101
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Nakamura T, Nishibu A, Yasoshima M, Tanoue C, Yoshida N, Hatta J, Miyamoto T, Nishii M, Yanagibashi T, Nagai Y, Takatsu K, Mochizuki T, Ogawa K. Analysis of Trichophyton antigen-induced contact hypersensitivity in mouse. J Dermatol Sci 2012; 66:144-53. [DOI: 10.1016/j.jdermsci.2012.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 02/16/2012] [Accepted: 02/17/2012] [Indexed: 12/20/2022]
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102
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Patogenia de la infección fúngica invasora. Enferm Infecc Microbiol Clin 2012; 30:151-8. [DOI: 10.1016/j.eimc.2011.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 09/08/2011] [Indexed: 12/18/2022]
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103
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104
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Abstract
This review considers the reasons why the staphylococcal vaccine trials may have failed, based on new information about protective immunity against Staphylococcus aureus. The clinical trials and future vaccine candidate antigens are reviewed. Challenges facing the development of a universal S. aureus vaccine are also considered. The lack of a biomarker that is able to predict protection is a major stumbling block in the development of a staphylococcal vaccine. The major new information involves the role of cell-mediated immunity, specifically T-helper 17 cells and interleukin 17, as well as the lack of protection afforded by specific antibodies. This has major implications for future vaccine development and planning of clinical trials.
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Affiliation(s)
- Richard A Proctor
- Departments of Medical Microbiology/Immunology and Medicine, University of Wisconsin School of Medicine and Public Health School, Madison, USA.
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105
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Engelhardt KR, Grimbacher B. Mendelian traits causing susceptibility to mucocutaneous fungal infections in human subjects. J Allergy Clin Immunol 2012; 129:294-305; quiz 306-7. [DOI: 10.1016/j.jaci.2011.12.966] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 12/13/2011] [Accepted: 12/16/2011] [Indexed: 01/08/2023]
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106
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van der Does AM, Joosten SA, Vroomans E, Bogaards SJP, van Meijgaarden KE, Ottenhoff THM, van Dissel JT, Nibbering PH. The antimicrobial peptide hLF1-11 drives monocyte-dendritic cell differentiation toward dendritic cells that promote antifungal responses and enhance Th17 polarization. J Innate Immun 2012; 4:284-92. [PMID: 22261275 DOI: 10.1159/000332941] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 09/02/2011] [Indexed: 12/17/2022] Open
Abstract
The hLF1-11 peptide comprising the first 11 N-terminal residues of human lactoferrin exerts antimicrobial activity in vivo, enhances the inflammatory response of monocytes and directs monocyte-macrophage differentiation toward cells with enhanced antimicrobial properties. In this study, we investigated the effects of hLF1-11 on human monocyte-dendritic cell (DC) differentiation and subsequent T cell activation. Results revealed that - compared to control (peptide-incubated) DCs - hLF1-11-differentiated DCs displayed enhanced expression of HLA class II antigens and dectin-1, and increased phagocytosis of Candida albicans. In addition, hLF1-11-differentiated DCs produced enhanced amounts of reactive oxygen species, IL-6 and IL-10, but not IL-12p40 and TNF-α, upon stimulation with C. albicans. Moreover, 6-day-cultured hLF1-11-differentiated DCs and control (peptide-incubated) DCs that had been stimulated with a Th17-inducing mix of antigens (including C. albicans) for 24 h were cocultured with autologous CD4+ T cells for 72 h and then the levels of IL-10, IL-17 and IFN-γ production and the percentage of cytokine-producing T cells were assessed. The results revealed that the hLF1-11-differentiated DCs induced an enhanced IL-17, but reduced IFN-γ, production by T cells as compared to control (peptide-incubated) DCs. Collectively, the hLF1-11 peptide drives monocyte-DC differentiation toward DCs that promote antifungal responses and enhance Th17 polarization.
