Control of latent Mycobacterium tuberculosis infection is dependent on CD8 T cells

It is estimated that one-third of the world's population is infected with Mycobacterium tuberculosis, but that only 10% of infected people break down with the disease. In the remaining 90% the infection remains clinically latent. In the present study, the immune mechanisms controlling the latent phase of tuberculosis infection were evaluated in a mouse model of latency and reactivation. Mice aerosol-infected with M. tuberculosis were treated with anti-mycobacterial drugs resulting in very low, stable bacterial numbers (<500 CFU in the spleen and lung) for 10-12 weeks followed by reactivation of the disease with increasing bacterial numbers. During latency, pathological changes in the lung had almost completely resolved and lymphocyte number and turnover were at the pre-infection level. The CD4 subset was highly active during the acute phase of infection and could be detected by intracellular staining for IFN-gamma as well as after antigen-specific stimulation with mycobacterial antigens. The CD8 subset was not involved in the acute stage of infection, but this subset was active and produced IFN-gamma during the latent phase of infection. In vivo depletion of T cell subsets supported these findings with a 6-7-fold increase in bacterial numbers in the lung following anti-CD4 treatment during the acute phase, while anti-CD8 treatment did not have an effect. The opposite was found during the latent phase where anti-CD8 treatment as well as anti-IFN-gamma treatment both resulted in a 10-fold increase in bacterial numbers in the lung, while anti-CD4 treatment induced only a modest change.