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Elife. 2018 Nov 14;7. pii: e41115. doi: 10.7554/eLife.41115.

High-resolution mapping of fluoroquinolones in TB rabbit lesions reveals specific distribution in immune cell types.

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Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, United States.
Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, United States.
Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States.
Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, University of California San Francisco, San Francisco, Canada.
Contributed equally


Understanding the distribution patterns of antibiotics at the site of infection is paramount to selecting adequate drug regimens and developing new antibiotics. Tuberculosis (TB) lung lesions are made of various immune cell types, some of which harbor persistent forms of the pathogen, Mycobacterium tuberculosis. By combining high resolution MALDI MSI with histology staining and quantitative image analysis in rabbits with active TB, we have mapped the distribution of a fluoroquinolone at high resolution, and identified the immune-pathological factors driving its heterogeneous penetration within TB lesions, in relation to where bacteria reside. We find that macrophage content, distance from lesion border and extent of necrosis drive the uneven fluoroquinolone penetration. Preferential uptake in macrophages and foamy macrophages, where persistent bacilli reside, compared to other immune cells present in TB granulomas, was recapitulated in vitro using primary human cells. A nonlinear modeling approach was developed to help predict the observed drug behavior in TB lesions. This work constitutes a methodological advance for the co-localization of drugs and infectious agents at high spatial resolution in diseased tissues, which can be applied to other diseases with complex immunopathology.


MALDI mass spectrometry imaging; drug distribution; fluoroquinolones; infectious disease; microbiology; rabbit model; tuberculosis

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