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Affiliation(s)
- Anne M van der Does
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
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107
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Kisand K, Peterson P. Autoimmune polyendocrinopathy candidiasis ectodermal dystrophy: known and novel aspects of the syndrome. Ann N Y Acad Sci 2012; 1246:77-91. [DOI: 10.1111/j.1749-6632.2011.06308.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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108
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Smeekens SP, Henriet SSV, Gresnigt MS, Joosten LAB, Hermans PWM, Netea MG, Warris A, van de Veerdonk FL. Low interleukin-17A production in response to fungal pathogens in patients with chronic granulomatous disease. J Interferon Cytokine Res 2011; 32:159-68. [PMID: 22191467 DOI: 10.1089/jir.2011.0046] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Patients with chronic granulomatous disease (CGD) cannot produce reactive oxygen species (ROS) due to a genetic defect in the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase system. Dysregulation of the L-tryptophan metabolism in mice with defects in NADPH oxidase, resulting in overproduction of interleukin (IL)-17, has been proposed to link ROS defects with hyperinflammation and susceptibility to pulmonary aspergillosis. In this study, we assessed the L-tryptophan metabolism and cytokine profiles in response to fungal pathogens in CGD patients. Peripheral blood mononuclear cells (PBMCs) from CGD patients showed increased production of IL-6, tumor necrosis factor-α, and interferon-γ upon stimulation with Aspergillus or Candida species, while IL-17A production was strikingly low compared with healthy controls. Indoleamine 2,3-dioxygenase expression was similar in PBMCs and neutrophils from CGD patients compared with healthy controls. Conversion of L-tryptophan to L-kynurenine, as measured by high-performance liquid chromatography, did not differ between CGD patients and healthy controls. Moreover, adding L-kynurenine to the cell cultures did not suppress fungal-induced IL-17A production. Although PBMCs of CGD patients produced more proinflammatory cytokines after stimulation, IL-17A production was strikingly low in response to fungal pathogens when compared with healthy controls. In addition, cells from CGD patients did not display a defective L-tryptophan metabolism.
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Affiliation(s)
- Sanne P Smeekens
- Department of Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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109
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Yano J, Noverr MC, Fidel PL. Cytokines in the host response to Candida vaginitis: Identifying a role for non-classical immune mediators, S100 alarmins. Cytokine 2011; 58:118-28. [PMID: 22182685 DOI: 10.1016/j.cyto.2011.11.021] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 11/23/2011] [Accepted: 11/25/2011] [Indexed: 01/06/2023]
Abstract
Vulvovaginal candidiasis (VVC), caused by Candida albicans, affects a significant number of women during their reproductive years. More than two decades of research have been focused on the mechanisms associated with susceptibility or resistance to symptomatic infection. Adaptive immunity by Th1-type CD4(+) T cells and downstream cytokine responses are considered the predominant host defense mechanisms against mucosal Candida infections. However, numerous clinical and animal studies have indicated no or limited protective role of cells and cytokines of the Th1 or Th2 lineage against vaginal infection. The role for Th17 is only now begun to be investigated in-depth for VVC with results already showing significant controversy. On the other hand, a clinical live-challenge study and an established animal model have shown that a symptomatic condition is intimately associated with the vaginal infiltration of polymorphonuclear leukocytes (PMNs) but with no effect on vaginal fungal burden. Subsequent studies identified S100A8 and S100A9 alarmins as key chemotactic mediators of the acute PMN response. These chemotactic danger signals appear to be secreted by vaginal epithelial cells upon interaction and early adherence of Candida. Thus, instead of a putative immunodeficiency against Candida involving classical immune cells and cytokines of the adaptive response, the pathological inflammation in VVC is now considered a consequence of a non-productive innate response initiated by non-classical immune mediators.
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Affiliation(s)
- Junko Yano
- Department of Microbiology, Immunology and Parasitology, Louisiana State University Health Sciences Center, New Orleans, LA, USA
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110
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Candida albicans morphogenesis and host defence: discriminating invasion from colonization. Nat Rev Microbiol 2011; 10:112-22. [PMID: 22158429 DOI: 10.1038/nrmicro2711] [Citation(s) in RCA: 583] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Candida albicans is a common fungal pathogen of humans that colonizes the skin and mucosal surfaces of most healthy individuals. Until recently, little was known about the mechanisms by which mucosal antifungal defences tolerate colonizing C. albicans but react strongly when hyphae of the same microorganism attempt to invade tissue. In this Review, we describe the properties of yeast cells and hyphae that are relevant to their interaction with the host, and the immunological mechanisms that differentially recognize colonizing versus invading C. albicans.
