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Host/Pathogen adaptation is not surprising to me.

I find it elegantly simple to understand that over time the host and

pathogen adjust to each other. How can that NOT happen if one is

infected for over 25 years as I was/am with Lyme? I think as the

host's immune system ages though, the pathogen eventually gets the

upper hand. I have had this though foremost in my mind as I devise

ways to ambush the buggers. I intend to keep the upper hand by hook

or by crook.

Barb

>

> This paper is of vast importance to the fine science of

microbicide.

> To see why, start out by reading the beginning of the Discussion.

>

> This is free online full text.

>

> I'm not in a real disciplined mood here but the controls and

> rationale in this paper seem tight... one possible shortcoming is

> well-addressed by the authors in the final few sentences of the

> Results. Also problematic is the assumption that all forms of the

> organism are capable of replication in order to form colonies in

the

> CFU assay. This may be a huge problem. See PMID 15548322.

>

> I think so, but I am not quite sure whether MTB infection is

> clinically pathogenic in the mice they used (the " normal " ones, not

> the IFNg knockouts which MTB easily kills). This " stalemate "

finding

> will be much more significant to me if MTB is indeed pathogenic to

> wild-type mice. On the other hand, the existence of a stalemate

> involving a subclinical infection would not be surprising - because

> such a stalemate is not very harmful to the host - and would be

much

> less suggestive reguarding the question of what is going on in our

> diseases and their treatment.

>

>

> ======================================================

>

> Infect Immun. 2005 Jan;73(1):546-51.

> Related Articles, Links

>

>

> Replication dynamics of Mycobacterium tuberculosis in chronically

> infected mice.

>

> Munoz-Elias EJ, Timm J, Botha T, Chan WT, Gomez JE, McKinney JD.

>

> Laboratory of Infection Biology, The Rockefeller University, 1230

> York Ave., New York, NY 10021, USA.

>

> The dynamics of host-pathogen interactions have important

> implications for the design of new antimicrobial agents to treat

> chronic infections such as tuberculosis (TB), which is notoriously

> refractory to conventional drug therapy. In the mouse model of TB,

> an acute phase of exponential bacterial growth in the lungs is

> followed by a chronic phase characterized by relatively stable

> numbers of bacteria. This equilibrium could be static, with little

> ongoing replication, or dynamic, with continuous bacterial

> multiplication balanced by bacterial killing. A static model

> predicts a close correspondence between " viable counts " (live

> bacteria) and " total counts " (live plus dead bacteria) in the lungs

> over time. A dynamic model predicts the divergence of total counts

> and viable counts over time due to the accumulation of dead

> bacteria. Here, viable counts are defined as bacterial CFU

> enumerated by plating lung homogenates; total counts are defined as

> bacterial chromosome equivalents (CEQ) enumerated by using

> quantitative real-time PCR. We show that the viable and total

> bacterial counts in the lungs of chronically infected mice do not

> diverge over time. Rapid degradation of dead bacteria is unlikely

to

> account for the stability of bacterial CEQ numbers in the lungs

over

> time, because treatment of mice with isoniazid for 8 weeks led to a

> marked reduction in the number of CFU without reducing the number

of

> CEQ. These observations support the hypothesis that the stable

> number of bacterial CFU in the lungs during chronic infection

> represents a static equilibrium between host and pathogen.

>

> PMID: 15618194 [PubMed - indexed for MEDLINE]

>

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> I think so, but I am not quite sure whether MTB infection is

> clinically pathogenic in the mice they used (the " normal " ones,

not

> the IFNg knockouts which MTB easily kills).

Yes, it is.

--------------------------------

J Med Microbiol. 1996 Aug;45(2):103-9.

Related Articles, Links

Persistent infection with virulent but not avirulent Mycobacterium

tuberculosis in the lungs of mice causes progressive pathology.

Dunn PL, North RJ.

Trudeau Institute Inc., Saranac Lake, NY 12983, USA.

