BACKGROUND
tuberculosis  is a major global health problem and still remains one of the world’s deadliest communicable diseases.
in  <dig>  an estimated  <dig>  million people developed tb and  <dig>  million died from the disease,  <dig>  <dig> of whom were hiv-positive  <cit> .
the resurgence of tb worldwide has intensified research efforts directed on examining the host defence and pathogenic mechanisms operative in mycobacterium tuberculosis  infection.
this is primarily because the organism lives inside the cells and thus t cells, rather than antibodies are required to eliminate bacteria  <cit> .
for proper t-cell activation, t cell receptor  engagement with antigen presenting cells  in presence of co-stimulation is required and any variation in this, could lead to t-cell anergy  <cit> .
the pathogenic mycobacteria resides inside macrophage and involves in the inhibition of several host-cell procedures, which allows its survival inside the host cells.
the host processes that are hampered by pathogenic bacteria, the molecules and mechanisms utilized by pathogenic mycobacteria to accomplish intracellular survival are not fully understood.
m. tuberculosis can modulate the adaptive immune response using various mechanisms directed on both the apcs and the t cells.
m. tuberculosis infected macrophages indirectly suppress t cell activation by interfering with antigen processing and presentation.
seitzer et al.
showed decreased expression of cd3-ζ, a key signalling domain of the tcr/cd <dig> complex in t cells from human tb patients  <cit> .
wang et al.
have shown that the potent t cell antigen esat- <dig> can directly suppress ifn-γ production in cd4+ t cells  <cit> .
directly inhibition of polyclonal murine cd4+ t cell activation by m. tuberculosis cell wall glycolipids by blocking zap- <dig> phosphorylation has been shown by mahon et al.
<cit>  and later they extended their study by reporting manlam induced inhibition of tcr signalling by interference with zap- <dig>  lck and lat phosphorylation in antigen-specific murine cd4+ t cells and primary human t cells  <cit> .
recently regulation of ifn-γ production by erk and p <dig> mapk signalling pathway and through slam costimulation has been suggested in tb  <cit> .
secretory antigens of m. tuberculosis are immunodominant and could have a role in the outcome of disease by modulation of cell signalling pathways.
inhibition of ifn-γ production through p <dig> mapk pathway by esat- <dig> has been reported in t cells from healthy individuals  <cit> .
however, mechanisms of action of m. tuberculosis antigens  on tcr/cd <dig> mediated signalling in tb patients have not been addressed till date hence needs to be investigated.
in the present study effect of ag85a, esat- <dig> , purified protein derivative   and h37rv  was investigated on tcr/cd28-triggered signalling which could be involved in t-cell dysfunctioning that leads to bacterial survival hence disease progression.
our objective was to study calcium mobilization, activation of mapks and binding of nfat and nfκb on il- <dig> promoter in peripheral blood mononuclear cells  of pulmonary tb patients and healthy individuals in presence or absence of m. tuberculosis antigens.
RESULTS
the concentration of antigens showing optimum proliferative index in lymphocyte transformation test  in pbmcs of pulmonary tb patients and ppd+ve healthy individuals  was considered as optimal working concentration for further signalling experiments.
standardized doses  showed stimulation indices  more than two in ppd + ve healthy individuals as well as in pulmonary tb patients.
the levels of s.i.
with antigens  were significantly lower in tb patients than ppd+ve healthy individuals and were also significantly lower to the s.i.
of pha and ppd stimulated cells .
serial concentrations of antigens  were used in ltt and optimal dose of antigen found by ltt results was observed to show the maximum effect.
m. tuberculosis antigens differentially curtail tcr triggered intracellular calcium mobilization
to find out the effect of m. tuberculosis antigens on intracellular calcium mobilization, we measured intracellular calcium concentration by spectrofluorometer.
we assessed tcr-triggered calcium mobilization by adding anti-cd <dig> antibody on cells pretreated with optimum doses of m. tuberculosis antigens .
we noticed that tcr triggered calcium mobilization in ppd+ve healthy individuals was significantly diminished by esat- <dig>  but it was increased by ag85a, ppd and h37rv though it was not statistically significant.
it showed that esat- <dig> inhibited the transmembrane calcium mobilization, while it was enhanced by other antigens.
tcr triggered transmembrane calcium mobilization was significantly curtailed in pulmonary tb patients, by ag85a and esat- <dig>  ppd and h37rv also inhibited the mobilization but it was not statistically significant .fig.
<dig>
m. tuberculosis antigens alter free intracellular calcium concentration in ppd+ve healthy individuals and pulmonary tb patients.
peripheral blood mononuclear cells  from  <dig> ppd+ve healthy donors and five pulmonary tb patients were stimulated with m. tuberculosis antigens for 4 h. fluorescence intensities were measured in ratio mode using varian eclipse spectrofluorometer as mentioned in material and methods.
bar diagrams show changes in i in anti cd <dig> and ionomycin treated cells of  ppd+ve healthy individuals  pulmonary tb patients and values in histogram are mean ± sem.
