlight clinical trials of drugs based on muramyl peptides, as well as clinical efficacy of drugs mifamurtide, lycopid, liasten and polimuramil. Such a multifactorial effect of muramyl peptides and a well-known mechanism of activity make them promising drugs in the treatment and preventing of infectious, allergic and oncological diseases, and in the composition of vaccines.

Experimental pulmonary cavity formation by mycobacterial components and synthetic adjuvants

An investigation was undertaken to determine the components of mycobacteria responsible for pulmonary cavity formation in tuberculosis. Rabbits received an intrapulmonary injection through the chest wall, of mycobacterial protein, II-p, mixed with either mycobacterial lipids, synthetic adjuvants or Nocardia cell wall skeleton as adjuvant. Six weeks later, they were killed and the lung lesions were examined. Cavities and necrosis were produced by the injection of II-p mixed with cord factor, Nocardia cell wall skeleton or N-acetylmuramyl dipeptide conjugated with long-chain branched fatty acids. Cavities were not produced by either the injection of II-p together with phospholipid, N-acetylmuramyl dipeptide (MDP), MDP-derivatives having no long-chain branched fatty acid, or by the injection of individual components of the mixtures. The results suggest that in tuberculosis a mycobacterial component with a long-chain branched fatty acid such as mycolic acid plays an important role in pulmonary cavity formation by enhancing the antigenicity of mycobacterial protein and helping it induce cell-mediated immunity at the site of the lesion. Passive transfer with sera from rabbits highly sensitized with tubercle bacilli failed to enhance cavity formation in the recipient animals.

Diagnosis of active tuberculosis by immunological methods. 2. Qualitative differences in the dermal response to tuberculin in patients with active pulmonary disease and healthy tuberculin-positive individuals

The tuberculin reactivity of 107 patients with active pulmonary tuberculosis and 143 healthy age-matched control subjects were compared. At 48 hours 96% of patients and 76% of control subjects were positive reactors. The diameters of the reactions were of similar size. At 24 hours 93% of patients and 65% of controls were positive: the reactions tended to be larger in the patient group but the difference was of no diagnostic value. The greatest discrimination was apparent at 6-8 hours when 72% of patients and only 3.5% of control subjects reacted. Although probably an Arthus reaction, this early response did not correlate significantly with antibody levels measured by enzyme-linked immunosorbent assay. Accordingly the two tests, to some extent, complemented each other diagnostically.

Tuberculin purified protein derivative-reactive T cells in cord blood lymphocytes

Lymphocytes obtained from cord blood of newborn babies who were born of healthy mothers were studied in vitro for their responsiveness to purified protein derivative (PPD) of tuberculin. Cord blood lymphocytes proliferated in vitro by stimulation with PPD, despite wide variations in the results. Studies with fractionated lymphocytes revealed that PPD-responding cells belonged to E-rosetting, nylon wool-nonadherent T lymphocytes. Non-E-rosetting B lymphocytes alone did not proliferate at all after stimulation with PPD. In addition, bromodeoxyuridine and light treatment of in vitro PPD-stimulated lymphocytes eliminated the responsiveness to PPD. These results suggest that T lymphocytes do exist in cord blood and respond in vitro to stimulation with PPD. A possible role for PPD-reactive T lymphocytes in cell-mediated protective immunity in newborns is discussed.

Reactivity of purified proteins and polysaccharides from Mycobacterium tuberculosis in delayed skin test and cultured lymphocyte mitogenesis assays

Hypersensitivity responses to two highly purified and well characterized mycobacterial proteins and a preparation of mycobacterial arabinogalactanarabinomannan were studied by using guinea pig skin tests and in vitro-cultured human lymphocyte mitogenesis stimulation assays. The purified proteins were found to elicit delayed-type hypersensitivity skin test reactions and to stimulate mitogenesis in cultured lymphocytes. The polysaccharide preparation was found to evoke delayed skin tests but not to stimulate cultured lymphocytes.

Cell wall of Mycobacterium lepraemurium strain Hawaii

The chemical properties of the cell wall of Mycobacterium lepraemurium strain Hawaii were investigated. Five subunits of the cell wall, arabinose mycolate, mycolic acids, tetrapeptide (Ala-Gln-diaminopimelic acid-Ala), disaccharide (N-acetylglucosaminyl-beta-1,4-N-glycolylmuramic acid), and arabinogalactan, were obtained, and their chemical structures were identified.