Bacterial interference with immunospecific defences

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Abstract
There are many descriptions of bacterial agents that can suppress different phases of specific immunity. Bacterial agents are frequently employed as tools to modulate the immune system in experimental models or clinical therapy. Little attention has been given to the implications of such immunoregulating properties for infectious processes or for the natural role of the microbial flora in the normal regulation of the immune system. There are very few studies attempting to investigate directly the possible role of bacterial immunosuppressant factors in acute infection. Several examples of natural and experimental chronic infections have been described in which progressive uncontrolled infection is associated with a depressed cell mediated immunity, but a causal relation is unproven. This depression is usually not antigenically specific and there is some evidence that it may be initiated and maintained by persistent cell-wall components of the microorganisms. The bacteria implicated in suppression are all facultative or obligate intracellular parasites that can multiply and survive in the monocyte/macrophage. Bacterial immunosuppressants may have a crucial role in the pathogenesis of progressive chronic inflammation that occurs after infection.