*, p <  <dig> ; **, p < <dig>
m. tuberculosis antigens modulate tcr/cd28-induced mapk activation
to determine whether m. tuberculosis antigens modulate tcr and tcr/cd <dig> induced mapk activation, we measured phosphorylation of erk ½ and p <dig> by western blot.
phosphorylation of mapks was studied in ag85a, esat- <dig>  ppd and h37rv stimulated cells of ppd+ve healthy individuals and pulmonary tb patients.
although there was notable individual variation, tcr/cd <dig> induced phosphorylation of erk1/ <dig> was observed to be significantly reduced by esat- <dig> in healthy individuals, while h37rv significantly increased phosphorylation of erk ½. ag85a had no significant effect on activation of erk ½, though ppd increased phosphorylaion but not significantly.
however, in pulmonary tb patients significant inhibition of tcr/cd <dig> triggered erk1/ <dig> phosphorylation by ag85a and esat- <dig> was observed.
ppd had no effect on phosphorylation of erk ½ and h37rv decreased but not significantly .
the phosphorylation of p <dig> in tcr/cd <dig> induced cells was also analysed after stimulation with m. tuberculosis antigens.
no effect of ag85a, esat- <dig>  ppd and h37rv on p <dig> phosphorylation in ppd+ve healthy individuals was noted.
on the other hand ag85a and esat- <dig> significantly curtailed phosphorylation of p <dig> in pulmonary tb patients .fig.
<dig>
m. tuberculosis antigens modulate tcr- and tcr/cd28-induced phosphorylation of erk1/ <dig> in ppd+ve healthy individuals and pulmonary tb patients.
peripheral blood mononuclear cells  from six ppd+ve healthy donors and  <dig> pulmonary tb patients were stimulated with m. tuberculosis antigens for 4 h. cells were then activated with anti cd <dig> and anti cd <dig> antibodies .
phosphorylated erk ½, total erk  and β- actin expression were determined by western blot.
one representative blot of healthy individual and tb patient is shown, where lane 1- control, lane 2- anti cd <dig> stimulated, lane 3- anti cd3 + anti cd <dig> stimulated, lane 4- anti cd3 + anti cd <dig> stimulated in presence of ag85a, lane 5- anti cd3 + anti cd <dig> stimulated in presence of esat- <dig>  lane 6- anti cd3 + anti cd <dig> stimulated in presence of ppd and lane 7-anti cd3 + anti cd <dig> stimulated in presence of h37rv.
densitometry was performed, and the ratios of phosphorylated to total protein expression were expressed as arbitrary units.
*p < .
<dig>  ** p < <dig> ; *** p < <dig>  by the mann–whitney u
fig.
<dig>
m. tuberculosis antigens modulate tcr- and tcr/cd28-induced p <dig> phosphorylation in ppd+ve healthy individuals and pulmonary tb patients.
peripheral blood mononuclear cells  from six ppd + ve healthy donors and  <dig> pulmonary tb patients were stimulated with m. tuberculosis antigens for 4 h. cells were then activated with anti cd <dig> and anti cd <dig> antibodies .
phosphorylated p <dig>  total p- <dig>  and β- actin expression were determined by western blot.
one representative blot of each study case is shown where lane 1- control, lane 2- anti cd <dig> stimulated, lane 3- anti cd3 + anti cd <dig> stimulated, lane 4- anti cd3 + anti cd <dig> stimulated in presence of ag85a, lane 5- anti cd3 + anti cd <dig> stimulated in presence of esat- <dig>  lane 6- anti cd3 + anti cd <dig> stimulated in presence of ppd and lane 7-anti cd3 + anti cd <dig> stimulated in presence of h37rv.
densitometry was performed, and the ratios of phosphorylated to total protein expression were expressed as arbitrary units.
*p < .
<dig>  ** p < <dig> ; *** p < <dig>  by the mann–whitney u test
m. tuberculosis antigens differentially modulate tcr/cd28-induced binding of nfκb and nfat
dna binding affinity of nfκb and nfat on il- <dig> promoter was also studied on tcr/cd <dig> activated cells by electrophoretic mobility shift assay .
ag85a, esat- <dig>  ppd and h37rv curtailed binding affinity of nfκb in ppd+ve healthy individuals but only esat- <dig> showed statistically significant reduction in binding affinity.
in pulmonary tb patients ag85a and esat- <dig> significantly curtailed the binding affinity of nfκb .
we also noted that ag85a, esat- <dig>  ppd and h37rv curtailed tcr/cd <dig> induced binding activity of nfat on il- <dig> promoter in ppd+ve healthy individuals and pulmonary tb patients both.
esat- <dig> was the only antigen that curtailed the binding activity of nfat significantly in healthy individuals and patients both, but significant inhibition by ppd and h37rv was observed in patients only, though no significant effect of ag85a was noted in healthy and patients both .fig.
<dig>
m. tuberculosis antigens modulate tcr- and tcr/cd28-induced dna binding affinity of nfκb to the promoter of il- <dig> cytokine in ppd+ve healthy individuals and pulmonary tb patients.
peripheral blood mononuclear cells  from  <dig> ppd+ve healthy donors and  <dig> pulmonary tb patients were stimulated with m. tuberculosis antigens for 4 h. cells were then activated with anti cd <dig> and anti cd <dig> antibodies .
nuclear lysates were prepared and binding affinity of nfκb was determined by emsa.
one representative blot of each study case is shown where lane 1- control, lane 2- anti cd <dig> stimulated, lane 3- anti cd3 + anti cd <dig> stimulated, lane 4- anti cd3 + anti cd <dig> stimulated in presence of ag85a, lane 5- anti cd3 + anti cd <dig> stimulated in presence of esat- <dig>  lane 6- anti cd3 + anti cd <dig> stimulated in presence of ppd and lane 7-anti cd3 + anti cd <dig> stimulated in presence of h37rv.
densitometry was performed, histograms represent mean band intensities.
*p < .
<dig>  ** p < <dig> ; *** p < <dig>  by the mann–whitney u test
fig.
