Immunization using parenteral and mucosal routes clearly results in quantitatively and qualitatively different immune responses, but effector mechanisms of protective immunity against respiratory infections, as well as tissue-specific responses, remain incompletely understood. Here, we found that priming of mice via cloud aerosol vaccination with F. tularensis LVS provided the means to obtain sufficient lung lymphocytes for detailed studies; similarly, parenteral priming engendered sufficient LVS-immune liver lymphocytes for analyses. In establishing feasibility, we found that cloud aerosol LVS exposure readily resulted in establishment of lung infection that disseminated to other organs of the reticuloendothelial system (Table ; Fig. ), with a resulting stimulation of cytokine production (Fig. ), antibody production (see text), effector T-cell priming (Fig. to ), and development of systemic and respiratory protective immunity against lethal LVS challenge (see text). The initial survival after primary aerosol LVS vaccination was clearly dependent on IFN-γ, TNF-α, and iNOS (Fig. ), likely products of both innate and adaptive immune responses.
Most importantly, adaptive immune responses by LVS-immune primed lung T lymphocytes that controlled the intracellular replication of bacteria in vitro were readily demonstrable. Similarly, liver T cells primed by intradermal vaccination with LVS clearly have the capacity to control the intracellular replication of bacteria in vitro. It is likely that specific antibodies produced after aerosol LVS vaccination contribute to at least part of the in vivo protection against LVS observed (
15,
16); here, however, T-cell function was studied in vitro independently of antibody function, which is not measured by this coculture system (
4,
8,
9,
14,
15; S. C. Cowley and K. L. Elkins, unpublished data). On a per-cell basis, the activities of LVS-immune lung and liver lymphocytes were comparable, if not superior, to the activity of splenic T cells primed by the homologous route (Fig. to ). Although challenging given the quantities of cells required, the present studies establish the feasibility of future studies designed to compare lymphocytes from each tissue obtained after parenteral and respiratory vaccination. At present, we nonetheless conclude that the ability of aerosol-primed, LVS-immune lung cells and parenterally primed, liver T cells to control intramacrophage
Francisella growth appears qualitatively similar to that of splenic T cells: growth control activities of cells from nonlymphoid organs, albeit primed by different routes of vaccination, were at most only partially dependent on the activity of IFN-γ (Fig. to ). This result is consistent with the concept that antigen-specific T cells primed in lymphoid sites migrate to nonlymphoid sites and are maintained in tissues as memory cells (
24).
A variety of methods have been used to initiate respiratory infections in experimental animals, including direct instillation of bacteria in liquid diluents into nasal passages or trachea, the use of a nose-only apparatus that forces animals to breath measured amounts of a nebulized bacterial suspension, and use of an apparatus that allows whole-body inhalation exposure (
1). The former two methods, already described for use in
Francisella infections, have the advantage of facilitating relatively precise control of the quantity and placement of dose in the airways, but at the expense of requiring anesthesia and/or animal confinement. The alternative approach of whole-body inhalation exposure, often used for studies of
Mycobacterium tuberculosis, may better mimic field conditions but has the disadvantage of having less precise control of inhaled dose, as well as the potential for nonrespiratory sites of entry, such as eyes or skin. Surprisingly, we find that by this method the apparent virulence of the attenuated LVS strain is quite high, resulting in significant lung pathology (data not shown) and lethality at doses nearly 2 orders of magnitude lower compared to intranasal (
42) or nose-only (
7) infection (Fig. ). A variety of explanations for these differences were explored but without clear-cut explanations emerging. The two bacterial stocks used here were obtained originally from different sources and prepared using similar, but not identical, media and growth conditions. Because direct comparisons that demonstrated that the apparent virulence of LVS tracked with the method of infection, and not with bacterial stock or type of mice (Fig. ), it is unlikely that the magnitude of differences in apparent virulence between i.n. and cloud aerosol infection observed here can be attributed to differences in the bacteria or mice. We found no evidence for entry via other portals, since very few bacteria were found in nasal passages, and symptoms of ocular or gastrointestinal infection were never observed. Further studies will be necessary to explore the possibility that the different methods result in different initial localization of LVS bacteria within lung tissue, e.g., within the upper or lower lung; attempts to study this point using green fluorescent protein-LVS coupled with several imaging amplification approaches were unfortunately limited by sensitivity and numbers of infecting bacteria (data not shown). Regardless, these results emphasize the need to completely characterize respiratory infection models and critically consider the impact of different experimental methodologies in interpreting results.