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111
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Is there a future for a Staphylococcus aureus vaccine? Vaccine 2011; 30:2921-7. [PMID: 22115633 DOI: 10.1016/j.vaccine.2011.11.006] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 10/21/2011] [Accepted: 11/01/2011] [Indexed: 12/21/2022]
Abstract
Multiple attempts to develop a vaccine to prevent Staphylococcus aureus infections have failed. To date, all have been based upon the development of opsonic antibodies. New information suggests that cell mediated immunity may be critical for protection against S. aureus infections. The arm of the immune system that provides the protection contains the Th17/IL-17 axis. Th17 cells release IL-17, which are important for mobilization and activation of neutrophils. Naturally, antibodies aid the neutrophils in the uptake and killing of staphylococci, but immune globulin does not seem to be sufficient to afford protection. New approaches that focus on Th17/IL-17 may allow for the development of a successful S. aureus vaccine.
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112
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Abstract
The discovery of the Th17 lineage in 2005 triggered a major change in how immunity to infectious diseases is viewed. Fungal infections, in particular, have long been a relatively understudied area of investigation in terms of the host immune response. Candida albicans is a commensal yeast that colonizes mucosal sites and skin. In healthy individuals, it is non-pathogenic, but in conditions of immune deficiency, this organism can cause a variety of infections associated with considerable morbidity. Candida can also cause disseminated infections that have a high mortality rate and are a major clinical problem in hospital settings. Although immunity to Candida albicans was long considered to be mediated by Th1 cells, new data in both rodent models and in humans have revealed an essential role for the Th17 lineage, and in particular its signature cytokine IL-17.
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113
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McKinnon LR, Nyanga B, Chege D, Izulla P, Kimani M, Huibner S, Gelmon L, Block KE, Cicala C, Anzala AO, Arthos J, Kimani J, Kaul R. Characterization of a Human Cervical CD4+T Cell Subset Coexpressing Multiple Markers of HIV Susceptibility. THE JOURNAL OF IMMUNOLOGY 2011; 187:6032-42. [DOI: 10.4049/jimmunol.1101836] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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114
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Aujla SJ, Alcorn JF. T(H)17 cells in asthma and inflammation. BIOCHIMICA ET BIOPHYSICA ACTA 2011; 1810:1066-79. [PMID: 21315804 DOI: 10.1016/j.bbagen.2011.02.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 01/25/2011] [Accepted: 02/02/2011] [Indexed: 12/16/2022]
Abstract
BACKGROUND The chronic airway disease asthma causes significant burden to patients as well as the healthcare system with limited options for prevention or cure. Inadequate treatment strategies are most likely due to the complex heterogeneous nature of asthma. Furthermore, the severe asthma phenotype is characterized by the lack of a response to standard medication, namely, corticosteroids. SCOPE OF REVIEW In the last several years it has been shown that the eosinophilic/atopic phenotype of asthma driven by T(H)2 mechanisms is not the only immunologic pathway contributing to disease. In fact, there has been evidence revealing that severe asthmatics in particular have neutrophilic inflammation, and this is associated with corticosteroid resistance. T(H)17 cells, a recently discovered lineage of T helper cells, play an important role in lung host defense against multiple pathogens via production of the cytokine IL-17. IL-17 promotes neutrophil production and chemotaxis via multiple factors. MAJOR CONCLUSIONS Mouse and human studies provide robust evidence that T(H)17 cells and IL-17 play a role in severe asthma and may contribute to corticosteroid resistance. GENERAL SIGNIFICANCE As we learn more about T(H)17 cells in severe asthma, the goal is to potentially target this pathway for treatment in the hope of significantly improving the quality of life for those children and adults affected with this disease. This article is part of a Special Issue entitled: Biochemistry of Asthma.
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Affiliation(s)
- Shean J Aujla
- Department of Pedaitrics, Children's Hospital of Pittsburgh of UPMC, Pitsburgh, PA 15224, USA
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115
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Vinh DC. Insights into human antifungal immunity from primary immunodeficiencies. THE LANCET. INFECTIOUS DISEASES 2011; 11:780-92. [PMID: 21958581 DOI: 10.1016/s1473-3099(11)70217-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Some mendelian (monogenic) disorders directly conferring increased susceptibility are associated with diverse infectious organisms, whereas others are restricted in scope to specific genera or even to one species. So far, most investigations of primary immunodeficiency disorders have focused on those conferring susceptibility to viral, bacterial, or mycobacterial infections, providing powerful insight into human determinants of host resistance to these microbes. Monogenic disorders that increase susceptibility to fungal infections are increasingly being recognised. Although infections associated with these disorders are probably less common than are iatrogenic associated mycoses, they provide valuable insight into human immunity to fungal infections. Investigation of these immunological pathways will ultimately lead to improvements in management of such infections in secondarily immunocompromised patients.
