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From the Whitehead Institute for Biomedical Research and Department
of Biology,*
the Massachusetts Institute of Technology,
Cambridge, Massachusetts; the Infectious Disease
Unit,
Massachusetts General Hospital, Boston,
Massachusetts; the Pulmonary Center,
Boston
University School of Medicine, Boston, Massachusetts; the Service
d’Anatomie Pathologiques,§
Hôpital Paul
Brousse, Universite Paris Sud, Villejuif, France; the Laboratory of
Human Genetics of Infectious Diseases,¶
Necker-Enfants Malades Medical School, Paris, France; and the Boston
Veterans Administration Medical Center,||
Boston, Massachusetts
Osteopontin (OPN) is a protein that is expressed in chronic
inflammatory diseases including tuberculosis, and its
deficiency predisposes to more severe mycobacterial infections in mice.
However, no reports have identified altered OPN expression
in, or correlated these alterations to, infections in
humans. The data presented herein identify alterations in the tissue
expression of OPN protein and describe an inverse correlation between
these levels and disease progression after inoculation of
Mycobacterium bovis bacillus Calmette-Guérin
vaccine in humans. Patients with regional adenitis and good clinical
outcomes had abundant OPN in infected lymph nodes. This pattern of OPN
accumulation was also observed in patients infected by M.
avium-intracellulare. In contrast, patients with
disseminated infection and histologically ill-defined granulomas had no
significant osteopontin accumulation in infected lymph nodes; these
patients had either deficiencies in the interferon-
receptor 1 or
idiopathic immune defects. The level of OPN protein expression was
inversely correlated with disseminated infection and, of
particular interest, with death of the patient. We conclude
that osteopontin expression correlates with an effective immune and
inflammatory response when humans are challenged by a mycobacterial
infection and that osteopontin contributes to human resistance against
mycobacteria.
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