title: Progression of chronic pulmonary tuberculosis in mice intravenously infected with ethambutol resistant Mycobacterium tuberculosis.
abstract: OBJECTIVE
  Ethambutol (EMB) is an important first line drug, however little information on its molecular mechanism of resistance and pathogenicity of resistant isolates is available. Present work was designed to study virulence of the EMB resistant M. tuberculosis strains and the host responses in-vivo on infection of EMB resistant M. tuberculosis using Balb/c mouse model of infection.
  
  
  METHODS
  Three groups of Balb/c mice (female, age 4-6 wk; 21 mice in each group) were infected intravenously with 106 CFU of M. tuberculosis H37Rv and two EMB resistant clinical isolates. Age and sex matched control animals were mock inoculated with Middlebrook 7H9 broth alone. At 10, 20, 30, 40, 50, 60, and 70 days post-infection three animals from each group were sacrificed by cervical dislocation and lung tissue was collected for further analysis.
  
  
  RESULTS
  Infection with EMB resistant M. tuberculosis led to progressive and chronic disease with significantly high bacillary load (p=0.02). Massive infiltration and exacerbated lung pathology with increased expression of IFN-gamma and TNF-alpha was observed in lungs of mice infected with EMB resistant strains. The present study suggests that infection with EMB resistant M. tuberculosis leads to chronic infection with subsequent loss of lung function, bacterial persistence with elevated expression of TNF-alpha resulting in increased lung pathology.
  
  
  CONCLUSIONS
  These findings highlight that EMB resistant M. tuberculosis regulates host immune response differentially and its pathogenicity is different from drug sensitive strains of M. tuberculosis.
authors.affiliation: Department of Internal Medicine/Infectious Diseases, University of Texas Southwestern Medical Center at Dallas, TX 75390, USA.
authors.forename: S
authors.initials: S
authors.lastname: Srivastava
authors.forename: A
authors.initials: A
authors.lastname: Ayyagari
authors.forename: T N
authors.initials: TN
authors.lastname: Dhole
authors.forename: N
authors.initials: N
authors.lastname: Krishnani
authors.forename: K K
authors.initials: KK
authors.lastname: Nyati
authors.forename: S K
authors.initials: SK
authors.lastname: Dwivedi
mesh_terms: D000818:Animals; D000995:Antitubercular Agents / Q000494:pharmacology*; D002908:Chronic Disease; D018450:Disease Progression; D024881:Drug Resistance, Bacterial; D004977:Ethambutol / Q000494:pharmacology*; D005260:Female; D008168:Lung / Q000382:microbiology / Q000473:pathology; D051379:Mice; D008807:Mice, Inbred BALB C; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000472:pathogenicity; D018088:Tuberculosis, Multidrug-Resistant / Q000276:immunology / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology*; D014397:Tuberculosis, Pulmonary / Q000276:immunology / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology*
chemical_list: D000995:Antitubercular Agents; D004977:Ethambutol