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Affiliation(s)
- Donald C Vinh
- Infectious Disease Susceptibility Program, Division of Infectious Diseases and Division of Immunology, Department of Medicine, McGill University Health Centre, Montreal General Hospital, Montreal, QC, Canada.
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116
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Oftedal BEV, Kämpe O, Meager A, Ahlgren KM, Lobell A, Husebye ES, Wolff ASB. Measuring autoantibodies against IL-17F and IL-22 in autoimmune polyendocrine syndrome type I by radioligand binding assay using fusion proteins. Scand J Immunol 2011; 74:327-333. [PMID: 21535082 DOI: 10.1111/j.1365-3083.2011.02573.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Autoantibodies against interleukin (IL)-17A, IL-17F and IL-22 have recently been described in patients with autoimmune polyendocrine syndrome type I (APS I), and their presence is reported to be highly correlated with chronic mucocutaneous candidiasis (CMC). The aim of this study was to develop a robust high-throughput radioligand binding assays (RLBA) measuring IL-17F and IL-22 antibodies, to compare them with current enzyme-linked immunosorbent assays (ELISA) of IL-17F and IL-22 and, moreover, to correlate the presence of these antibodies with the presence of CMC. Interleukins are small molecules, which makes them difficult to express in vitro. To overcome this problem, they were fused as dimers, which proved to increase the efficiency of expression. A total of five RLBAs were developed based on IL-17F and IL-22 monomers and homo- or heterodimers. Analysing the presence of these autoantibodies in 25 Norwegian APS I patients revealed that the different RLBAs detected anti-IL-17F and anti-IL-22 with high specificity, using both homo- and heterodimers. The RLBAs based on dimer proteins are highly reproducible with low inter- and intravariation and have the advantages of high throughput and easy standardization compared to ELISA, thus proving excellent choices for the screening of IL-17F and IL-22 autoantibodies.
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Affiliation(s)
- B E V Oftedal
- Institute of Medicine, University of BergenDepartment of Medicine, Haukeland University Hospital, Bergen, NorwayDepartment of Medical Science, Uppsala University, Uppsala, SwedenBiotherapeutics, The National Institute for Biological Standards and Control, Blanche Lane, EN6 3QG South Mimms, Herts, UK
| | - O Kämpe
- Institute of Medicine, University of BergenDepartment of Medicine, Haukeland University Hospital, Bergen, NorwayDepartment of Medical Science, Uppsala University, Uppsala, SwedenBiotherapeutics, The National Institute for Biological Standards and Control, Blanche Lane, EN6 3QG South Mimms, Herts, UK
| | - A Meager
- Institute of Medicine, University of BergenDepartment of Medicine, Haukeland University Hospital, Bergen, NorwayDepartment of Medical Science, Uppsala University, Uppsala, SwedenBiotherapeutics, The National Institute for Biological Standards and Control, Blanche Lane, EN6 3QG South Mimms, Herts, UK
| | - K M Ahlgren
- Institute of Medicine, University of BergenDepartment of Medicine, Haukeland University Hospital, Bergen, NorwayDepartment of Medical Science, Uppsala University, Uppsala, SwedenBiotherapeutics, The National Institute for Biological Standards and Control, Blanche Lane, EN6 3QG South Mimms, Herts, UK
| | - A Lobell
- Institute of Medicine, University of BergenDepartment of Medicine, Haukeland University Hospital, Bergen, NorwayDepartment of Medical Science, Uppsala University, Uppsala, SwedenBiotherapeutics, The National Institute for Biological Standards and Control, Blanche Lane, EN6 3QG South Mimms, Herts, UK
| | - E S Husebye
- Institute of Medicine, University of BergenDepartment of Medicine, Haukeland University Hospital, Bergen, NorwayDepartment of Medical Science, Uppsala University, Uppsala, SwedenBiotherapeutics, The National Institute for Biological Standards and Control, Blanche Lane, EN6 3QG South Mimms, Herts, UK
| | - A S B Wolff
- Institute of Medicine, University of BergenDepartment of Medicine, Haukeland University Hospital, Bergen, NorwayDepartment of Medical Science, Uppsala University, Uppsala, SwedenBiotherapeutics, The National Institute for Biological Standards and Control, Blanche Lane, EN6 3QG South Mimms, Herts, UK
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117
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Smeekens SP, van de Veerdonk FL, Joosten LAB, Jacobs L, Jansen T, Williams DL, van der Meer JWM, Kullberg BJ, Netea MG. The classical CD14⁺⁺ CD16⁻ monocytes, but not the patrolling CD14⁺ CD16⁺ monocytes, promote Th17 responses to Candida albicans. Eur J Immunol 2011; 41:2915-24. [PMID: 21695694 DOI: 10.1002/eji.201141418] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 05/30/2011] [Accepted: 06/17/2011] [Indexed: 01/09/2023]