A strain of Mycobacterium tuberculosis (H37Rv) considered virulent

for mice and a strain (R1Rv) considered relatively avirulent were

compared for their ability to survive host immunity in the lungs and

to induce lung pathology. Although both strains of M. tuberculosis

were capable of causing a slowly progressive infection in the lungs

of immunocompetent mice, only the H37Rv strain was capable of

inducing progressive destructive pathology and of causing loss of

lung function over a 300-day period. Therefore, the ability to

survive host immunity in the lungs and the ability to cause lung

pathology are separate manifestations of mycobacterial virulence.

PMID: 8683545 [PubMed - indexed for MEDLINE]

Tuber Lung Dis. 1997;78(1):57-66.

Related Articles, Links

Progression of chronic pulmonary tuberculosis in mice aerogenically

infected with virulent Mycobacterium tuberculosis.

Rhoades ER, AA, Orme IM.

Department of Microbiology, Colorado State University, USA.

brhoades@...

There are several critical differences in the pulmonary

granulomatous response to Mycobacterium tuberculosis between the

mouse and other animal models such as the guinea pig or rabbit. One

key difference is a conspicuous lack of central caseating necrosis

in pulmonary lesions of immunologically intact mice. To determine

whether normal mice could develop such pathology in response to

highly virulent clinical isolates of M. tuberculosis, C57BL/6 mice

were infected aerogenically with varying doses of three different

strains, and the development of a granulomatous response was

followed for as long as a year. Whereas such conditions failed to

induce caseating necrosis in the lungs of these mice, all of the

infections induced a granulomatous response which progressed

similarly. We present here a descriptive report of the gross

pathological progression of tuberculosis in the lungs of the mice.

In each case, the disease progressed in five discrete stages, which

were delineated on the basis of several criteria including the

extent of granulomatous involvement, the cell types present, the

degree of lymphocyte organization, and the presence of destructive

sequelae such as airway epithelium erosion and airway debris.

Quicker progression of disease along these five stages was induced

by increasing the size of the inoculum or by the more virulent

mycobacterial strains. The infections with the virulent strains were

not resolved, and the later stages of the granulomatous response

coincided with an increasing bacillary load and a loss of organized

lymphocytes in the infected lungs which ultimately resulted in the

death of the host. These results indicate that although C57BL/6 mice

do not manifest a caseating form of pulmonary tuberculosis, they

manifest an equally pathogenic granulomatous response which appears

as a chronic interstitial fibrosing response that fails to contain

the infection at a time that organized lymphocyte involvement wanes

in the lung.

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Whats most interesting here to me is that this experiment suggests

that taking a drug or drugs at the MIC might do you no good

whatsoever if you had a low-turnover (static) infection like murine

TB - where the same bacterial individuals apparently just sit and

sit, keeping the mice sick, but dont grow significantly or suffer

significant attrition.

Perhaps a higher turnover of your pathogens, Barb, could be one

reason for your successful chemotherapy.

If this experiment does mean what it seems to mean, then

chemotherapy which is above the MIC but below the MBC should do

nothing for murine TB - but such chemotherapy should be able to cure

any sort of high-turnover infection. However, since complex, often

unknown factors come into play in vivo, such experimentation cannot

be nearly as tidy as this description suggests. The MICs and MBCs

might not translate tidily to infections of mammals.

Anyway, I doubt that near-zero turnover is the sole key to our

illnesses, for several reasons. I suspect the mystery phenomenon

seen in the Geiffers Cpn/monocytes paper could be more central.

One interesting question is whether beta-lactams can kill the

non-growing organisms a near-zero-turnover infection comprises. The

textbook answer would be a simple no, but I am trying to look a

little deeper. And if beta-lactams really cannot affect an infection

which is in stasis, then anyone benefiting from beta-lactams would

have to be concluded to have an infection with significant turnover,

rather than a static infection like murine TB.

>

> Host/Pathogen adaptation is not surprising to me.

> I find it elegantly simple to understand that over time the host

and

> pathogen adjust to each other. How can that NOT happen if one is

> infected for over 25 years as I was/am with Lyme? I think as the

> host's immune system ages though, the pathogen eventually gets the

> upper hand. I have had this though foremost in my mind as I

devise

> ways to ambush the buggers. I intend to keep the upper hand by

hook

> or by crook.

>

> Barb

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