Repetitive aerosol exposure promotes cavitary tuberculosis and enables screening for targeted inhibitors of extensive lung destruction

ME Urbanowski, EA Ihms, K Bigelow… - The Journal of …, 2018 - academic.oup.com
ME Urbanowski, EA Ihms, K Bigelow, A Kübler, PT Elkington, WR Bishai
The Journal of Infectious Diseases, 2018academic.oup.com
Background Cavitation is a serious consequence of tuberculosis. We tested the hypothesis
that repetitive exposure to the same total bacterial burden of Mycobacterium tuberculosis
drives greater lung destruction than a single exposure. We also tested whether inhibition of
endogenous matrix metalloproteinase-1 (MMP-1) may inhibit cavitation during tuberculosis.
Methods Over a 3-week interval, we infected rabbits with either 5 aerosols of 500 colony-
forming units (CFU) of M. tuberculosis or a single aerosol of 2500 CFU plus 4 sham …
Background
Cavitation is a serious consequence of tuberculosis. We tested the hypothesis that repetitive exposure to the same total bacterial burden of Mycobacterium tuberculosis drives greater lung destruction than a single exposure. We also tested whether inhibition of endogenous matrix metalloproteinase-1 (MMP-1) may inhibit cavitation during tuberculosis.
Methods
Over a 3-week interval, we infected rabbits with either 5 aerosols of 500 colony-forming units (CFU) of M. tuberculosis or a single aerosol of 2500 CFU plus 4 sham aerosols. We administered the MMP-1 inhibitor cipemastat (100 mg/kg daily) during weeks 5–10 to a subset of the animals.
Results
Repetitive aerosol infection produced greater lung inflammation and more cavities than a single aerosol infection of the same bacterial burden (75% of animals vs 25%). Necropsies confirmed greater lung pathology in repetitively exposed animals. For cipemastat-treated animals, there was no significant difference in cavity counts, cavity volume, or disease severity compared to controls.
Conclusions
Our data show that repetitive aerosol exposure with M. tuberculosis drives greater lung damage and cavitation than a single exposure. This suggests that human lung destruction due to tuberculosis may be exacerbated in settings where individuals are repeatedly exposed. MMP-1 inhibition with cipemastat did not prevent the development of cavitation in our model.
Oxford University Press