A significant therapeutic effect of immunoglobulins administered alone, or in combination with conventional chemotherapy, in experimental pulmonary tuberculosis caused by drug-sensitive or drug-resistant strains.

The recommended chemotherapy for drug-sensitive tuberculosis (TB) consists of four different antibiotics administrated for 6 months. This long treatment leads to significant compliance problems and consequently to recrudescence of the disease and to the development of multidrug-resistant (MDR) strains. Thus, new alternatives are needed to shorten or simplify the treatment of TB. Antibodies have therapeutic effects in animal models of TB, so their use as adjuvants in drug-sensitive and MDR TB is an interesting alternative. To assess the effect of antibodies, BALB/c mice with active late disease 60 days after infection with drug-sensitive TB strain H37Rv were treated with intravenous immunoglobulin (IVIg), alone or in combination with conventional chemotherapy. When compared with control non-treated animals, IVIg alone produced a significantly decreased burden of pulmonary bacilli. This decrease was even greater when IVIg was used in combination with conventional chemotherapy. The combined therapy also significantly reduced tissue damage (pneumonia) when compared to infected animals treated only with antibiotics. IVIg treatment also caused decreased bacillary burdens in mice infected with an MDR strain. In vitro experiments suggested that improving phagocytosis by efficient opsonization is perhaps the principal mechanism of this beneficial therapeutic effect.

The protective effect of immunoglobulin in murine tuberculosis is dependent on IgG glycosylation.

Antibodies have demonstrated having a protective effect in animal models of tuberculosis (TB). These experiments have considered the specificity of antigen recognition and the different isotypes and subclasses as significant contributors of this effect. However, the carbohydrate chain heterogeneity on the Fc region of IgG (Fc-IgG) can play an important role in modulating the immune response. Patients with TB usually have high titers of specific IgG; however, the carbohydrate associated with Fc-IgG usually lacks galactose. To assess the effect of this abnormal IgG in murine pulmonary TB, we evaluated the specificity of recognition to Mycobacterium tuberculosis antigens in vitro and protective effects in vivo comparing human intravenous immunoglobulin (IVIg) and IVIg treated with an endoglycosidase to remove the glycan residues (EndoS-treated IVIg). Our results showed similar antigen recognition. The study of distribution and kinetics of IVIg in serum and bronchial lavage after intraperitoneal (i.p.) administration in mice showed that IVIg circulates for 21 days. Finally, the protective effect of intact and EndoS-treated IVIg administered by i.p was studied in a murine model of progressive TB. IVIg treatment caused reduction in pulmonary bacilli loads, larger granulomas, and less pneumonia, while animals treated with EndoS-treated IVIg were not protected compared with control animals. Thus, IVIg has a protective activity in experimental pulmonary TB, and this effect requires intact Fc oligosaccharides.

[Glycosylation of antibodies and their pathogenic effect]. / La glicosilación de los anticuerpos y su efecto patogénico.

Immunoglobulin G (IgG) has covalently linked a sugar chain in the crystallizable fragment (Fc). This structure consists of double stranded glycosidic complexes with a high degree of heterogeneity that contribute to define the affinity to their specific receptors, and partly determine their biological activity. Recently was identified an anti-inflammatory mechanism mediated by IgG based on their different alternatives of Fc glycosylation and their interaction with the specific adhesion receptor of dendritic cells (DC-SIGN). This mechanism has clinical and therapeutic implications in autoimmune diseases. The objective of this review is to describe the biochemical structure of sugars associated to the Fc of IgG and its variants in relation to specific functions and pathogenicity, particularly in tuberculosis, in which may also have therapeutic implication.

Prophylactic effect of administration of human gamma globulins in a mouse model of tuberculosis.

The protective effect of human gamma globulins on Mycobacterium tuberculosis infection was evaluated in a mouse model of intratracheal infection. Animals receiving human gamma globulins intranasally, 2h before intratracheal challenge showed a significant decrease in lung bacilli load compared to non-treated animals in different time intervals of up to 2 months after challenge. The same effect was obtained when M. tuberculosis was pre-incubated with the gamma globulin before challenge. The protective effect of the gamma-globulin formulation was abolished after pre-incubation with M. tuberculosis. These results suggest a potential role of specific antibodies in the defence against mycobacterial infections.

Induction of a protective response with an IgA monoclonal antibody against Mycobacterium tuberculosis 16kDa protein in a model of progressive pulmonary infection.

Mycobacterium tuberculosis is a facultative intracellular pathogen for which cell-mediated immunity is considered the major component of the immune response. For many decades, the prevailing scientific view has been the antibodies have little or no role in modifying the course of M. tuberculosis infection. In recent years, several studies have challenged this dogma, and there is a body of evidence that supports a role of antibodies against M. tuberculosis. In the present work, we evaluated the protective activity of two monoclonal antibodies (TBA61 and TBA84). Here, we chose the intratracheal model of pulmonary infection to evaluate bacterial load and morphometric and histological changes in the lungs of treated mice. Data obtained revealed the reduction of bacterial load and milder morphometric and histopathological changes in mice treated with TBA61 at 21 days post-infection with M. tuberculosis H37Rv compared to those treated with TBA84 and control mice. These results allow continuing exploring the potential use of monoclonal antibodies as prophylactic and therapeutic agents against intracellular pathogens such as M. tuberculosis.

Papel de los anticuerpos en la protección contra Micobacterium tuberculosis / Role of antibodies in protecting against Micobacterium tuberculosis

Convencionalmente se asume que la defensa del hospedero contra Mycobacterium tuberculosis se basa en los mecanismos de inmunidad celular exclusivamente y se descarta el papel de los anticuerpos en la protección. En este trabajo se analizan evidencias recientes que retan este dogma y sugieren la importancia de considerar la manipulación de la respuesta inmune humoral como una alternativa en la investigación de vacunas contra la tuberculosis(AU)

The effect of the administration of human gamma globulins in a model of BCG infection in mice.

The effect of the administration of a commercial preparation of human gamma globulins has been evaluated in a mouse model of intranasal infection with BCG. First, we demonstrated the passage of specific antibodies to saliva and lung lavage following the intranasal or intraperitoneal administration to mice of human gamma globulins. This treatment of mice inhibited BCG colonization of the lungs (p < 0.01). A similar inhibitory effect was observed after infection of mice with gamma globulin opsonized BCG organisms (p < 0.01). These results are relevant for the development of new strategies for the control and treatment of tuberculosis.