Subcellular antibiotic visualization reveals a dynamic drug reservoir in infected macrophages

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Science  28 Jun 2019:
Vol. 364, Issue 6447, pp. 1279-1282
DOI: 10.1126/science.aat9689

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  • RE:Diagnostic test for tuberculosis

    Title: diagnostic test for tuberculosis
    In their report ‘’ Subcellular antibiotic visualisation reveals a dynamic drug reservoir in infected macrophages’’ (28 June, p. 1279) Greenwood et al claim that ‘lipid laden foamy macrophages are a hallmark of tuberculosis pathogenesis’ (1). However, Jones Williams et al wrote that epithelioid cells in sarcoidosis and tuberculous granulomas were ‘primarily biosynthetic rather than phagocytic’(2). The cytoplasm of the cells contained extensive rough endoplasmic reticulum. Foamy macrophages were not present. As the immune response is not directed against any mycobacterium antigen, it is doubtful if skin testing with tuberculin can be used as a specific diagnostic test. An autoimmune animal model of tuberculoid leprosy has been developed using human sensory peripheral nerve tissue as antigen. Rabbit were injected with sensory nerve plus adjuvant. Some of the rabbits developed a state of granulomatous hypersensitivity ie skin testing with dilute nerve in saline produced a epithelioid cell granuloma. The cytoplasm of the epithelioid cells contained extensive rough endoplasmic reticulum filled with an electron dense product, and similar to the epithelioid cells in sarcoidosis and tuberculosis (3). In our experiments, the antigen is a non-myelin protein, active in doses of 1 µg and can be used to develop a diagnostic skin test (4). The Kveim reagent contains granulomatous tissue from the spleen or lymph nodes of patients with s...

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    Competing Interests: None declared.