Lipoarabinomannan

Proposed Mechanisms

There are many proposed mechanisms behind ManLAM function. Activation of a PI3K pathway is sufficient to trigger phosphorylation of the Bcl-2 family member Bad by ManLAM. ManLAM is able to activate the serine/threonine kinase Akt via phosphorylation which is then able to phosphorylate Bad. Dephosphorylated Bad serves as a pro-apoptotic protein and its activation allows for cell survival. This demonstrates one virulence-associated mechanism by which bacteria are able to up-regulate signaling pathways to control host cell apoptosis.^[8]

ManLAM may also directly activate SHP-1, a phosphotyrosine phosphatase known to be involved in terminating activation signals. SHP-1 negatively regulates pathways related to the actions of IFN-γ and insulin. LAM may regulate SHP-1 by multiple mechanisms including direct interactions, phosphorylation, and subcellular localization. Once activated, SHP-1 translocates from the cytosol to the membrane. By activating a phosphatase, LAM can inhibit LPS and IFN-γ induced protein tyrosine phosphorylation in monocytes. This decreases production of TNF-α, a molecule necessary in forming granulomas against M. tuberculosis and important in macrophage defense against bacterium via nitrogen oxide production. LAM's activation of SHP-1 also works to deactivate IL-12. IL-12 is important for innate resistance to M. tuberculosis infections. It activates natural killer cells which produce IFN-γ to activate macrophages. By impairing the function of these two molecules by SHP-1 activation, ManLAM may promote intracellular survival.^[2]

Other models suggest that ManLAM acts to mediate immunosuppressive effects through suppression of LPS-induced IL-12 p40 protein production. ManLAM is thought to inhibit the IL-1 receptor-associated kinase (IRAK)-TRAF6 interaction, IκB-α phosphorylation, and nuclear translocation of c-Rel and p50 which causes reduced IL-12 p40 production.^[10]

Proposed mechanisms of ManLAM functions

PILAM

LAMS capped with phosphoinositol are typically found in nonpathogenic species including M. smegmatis. In contrast to ManLAMs, PILAMs are pro-inflammatory. CD14, a recognition receptor present on macrophages, associate with toll-like receptor 2 (TLR2) is described to be a receptor for PILAM.^[11] Binding of PILAM to the receptor elicits the activation of an intracellular signaling cascade which activates transcription factors that initiate transcription of proinflammatory cytokine genes. This may lead to TNF-α, IL-8, and IL-12 activation and apoptosis of macrophages.^[1][12]

AraLAM (CheLAM)

Certain species of rapid-growing bacterium such as M. chelonae and laboratory strains (H37Ra) contain LAMs that are absent of both mannose and phosphoinosital caps.^[1] This form of LAM is characterized by 1,3 –mannosyl side chains instead of the 1,2 commonly found in others mycobacterial species.^[12] These forms are considered to be more potent than the mannose-capped ManLAM in inducing functions associated with macrophage activation.^[9] In addition to stimulation of early genes such as c-fos, KC, and JE, AraLAM induces transcription of the mRNA for cytokines (such as TNF-α, IL 1-α, IL 1-β, IL-6, IL-8, and IL-10) characteristically produced by macrophages.^[2][9] Proto-oncogenes c-fos and c-myc are involved in the regulation of gene transcription while JE and KC are peptide cytokines that serve as specific chemoattractants for neutrophils and monocytes.^[13] Activation of TNF-α creates pathologic manifestations of disease such as tissue necrosis, nerve damage, and protective immunity. ^[14] O-acyl groups of the arabinomannan moiety may be responsible for TNF-inducing activity which causes the tuberculosis symptoms of fever, weight loss, and necrosis.^[15] However, the presence of ManLAMs decreases AraLAM activity, suppressing an immune response.^[9]