Abstract. Why 5-10% of people develop tuberculosis (TB) after Mycobacterium tuberculosis (Mtb) infection is
largely unknown. Th1 immunity is the dominant mechanism of control. In contrast, how type 2 immunity affects
immunity to TB is a clinically important knowledge gap. Th2 immune responses are elicited by helminths
parasites, and half of the 180 million school age children in Sub-Saharan Africa are estimated to be infected
with helminths. Chronic helminth infection induces Th2 and Tregs, both which inhibit Th1 immunity, and impair
BCG efficacy. IL-4, IL-5, and IL-13 are the canonical cytokines of Th2 cells. These cytokines are also produced
by innate cells including eosinophils and mast cells. We discovered that BCG vaccination worsens subsequent
Mtb infection in CC040 mice and is associated with the emergence of IL-4-producing cells in the lung. Our
overarching hypothesis is that IL-4 production in CC040 mice permits Mtb growth and exacerbates disease in
BCG vaccinated mice. While the mouse has been outstanding in developing immunological concepts that
translate into humans, standard inbred strains lack the genetic diversity of people. Th1 immunity develops
following Mtb infection in C57BL/6 (B6) mice, the “go to” strain for immunologists. However, B6 mice poorly
model other immune responses including Th2 and Th17 responses, and MAIT cells. To address the short-
comings of the murine TB model, we are using Collaborative Cross (CC) mice to study mechanisms of
vaccine-induced immunity against TB. CC mice are derived from eight founder strains that include wild-derived
mice. The breeding schemes captured >90% of the diversity present in the Mus species and led to the creation
of ~70 CC strains. In one of these, the CC040 strain, we detect a clinically relevant phenotype that is not
detected in traditional mouse models (i.e., B6). Using the CC040 mouse strain, we will ask how IL-4 affects
vaccine-induced protection against Mtb infection. We will determine which cell types produce IL-4 and whether
IL-4 is induced by BCG and/or Mtb infection. Next, we will measure how immunity is altered in an IL-4-sufficient
environment by performing scRNAseq of lung cells from IL-4-sufficient or depleted CC040 mice, following BCG
vaccination and Mtb infection. Two strategies will be used to determine how IL-4 affects vaccine-induced
protection against Mtb infection. Whether IL-4 is detrimental to BCG-mediated protection and heightens the
susceptibility of CC040 mice to TB will be tested by depletion of IL-4 or IL-4-producing cells. Another approach
will use genetic segregation and mapping analysis to determine the role of IL-4 signaling and identify genetic
susceptibility loci specifically driving IL-4-enhanced Mtb disease. New insights into how mast cells and
eosinophils affect TB susceptibility are changing the way we view immunity to mycobacteria. Clinical and
epidemiological data indicates that IL-4 production during chronic helminth infection could impair BCG efficacy
and immunity to TB. The CC040 strain will be an important tool to unravel how IL-4 and IL-4 producing cells
affect immunity to Mtb.