Abstract

ABSTRACTRoughly one third of the human population carries a latent Mycobacterium tuberculosis infection, with a 5-10% lifetime risk of reactivation to active tuberculosis and further spreading the disease. The mechanisms leading to the reactivation of a latent Mycobacterium tuberculosis infection are insufficiently understood. Here, we used a natural fish pathogen, Mycobacterium marinum, to model the reactivation of a mycobacterial infection in the adult zebrafish (Danio rerio). A low-dose intraperitoneal injection (∼40 colony-forming units) led to a latent infection, with mycobacteria found in well-organized granulomas surrounded by a thick layer of fibrous tissue. A latent infection could be reactivated by oral dexamethasone treatment, which led to disruption of the granuloma structures and dissemination of bacteria. This was associated with the depletion of lymphocytes, especially CD4+ T cells. Using this model, we verified that ethambutol is effective against an active disease but not a latent infection. In addition, we screened 15 mycobacterial antigens as postexposure DNA vaccines, of which RpfB and MMAR_4207 reduced bacterial burdens upon reactivation, as did the Ag85-ESAT-6 combination. In conclusion, the adult zebrafish-M. marinum infection model provides a feasible tool for examining the mechanisms of reactivation in mycobacterial infections, and for screening vaccine and drug candidates.This article has an associated First Person interview with the first author of the paper.

Highlights

  • IntroductionMycobacterium tuberculosis (Mtb), the causative agent of TB, led to 1.4 million deaths and 10.4 million new infections in 2015

  • Tuberculosis (TB) remains one of the major global health problems

  • Dexamethasone treatment leads to an elevated bacterial burden in zebrafish with a latent M. marinum infection In humans, the reactivation of a latent TB infection often follows immunosuppression

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Summary

Introduction

Mycobacterium tuberculosis (Mtb), the causative agent of TB, led to 1.4 million deaths and 10.4 million new infections in 2015 The World Health Organization (WHO) estimates that one third of the human population carries a latent TB infection, and has up to a 10% lifetime risk of it reactivating into an active disease. Both vaccines and antibiotics have their limitations in combating TB. To reach the ambitious goal of eliminating TB by the year 2050, innovative approaches are needed

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