Liquefaction and cavity formation in pulmonary TB: A simple method in rabbit skin to test inhibitors - 22/08/11

Doi : 10.1016/j.tube.2009.05.006

Arthur M. Dannenberg ^a,^b,^⁎
^a Department of Environmental Health Sciences, Molecular microbiology and Immunology, and Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
^b Department of Pathology, School of Medicine; and Center for Tuberculosis Research, Johns Hopkins University, Baltimore, MD 21205, USA

Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA. Tel.: +1 410 377 7125 (home), +1 410 955 3062 (work, usually Tuesday and Thursday); fax: +1 410 955 0105 (only when I’m at work).

Summary

To control tuberculosis in the world today an additional approach would be most welcomed. Preventing (or reducing) pulmonary cavity formation is one such approach that has been almost completely neglected. Pulmonary cavity formation and the extracellular growth of tubercle bacilli in cavities cause bronchial spread of the disease in adult patients and spread of the bacillus to the environment where they infect other people. Therefore, cavity formation perpetuates tuberculosis in mankind. If no cavities form, the patient is much less infectious. Also, cavity formation often allows the tubercle bacillus to multiply (extracellularly) to tremendous numbers. Therefore, in humans almost all multidrug-resistant tubercle bacilli develop in cavities. This communication reviews the literature on liquefaction and cavity formation, and lists some of the responsible hydrolytic enzymes. It also describes a simple method to identify inhibitory pharmaceuticals, i.e., to observe their effect on the liquefaction and ulceration of skin lesions produced in rabbits by ascending concentrations of live or dead tubercle bacilli.

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Keywords : Tuberculosis cavity formation, Tuberculosis liquefaction, Pulmonary tuberculosis, Tuberculosis ulceration in skin, Tuberculosis in rabbits