differential expression of mirnas by macrophages infected with virulent and avirulent mycobacterium...
TRANSCRIPT
Tuberculosis 93 S1 (2013) S47–S50
1. Introduction
The ability of Mycobacterium tuberculosis to survive inside host
macrophages and tubercle granulomas constitutes the major
virulence attributes of this species. Whereas the macrophages are
capable of generating a variety of antimicrobial responses such
as anti-bacterial peptides, hydrolases and toxic reactive oxygen
and nitrogen intermediates,1 granulomas are deprived of oxygen
and nutrients.2 Although how M. tuberculosis is able to survive
in these environments still remains a mystery, accumulating
evidence indicates that M. tuberculosis is capable of modulating
cellular processes such as cytokine responses of macrophages,
MHC class II expression and antigen presentation in phagocytes,
phagosomal processing by MHC class I pathway, phagolysosome
biogenesis and apoptosis of macrophages/dendritic cells.3
Currently, many of the above cellular processes of eukaryotic
cells are under the control of microRNAs (miRNAs)4,5 and it is
possible that M. tuberculosis alters the expression of miRNAs to
modulate the function of macrophages for its favor.
miRNAs are small non-coding RNAs ranging from 19 to 24
nucleotides in length and are encoded by eukaryotic and some
viral genomes.4 They are processed from hairpin structures by
the sequential action of two RNAse type III nucleases, namely
Drosha and Dicer.6 Mature miRNAs bind with complementary
sequences in the 3´ untranslated region of target protein coding
mRNAs and repress their translation post-transcriptionally or
degrade the mRNA, causing an effect more or less similar to that
of gene silencing by RNAi.7,8 It is estimated that miRNAs regulate
approximately 1/3 of the protein coding genes in human and
miRNAs play critical roles in human cancer, cardiovascular and
neurodegenerative diseases.9-11 They are now considered, due to
their importance in disease pathogenesis, as possible therapeutic
targets for diseases.12,13
Recently, attempts have been made to determine the effects of
mycobacterial infection on the expression of miRNAs of the host.
Interestingly, some of the studies were conducted in samples
directly derived from patients infected with mycobacteria. Liu
et al14 analyzed the expression of miRNAs in peripheral blood
mononuclear cells (PBMCs) of TB patients and healthy controls
and reported that PBMCs from TB patients have elevated levels
of several miRNAs which include miR-500, miR-144 and miR-
452. In the skin biopsy of leprosy patients, the levels of miR-21
are elevated.15 While M. tuberculosis infection of PBMCs derived
macrophages down regulates the expression of miR-155,16
infection of mouse bone marrow derived macrophages (BMDMs)
upregulates miR-155.17 Murine T cells infected with BCG and
human monocyte derived macrophages infected with M. avium
also display differential expression of several miRNAs.18,19 Further,
mycobacterial component lipomannan (LM) of M. tuberculosis
and M. smegmatis has been reported to induce miR-125a and
miR-155, respectively, in human macrophages.16
Although some of the studies reported above have used
macrophages to determine the miRNAs affected by mycobacterial
K E Y W O R D S
Macrophage
M. tuberculosis
Virulence
Infection
miRNA
Differential expression
A B S T R A C T
MicroRNAs (miRNAs) are small non-coding RNAs which post-transcriptionally regulate a wide range of
biological processes that include cellular differentiation, development, immunity and apoptosis. There
is a growing body of evidences that bacteria modulate immune responses by altering the expression
of host miRNAs. Since macrophages are immune cells associated with innate and adaptive immunity,
we investigated whether Mycobacterium tuberculosis infection affects miRNAs of macrophages.
THP-1 macrophages infected with virulent (H37Rv) and avirulent (H37Ra) strains of M. tuberculosis
were analyzed for changes in miRNAs’ expression using microarray. This revealed that nine miRNA
genes (miR-30a, miR-30e, miR-155, miR-1275, miR-3665, miR-3178, miR-4484, miR-4668-5p and
miR-4497) were differentially expressed between THP-1cells infected with M. tuberculosis H37Rv and
M. tuberculosis H37Ra strains. Additional characterization of these genes is likely to provide insights
into their role in the pathogenesis of tuberculosis.
© 2013 Elsevier Ltd. All rights reserved.
