Gamma interferon (IFN-␥) is a crucial cytokine for protection againstTuberculosis (TB) is a major health problem throughout the world and is responsible for more deaths than any other single infectious disease. In China, an estimated 0.16 million (range, 0.064 to 0.32 million) people died from TB in 2008 (21). TB is a disease mainly caused by Mycobacterium tuberculosis, and host interactions with this bacterium may lead to a cell-mediated protective immune response. Gamma interferon (IFN-␥) functions as a key cytokine in this response by activating infected macrophages and inducing a microbiocidal state. Mice lacking IFN-␥ are extremely susceptible to M. tuberculosis, and infection leads to unchecked growth of M. tuberculosis in the organs of these mice (6). In humans, IFN-␥ also appears to play a pivotal role because children carrying mutations in the IFN-␥ receptor genes and subjects with defects regarding IFN-␥ receptor expression exhibit depressed IFN-␥ production and increased susceptibility to serious mycobacterial infections (10, 11).IFN-␥ is crucial for protection against M. tuberculosis, but the basis for its selective transcription is still unknown. Within the region between bp Ϫ108 and Ϫ40 of the IFN-␥ promoter are two conserved and essential regulatory elements, which confer activation-specific expression in T cells (14). The distal conserved element (bp Ϫ96 to Ϫ80) contained a consensus GATA motif and a potential regulatory motif found in the promoter regions of the granulocyte-macrophage colony-stimulating factor (GM-CSF) and macrophage inflammatory protein (MIP) genes (13). CREB is a 43-kDa transcription factor in the basic leucine zipper (bZIP) family that binds to cyclic AMP responsive element (CRE) via its TGACGTCA sequence and activates the basal transcription machinery (4). The proximal IFN-␥ promoter contains CRE-like sequences (ACGT) where CREB binds and regulates IFN-␥ transcription. Studies examining the binding of CREB proteins to the IFN-␥ proximal promoter yield contradictory results regarding the transcription of IFN-␥. Experiments using Jurkat T cells and transgenic mice suggest that CREB proteins inhibit the transcription of IFN-␥ (14, 22); however, these results could not be reproduced using human T cells (15, 16). We performed chromatin immunoprecipitation (ChIP) and the electrophoretic mobility shift assay (EMSA) to investigate whether CREB binds to the IFN-␥ proximal promoter and/or functions in IFN-␥ secretion in CD3 ϩ T cells obtained from latent TB infection (LTBI) or TB patients. Our results suggest that CREB could promote the transcription and production of IFN-␥ by binding with the IFN-␥ proximal promoter under conditions of LTBI. However, the regulatory role of CREB is decreased in patients with active TB due to diminished expression of CREB proteins. These results strongly support the idea that CREB is a positive transcriptional regulator of IFN-␥ in latent but not active tuberculosis infections.
MATERIALS AND METHODSStudy population. Peripheral blood was obtained from 2...