<dig>
m. tuberculosis antigens modulate tcr- and tcr/cd28-induced dna binding of nfat to the promoter of il- <dig> cytokine in ppd+ve healthy individuals and pulmonary tb patients.
peripheral blood mononuclear cells  from  <dig> ppd+ve healthy donors and  <dig> pulmonary tb patients were stimulated with m. tuberculosis antigens for 4 h. cells were then activated with anti cd <dig> and anti cd <dig> antibodies .
nuclear lysates were prepared and binding affinity of nfat was determined by emsa.
one representative example of each study case is shown where lane 1- control, lane 2- anti cd <dig> stimulated, lane 3- anti cd3 + anti cd <dig> stimulated, lane 4- anti cd3 + anti cd <dig> stimulated in presence of ag85a, lane 5- anti cd3 + anti cd <dig> stimulated in presence of esat- <dig>  lane 6- anti cd3 + anti cd <dig> stimulated in presence of ppd and lane 7-anti cd3 + anti cd <dig> stimulated in presence of h37rv.
densitometry was performed, histograms represent mean band intensities.
*p < .
<dig> ** p < <dig> ; *** p < <dig>  by the mann–whitney u test
discussion
the outcome of tb mainly depends on t-cell response, which is altered through multiple, but poorly understood mechanisms.
this study was designed to investigate the impact of m. tuberculosis antigens on t cell activation and their role in modulation of t-cell physiology in disease, which still needs to be defined.
here, we observed that patients with active pulmonary tb have a significant diminished tcr triggered intracellular calcium mobilization in response to secretory m. tuberculosis antigens which is an important regulatory signal-transduction stage of t cell activation.
further, selective modulation in tcr/cd28-induced late signalling events like mapks and binding of nfat and nfκb which is important in the activation of certain t cell genes for cytokine production was also noted in presence of m. tuberculosis antigens.
the data suggests that these alterations could explain the loss of a protective immune response by reducing production of proinflammatory cytokines il- <dig> against m. tuberculosis to some extent, and it may also help us to figure out the mechanisms leading to t cell dysfunction in tb.
optimal t cell activation involves stimulation through the tcr by mhc-peptide complex along with additional signalling through co-stimulatory receptors.
the tcr is a complex consisting intracellular signal transducing domains, immunoreceptor tyrosine-based activation motifs .
once phosphorylated, itams become recruitment sites for zap- <dig>  activated zap- <dig> is then recruited to phosphorylate the multiple transmembrane molecules.
these signalling molecules activate multiple secondary signalling pathways including ca2+ signalling, ras/map kinase, and protein kinase c  pathways that ultimately activate several transcription factors including nfat, ap- <dig> and nf-κb that are essential for full il- <dig> gene expression and t cell activation .
we observed that esat- <dig> curtailed tcr triggered calcium mobilization in pulmonary tb patients and ppd+ve healthy individuals both but the inhibition is more in patients as compared to healthy individuals.
on the other hand, ag85a, ppd and h37rv diminished transmembrane calcium mobilization in pulmonary tb patients but enhanced the transmembrane calcium influx in ppd+ve healthy individuals.
present study confirms that mycobaterial antigens: ag85a, esat- <dig>  ppd and h37rv, altered calcium signalling and consequently might play a critical role in the pathogenesis of the disease.
altered calcium signalling and other signalling events has been noted in leprosy patients and t cell lines and modulation by lipid and soluble fraction of m. leprae lysates was shown which could play a major role in the pathogenesis .
our results are in close concordance with other reports where pbmcs from patients with leprosy have been reported to have reduced cytosolic i concentrations  <cit> .
in macrophages curtailment of i levels by m. tuberculosis has been shown, which could be linked with reduced phagosome-lysosome fusion, thus for increased survival of mycobacteria  <cit> .
only one report is available on intracellular calcium modulation by h37rv in newly diagnosed and treated tb patients and ppd+ve and ppd-ve healthy controls  <cit> .
in addition, we used ppd and immunodominant m. tuberculosis secretory antigens.
on the contrary, it has been previously reported that esat- <dig> did not affect phosphorylation of zap- <dig> and intracellular calcium levels but esat- <dig> inhibits t cell immune responses by affecting downstream signalling molecules  <cit> .
the importance of the mapks signal transduction pathway in controlling many aspects of immune-mediated inflammatory responses has made it a priority for research, related to many human diseases.
therefore, we further studied downstream signalling events such as activation of mapks and nuclear translocation of transcription factors nfκb and nfat, important events for both cytokine production and cell activation.
interestingly, we observed that esat- <dig> significantly curtailed tcr/cd <dig> induced phosphorylation of erk1/ <dig> in healthy individuals and pulmonary tb patients both.
we did not observe any effect on p <dig> phosphorylation in tcr/cd <dig> induced cells of healthy individual after treatment with m. tuberculosis antigen whereas in pulmonary tb patients ag85a and esat- <dig> significantly curtailed p <dig> phosphorylation.
palma-nicholas  <cit>  reported down-modulation of mapk–erk1/ <dig> pathway in total spleen cells from naive balb/c mice by the cell-surface lipid di-o-acyl-trehalose , which further leads to lowering of th- <dig> type cytokine production.
as per our knowledge ours is the first study where differential modulation of tcr or tcr/cd <dig> induced downstream signalling events like mapks in the pbmcs of pulmonary tb patients has been observed.
the finding suggests modulation of erk1/ <dig> and p <dig> both or majorly p <dig> in t cells by m. tuberculosis that could lead to t cell dysfunction or low th <dig> cytokine production.