Differential expression of miRNAs by macrophages infected with virulent and avirulent Mycobacterium tuberculosis
Kishore Dasa,b, Sankaralingam Saikolappana,b, Subramanian Dhandayuthapani*a,b
aDepartment of Microbiology and Immunology and Regional Academic Health Center, University of Texas Health Science Center at San Antonio, Edinburg, TX 78541, USAbCenter of Excellence in Infectious Diseases, Paul L. Foster School of Medicine, Texas Tech Health Sciences Center, 5001 El Paso Drive, El Paso, TX 79905, USA
* Corresponding author at: Center of Excellence in Infectious Diseases, Paul L.
Foster School of Medicine, Texas Tech Health Sciences Center, 5001 El Paso Drive,
El Paso, TX 79905. Tel.: Tel.: 915 215-4239; Fax: 915 215-1271
E-mail address: [email protected] (S. Dhandayuthapani).
1472-9792/$ – see front matter © 2013 Elsevier Ltd. All rights reserved.
Contents lists available at ScienceDirect
Tuberculosis
j our na l homepage: h t tp : / / in t l .e lsev ie rhea l th .com/ jour na ls / tube
S48 K. Das et al. / Tuberculosis 93 S1 (2013) S47–S50
infections, none of these studies analyzed miRNAs responding
specifically to virulent and avirulent strains of M. tuberculosis.
Identification of such miRNAs will not only help understand
their role in pathogenesis but also provide targets for potential
therapy. Therefore, we conducted experiments in this study
to analyze the expression of miRNAs in THP-1 macrophages
infected with virulent and avirulent strains of M. tuberculosis. We
report here that nine miRNA genes are differentially regulated by
virulent and avirulent strains of M. tuberculosis in THP-1 cells.
2. Materials and Methods
2.1 Bacterial strains and culture
M. tuberculosis H37Rv (27294) and H37Ra (25177) strains
are from ATCC. They were grown in Middlebrook 7H9 broth
containing oleic acid-albumin-dextrose-catalase (OADC) (10%)
and Tween80 (0.05%) at 37°C. They were washed with phosphate
buffered saline (PBS) and passed through a syringe, to disrupt the
clumps, before infecting THP-1 cells.
2.2 Cell culture and infection
THP-1 cell line was grown in RPMI medium containing 10%
fetal bovine serum (FBS) at 37ºC with 5% CO2.
Adherent THP-1
cells (3x106 cells), differentiated into macrophages by treating
with 100 nM PMA (Phorbol-12-myristate-13-acetate) for 72 h,
were infected with M. tuberculosis H37Rv and H37Ra strains,
separately, at an MOI of 10 (10 bacteria: 1 cell). Uninfected cells
which received only phosphate buffered saline (PBS) served
as controls. After 4-6 h incubation at 37ºC, non-phagocytosed
bacteria were washed off using PBS. Cells were replenished with
fresh RPMI and incubated for 24 h at 37ºC with 5%CO2. After 24 h,
cells were harvested and RNA was isolated.
2.3 RNA isolation
RNA from macrophages was isolated using PureZol (BioRad,
Hercules, CA) reagent following manufacturer’s protocol. Quanti-
tation of RNA was done using a Nanodrop (Thermo Scientific).
2.4 miRNA microarray
Microarray hybridization and data analyses were performed
by commercial provider ‘LC Sciences’, Houston, TX, (www.
lcsciences.com). The hybridization of microarray was performed
as follows. Two g total RNA samples were 3’-extended with a
poly(A) tail using poly(A) polymerase. An oligonucleotide tag was
then ligated to the poly(A) tail for later fluorescent dye staining.
Hybridization was performed overnight on a Paraflo microfluidic
chip using a micro-circulation pump (Atactic Technologies).20
On the microfluidic chip, each detection probe consisted of a
chemically modified nucleotide coding segment complementary
to target microRNA (from miRBase, http://microrna.sanger.
ac.uk/sequences/). The detection probes were made by in situ
synthesis using PGR (photogenerated reagent) chemistry. The
hybridization melting temperatures were balanced by chemical
modifications of the detection probes. For hybridization, 100 L
6x SSPE buffer (0.90 M NaCl, 60 mM Na2HPO
4, 6 mM EDTA, pH 6.8)
containing 25% formamide was used. After RNA hybridization,
tag-conjugating Cy3 was circulated through the microfluidic
chip for dye staining. Fluorescence images were collected using
a laser scanner (GenePix 4000B, Molecular Device) and digitized
using Array-Pro image analysis software (Media Cybernetics).
