Mice were returned to normal water for a further two weeks following the cessation of treatment, to flush any residual in vivo antibiotics inhibiting bacterial culture. At the end of each treatment regimen, bacterial burden in the individual organs/tissues was determined as described previously; with the inclusion

of the liver as an additional potential reservoir of bacilli. Fig. 2A shows that 1 month of treatment was sufficient to clear residual bacilli from the spleen; but a further 2 months of treatment were required to consistently clear persistent BCG from the d.LNs in all animals. The pre-treatment burdens observed in both the spleen and d.LNs were equivalent to previous experiments buy Ruxolitinib (Fig. 2A cf. Fig. 1A). BCG in lungs and liver were undetectable in this experiment. As further experiments were critically dependant on consistent efficacy of treatment, a further experiment included

vaccinated mice given an additional 3 months rest after cessation of 3 months treatment. In contrast to immunised, untreated mice (which had a burden of 2.7 log10 CFU (±0.6) in the d.LNs ∼7.5 months p.i.), no viable BCG were detected in the treatment group (Fig. 2B) confirming the efficacy of antimicrobial treatment. To evaluate the effect of persistent BCG bacilli on specific IFN-γ responses, groups of mice were immunized with BCG or placebo control for 6 weeks, prior to treatment with antibiotics or placebo for 3 months. To ensure that: (a) analyses were

not influenced see more by short-lived effector T cell responses; and (b) BCG bacilli were effectively cleared, animals were not rested for 3 months after treatment. The frequency of BCG-specific IFN-γ secreting cells in the spleen was then evaluated by ex vivo ELISPOT stimulated with the defined protein cocktail. Fig. 2C shows that the significant IFN-γ response induced by BCG immunization (613 SFU/million cells) was completely abrogated in BCG abbreviated animals (p < 0.001). These data clearly demonstrate that, the persisting IFN-γ responses observed in BCG immunized animals were due to persistent BCG bacilli, rather than long-term memory. To further investigate whether this ablation of the IFN-γ responses (ELISPOT) in BCG abbreviated mice was specific to CD4 T cells and of what memory phenotype, the CD4 T cell responses specific to BCG in spleen and lung were assessed by intracellular cytokine staining (ICS) after stimulation with defined protein cocktail (Fig. 3). Fig. 3A shows BCG immunization induces significant populations of multifunctional CD4 T cells (IFN-γ+/IL-2+/TNF-α+, IFN-γ+/TNF-α+ and IL-2+/TNF-α+), in both spleen and lung-derived cells, with frequencies considerably higher in the lungs as reported previously [9]. ICS performed on d.LN samples of BCG immunized mice in previous experiments were unable to detect significant populations of cytokine producing cells (data not shown), and so were not performed here.