Abstract
In the present study, we investigated the functional differences between cluster of differentiation (CD)14(++) CD16(-) and CD14(+) CD16(+) monocytes during anti-Candida host defense. CD14(++) CD16(-) are the "classical" monocytes and represent the majority of circulating monocytes in humans, while CD14(+) CD16(+) monocytes patrol the vasculature for maintenance of tissue integrity and repair. Both monocyte subsets inhibited the germination of live Candida albicans, and there was no difference in their capacity to phagocytose and kill Candida. Although production of IL-6 and IL-10 induced by C. albicans was found to be similar between monocyte subsets, IL-1β and prostaglandin E2 (PGE2) production was higher in CD14(++) CD16(-) compared with CD14(+) CD16(+) monocytes. In line with the increased production of IL-1β and PGE2, central mediators for inducing Th17 responses, CD14(++) CD16(-) monocytes induced greater Th17 responses upon stimulation with heat-killed C. albicans yeast. The percentage of cells that expressed mannose receptor (MR) was higher in the CD14(++) CD16(-) monocyte subset, and MR-specific stimulation induced higher Th17 responses only in co-cultures of CD14(++) CD16(-) monocytes and CD4 lymphocytes. In conclusion, both monocyte subsets have potent innate antifungal properties, but only CD14(++) CD16(-) monocytes are capable of inducing a potent Th17 response to C. albicans, an important component of antifungal host defense.
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Affiliation(s)
- Sanne P Smeekens
- Department of Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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118
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Systems biology of infectious diseases: a focus on fungal infections. Immunobiology 2011; 216:1212-27. [PMID: 21889228 DOI: 10.1016/j.imbio.2011.08.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Accepted: 08/06/2011] [Indexed: 12/21/2022]
Abstract
The study of infectious disease concerns the interaction between the host species and a pathogen organism. The analysis of such complex systems is improving with the evolution of high-throughput technologies and advanced computational resources. This article reviews integrative, systems-oriented approaches to understanding mechanisms underlying infection, immune response and inflammation to find biomarkers of disease and design new drugs. We focus on the systems biology process, especially the data gathering and analysis techniques rather than the experimental technologies or latest computational resources.
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119
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Inatsu A, Kogiso M, Jeschke MG, Asai A, Kobayashi M, Herndon DN, Suzuki F. Lack of Th17 cell generation in patients with severe burn injuries. THE JOURNAL OF IMMUNOLOGY 2011; 187:2155-61. [PMID: 21821800 DOI: 10.4049/jimmunol.1003235] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Immunodeficient patients with severe burn injuries are extremely susceptible to infection with Candida albicans. In addition to Th1 cells, IL-17-producing CD4(+) T cells (Th17 cells) have recently been described as an important effector cell in host anti-Candida resistance. In this study, therefore, we tried to induce Th17 cells in cultures of severely burned patient PBMC by stimulation with the C. albicans Ag (CAg). In the results, the biomarkers for Th17 cells (IL-17 production and intracellular expression of IL-17 and retinoic acid receptor-related orphan receptor γt) were not displayed by burn patient PBMC stimulated with CAg, whereas these biomarkers of Th17 cells were detected in cultures of healthy donor PBMC stimulated with CAg. Burn patient sera were shown to be inhibitory on CAg-stimulated Th17 cell generation in healthy donor PBMC cultures; however, Th17 cells were induced by CAg in healthy donor PBMC cultures supplemented with burn patient sera that were previously treated with anti-IL-10 mAb. Also, the biomarkers of Th17 cells were not induced by CAg in healthy donor PBMC cultures supplemented with rIL-10. IL-10 was detected in serum specimens derived from severely burned patients. These results indicate that Th17 cells are not generated in burn patient PBMC cultures supplemented with CAg. IL-10, produced in response to burn injuries, is shown to be inhibitory on Th17 cell generation. The high susceptibility of severely burned patients to C. albicans infection might be influenced if burn-associated IL-10 production is intervened.