inhibition of ifn-γ by esat- <dig> in human t cells through p <dig> mapk has been reported earlier  <cit> , however, our observation of inhibition of p <dig> by ag85a in tb patients is a novel information and confirms the role of p <dig> in the t cell dysfunction.
similar to our findings differential modulation of downstream signalling events like mapks by m. leprae antigens stimulated t cells from leprosy patients have been reported earlier  <cit> .
further, diminished and differential phosphorylation of mapks by m. leprae antigens in t cell lines after stimulation with anti cd <dig> or anti cd3+cd <dig> has also been reported  <cit> .
effect of secretory protein esat- <dig> of m. tuberculosis in the modulation of macrophage signalling pathways particularly erk1/ <dig> mapk pathway has been shown in one study  <cit> .
further, binding affinity of nfκb and nfat of antigen treated cells in pulmonary tb patients and in ppd+ve healthy individuals was also assessed by emsa.
we observed that esat- <dig> significantly reduced the binding of nfκb in healthy individuals and pulmonary tb patients.
we also noticed curtailment of binding activity of nfat in anti cd3+cd <dig> stimulated cells in pulmonary tb patients after treatment with esat- <dig>  ppd and h37rv.
esat- <dig> induced cells were showing significant inhibition of nfat binding in pulmonary tb patients and healthy individuals both.
our findings of reduced nfat binding in esat- <dig> stimulated cells in healthy individuals and tb patients could be correlated with the reduced ca2+ mobilization of esat − <dig> stimulated cells in healthy and patients both.
calcium is an essential element in many t-cell responses, including a pathway that leads to the movement of a major transcription factor, nfat, from the cytoplasm into the nucleus where nfat supports the transcription of genes required for the expression of the t cell growth-promoting cytokines il- <dig>  <cit> .
no study on the expression of nfkb and nfat in activated t cells in tb patients is available till date, however, zea et al.
<cit>  have noticed reduced expression of p <dig> of nfkb in t cells of pulmonary tb patients.
tchou- wong et al.
<cit>  revealed specific binding of nuclear protein to the nfkb site upon induction with m. tuberculosis in human monocytic leukemic cell line thp- <dig>  impaired nuclear translocation of nfκb and nfat was also noticed in leprosy patients .
while inhibition of t-cell activation is a novel observation for m. tuberculosis, it has been shown to occur with other pathogens.
these include bacteria, viruses, and protozoan parasites.
bacterial toxins, including those from helicobacter pylori and bacillus anthracis, can suppress tcr signalling by blocking calcium influx and mapks, respectively .
salmonella enterica may also express a protein that can down-modulate tcr expression  <cit> .
our study indicates that m. tuberculosis has several ways to destabilize the host’s t-cell response besides what is already established.
although previous studies of cell signalling pathways in tb have contributed upto some extent to our knowledge of their role in host protective immune responses, a number of critical questions are not well understood.
research into the development of tb vaccines and immunodiagnostics has focused on the proteins released by m. tuberculosis, because these antigens are thought to induce protective cell mediated immunity and immune responses of diagnostic value.
ag85a and esat- <dig> are widely studied for their potential to trigger effective host immune responses against tb, but very little is known regarding their role in the t cells signalling mechanisms underlying proinflammatory cytokine secretion by t cells.
our data demonstrate that the stimulation of human peripheral blood cells in vitro with the ag85a and esat- <dig> antigens of m. tuberculosis markedly down modulated tcr activation by reducing activation of t cells by affecting upstream as well as downstream tcr signalling events.
we suggest that these mycobacterial antigens can affect activation of intracellular t cell signalling pathways, such as calcium mobilization, mapks that are required for production of il- <dig>  further work is required to delineate the molecular mechanisms underlying these effects, to better understand interactions between m. tuberculosis and human immune system and to facilitate development of esat- <dig> and ag85a-based vaccines.
CONCLUSIONS
this study has shown that a significant number of the patients with pulmonary tb had alterations in the expression of several t cell signal-transduction proteins, alterations that were similar to those reported earlier in patients with leprosy.
the similarity of t cell signal-transduction alterations in diseases with different pathophysiological characteristics suggests the possibility that a common mechanism causes such changes.
follow-up studies are needed to determine whether such alterations revert after successful treatment and also whether these can be modulated by immunotherapy.
it would also be of interest to know variations in different forms of tuberculosis and determine relationship with activation of different cytokines.
these observations of molecular and functional characteristics in tb may provide new tools to analyse and monitor patients, to reveal how these characteristics affect the development of immune dysfunction and to study new pathways to block suppressor mechanisms.
this endeavour will enhance our knowledge of disease pathogenesis, contributing to a better understanding of the immune response to m. tuberculosis.

