Accordingly, Doxorubicin IL-23 is important for inducing vaccine-induced Th17 and Th1-cell immunity following vaccination with an attenuated intracellular

live bacteria, BCG, and vaccine-induced protection following M. tuberculosis challenge. Following BCG vaccination, both Th1- and Th17-cell responses are detected in the DLNs on day 14 postvaccination. However, by tracking kinetics of Th1- and Th17-cell responses, we show that the Th17 responses occur early, coincide with high induction of PGE2 production in vivo, and precede the induction of Th1-cell responses. The induction of Th1-cell responses is IL-17 dependent since the il17ra−/− mice and depletion of IL-17 results in reduced Th1-cell responses. Until recently, nonimmune cells such as fibroblasts and epithelial cells were considered primary responders to IL-17 (reviewed in 31). However, recently, myeloid cells such as macrophages

12, 32, 33 and DCs 12 have been shown to express IL-17 receptors, respond to IL-17 12, 32 and mediate host immune responses. IL-17 can act on macrophages for direct bacterial killing 12, 34, whereas IL-17-dependent responses in DCs results in the induction of IL-12 12, 13 and Th1-cell differentiation 12. Collectively, these studies suggest that the IL-17 pathway when required provides critical “help” in the generation of Th1-cell responses. This is evident from the reduced IL-12p40 and IL-12p35 mRNA levels and the decreased IFN-γ ever responses in vivo in DLNs of BCG-vaccinated il17ra−/− mice when compared with B6 BCG-vaccinated mice. We also show that dependence on IL-17 to drive Th1-cell FK506 mw responses is a host strategy to overcome Th1-cell inhibitory effects of IL-10, which is also induced by BCG. Accordingly, neutralization of IL-10 results in IL-12 production in DCs and increased IFN-γ responses in T cells. However, it cannot be eliminated that factors other than IL-12 are also modulated by inhibition of IL-10 and mediate the increased Th1-cell responses. Importantly, in contrast to B6 mice, il10−/− BCG-vaccinated

mice were able to induce effective Th1-cell responses in the absence of IL-17, suggesting that IL-17 is required to drive Th1-cell responses in order to overcome Th1-cell inhibitory effects of IL-10. IL-23 is critical for in vivo generation of Th17 cells following mycobacterial exposure 23–25 and not surprisingly, il23p19−/− BCG-vaccinated mice had reduced Th17- and Th1-cell responses, which correlated with lower protection upon challenge with M. tuberculosis. However, since vaccine-induced protection is reduced and not completely lost in the absence of IL-23, it is likely that factors other than IL-23 can also mediate vaccine-induced protection. These studies imply that IL-23-dependent IL-17 is a critical factor in deciding efficacy outcomes of BCG vaccine-induced immunity against TB.