title: Mycobacterium bovis BCG infection severely delays Trichuris muris expulsion and co-infection suppresses immune responsiveness to both pathogens.
abstract: BACKGROUND
  The global epidemiology of parasitic helminths and mycobacterial infections display extensive geographical overlap, especially in the rural and urban communities of developing countries. We investigated whether co-infection with the gastrointestinal tract-restricted helminth, Trichuris muris, and the intracellular bacterium, Mycobacterium bovis (M. bovis) BCG, would alter host immune responses to, or the pathological effect of, either infection.
  
  
  RESULTS
  We demonstrate that both pathogens are capable of negatively affecting local and systemic immune responses towards each other by modifying cytokine phenotypes and by inducing general immune suppression. T. muris infection influenced non-specific and pathogen-specific immunity to M. bovis BCG by down-regulating pulmonary TH1 and Treg responses and inducing systemic TH2 responses. However, co-infection did not alter mycobacterial multiplication or dissemination and host pulmonary histopathology remained unaffected compared to BCG-only infected mice. Interestingly, prior M. bovis BCG infection significantly delayed helminth clearance and increased intestinal crypt cell proliferation in BALB/c mice. This was accompanied by a significant reduction in systemic helminth-specific TH1 and TH2 cytokine responses and significantly reduced local TH1 and TH2 responses in comparison to T. muris-only infected mice.
  
  
  CONCLUSIONS
  Our data demonstrate that co-infection with pathogens inducing opposing immune phenotypes, can have differential effects on compartmentalized host immune protection to either pathogen. In spite of local and systemic decreases in TH1 and increases in TH2 responses co-infected mice clear M. bovis BCG at the same rate as BCG only infected animals, whereas prior mycobacterial infection initiates prolonged worm infestation in parallel to decreased pathogen-specific TH2 cytokine production.
authors.affiliation: Division of Molecular Biology and Human Genetics, MRC Centre for Molecular and Cellular Biology, NRF/DST Centre of Excellence in Biomedical TB Research, Faculty Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa. hannonel@gmail.com.
authors.forename: Hendrik J
authors.initials: HJ
authors.lastname: Nel
authors.forename: Nelita
authors.initials: N
authors.lastname: du Plessis
authors.forename: Leanie
authors.initials: L
authors.lastname: Kleynhans
authors.forename: André G
authors.initials: AG
authors.lastname: Loxton
authors.forename: Paul D
authors.initials: PD
authors.lastname: van Helden
authors.forename: Gerhard
authors.initials: G
authors.lastname: Walzl
mesh_terms: D000818:Animals; D060085:Coinfection / Q000276:immunology* / Q000382:microbiology / Q000469:parasitology; D004195:Disease Models, Animal; D005260:Female; D007108:Immune Tolerance; D051379:Mice; D008807:Mice, Inbred BALB C; D009163:Mycobacterium bovis / Q000302:isolation & purification*; D014257:Trichuriasis / Q000150:complications / Q000276:immunology* / Q000469:parasitology; D014258:Trichuris / Q000302:isolation & purification*; D014376:Tuberculosis / Q000150:complications / Q000276:immunology* / Q000382:microbiology