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Infect Immun, March 1998, p. 1190-1199, Vol. 66, No. 3
0019-9567/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Expression of Virulence of Mycobacterium tuberculosis within Human Monocytes: Virulence Correlates with Intracellular Growth and Induction of Tumor Necrosis Factor Alpha but Not with Evasion of Lymphocyte-Dependent Monocyte Effector Functions

Richard F. Silver,1,2,3,* Qing Li,3 and Jerrold J. Ellner2,3

Divisions of Pulmonary and Critical Care Medicine1 and Infectious Diseases,3 Case Western Reserve University School of Medicine, and University Hospitals of Cleveland,2 Cleveland, Ohio

Received 2 December 1996/Returned for modification 30 January 1997/Accepted 9 December 1997

We assessed the applicability of an in vitro model of low-level infection of human monocytes to the characterization of the virulence of strains of the Mycobacterium tuberculosis family. Peripheral blood monocytes were infected at a 1:1 ratio with the virulent M. tuberculosis strain H37Rv, the avirulent M. tuberculosis strain H37Ra, and the attenuated M. bovis strain BCG. Both the percentages of cells infected by the three strains and the initial numbers of intracellular organisms were equivalent, as were levels of monocyte viability up to 7 days following infection. Intracellular growth reflected virulence, as H37Rv replicated in logarithmic fashion throughout the assay, BCG growth reached a plateau at 4 days, and H37Ra did not grow at all. The same patterns of growth were observed following infection of human alveolar macrophages with H37Rv and H37Ra. Monocyte production of tumor necrosis factor alpha was significantly higher following infection with virulent H37Rv than with either BCG or H37Ra. In contrast, there was no clear correlation of interleukin 10 production with virulence. Nonadherent cells of purified-protein-derivative-positive donors mediated equivalent degrees of reduction of the intracellular growth of H37Rv, BCG, and H37Ra. Low-level infection of human monocytes with H37Rv, BCG, and H37Ra thus provides an in vitro model for assessment of the virulence of these M. tuberculosis family strains. Furthermore, it is suggested that the virulence of these strains is expressed primarily by their differing abilities to adapt to the intracellular environment of the mononuclear phagocyte.

* Corresponding author. Mailing address: Divisions of Pulmonary and Critical Care Medicine and Infectious Diseases, Case Western Reserve University School of Medicine, Biomedical Research Building, Rm. 421, 10900 Euclid Ave., Cleveland, OH 44106-4941. Phone: (216) 368-1151. Fax: (216) 368-2034. E-mail: rfs4{at}po.cwru.edu.




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