Data were analyzed by first subtracting the background and then
normalizing the signals using a LOWESS filter (Locally-weighted
Regression).21 miRNA expression data between two groups were
subjected to t-Test and more than two groups were subjected to
ANOVA.
3. Results and Discussion
Figure 1 shows the clusters of differentially expressed
miRNAs. A total of 41 miRNA genes were differentially expressed
between the uninfected control, M.tuberculosis H37Rv and
M.tuberculosis H37Ra infected cells at p value >0.01. This included
seven under expressed genes (values below 500) and they were
not considered for further analysis. The expression data for the
remaining 34 miRNA genes are shown in Table 1. Among these,
15 and 19 miRNAs were up- and down regulated, respectively,
in THP-1 cells infected with M. tuberculosis H37Rv strain when
Figure 1. Diagram showing clustering of differentially expressed miRNAs.
Each row represents a miRNA and each column represents a sample. The color
scale shown at the top illustrates the relative expression of miRNA. Red color
represents high expression and green color represents low expression. MT1, MT2
and MT3 are RNA samples from uninfected, Mtb H37Rv infected, Mtb H37Ra
infected THP-1 cells, respectively.
K. Das et al. / Tuberculosis 93 S1 (2013) S47–S50 S49
compared to uninfected cells. A similar up- and down regulation
of miRNAs were also noticed between THP-1 cells uninfected
and infected with M. tuberculosis H37Ra strain. However, it was
noticed that a cluster of genes showed differential expression
between THP-1 cells infected with M. tuberculosis H37Rv and
H37Ra strains. This included five genes (miR-4668-5p, miR-30e,
miR-1275, miR-30a and miR-3178) that showed more than
one fold elevated expression in cells infected with H37Rv than
H37Ra, one gene (miR-4484) that showed more than one fold
elevated expression in cells infected with H37Ra than H37Rv,
and 3 genes (miR-155, miR-3665 and miR-4497) that showed
more than one fold reduced expression in cells infected with
M. tuberculosis H37Rv than M. tuberculosis H37Ra. Pubmed
search for the function of these miRNAs provided only limited
information. While miR-30e is activated by -catenin,22 miR-30a
inhibits epithelial to mesenchyme transition.23 miR-1275 seems
to be associated with liver metastases of cancer24 and miR-155
targets a negative regulator associated with TNF- production.16
Other miRNAs have not been studied in detail so far and this
prevents us to predict any potential roles for the differentially
expressed miRNAs.
It was difficult to compare the results of the present study
directly with previously published studies on M. tuberculosis
because each study had used a different cell/tissue type like
PBMCs,14 PBMCs derived macrophages,16 BMDMs,17 RAW264.7
cell line,17 human serum25 and sputum.26 However, a single
miRNA that is reported to be affected due to M. tuberculosis
infection in most of these studies, including this study which
used THP-1 cell line, is miR-155. But this miRNA, contrary to our
results which showed slight down regulation of expression, has
been found to be upregulated in all these studies, although the
extent of upregulation varies with different cell types/tissues.
Specifically, M. tuberculosis components lipomannan and ESAT-6
have been shown to induce miR-155 in PBMCs and BMDMs,
respectively.16 This is in sharp contrast to the observation made
with the intracellular pathogen F. tularensis which suppresses
the induction of miR-155. It seems that miR-155 is induced
through TLR and NOD like receptors mediated pathways and
any discrepancy in the induction of this miRNA by different
bacterial pathogens may indicate the differences in the ligands
for the above receptors. What is interesting, however, is that the
induction of miR-155 by M. tuberculosis seems to enhance its
survival in BMDMs.17
The virulent M. tuberculosis strain H37Rv and avirulent H37Ra
used in this study have the same ancestral parent, H37, a clinical
isolate from a pulmonary TB patient at the Trudeau Sanatorium.
Table1Data obtained for the differentially expressed miRNA genes.