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Affiliation(s)
- Akihito Inatsu
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA
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120
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Liu L, Okada S, Kong XF, Kreins AY, Cypowyj S, Abhyankar A, Toubiana J, Itan Y, Audry M, Nitschke P, Masson C, Toth B, Flatot J, Migaud M, Chrabieh M, Kochetkov T, Bolze A, Borghesi A, Toulon A, Hiller J, Eyerich S, Eyerich K, Gulácsy V, Chernyshova L, Chernyshov V, Bondarenko A, María Cortés Grimaldo R, Blancas-Galicia L, Madrigal Beas IM, Roesler J, Magdorf K, Engelhard D, Thumerelle C, Burgel PR, Hoernes M, Drexel B, Seger R, Kusuma T, Jansson AF, Sawalle-Belohradsky J, Belohradsky B, Jouanguy E, Bustamante J, Bué M, Karin N, Wildbaum G, Bodemer C, Lortholary O, Fischer A, Blanche S, Al-Muhsen S, Reichenbach J, Kobayashi M, Rosales FE, Lozano CT, Kilic SS, Oleastro M, Etzioni A, Traidl-Hoffmann C, Renner ED, Abel L, Picard C, Maródi L, Boisson-Dupuis S, Puel A, Casanova JL. Gain-of-function human STAT1 mutations impair IL-17 immunity and underlie chronic mucocutaneous candidiasis. J Exp Med 2011; 208:1635-48. [PMID: 21727188 PMCID: PMC3149226 DOI: 10.1084/jem.20110958] [Citation(s) in RCA: 594] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Accepted: 06/22/2011] [Indexed: 01/14/2023] Open
Abstract
Chronic mucocutaneous candidiasis disease (CMCD) may be caused by autosomal dominant (AD) IL-17F deficiency or autosomal recessive (AR) IL-17RA deficiency. Here, using whole-exome sequencing, we identified heterozygous germline mutations in STAT1 in 47 patients from 20 kindreds with AD CMCD. Previously described heterozygous STAT1 mutant alleles are loss-of-function and cause AD predisposition to mycobacterial disease caused by impaired STAT1-dependent cellular responses to IFN-γ. Other loss-of-function STAT1 alleles cause AR predisposition to intracellular bacterial and viral diseases, caused by impaired STAT1-dependent responses to IFN-α/β, IFN-γ, IFN-λ, and IL-27. In contrast, the 12 AD CMCD-inducing STAT1 mutant alleles described here are gain-of-function and increase STAT1-dependent cellular responses to these cytokines, and to cytokines that predominantly activate STAT3, such as IL-6 and IL-21. All of these mutations affect the coiled-coil domain and impair the nuclear dephosphorylation of activated STAT1, accounting for their gain-of-function and dominance. Stronger cellular responses to the STAT1-dependent IL-17 inhibitors IFN-α/β, IFN-γ, and IL-27, and stronger STAT1 activation in response to the STAT3-dependent IL-17 inducers IL-6 and IL-21, hinder the development of T cells producing IL-17A, IL-17F, and IL-22. Gain-of-function STAT1 alleles therefore cause AD CMCD by impairing IL-17 immunity.