 tuberculosis is a major global health problem and still remains one of the world’s deadliest communicable diseases. in an estimated million people developed tb and million died from the disease, of whom were hiv-positive. the resurgence of tb worldwide has intensified research efforts directed on examining the host defence and pathogenic mechanisms operative in mycobacterium tuberculosis infection. this is primarily because the organism lives inside the cells and thus t cells, rather than antibodies are required to eliminate bacteria. for proper t-cell activation, t cell receptor engagement with antigen presenting cells in presence of co-stimulation is required and any variation in this, could lead to t-cell anergy. the pathogenic mycobacteria resides inside macrophage and involves in the inhibition of several host-cell procedures, which allows its survival inside the host cells. the host processes that are hampered by pathogenic bacteria, the molecules and mechanisms utilized by pathogenic mycobacteria to accomplish intracellular survival are not fully understood. m. tuberculosis can modulate the adaptive immune response using various mechanisms directed on both the apcs and the t cells. m. tuberculosis infected macrophages indirectly suppress t cell activation by interfering with antigen processing and presentation. seitzer et al. showed decreased expression of cd3-ζ, a key signalling domain of the tcr/cd complex in t cells from human tb patients. wang et al. have shown that the potent t cell antigen esat- can directly suppress ifn-γ production in cd4+ t cells. directly inhibition of polyclonal murine cd4+ t cell activation by m. tuberculosis cell wall glycolipids by blocking zap- phosphorylation has been shown by mahon et al. and later they extended their study by reporting manlam induced inhibition of tcr signalling by interference with zap- lck and lat phosphorylation in antigen-specific murine cd4+ t cells and primary human t cells. recently regulation of ifn-γ production by erk and p mapk signalling pathway and through slam costimulation has been suggested in tb. secretory antigens of m. tuberculosis are immunodominant and could have a role in the outcome of disease by modulation of cell signalling pathways. inhibition of ifn-γ production through p mapk pathway by esat- has been reported in t cells from healthy individuals. however, mechanisms of action of m. tuberculosis antigens on tcr/cd mediated signalling in tb patients have not been addressed till date hence needs to be investigated. in the present study effect of ag85a, esat-, purified protein derivative and h37rv was investigated on tcr/cd28-triggered signalling which could be involved in t-cell dysfunctioning that leads to bacterial survival hence disease progression. our objective was to study calcium mobilization, activation of mapks and binding of nfat and nfκb on il- promoter in peripheral blood mononuclear cells of pulmonary tb patients and healthy individuals in presence or absence of m. tuberculosis antigens.  the concentration of antigens showing optimum proliferative index in lymphocyte transformation test in pbmcs of pulmonary tb patients and ppd+ve healthy individuals was considered as optimal working concentration for further signalling experiments. standardized doses showed stimulation indices more than two in ppd + ve healthy individuals as well as in pulmonary tb patients. the levels of s.i. with antigens were significantly lower in tb patients than ppd+ve healthy individuals and were also significantly lower to the s.i. of pha and ppd stimulated cells. serial concentrations of antigens were used in ltt and optimal dose of antigen found by ltt results was observed to show the maximum effect. m. tuberculosis antigens differentially curtail tcr triggered intracellular calcium mobilization to find out the effect of m. tuberculosis antigens on intracellular calcium mobilization, we measured intracellular calcium concentration by spectrofluorometer. we assessed tcr-triggered calcium mobilization by adding anti-cd antibody on cells pretreated with optimum doses of m. tuberculosis antigens. we noticed that tcr triggered calcium mobilization in ppd+ve healthy individuals was significantly diminished by esat- but it was increased by ag85a, ppd and h37rv though it was not statistically significant. it showed that esat- inhibited the transmembrane calcium mobilization, while it was enhanced by other antigens. tcr triggered transmembrane calcium mobilization was significantly curtailed in pulmonary tb patients, by ag85a and esat- ppd and h37rv also inhibited the mobilization but it was not statistically significant.fig. m. tuberculosis antigens alter free intracellular calcium concentration in ppd+ve healthy individuals and pulmonary tb patients. peripheral blood mononuclear cells from ppd+ve healthy donors and five pulmonary tb patients were stimulated with m. tuberculosis antigens for 4 h. fluorescence intensities were measured in ratio mode using varian eclipse spectrofluorometer as mentioned in material and methods. bar diagrams show changes in i in anti cd and ionomycin treated cells of ppd+ve healthy individuals pulmonary tb patients and values in histogram are mean ± sem. *, p < ; **, p < m. tuberculosis antigens modulate tcr/cd28-induced mapk activation to determine whether m. tuberculosis antigens modulate tcr and tcr/cd induced mapk activation, we measured phosphorylation of erk ½ and p by western blot. phosphorylation of mapks was studied in ag85a, esat- ppd and h37rv stimulated cells of ppd+ve healthy individuals and pulmonary tb patients. although there was notable individual variation, tcr/cd induced phosphorylation of erk1/ was observed to be significantly reduced by esat- in healthy individuals, while h37rv significantly increased phosphorylation of erk ½. ag85a had no significant effect on activation of erk ½, though ppd increased phosphorylaion but not significantly. however, in pulmonary tb patients significant inhibition of tcr/cd triggered erk1/ phosphorylation by ag85a and esat- was observed. ppd had no effect on phosphorylation of erk ½ and h37rv decreased but not significantly. the phosphorylation of p in tcr/cd induced cells was also analysed after stimulation with m. tuberculosis antigens. no effect of ag85a, esat- ppd and h37rv on p phosphorylation in ppd+ve healthy individuals was noted. on the other hand ag85a and esat- significantly curtailed phosphorylation of p in pulmonary tb patients.fig. m. tuberculosis antigens modulate tcr- and tcr/cd28-induced phosphorylation of erk1/ in ppd+ve healthy individuals and pulmonary tb patients. peripheral blood mononuclear cells from six ppd+ve healthy donors and pulmonary tb patients were stimulated with m. tuberculosis antigens for 4 h. cells were then activated with anti cd and anti cd antibodies. phosphorylated erk ½, total erk and β- actin expression were determined by western blot. one representative blot of healthy individual and tb patient is shown, where lane 1- control, lane 2- anti cd stimulated, lane 3- anti cd3 + anti cd stimulated, lane 4- anti cd3 + anti cd stimulated in presence of ag85a, lane 5- anti cd3 + anti cd stimulated in presence