No Infection Mtb H37Rv infected Fold change from Mtb H37Ra Infected Fold change from
No miRNA MT1a MT2a uninfected MT3a uninfected
1 hsa-miR-4668-5p 100±3 4290±922 43.0 170±31 1.7
2 hsa-miR-30e 448±0 2148±266 4.8 1038±30 2.3
3 hsa-miR-106b 337±24 693±18 2.0 460±24 1.36
4 hsa-miR-27a 2355±210 5247±612 2.2 5256±211 2.23
5 hsa-miR-4484 253±50 5185±406 20.5 5537±199 21.88
6 hsa-miR-4532 180±38 546±32 3.0 571±12 3.17
7 hsa-miR-1246 8857±908 19463±1264 2.19 18370±755 2.07
8 hsa-miR-21 15001±717 27577±2868 1.83 23126±1521 1.54
9 hsa-miR-1275 150±18 680±36 4.53 427±21 2.84
10 hsa-miR-19b 1132±58 3077±202 2.71 2231±77 1.97
11 hsa-miR-106a 5105±314 7607±140 1.49 6801±169 1.33
12 hsa-miR-29a 5686±304 10576±241 1.86 8872±11 1.56
13 hsa-miR-30a 188±19 1010±126 5.37 641±57 3.40
14 hsa-miR-3178 494±58 3351±243 6.78 2576±172 5.21
15 hsa-miR-762 176±7 564±41 3.20 423±37 2.40
16 hsa-miR-155 4395±500 2446±122 0.55 4510±201 1.02
17 hsa-miR-3665 7719±276 6526±5 0.85 8422±317 1.09
18 hsa-miR-4497 4109±54 2961±1 0.72 4514±51 1.09
19 hsa-miR-1280 831±6 289±62 0.34 448±16 0.54
20 hsa-miR-151-5p 1606±59 565±81 0.35 709±62 0.44
21 hsa-miR-151b 1011±72 450±65 0.45 570±41 0.56
22 hsa-miR-1307 276±27 164±4 0.59 191±5 0.69
23 hsa-miR-3141 1696±49 841±1 0.49 999±109 0.59
24 hsa-miR-4298 1408±40 735±9 0.52 957±53 0.68
25 hsa-miR-4739 842±3 759±28 0.90 674±9 0.88
26 hsa-miR-4281 1443±107 894±54 0.62 750±8 0.89
28 hsa-miR-191 9545±431 7059±149 0.74 7040±176 0.74
29 hsa-miR-193a-5p 1539±49 662±32 0.43 712±4 0.46
30 hsa-miR-361-5p 1703±12 787±104 0.46 913±43 0.53
31 hsa-miR-92b 3885±86 1922±308 0.49 1912±12 0.49
32 hsa-miR-92a 13673±531 8645±661 0.63 8011±143 0.58
33 hsa-miR-222 20731±585 15388±912 0.74 14999±182 0.72
34 hsa-miR-93 12376±102 1394±126 0.58 1344±31 0.56
a Values are Mean±SD. MT1, MT2 and MT3 are RNA samples from uninfected, Mtb H37Rv infected, Mtb H37Ra infected THP-1 cells, respectively.
S50 K. Das et al. / Tuberculosis 93 S1 (2013) S47–S50
They were initially differentiated based on the differences in
cord factor (TDM)27 production and ability to multiply within
macrophages.27,28 However, recent developments in ‘omics’
(genomics, proteomics, bioinformatics) have highlighted several
additional differences between them. In particular, the H37Ra
genome appears to be 8445 bp larger than H37Rv, despite the fact
it has 21 deletions.29 In addition, the most significant difference
between the two strains is the deficiency of H37Ra to translocate
the secretory and immunogenic proteins ESAT-6 and CFP-10 of
ESX-1 locus.30 ESAT-6 and CFP-10 are major virulence factors of
M. tuberculosis and some of the effects of these proteins in hosts
are suppression of proinflammatory responses,31 necrosis,32
apoptosis,33 membrano-lysis34 and cytolysis.35,36 Whether these
molecules have any roles in the observed alterations in the
expression of miRNAs between THP-1 cells infected with H37Rv
and H37Ra remains an important area of investigation.
In summary, we have identified nine miRNAs showing
differential expression in THP-1 cells infected with M. tuberculosis
H37Rv and H37Ra strains. Additional characterization of these
genes is necessary to better understand their role in tuberculosis
pathogenesis.
Acknowledgement
This study was partly supported by NIH/NIAID. This agency
has no role in the following: study design, data collection,
analysis and interpretation of data, writing of the manuscript
and in the decision to submit the manuscript for publication.
Funding
NIH/NIAID Grant R21AI089346.
Competing Interests
None declared
Ethical Approval
Not required
References
1. Fenton MJ, Vermeu len MW. Immunopathology of tuberculosis: roles of
macrophages and monocytes. Infect Immun 1996;64:683-90.
2. Yuan Y, Crane DD, Barry CE, 3rd. Stationary phase-associated protein
expression in Mycobacterium tuberculosis: function of the mycobacterial
alpha-crystallin homolog. J Bacteriol 1996;178:4484-92.
