Abstract:
:Tuberculosis remains second only to HIV/AIDS as the leading cause of mortality worldwide due to a single infectious agent. Despite chemotherapy, the global tuberculosis epidemic has intensified because of HIV co-infection, the lack of an effective vaccine and the emergence of multi-drug-resistant bacteria. Alternative host-directed strategies could be exploited to improve treatment efficacy and outcome, contain drug-resistant strains and reduce disease severity and mortality. The innate inflammatory response elicited by Mycobacterium tuberculosis (Mtb) represents a logical host target. Here we demonstrate that interleukin-1 (IL-1) confers host resistance through the induction of eicosanoids that limit excessive type I interferon (IFN) production and foster bacterial containment. We further show that, in infected mice and patients, reduced IL-1 responses and/or excessive type I IFN induction are linked to an eicosanoid imbalance associated with disease exacerbation. Host-directed immunotherapy with clinically approved drugs that augment prostaglandin E2 levels in these settings prevented acute mortality of Mtb-infected mice. Thus, IL-1 and type I IFNs represent two major counter-regulatory classes of inflammatory cytokines that control the outcome of Mtb infection and are functionally linked via eicosanoids. Our findings establish proof of concept for host-directed treatment strategies that manipulate the host eicosanoid network and represent feasible alternatives to conventional chemotherapy.
journal_name
Naturejournal_title
Natureauthors
Mayer-Barber KD,Andrade BB,Oland SD,Amaral EP,Barber DL,Gonzales J,Derrick SC,Shi R,Kumar NP,Wei W,Yuan X,Zhang G,Cai Y,Babu S,Catalfamo M,Salazar AM,Via LE,Barry CE 3rd,Sher Adoi
10.1038/nature13489subject
Has Abstractpub_date
2014-07-03 00:00:00pages
99-103issue
7507eissn
0028-0836issn
1476-4687pii
nature13489journal_volume
511pub_type
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