of esat- lane 6- anti cd3 + anti cd stimulated in presence of ppd and lane 7-anti cd3 + anti cd stimulated in presence of h37rv. densitometry was performed, and the ratios of phosphorylated to total protein expression were expressed as arbitrary units. *p <. ** p <; *** p < by the mann–whitney u fig. m. tuberculosis antigens modulate tcr- and tcr/cd28-induced p phosphorylation in ppd+ve healthy individuals and pulmonary tb patients. peripheral blood mononuclear cells from six ppd + ve healthy donors and pulmonary tb patients were stimulated with m. tuberculosis antigens for 4 h. cells were then activated with anti cd and anti cd antibodies. phosphorylated p total p- and β- actin expression were determined by western blot. one representative blot of each study case is shown where lane 1- control, lane 2- anti cd stimulated, lane 3- anti cd3 + anti cd stimulated, lane 4- anti cd3 + anti cd stimulated in presence of ag85a, lane 5- anti cd3 + anti cd stimulated in presence of esat- lane 6- anti cd3 + anti cd stimulated in presence of ppd and lane 7-anti cd3 + anti cd stimulated in presence of h37rv. densitometry was performed, and the ratios of phosphorylated to total protein expression were expressed as arbitrary units. *p <. ** p <; *** p < by the mann–whitney u test m. tuberculosis antigens differentially modulate tcr/cd28-induced binding of nfκb and nfat dna binding affinity of nfκb and nfat on il- promoter was also studied on tcr/cd activated cells by electrophoretic mobility shift assay. ag85a, esat- ppd and h37rv curtailed binding affinity of nfκb in ppd+ve healthy individuals but only esat- showed statistically significant reduction in binding affinity. in pulmonary tb patients ag85a and esat- significantly curtailed the binding affinity of nfκb. we also noted that ag85a, esat- ppd and h37rv curtailed tcr/cd induced binding activity of nfat on il- promoter in ppd+ve healthy individuals and pulmonary tb patients both. esat- was the only antigen that curtailed the binding activity of nfat significantly in healthy individuals and patients both, but significant inhibition by ppd and h37rv was observed in patients only, though no significant effect of ag85a was noted in healthy and patients both.fig. m. tuberculosis antigens modulate tcr- and tcr/cd28-induced dna binding affinity of nfκb to the promoter of il- cytokine in ppd+ve healthy individuals and pulmonary tb patients. peripheral blood mononuclear cells from ppd+ve healthy donors and pulmonary tb patients were stimulated with m. tuberculosis antigens for 4 h. cells were then activated with anti cd and anti cd antibodies. nuclear lysates were prepared and binding affinity of nfκb was determined by emsa. one representative blot of each study case is shown where lane 1- control, lane 2- anti cd stimulated, lane 3- anti cd3 + anti cd stimulated, lane 4- anti cd3 + anti cd stimulated in presence of ag85a, lane 5- anti cd3 + anti cd stimulated in presence of esat- lane 6- anti cd3 + anti cd stimulated in presence of ppd and lane 7-anti cd3 + anti cd stimulated in presence of h37rv. densitometry was performed, histograms represent mean band intensities. *p <. ** p <; *** p < by the mann–whitney u test fig. m. tuberculosis antigens modulate tcr- and tcr/cd28-induced dna binding of nfat to the promoter of il- cytokine in ppd+ve healthy individuals and pulmonary tb patients. peripheral blood mononuclear cells from ppd+ve healthy donors and pulmonary tb patients were stimulated with m. tuberculosis antigens for 4 h. cells were then activated with anti cd and anti cd antibodies. nuclear lysates were prepared and binding affinity of nfat was determined by emsa. one representative example of each study case is shown where lane 1- control, lane 2- anti cd stimulated, lane 3- anti cd3 + anti cd stimulated, lane 4- anti cd3 + anti cd stimulated in presence of ag85a, lane 5- anti cd3 + anti cd stimulated in presence of esat- lane 6- anti cd3 + anti cd stimulated in presence of ppd and lane 7-anti cd3 + anti cd stimulated in presence of h37rv. densitometry was performed, histograms represent mean band intensities. *p <. ** p <; *** p < by the mann–whitney u test discussion the outcome of tb mainly depends on t-cell response, which is altered through multiple, but poorly understood mechanisms. this study was designed to investigate the impact of m. tuberculosis antigens on t cell activation and their role in modulation of t-cell physiology in disease, which still needs to be defined. here, we observed that patients with active pulmonary tb have a significant diminished tcr triggered intracellular calcium mobilization in response to secretory m. tuberculosis antigens which is an important regulatory signal-transduction stage of t cell activation. further, selective modulation in tcr/cd28-induced late signalling events like mapks and binding of nfat and nfκb which is important in the activation of certain t cell genes for cytokine production was also noted in presence of m. tuberculosis antigens. the data suggests that these alterations could explain the loss of a protective immune response by reducing production of proinflammatory cytokines il- against m. tuberculosis to some extent, and it may also help us to figure out the mechanisms leading to t cell dysfunction in tb. optimal t cell activation involves stimulation through the tcr by mhc-peptide complex along with additional signalling through co-stimulatory receptors. the tcr is a complex consisting intracellular signal transducing domains, immunoreceptor tyrosine-based activation motifs. once phosphorylated, itams become recruitment sites for zap- activated zap- is then recruited to phosphorylate the multiple transmembrane molecules. these signalling molecules activate multiple secondary signalling pathways including ca2+ signalling, ras/map kinase, and protein kinase c pathways that ultimately activate several transcription factors including nfat, ap- and nf-κb that are essential for full il- gene expression and t cell activation. we observed that esat- curtailed tcr triggered calcium mobilization in pulmonary tb patients and ppd+ve healthy individuals both but the inhibition is more in patients as compared to healthy individuals. on the other hand, ag85a, ppd and h37rv diminished transmembrane calcium mobilization in pulmonary tb patients but enhanced the transmembrane calcium influx in ppd+ve healthy individuals. present study confirms that mycobaterial antigens: ag85a, esat- ppd and h37rv, altered calcium signalling and consequently might play a critical role in the pathogenesis of the disease. altered calcium signalling and other signalling events has been noted in leprosy patients and t cell lines and modulation by lipid and soluble fraction of m. leprae lysates was shown which could play a major role in the pathogenesis. our results are in close concordance with other reports where pbmcs from patients with leprosy have been reported to have reduced cytosolic i concentrations. in macrophages curtailment of i levels by m. tuberculosis has been shown, which could be linked with reduced phagosome-lysosome fusion, thus for increased survival of mycobacteria. only one report is available on