3. Ahmad S. Pathogen esis, immunology, and diagnosis of latent
Mycobacterium tuberculosis infection. Clinical & developmental immunology
2011;2011:814943.
4. Bartel DP, Chen C Z. Micromanagers of gene expression: the potentially
widespread influence of metazoan microRNAs. Nat Rev Genet 2004;5:396-
400.
5. Giraldez AJ, Cina lli RM, Glasner ME, Enright AJ, Thomson JM, Baskerville
S, Hammond SM, Bartel DP, Schier AF. MicroRNAs regulate brain
morphogenesis in zebrafish. Science 2005;308:833-8.
6. Kim VN. MicroRNA biogenesis: coordinated cropping and dicing. Nat Rev Mol
Cell Biol 2005;6:376-85.
7. Hutvagner G, Zamo re PD. A microRNA in a multiple-turnover RNAi enzyme
complex. Science 2002;297:2056-60.
8. Liu J. Control of protein synthesis and mRNA degradation by microRNAs. Curr
Opin Cell Biol 2008;20:214-21.
9. Bartel DP. MicroR NAs: target recognition and regulatory functions. Cell
2009;136:215-33.
10. Grosshans H, Fil ipowicz W. Proteomics joins the search for microRNA targets.
Cell 2008;134:560-2.
11. Stefani G, Slack FJ. Small non-coding RNAs in animal development. Nat Rev
Mol Cell Biol 2008;9:219-30.
12. Kota SK, Balasub ramanian S. Cancer therapy via modulation of micro RNA
levels: a promising future. Drug Discov Today;15:733-40.
13. Czech MP. MicroR NAs as therapeutic targets. N Engl J Med 2006;354:1194-5.
14. Liu Y, Wang X, J iang J, Cao Z, Yang B, Cheng X. Modulation of T cell cytokine
production by miR-144* with elevated expression in patients with pulmonary
tuberculosis. Mol Immunol 2011;48:1084-90.
15. Liu PT, Wheelwri ght M, Teles R, Komisopoulou E, Edfeldt K, Ferguson B, Mehta
MD, Vazirnia A, Rea TH, Sarno EN, Graeber TG, Modlin RL. MicroRNA-21 targets
the vitamin D-dependent antimicrobial pathway in leprosy. Nature medicine
2012;18:267-73.
16. Rajaram MV, Ni B , Morris JD, Brooks MN, Carlson TK, Bakthavachalu B,
Schoenberg DR, Torrelles JB, Schlesinger LS. Mycobacterium tuberculosis
lipomannan blocks TNF biosynthesis by regulating macrophage MAPK-activated
protein kinase 2 (MK2) and microRNA miR-125b. Proc Natl Acad Sci U S A
2011;108:17408-13.
17. Kumar R, Halder P, Sahu SK, Kumar M, Kumari M, Jana K, Ghosh Z, Sharma P,
Kundu M, Basu J. Identification of a novel role of ESAT-6-dependent miR-155
induction during infection of macrophages with Mycobacterium tuberculosis.
Cell Microbiol 2012;14:1620-31.
18. Ma F, Xu S, Liu X, Zhang Q, Xu X, Liu M, Hua M, Li N, Yao H, Cao X. The microRNA
miR-29 controls innate and adaptive immune responses to intracellular bacterial
infection by targeting interferon-gamma. Nat Immunol 2011;12:861-9.
19. Sharbati J, Lewi n A, Kutz-Lohroff B, Kamal E, Einspanier R, Sharbati S. Integrated
microRNA-mRNA-analysis of human monocyte derived macrophages upon
Mycobacterium avium subsp. hominissuis infection. PLoS One 2011;6:e20258.
20. Zhu Q, Hong A, S heng N, Zhang X, Matejko A, Jun KY, Srivannavit O, Gulari E, Gao
X, Zhou X. microParaflo biochip for nucleic acid and protein analysis. Methods
Mol Biol 2007;382:287-312.
21. Bolstad BM, Iriz arry RA, Astrand M, Speed TP. A comparison of normalization
methods for high density oligonucleotide array data based on variance and bias.
Bioinformatics 2003;19:185-93.
22. Schepeler T, Hol m A, Halvey P, Nordentoft I, Lamy P, Riising EM, Christensen
LL, Thorsen K, Liebler DC, Helin K, Orntoft TF, Andersen CL. Attenuation of
the beta-catenin/TCF4 complex in colorectal cancer cells induces several
growth-suppressive microRNAs that target cancer promoting genes. Oncogene
2012;31:2750-60.
