MycobacteriumulceransTriggers T-Cell Immunity followed by Local and Regional but Not Systemic Immunosuppression
ABSTRACTBuruli ulcer is a neglected infectious disease caused byMycobacterium ulceransand is characterized by necrotic cutaneous lesions induced by the exotoxin mycolactone. Despite evidence of Th1-mediated protective immunity,M. ulceransinfection has been associated with systemic immunosuppression. We show that early during mouse infection with either mycolactone-positive or negative strains, pathogen-specific gamma interferon (IFN-γ)-producing T cells developed in the draining lymph node (DLN). CD4+cells migrated to the infection foci, but progressive infection with virulentM. ulceransled to the local depletion of recruited cells. Moreover, dissemination of virulentM. ulceransto the DLN was accompanied by extensive DLN apoptotic cytopathology, leading to depletion of CD4+T cells and abrogation of IFN-γ expression. Advanced footpad infection with virulentM. ulceransdid not induce increased susceptibility to systemic coinfection byListeria monocytogenes. These results show that infection withM. ulceransefficiently triggers a mycobacterium-specific T-cell response in the DLN and that progression of infection with highly virulentM. ulceransleads to a local and regional suppression of that immune response, but without induction of systemic immunosuppression. These results suggest that prophylactic and/or therapeutic interventions to prevent dissemination ofM. ulceransto DLN during the early phase of infection would contribute for the maintenance of protective immunity and disease control.