The common mycobacterial antigens and their importance in the treatment of disease.
The mycobacteria are one of a number of genera making up the aerobic Actinomycetales. Their antigens demonstrable by immuno-precipitation methods can be divided into four groups. The group i antigens, common to all mycobacterial species, cross-react with their counterparts in animal cells, largely derived from mitochondria. Notable amongst these antigens are the heat-shock, or stress, proteins and possibly bacterial sugars. Tests of cell-mediated immunity show that people can be separated by their responsiveness in skin-test, or lymphocyte proliferation techniques, into four categories of responders. Category 1 individuals respond to all mycobacterial reagents through recognition of the group i antigens. Many chronic diseases are associated with a lack of cell-mediated responsiveness to the group i antigens, and have a raised antibody titre to them. This reflects a predominance of T helper 2 activity and reduced T helper 1 responsiveness as part of the pathogenesis of their diseases, which include chronic bacterial, viral and parasitic infections, allergies, auto-immunities and neoplasms. Packaged together, the group i antigens and the cell-wall adjuvants of selected aerobic Actinomycetales make potent immuno-modulatory reagents. An example is heat-killed Mycobacterium vaccae, useful in both prevention and treatment of disease. Treatment with such reagents results in alleviation of disease, restoration of cellular responsiveness to the common mycobacterial antigens and a decrease in antibody titres to them. This new approach to treatment for such a wide range of diseases has few disadvantageous side effects and can accompany other non-immunosuppressive therapies.
Centre for Infectious Diseases and International Health, Windeyer Institute of Medical Sciences, University College London, 46 Cleveland Street, London W1T 4JF, UK. johnls@dircon.co.uk.
John
J
Stanford
Cynthia
C
Stanford
Gerard
G
Stansby
Oscar
O
Bottasso
Georges
G
Bahr
John
J
Grange
D000818:Animals; D000942:Antigens, Bacterial / Q000276:immunology*; D001327:Autoimmune Diseases / Q000276:immunology; D006360:Heat-Shock Proteins / Q000378:metabolism; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology; D009161:Mycobacterium / Q000276:immunology*; D009164:Mycobacterium Infections / Q000175:diagnosis / Q000276:immunology* / Q000473:pathology; D012882:Skin Tests
D000942:Antigens, Bacterial; D006360:Heat-Shock Proteins