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Host defense against Mycobacterium-avium complex.

S Schnittman1, H C Lane, F G Witebsky

  • 1Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892.

Journal of Clinical Immunology
|July 1, 1988
PubMed
Summary
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Mycobacterium avium complex (MAC) infections are common in AIDS patients. This study found that monocytes and lymphocytes are not the primary defect, suggesting a potential role for antibody deficiency in MAC susceptibility.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Microbiology

Background:

  • Mycobacterium avium complex (MAC) is a leading cause of disseminated bacterial infection in acquired immunodeficiency syndrome (AIDS) patients.
  • The specific host defense defect enabling MAC infection in AIDS is not fully understood, as it's rarely seen in other immunocompromised individuals.

Purpose of the Study:

  • To investigate the immune response to MAC infection in monocytes and lymphocytes from both AIDS patients and healthy controls.
  • To identify potential cellular or humoral immune defects contributing to MAC susceptibility in AIDS.

Main Methods:

  • Monocytes from normal and AIDS patients were assessed for phagocytosis, superoxide anion (SOA) production, and killing of MAC.
  • The effects of recombinant interferon-gamma, tumor necrosis factor-alpha, and interleukin-2 on monocyte and lymphocyte functions were evaluated.

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  • The impact of anti-MAC immune serum on monocyte-mediated killing of MAC was examined.

    • Main Results:

    • Monocytes from AIDS patients and controls showed similar MAC phagocytosis but elevated baseline SOA production in AIDS patients.
    • Neither cytokine pretreatment nor interleukin-2 stimulation enhanced MAC killing by monocytes or lymphocytes.
    • Anti-MAC immune serum significantly improved MAC killing by monocytes and prevented bacterial outgrowth in both patient groups.

    Conclusions:

    • The primary host defense defect in MAC infection does not appear to reside in monocyte function or the examined in vitro lymphocyte responses.
    • The findings suggest that a lack of specific antibody against MAC may contribute to the propensity for disseminated infection in AIDS patients.