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Clinical and Vaccine Immunology, October 2007, p. 1279-1284, Vol. 14, No. 10
1071-412X/07/$08.00+0     doi:10.1128/CVI.00190-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Molecular Characterization of Clinical Isolates of Mycobacterium tuberculosis and Their Association with Phenotypic Virulence in Human Macrophages

Departments of Microbiology,¹ Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong,² Department of Pathology, Kwong Wah Hospital, Hong Kong,³ Department of Infectious Diseases, HuaShan Hospital, Shanghai, China⁴

Received 9 May 2007/ Returned for modification 5 July 2007/ Accepted 6 August 2007

Among 125 clinical isolates of Mycobacterium tuberculosis collected in Hong Kong and Shanghai, China, between 2002 and 2004, IS6110 typing revealed that 71 strains (57%) belonged to the Beijing family. The intracellular growth of the strains in human peripheral blood monocyte-derived macrophages was measured ex vivo on days 0, 3, 6, and 10. Among all tested strains, three hypervirulent strains showed significant increases in intracellular growth after 10 days of incubation. With an initial bacterial load of 10⁴ CFU, most of the clinical isolates and H37Ra (an avirulent strain) exhibited no intracellular survival on day 10, while the three hypervirulent strains together with H37Rv (a virulent strain) showed on average a two- to fourfold rise in CFU count. These three hypervirulent strains belonging to a non-Beijing family were isolated from patients suffering from tuberculosis meningitis. Cytokines secreted by gamma interferon-activated macrophages were measured daily after challenge with selected strains of M. tuberculosis. The levels of tumor necrosis factor alpha were elevated after 24 h of infection among all strains, but the levels were significantly lower among the three hypervirulent strains, whereas interleukin 10 (IL-10) and IL-12 were not detected. Results were concordant with the differential expression of the corresponding cytokine genes in activated macrophages, as monitored by real-time PCR. Our findings highlighted that these three hypervirulent strains may possess an innate mechanism for escaping host immunity, which accounts for their characteristic virulence in patients presenting with a more severe form of disease.

Published ahead of print on 22 August 2007.