intracellular calcium modulation by h37rv in newly diagnosed and treated tb patients and ppd+ve and ppd-ve healthy controls. in addition, we used ppd and immunodominant m. tuberculosis secretory antigens. on the contrary, it has been previously reported that esat- did not affect phosphorylation of zap- and intracellular calcium levels but esat- inhibits t cell immune responses by affecting downstream signalling molecules. the importance of the mapks signal transduction pathway in controlling many aspects of immune-mediated inflammatory responses has made it a priority for research, related to many human diseases. therefore, we further studied downstream signalling events such as activation of mapks and nuclear translocation of transcription factors nfκb and nfat, important events for both cytokine production and cell activation. interestingly, we observed that esat- significantly curtailed tcr/cd induced phosphorylation of erk1/ in healthy individuals and pulmonary tb patients both. we did not observe any effect on p phosphorylation in tcr/cd induced cells of healthy individual after treatment with m. tuberculosis antigen whereas in pulmonary tb patients ag85a and esat- significantly curtailed p phosphorylation. palma-nicholas reported down-modulation of mapk–erk1/ pathway in total spleen cells from naive balb/c mice by the cell-surface lipid di-o-acyl-trehalose, which further leads to lowering of th- type cytokine production. as per our knowledge ours is the first study where differential modulation of tcr or tcr/cd induced downstream signalling events like mapks in the pbmcs of pulmonary tb patients has been observed. the finding suggests modulation of erk1/ and p both or majorly p in t cells by m. tuberculosis that could lead to t cell dysfunction or low th cytokine production. inhibition of ifn-γ by esat- in human t cells through p mapk has been reported earlier, however, our observation of inhibition of p by ag85a in tb patients is a novel information and confirms the role of p in the t cell dysfunction. similar to our findings differential modulation of downstream signalling events like mapks by m. leprae antigens stimulated t cells from leprosy patients have been reported earlier. further, diminished and differential phosphorylation of mapks by m. leprae antigens in t cell lines after stimulation with anti cd or anti cd3+cd has also been reported. effect of secretory protein esat- of m. tuberculosis in the modulation of macrophage signalling pathways particularly erk1/ mapk pathway has been shown in one study. further, binding affinity of nfκb and nfat of antigen treated cells in pulmonary tb patients and in ppd+ve healthy individuals was also assessed by emsa. we observed that esat- significantly reduced the binding of nfκb in healthy individuals and pulmonary tb patients. we also noticed curtailment of binding activity of nfat in anti cd3+cd stimulated cells in pulmonary tb patients after treatment with esat- ppd and h37rv. esat- induced cells were showing significant inhibition of nfat binding in pulmonary tb patients and healthy individuals both. our findings of reduced nfat binding in esat- stimulated cells in healthy individuals and tb patients could be correlated with the reduced ca2+ mobilization of esat − stimulated cells in healthy and patients both. calcium is an essential element in many t-cell responses, including a pathway that leads to the movement of a major transcription factor, nfat, from the cytoplasm into the nucleus where nfat supports the transcription of genes required for the expression of the t cell growth-promoting cytokines il-. no study on the expression of nfkb and nfat in activated t cells in tb patients is available till date, however, zea et al. have noticed reduced expression of p of nfkb in t cells of pulmonary tb patients. tchou- wong et al. revealed specific binding of nuclear protein to the nfkb site upon induction with m. tuberculosis in human monocytic leukemic cell line thp- impaired nuclear translocation of nfκb and nfat was also noticed in leprosy patients. while inhibition of t-cell activation is a novel observation for m. tuberculosis, it has been shown to occur with other pathogens. these include bacteria, viruses, and protozoan parasites. bacterial toxins, including those from helicobacter pylori and bacillus anthracis, can suppress tcr signalling by blocking calcium influx and mapks, respectively. salmonella enterica may also express a protein that can down-modulate tcr expression. our study indicates that m. tuberculosis has several ways to destabilize the host’s t-cell response besides what is already established. although previous studies of cell signalling pathways in tb have contributed upto some extent to our knowledge of their role in host protective immune responses, a number of critical questions are not well understood. research into the development of tb vaccines and immunodiagnostics has focused on the proteins released by m. tuberculosis, because these antigens are thought to induce protective cell mediated immunity and immune responses of diagnostic value. ag85a and esat- are widely studied for their potential to trigger effective host immune responses against tb, but very little is known regarding their role in the t cells signalling mechanisms underlying proinflammatory cytokine secretion by t cells. our data demonstrate that the stimulation of human peripheral blood cells in vitro with the ag85a and esat- antigens of m. tuberculosis markedly down modulated tcr activation by reducing activation of t cells by affecting upstream as well as downstream tcr signalling events. we suggest that these mycobacterial antigens can affect activation of intracellular t cell signalling pathways, such as calcium mobilization, mapks that are required for production of il- further work is required to delineate the molecular mechanisms underlying these effects, to better understand interactions between m. tuberculosis and human immune system and to facilitate development of esat- and ag85a-based vaccines.  this study has shown that a significant number of the patients with pulmonary tb had alterations in the expression of several t cell signal-transduction proteins, alterations that were similar to those reported earlier in patients with leprosy. the similarity of t cell signal-transduction alterations in diseases with different pathophysiological characteristics suggests the possibility that a common mechanism causes such changes. follow-up studies are needed to determine whether such alterations revert after successful treatment and also whether these can be modulated by immunotherapy. it would also be of interest to know variations in different forms of tuberculosis and determine relationship with activation of different cytokines. these observations of molecular and functional characteristics in tb may provide new tools to analyse and monitor patients, to reveal how these characteristics affect the development of immune dysfunction and to study new pathways to block suppressor mechanisms. this endeavour will enhance our knowledge of disease pathogenesis, contributing to a better understanding of the immune response to m. tuberculosis. 