23. Kumarswamy R, Mu dduluru G, Ceppi P, Muppala S, Kozlowski M, Niklinski
J, Papotti M, Allgayer H. MicroRNA-30a inhibits epithelial-to-mesenchymal
transition by targeting Snai1 and is downregulated in non-small cell lung cancer.
Int J Cancer 2012;130:2044-53.
24. Kahlert C, Klupp F, Brand K, Lasitschka F, Diederichs S, Kirchberg J, Rahbari N,
Dutta S, Bork U, Fritzmann J, Reissfelder C, Koch M, Weitz J. Invasion front-
specific expression and prognostic significance of microRNA in colorectal liver
metastases. Cancer Sci 2011;102:1799-807.
25. Fu Y, Yi Z, Wu X , Li J, Xu F. Circulating microRNAs in patients with active
pulmonary tuberculosis. J Clin Microbiol 2011;49:4246-51.
26. Yi Z, Fu Y, Ji R , Li R, Guan Z. Altered microRNA signatures in sputum of patients
with active pulmonary tuberculosis. PLoS One 2012;7:e43184.
27. Gao Q, Kripke K, Arinc Z, Voskuil M, Small P. Comparative expression studies
of a complex phenotype: cord formation in Mycobacterium tuberculosis.
Tuberculosis (Edinb) 2004;84:188-96.
28. McDonough KA, Kr ess Y, Bloom BR. Pathogenesis of tuberculosis: interaction of
Mycobacterium tuberculosis with macrophages. Infect Immun 1993;61:2763-73.
29. Zheng H, Lu L, W ang B, Pu S, Zhang X, Zhu G, Shi W, Zhang L, Wang H, Wang S,
Zhao G, Zhang Y. Genetic basis of virulence attenuation revealed by comparative
genomic analysis of Mycobacterium tuberculosis strain H37Ra versus H37Rv.
PLoS One 2008;3:e2375.
30. Frigui W, Bottai D, Majlessi L, Monot M, Josselin E, Brodin P, Garnier T, Gicquel B,
Martin C, Leclerc C, Cole ST, Brosch R. Control of M. tuberculosis ESAT-6 secretion
and specific T cell recognition by PhoP. PLoS Pathog 2008;4:e33.
31. Stanley SA, Ragh avan S, Hwang WW, Cox JS. Acute infection and macrophage
subversion by Mycobacterium tuberculosis require a specialized secretion
system. Proc Natl Acad Sci U S A 2003;100:13001-6.
32. Junqueira-Kipnis AP, Basaraba RJ, Gruppo V, Palanisamy G, Turner OC, Hsu T,
Jacobs WR, Jr., Fulton SA, Reba SM, Boom WH, Orme IM. Mycobacteria lacking
the RD1 region do not induce necrosis in the lungs of mice lacking interferon-
gamma. Immunology 2006;119:224-31.
33. Derrick SC, Morr is SL. The ESAT6 protein of Mycobacterium tuberculosis induces
apoptosis of macrophages by activating caspase expression. Cell Microbiol
2007;9:1547-55.
34. de Jonge MI, Peh au-Arnaudet G, Fretz MM, Romain F, Bottai D, Brodin P,
Honore N, Marchal G, Jiskoot W, England P, Cole ST, Brosch R. ESAT-6 from
Mycobacterium tuberculosis dissociates from its putative chaperone CFP-10
under acidic conditions and exhibits membrane-lysing activity. J Bacteriol
2007;189:6028-34.
35. Guinn KM, Hickey MJ, Mathur SK , Zakel KL, Grotzke JE, Lewinsohn DM, Smith S,
Sherman DR. Individual RD1-region genes are required for export of ESAT-6/CFP-
10 and for virulence of Mycobacterium tuberculosis. Mol Microbiol 2004;51:359-
70.
36. Hsu T, Hingley-Wilson SM, Chen B, Chen M, Dai AZ, Morin PM, Marks CB, Padiyar
J, Goulding C, Gingery M, Eisenberg D, Russell RG, Derrick SC, Collins FM, Morris
SL, King CH, Jacobs WR, Jr. The primary mechanism of attenuation of bacillus
Calmette-Guerin is a loss of secreted lytic function required for invasion of lung
interstitial tissue. Proc Natl Acad Sci U S A 2003;100:12420-5.