Abstract

Pyrazinamide (PZA) is one of the first line antibiotics used for the treatment of tuberculosis (TB). In the present study, we have used in vitro and in vivo systems to investigate whether PZA, in addition to its known anti-mycobacterial properties, modulate the host immune response during Mycobacterium tuberculosis (Mtb) infection. In vitro we have examined the effect of PZA on cytokine and chemokine release by Mtb-infected or Toll-like receptor (TLR) -stimulated primary human monocytes. In vivo, we have investigated at the transcriptional levels using genome-wide microarray gene expression analysis, whether PZA treatment of Mtb-infected mice alters the host immune response to Mtb infection in the lungs. Here, we report that PZA treatment of Mtb-infected human monocytes and mice significantly reduces the release of pro-inflammatory cytokines and chemokines, including IL-1β, IL-6, TNF-α and MCP-1 at the protein and at the gene transcription levels, respectively. Data from microarray analysis also reveal that PZA treatment of Mtb-infected mice significantly alters the expression level of genes involved in the regulation of the pro-inflammatory mediators, lung inflammatory response and TLR signaling networks. Specifically, genes coding for adenylate cyclase and Peroxisome-Proliferator Activated Receptor (PPAR), molecules known for their anti-inflammatory effect, were found to be up-regulated in the lungs of PZA-treated Mtb-infected mice. Based on the microarray findings, we propose that PZA treatment modulates the host immune response to Mtb infection by reducing pro-inflammatory cytokine production, probably through PPAR- and NF-kB- dependent pathways. In addition, our results suggest that inclusion or exclusion of PZA in the TB treatment regimen could potentially affect the biomarker signature detected in the circulation of TB patients.

Highlights

  • Tuberculosis (TB) is one of the leading causes of adult deaths attributable to a single infectious agent in humans

  • Levels of IL-1 receptor antagonist (IL-1Ra) were unaffected by PZA treatment and comparable to those induced by Mycobacterium tuberculosis (Mtb) infection alone indicating that the effect of PZA was selective for specific pro-inflammatory cytokines/chemokines (Supplementary Figure S1)

  • Since PZA treatment reduced the pro-inflammatory cytokine levels in human monocytes and down-regulated the expression of many genes involved in inflammatory response network and Toll-like receptor (TLR) signaling in mouse lungs, we investigated the possible mechanism for the anti-inflammatory activities of PZA

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Summary

Introduction

Tuberculosis (TB) is one of the leading causes of adult deaths attributable to a single infectious agent in humans. Sputum culture status is not applicable in the context of extra-pulmonary disease [9] These limitations emphasize the need for additional surrogate biomarkers of response to TB treatment. In the present study, we tested our hypothesis by exploring the ability of PZA to modulate the host immune response during Mtb infection. Using both in vitro (human monocytes) and in vivo (mouse) Mtb-infection systems, we investigated whether PZA treatment can influence the host immune response, potentially contributing to the observed patterns of cytokine/chemokine in the serum of TB patients in response to treatment. Results from our in vitro cytokine measurements and genome-wide transcription analysis of Mtbinfected mouse lungs suggest that PZA treatment modulates the host immune response to Mtb infection by reducing proinflammatory cytokine production, probably through an NF-kBdependent pathway

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