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Affiliation(s)
- Luyan Liu
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Medical School, Institut National de la Santé et de la Recherche Médicale U980 and University Paris Descartes, 75015 Paris, France
| | - Satoshi Okada
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065
| | - Xiao-Fei Kong
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065
| | - Alexandra Y. Kreins
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065
| | - Sophie Cypowyj
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065
| | - Avinash Abhyankar
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065
| | - Julie Toubiana
- Department of Pediatrics, Bioinformatics Unit, Department of Dermatology, Department of Infectious Diseases, Pediatric Hematology-Immunology Unit, and Center for Immunodeficiency, Necker Hospital, AP-HP, and University Paris Descartes, 75015 Paris, France
| | - Yuval Itan
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065
| | - Magali Audry
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065
| | - Patrick Nitschke
- Department of Pediatrics, Bioinformatics Unit, Department of Dermatology, Department of Infectious Diseases, Pediatric Hematology-Immunology Unit, and Center for Immunodeficiency, Necker Hospital, AP-HP, and University Paris Descartes, 75015 Paris, France
| | - Cécile Masson
- Department of Pediatrics, Bioinformatics Unit, Department of Dermatology, Department of Infectious Diseases, Pediatric Hematology-Immunology Unit, and Center for Immunodeficiency, Necker Hospital, AP-HP, and University Paris Descartes, 75015 Paris, France
| | - Beata Toth
- Department of Infectious and Pediatric Immunology, Medical and Health Science Center, University of Debrecen, 4032 Debrecen, Hungary
| | - Jérome Flatot
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Medical School, Institut National de la Santé et de la Recherche Médicale U980 and University Paris Descartes, 75015 Paris, France
| | - Mélanie Migaud
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Medical School, Institut National de la Santé et de la Recherche Médicale U980 and University Paris Descartes, 75015 Paris, France
| | - Maya Chrabieh
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Medical School, Institut National de la Santé et de la Recherche Médicale U980 and University Paris Descartes, 75015 Paris, France
| | - Tatiana Kochetkov
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065
| | - Alexandre Bolze
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Medical School, Institut National de la Santé et de la Recherche Médicale U980 and University Paris Descartes, 75015 Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065
| | - Alessandro Borghesi
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Medical School, Institut National de la Santé et de la Recherche Médicale U980 and University Paris Descartes, 75015 Paris, France
| | - Antoine Toulon
- Department of Pediatrics, Bioinformatics Unit, Department of Dermatology, Department of Infectious Diseases, Pediatric Hematology-Immunology Unit, and Center for Immunodeficiency, Necker Hospital, AP-HP, and University Paris Descartes, 75015 Paris, France
| | - Julia Hiller
- Center for Allergy and Environment, Helmholtz Center/TUM, 80802 Munich, Germany
| | - Stefanie Eyerich
- Center for Allergy and Environment, Helmholtz Center/TUM, 80802 Munich, Germany
| | - Kilian Eyerich
- Center for Allergy and Environment, Helmholtz Center/TUM, 80802 Munich, Germany
- Department of Dermatology, Technische Universitat, 80802 Munich, Germany
| | - Vera Gulácsy
- Department of Infectious and Pediatric Immunology, Medical and Health Science Center, University of Debrecen, 4032 Debrecen, Hungary
| | - Ludmyla Chernyshova
- Department of Pediatric Infectious Diseases and Clinical Immunology, National Medical Academy for Post-Graduate Education, 01024 Kiev, Ukraine
| | - Viktor Chernyshov
- Laboratory of Immunology, Institute of Pediatrics, Obstetrics, and Gynecology, National Academy of Medical Sciences, 01024 Kiev, Ukraine
| | - Anastasia Bondarenko
- Department of Pediatric Infectious Diseases and Clinical Immunology, National Medical Academy for Post-Graduate Education, 01024 Kiev, Ukraine
| | | | | | | | - Joachim Roesler
- Department of Pediatrics, University Hospital Carl Gustav Carus, 01307 Dresden, Germany
| | - Klaus Magdorf
- Department of Pediatric Pneumology and Immunology, Charité Medical School of Berlin, 11117 Berlin, Germany
| | - Dan Engelhard
- Department of Pediatrics, Hadassah University Hospital, 91120 Jerusalem, Israel
| | - Caroline Thumerelle
- Pneumology and Allergology Unit, Hospital Jeanne de Flandres, 59037 Lille, France
| | | | - Miriam Hoernes
- Division of Immunology, Hematology, and BMT, Children’s Research Center, Children’s Hospital, University of Zurich, 8032 Zurich, Switzerland
| | - Barbara Drexel
- Division of Immunology, Hematology, and BMT, Children’s Research Center, Children’s Hospital, University of Zurich, 8032 Zurich, Switzerland
| | - Reinhard Seger
- Division of Immunology, Hematology, and BMT, Children’s Research Center, Children’s Hospital, University of Zurich, 8032 Zurich, Switzerland
