20Immune responses following Mycobacterium tuberculosis (Mtb) infection or vaccination 21 are frequently assessed by measuring T cell recognition of crude Mtb antigens, 22 recombinant proteins, or peptide epitopes. We previously showed that not all Mtb-23 specific T cells recognize Mtb-infected macrophages. Thus, an important question is 24 what proportion of T cells elicited by Mtb infection recognize Mtb-infected macrophages.
25We answer this question by developing a modified elispot assay using viable Mtb-26 infected macrophages, a low multiplicity of infection and purified T cells. In C57BL/6 27 mice, CD4 and CD8 T cells were classically MHC restricted. Comparable frequencies of 28 T cells that recognize Mtb-infected macrophages were determined using interferon-γ 29 elispot and intracellular cytokine staining, and lung CD4 T cells more sensitively 30 recognized Mtb-infected macrophages than lung CD8 T cells. Compared to the numbers 31 of Mtb antigen-specific T cells for antigens such as ESAT-6 and TB10.4, low frequencies 32 of pulmonary CD4 and CD8 T cells elicited by aerosolized Mtb infection recognize Mtb-33 infected macrophages. Finally, we demonstrate that BCG vaccination elicits T cells that 34 recognize Mtb-infected macrophages. We propose that the frequency of T cells that 35 recognize infected macrophages could correlate with protective immunity and may be an 36 alternative approach to measuring T cell responses to Mtb antigens.
37with the failure of T cells specific for those antigens to recognize Mtb-infected 64 macrophages 4 . Importantly, following aerosol infection, Mtb disseminates to the 65 mediastinal lymph node, where T cells are first primed by dendritic cells, which then 66 expand and traffic to the lung 9, 10 . We speculate that there may be a mismatch in the 67 antigens presented (or cross-presented) by uninfected DC in the lymph nodes and 68 antigens presented by infected macrophages in the lung. Thus, T cells primed in the lymph 69 nodes during natural infection may not necessarily recognize antigens presented by Mtb-70 infected macrophages in the lung 11 . Regardless of the mechanism, we wondered whether 71 the inability of some T cells to recognize Mtb-infected macrophages might explain why the 72 number of antigen-specific T cells may not necessarily correlate with vaccine-induced 73 protection.
74To assess T cell recognition of Mtb-infected macrophages we developed a 75 modified elispot assay based on interferon (IFN)-g spot forming cells (SFC). Using a low 76 multiplicity of infection (MOI), we quantify the frequency of T cells that recognize Mtb-77 infected macrophages during primary infection in mice. We find that an unexpectedly low 78 frequency of ex vivo CD8 and CD4 T cells recognizes Mtb-infected macrophages. We 79 demonstrate that majority of the T cells from C57BL/6 mice that recognize Mtb-infected 80 macrophages are conventionally MHC-restricted T cells. Our data shows that CD4 T 81 cells efficiently detect Mtb-infected macrophages at a lower MOI, whereas CD8 T cells 82 on...