Exploitation of gene knockout mice models to study the pathogenesis of leprosy.

Shepard's technique for growth of Mycobacterium leprae in the mouse footpad, described in 1960, and more recent studies in thymectomized-irradiated mice and rats, athymic nude mice, nude rats and severe combined immunodeficiency (SCID) mice have defined the role of T-cell mediated immunity (CMI) in leprosy. However, the normal mouse and the immunocompromised mouse and rat represent only elements of polar tuberculoid disease and polar lepromatous leprosy, respectively. Transgenic, knockout (KO) mice may be employed to study the roles of individual genes in the ability of the host to mount an effective immune response to pathogens, and may also allow development of mouse models for the immunologically unstable borderline areas of the spectrum. We are exploiting certain KO mice to improve our understanding of CMI to M. leprae, and to study the role of the microenvironment of the leprosy granuloma in pathogenesis. CGD (chronic granulomatous disease) mice and iNOS-KO mice lack the ability to produce reactive oxygen intermediates (ROI) and reactive nitrogen intermediates (RNI), respectively, whereas the T cells of GKO mice are unable to produce interferon-gamma (IFN gamma). iNOS-KO mice exhibit an enhanced capacity to form granulomas, and the histopathology of the infected footpad tissues of this strain share many elements of borderline tuberculoid disease. The macrophages of CGD mouse kill or inhibit multiplication of M. leprae, although they lack ROI. Multiplication of the organisms in the footpad is enhanced in GKO mice, although these mice retain some host resistance. In addition, we have been investigating supplementary, conditional approaches to KO mouse models. For example, the down-regulatory effects of local prostaglandin production can be controlled with essential fatty acid deficient diets or indomethacin, RNI can be blocked in CGD and GKO mice by treatment with aminoguanidine, NG monomethyl arginine or N6-(1-iminoethyl)-L-lysine, and local elaboration of TNF alpha can be neutralized by anti-TNF alpha antibody or excess TNF alpha receptor. Other cytokines can be neutralized by antibody as well, broadening the range of conditional knockout models.