Current anti-tuberculosis (TB) strategies require months of treatment, and the development of multi-drug re- sistant mutants of M. tuberculosis (Mtb) has increased both the complexity and cost of treatment. As such, the NIAID recently proposed targeting infected individuals? responses to infection as a means to enhance anti-TB defenses. These ?host-directed therapies? could be combined with proven antibiotic strategies against TB, providing an overall enhancement of treatment and patient care. Amino acids are integral to immune function, yet there is a fundamental gap in understanding the therapeutic potential of targeting amino acid metabolism during disease. The long-term goal is to define the interplay between amino acid metabolism and immune re- sponses, providing new therapeutic avenues to manipulate immune activity. The objective of this study is to identify the role of L-citrulline metabolism on macrophage (M?)-mediated immune responses to Mtb. The ap- plicant will use Mtb H37Rv infection in human and mouse M?s, as well as in vivo infection in mice, to examine L-citrulline metabolism during Mtb infection. The central hypothesis is that L-citrulline metabolism is required for anti-TB M? activity and can be harnessed to assist host defense to TB in vivo. The hypothesis is support- ed as a) L-citrulline enhances M? NO production and anti-Mtb activity in vitro, b) L-citrulline metabolism by myeloid cells is necessary for mycobacterial defenses in vivo, c) L-citrulline supplementation decreases lung mycobacterial burden, and d) lung M?s are the predominant L-citrulline utilizing cells during infection. The ra- tionale for the proposed research is that uncovering mechanics of immune-mediated infection control will likely lead to novel methods for treating those infected with Mtb ? which kills well over 1 million annually. The appli- cant will test the central hypothesis by investigating three specific aims: 1) to examine how L-citrulline is uti- lized in Mtb-infected M?s, 2) to define the metabolism of L-citrulline in human M?s infected with Mtb, and 3) to identify how harnessing L-citrulline metabolism enhances anti-mycobacterial host defenses. Under the first and second aims, the applicant will utilize a combination of innovative cell culture and mass spectrometry ap- proaches with titrating amino acid concentrations to determine the benefit(s) of L-citrulline metabolism in hu- man and mouse M?s. These experiments will define the mechanistic consequences of this pathway that will complement in vivo experiments under the third aim, where the applicant will use an original approach to en- hance Mtb clearance in the lungs by supplementing mice with L-citrulline. The proposed research is significant as we anticipate harnessing L-citrulline metabolism will augment M?-mediated control of TB, and in combina- tion with anti-mycobacterial antibiotic therapy will result in efficient treatment strategies for patients suffering with TB. This research is also expected to have broad implications on host defense mechanisms ? enhancing pathogen control and individual components of the immune system by altering amino acid metabolism.

Public Health Relevance

Considering the rapid development of resistance against commonly used therapies targeting Mycobacterium tuberculosis (Mtb), new approaches designed to augment host defenses are urgently needed. The proposed research aims to harness L-citrulline metabolism in the immune system as a ?host-directed therapy? against tuberculosis. This research is relevant to public health because enhancing anti-mycobacterial immunity via L- citrulline supplementation will be cost-effective and is presumed safe for treating patients with tuberculosis in- fection in combination with current anti-tuberculosis therapeutics.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
5R01AI116668-02
Application #
9304965
Study Section
Immunity and Host Defense (IHD)
Program Officer
Eichelberg, Katrin
Project Start
2016-07-01
Project End
2021-06-30
Budget Start
2017-07-01
Budget End
2018-06-30
Support Year
2
Fiscal Year
2017
Total Cost
Indirect Cost
Name
Cincinnati Children's Hospital Medical Center
Department
Type
DUNS #
071284913
City
Cincinnati
State
OH
Country
United States
Zip Code
45229