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CD 4 Regulatory T cells in a Cynomolgus Macaque Model of Mycobacterium tuberculosis Infection 1 , 2 , 3

Background—Mycobacterium tuberculosis (M. tuberculosis) infection in humans results in either latent infection or active tuberculosis (TB). We sought to determine whether a higher frequency of regulatory T cells predispose an individual toward active disease or whether the Tregs develop in response to active disease. Methods—In cynomolgus macaques infected with a low dose M. tuberculosis approximately 50% develop primary TB and 50% present with latent infection. 41 animals were followed for 6-8 months to correlate the frequency of Foxp3+ cells in peripheral blood and airways with outcome of infection. Results—In all animals, the frequency of Tregs (CD4+Foxp3+) in peripheral blood rapidly decreased and simultaneously increased in the airways. Latently infected monkeys had a significantly higher frequency of Tregs in peripheral blood prior to infection and during early infection than those that developed active disease. Monkeys with active disease had increased Tregs in PBMC as they developed disease. Conclusions—Our data suggest that increased Tregs in active disease occur in response to more inflammation, rather than act as a causative factor in progression to active disease.