Macrophages in resistance to rickettsial infections: protection against lethal Rickettsia tsutsugamushi infections by treatment of mice with macrophage-activating agents.

Peritoneal macrophages of BALB/c and C3H/HeN mice activated in vivo by intraperitoneal inoculation of viable Mycobacterium bovis strain BCG or the nonliving macrophage-activating agent Propionibacterium acnes (Corynebacterium parvum), were resistant to infection with Rickettsia tsutsugamushi, and they killed bacteria that did gain entry into the intracellular environment of these cells. This macrophage resistance to infection and intracellular destruction of rickettsiae was dependent upon development of an immune response to the activating agents, since macrophages elicited by sterile inflammatory agents failed to display either microbicidal activity unless cells were exposed to factors present in lymphokine-rich culture fluids from antigen or mitogen stimulated spleen cells (LK) in vitro. C3H/HeN mice that had been treated with activating agents, but not sterile inflammatory irritants, also survived intraperitoneal inoculation of up to 10(4) R. tsutsugamushi. This nonspecific protection required the chronic presence of activated macrophages: acute immune response induced by intraperitoneal injection of PPD into mice inoculated intradermally with BCG, or intraperitoneal inoculation of conconavalin A, were not sufficient to induce survival of rickettsial disease, although macrophages from these animals were activated to kill rickettsiae at the time of challenge. The critical nature of activated macrophages in nonspecific protection against rickettsial infection was demonstrated with the macrophage-defective C3H/HeJ mice. These mice are equally as susceptible as C3H/HeN mice to intraperitoneal inoculation of R. tsutsugamushi, but do not develop activated macrophages in response to BCG infection, and are not protected against lethal rickettsial challenge following BCG treatment.