NOD2 and Toll-Like Receptors Are Nonredundant Recognition Systems of Mycobacterium tuberculosis

Abstract
Infection with Mycobacterium tuberculosis is one of the leading causes of death worldwide. Recognition of M. tuberculosis by pattern recognition receptors is crucial for activation of both innate and adaptive immune responses. In the present study, we demonstrate that nucleotide-binding oligomerization domain 2 (NOD2) and Toll-like receptors (TLRs) are two nonredundant recognition mechanisms of M. tuberculosis. CHO cell lines transfected with human TLR2 or TLR4 were responsive to M. tuberculosis. TLR2 knock-out mice displayed more than 50% defective cytokine production after stimulation with mycobacteria, whereas TLR4-defective mice also released 30% less cytokines compared to controls. Similarly, HEK293T cells transfected with NOD2 responded to stimulation with M. tuberculosis. The important role of NOD2 for the recognition of M. tuberculosis was demonstrated in mononuclear cells of individuals homozygous for the 3020insC NOD2 mutation, who showed an 80% defective cytokine response after stimulation with M. tuberculosis. Finally, the mycobacterial TLR2 ligand 19-kDa lipoprotein and the NOD2 ligand muramyl dipeptide synergized for the induction of cytokines, and this synergism was lost in cells defective in either TLR2 or NOD2. Together, these results demonstrate that NOD2 and TLR pathways are nonredundant recognition mechanisms of M. tuberculosis that synergize for the induction of proinflammatory cytokines. Tuberculosis is one of the most prevalent infections worldwide, with 2 billion people believed to be infected, and 2 million deaths each year. In addition to representing a major health care problem in developing countries, concern is also growing about the increased incidence of tuberculosis in developed countries, especially in immunocompromised patients such as those with AIDS, transplantation, and immunosuppressive therapy. The present study describes the pathways that enable leukocytes to recognize M. tuberculosis, and demonstrates for the first time that NOD2, member of a new class of intracellular receptors, is an independent recognition mechanism for mycobacteria. NOD2 acts together with the earlier-described Toll-like receptors for the activation of host defenses during the encounter of leukocytes with M. tuberculosis. Understanding the mechanisms through which the cells of the immune system recognize M. tuberculosis can be an important step in designing new therapeutic approaches, as well as improving the limited success of current vaccination strategies.

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