here, we investigated effect of m. tuberculosis antigens ag85a and esat- on t cell signalling events in cd3/cd induced peripheral blood mononuclear cells of ppd+ve healthy individuals and pulmonary tb patients. we studied cd induced intracellular calcium mobilization in pbmcs of healthy individuals and tb patients by spectrofluorimetry, cd and cd induced activation of mitogen activated protein kinases in pbmcs of healthy individuals and tb patients by western blotting and binding of transcription factors nfat and nfκb by electrophorectic mobility shift assay. we observed cd triggered modulations in free intracellular calcium concentrations in ppd+ve healthy individuals and pulmonary tb patients after the treatment of m. tuberculosis antigens. as regards the downstream signalling events, phosphorylation of mapks, extracellular signal-regulated kinase and and p was curtailed by m. tuberculosis antigens in tb patients whereas, in ppd+ve healthy individuals only erk1/ phosphorylation was inhibited. the molecules and mechanisms utilized to accomplish immune subversion by m. tuberculosis are not fully understood. understanding the molecular mechanism of t cell response to m. tuberculosis is important for development of efficacious vaccine against tb. besides, the terminal signalling events like binding of transcription factors nfat and nfκb was also altered by m. tuberculosis antigens. altogether, our results suggest that m. tuberculosis antigens, specifically esat- interfere with tcr/cd28-induced upstream as well as downstream signalling events which might be responsible for defective il- production which further contributed in t-cell unresponsiveness, implicated in the progression of disease. this study showed the effect of secretory antigens of m. tuberculosis in the modulation of t cell signalling pathways. to the best of our knowledge, this is the first study to investigate effect of ag85a and esat- on tcr- and tcr/cd28- induced upstream and downstream signalling events of t-cell activation in tb patients. mycobacterium tuberculosis modulates host immune response, mainly t cell responses for its own survival leading to disease or latent infection.
 mycobacterium tuberculosis modulates host immune response, mainly t cell responses for its own survival leading to disease or latent infection. the molecules and mechanisms utilized to accomplish immune subversion by m. tuberculosis are not fully understood. understanding the molecular mechanism of t cell response to m. tuberculosis is important for development of efficacious vaccine against tb. methods here, we investigated effect of m. tuberculosis antigens ag85a and esat- on t cell signalling events in cd3/cd induced peripheral blood mononuclear cells of ppd+ve healthy individuals and pulmonary tb patients. we studied cd induced intracellular calcium mobilization in pbmcs of healthy individuals and tb patients by spectrofluorimetry, cd and cd induced activation of mitogen activated protein kinases in pbmcs of healthy individuals and tb patients by western blotting and binding of transcription factors nfat and nfκb by electrophorectic mobility shift assay.  we observed cd triggered modulations in free intracellular calcium concentrations in ppd+ve healthy individuals and pulmonary tb patients after the treatment of m. tuberculosis antigens. as regards the downstream signalling events, phosphorylation of mapks, extracellular signal-regulated kinase and and p was curtailed by m. tuberculosis antigens in tb patients whereas, in ppd+ve healthy individuals only erk1/ phosphorylation was inhibited. besides, the terminal signalling events like binding of transcription factors nfat and nfκb was also altered by m. tuberculosis antigens. altogether, our results suggest that m. tuberculosis antigens, specifically esat- interfere with tcr/cd28-induced upstream as well as downstream signalling events which might be responsible for defective il- production which further contributed in t-cell unresponsiveness, implicated in the progression of disease.  to the best of our knowledge, this is the first study to investigate effect of ag85a and esat- on tcr- and tcr/cd28- induced upstream and downstream signalling events of t-cell activation in tb patients. this study showed the effect of secretory antigens of m. tuberculosis in the modulation of t cell signalling pathways. this inflection is accomplished by altering the proximal and distal events of signalling cascade which could be involved in t-cell dysfunctioning during the progression of the disease. electronic supplementary material the online version of this article contains supplementary material, which is available to authorized users. issue-copyright-statement© the author 2015 