Like all other intracellular pathogens, survival of parenteral LVS infection of mice is clearly dependent on IFN-γ, TNF-α, and iNOS (
15). However, previous studies using a lethal 10
4 CFU dose of LVS administered by nose-only infection found no obvious differences in CFU in lungs after 4 days of infection between mice treated with anti-IFN-γ and control mice (
6). Further, 40 to 50% of GKO mice and TNF receptor knockout mice and 100% of iNOS knockout mice infected with a 10
2 sublethal LVS dose by aerosol survived (
5). These studies were interpreted as implying that different host defenses were operative in
Francisella infections in different tissues or after different routes of exposure. In clear contrast, here we showed that murine survival of a sublethal dose of LVS administered by cloud aerosol was clearly dependent on IFN-γ, TNF-α, and iNOS (Fig. ), the same mediators that are critical following parenteral infection (
15). Although differences due to different LVS strains or different bacterial growth methods cannot yet be ruled out, the qualitatively different results appear more likely due to different infection methodologies. Here, studies comparing the time course of dissemination and bacterial burdens in the various knockout mice indicated a clear temporal relationship between these mediators: impacts on the course of LVS infection in the absence of IFN-γ were apparent within only 2 days after infection (Fig. ), TNF-α only after 3 days (Fig. and data not shown), and iNOS only after 7 days (Fig. and data not shown). Of note, it is likely that both IFN-γ and TNF-α are initially derived from multiple types of myeloid cells of the innate immune system (
11), including NK cells (
26,
40). Notably, the slower time course of death in iNOS knockout mice seen here (Fig. ) and previously after parenteral LVS infection (
25) is most consistent with a role primarily during the later adaptive phase of immunity. This interpretation may be consistent with the previous conclusion that alveolar macrophages, while having the capacity to respond to IFN-γ to control the intracellular replication of LVS, do so in a largely iNOS-independent fashion (
29). Thus, iNOS may be of lesser importance in lung responses than in splenic or liver responses to LVS infection.
Studies using both humans (
22,
33,
34) and nonhuman primates (
39) have suggested that aerosol LVS vaccination is superior to parenteral vaccination in reducing disease symptoms, bacterial burdens, and/or dissemination upon aerosol challenge with fully virulent type A
Francisella. Similarly, a larger proportion of BALB/c mice vaccinated with LVS i.n. survived lethal type A
Francisella challenge than did those vaccinated s.c. (
7,
42), indicating than these properties can be modeled using mice. On the other hand, the demonstration of protection against death following either aerosol or i.d. type A challenge reportedly required the use of BALB/c mice and was not evident in C57BL/6J mice (
7,
42); these observations are not yet understood. The ability to detect effector T-cell activities, including control of the intramacrophage growth of
Francisella, using LVS-immune lung and liver lymphocytes will no doubt aid in determining the basis for the differences between mouse strains and thus in further evaluating the utility of the mouse model. Here, we demonstrated a clear increase in myeloid cells and especially T cells in lungs and livers of vaccinated mice; these numbers may increase by proliferation, recruitment, or both. Of note, the increased cell numbers were maintained in LVS-immune livers primed by intradermal vaccination but not in LVS-immune lungs primed by aerosol infection. This raises the question as to whether
Francisella effector memory T-cell populations are not maintained appropriately in lungs via continual recruitment, such as is the case in respiratory Sendai virus infections (
18). Future studies to compare the interactions of LVS-immune T cells with bone marrow-derived macrophages, used here and previously because of the relative ease of obtaining larger quantities, to those with primary splenic, alveolar, and liver macrophages can now be performed. An equally important point of future focus will be the detailed architecture which allows
Francisella-immune T cells to interact with and effect control of intracellular bacterial growth within tissues in vivo. In livers, for instance,
Francisella replicates in macrophages, hepatocytes, and possibly endothelial cells (
36). However, it has been argued that hepatocytes contact sinus endothelial cells and stellate cells but are unlikely to interact directly with T cells in a liver sinusoid (
23).
Similar to activities in the lung, the effector activities of lymphocytes from liver have received considerably less attention than those from the professional lymphoid organs (including spleen and lymph nodes). Comparisons may be further confounded by differing compositions of liver leukocyte preparations with different methodologies; for instance, the liver leukocyte preparations studied here appear to be markedly different from those analyzed in another recent study (
31). Despite such differences, recent studies using LVS vaccination have demonstrated the capacity of immune lung T cells (
26) and liver lymphocytes (
2,
40) to produce intracellular IFN-γ. Further, important differences between the intracellular cytokines detected in lung T cells after i.n. vaccination (IL-17A
+, Th-17 like) compared to those after i.d. vaccination (IFN-γ
+, Th-1 like) that are regulated at least in part by prostaglandin E
2 have been uncovered; indeed, the environment in the lung may be considerably more immunosuppressive than that in other organs (
3,
41). However, as emphasized here (Fig. to ) and in previous studies (
8,
9,
15), IFN-γ production alone by any cell type is highly unlikely to predict successful vaccination. Thus, the capacity to evaluate relevant T-cell effector functions beyond simple production of cytokines is critical to progress in understanding tissue-specific protective mechanisms. The in vitro approach used here does not focus on cytokine production or T-cell proliferation, two traditional measures of T-cell function, but instead on the ability of immune T cell populations to directly impact the replication of bacteria. Importantly, LVS-immune lung and liver lymphocytes have readily detectable and qualitatively similar functions to those of LVS-immune splenic lymphocytes by this criterion, although the impact of vaccination by different routes of exposure remains to be comprehensively compared. In all cases, neutralization of IFN-γ or use of infected macrophages that could not respond to IFN-γ had at best a modest impact on bacterial growth control. Thus, the important roles of IFN-γ often observed in vivo during secondary
Francisella challenge (
7,
27,
30,
32,
37) are not likely to be at the level of activation of infected macrophages. Future studies will therefore seek to exploit the in vitro approach used here, coupled with in vivo studies, to determine the full range of effector mechanisms operable by these different sources of T cells beyond IFN-γ and derive functional correlates of protection for this and other intracellular bacteria.