| | - Theresia Kusuma
- University Children’s Hospital at Dr. von Haunersches Kinderspital, Ludwig Maximilian University, 80337 Munich, Germany
| | - Annette F. Jansson
- University Children’s Hospital at Dr. von Haunersches Kinderspital, Ludwig Maximilian University, 80337 Munich, Germany
| | - Julie Sawalle-Belohradsky
- University Children’s Hospital at Dr. von Haunersches Kinderspital, Ludwig Maximilian University, 80337 Munich, Germany
| | - Bernd Belohradsky
- University Children’s Hospital at Dr. von Haunersches Kinderspital, Ludwig Maximilian University, 80337 Munich, Germany
| | - Emmanuelle Jouanguy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Medical School, Institut National de la Santé et de la Recherche Médicale U980 and University Paris Descartes, 75015 Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Medical School, Institut National de la Santé et de la Recherche Médicale U980 and University Paris Descartes, 75015 Paris, France
| | - Mélanie Bué
- University Hospital Center of Brest, 29609 Brest, France
| | - Nathan Karin
- Rappaport Faculty of Medicine, Technion, 31096 Haifa, Israel
| | - Gizi Wildbaum
- Rappaport Faculty of Medicine, Technion, 31096 Haifa, Israel
| | - Christine Bodemer
- Department of Infectious and Pediatric Immunology, Medical and Health Science Center, University of Debrecen, 4032 Debrecen, Hungary
| | - Olivier Lortholary
- Department of Infectious and Pediatric Immunology, Medical and Health Science Center, University of Debrecen, 4032 Debrecen, Hungary
| | - Alain Fischer
- Department of Infectious and Pediatric Immunology, Medical and Health Science Center, University of Debrecen, 4032 Debrecen, Hungary
| | - Stéphane Blanche
- Department of Infectious and Pediatric Immunology, Medical and Health Science Center, University of Debrecen, 4032 Debrecen, Hungary
| | - Saleh Al-Muhsen
- Rappaport Faculty of Medicine, Technion, 31096 Haifa, Israel
| | - Janine Reichenbach
- Division of Immunology, Hematology, and BMT, Children’s Research Center, Children’s Hospital, University of Zurich, 8032 Zurich, Switzerland
| | - Masao Kobayashi
- Division of Immunology, Hematology, and BMT, Children’s Research Center, Children’s Hospital, University of Zurich, 8032 Zurich, Switzerland
| | | | | | - Sara Sebnem Kilic
- Department of Pediatrics, Uludag University School of Medicine, 16059 Bursa, Turkey
| | - Matias Oleastro
- National Children’s Hospital Prof. Dr. Juan P. Garrahan, 12049 Buenos Aires, Argentina
| | - Amos Etzioni
- Rappaport Faculty of Medicine, Technion, 31096 Haifa, Israel
| | - Claudia Traidl-Hoffmann
- Center for Allergy and Environment, Helmholtz Center/TUM, 80802 Munich, Germany
- Department of Dermatology, Technische Universitat, 80802 Munich, Germany
| | - Ellen D. Renner
- University Children’s Hospital at Dr. von Haunersches Kinderspital, Ludwig Maximilian University, 80337 Munich, Germany
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Medical School, Institut National de la Santé et de la Recherche Médicale U980 and University Paris Descartes, 75015 Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065
| | - Capucine Picard
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Medical School, Institut National de la Santé et de la Recherche Médicale U980 and University Paris Descartes, 75015 Paris, France
- Department of Pediatrics, Bioinformatics Unit, Department of Dermatology, Department of Infectious Diseases, Pediatric Hematology-Immunology Unit, and Center for Immunodeficiency, Necker Hospital, AP-HP, and University Paris Descartes, 75015 Paris, France
| | - László Maródi
- Department of Infectious and Pediatric Immunology, Medical and Health Science Center, University of Debrecen, 4032 Debrecen, Hungary
| | - Stéphanie Boisson-Dupuis
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Medical School, Institut National de la Santé et de la Recherche Médicale U980 and University Paris Descartes, 75015 Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065
| | - Anne Puel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Medical School, Institut National de la Santé et de la Recherche Médicale U980 and University Paris Descartes, 75015 Paris, France
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Medical School, Institut National de la Santé et de la Recherche Médicale U980 and University Paris Descartes, 75015 Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065
- Department of Pediatrics, Bioinformatics Unit, Department of Dermatology, Department of Infectious Diseases, Pediatric Hematology-Immunology Unit, and Center for Immunodeficiency, Necker Hospital, AP-HP, and University Paris Descartes, 75015 Paris, France
- Prince Naif Center for Immunology Research, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, 11461Saudi Arabia
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Eyerich S, Onken AT, Weidinger S, Franke A, Nasorri F, Pennino D, Grosber M, Pfab F, Schmidt-Weber CB, Mempel M, Hein R, Ring J, Cavani A, Eyerich K. Mutual antagonism of T cells causing psoriasis and atopic eczema. N Engl J Med 2011; 365:231-8. [PMID: 21774711 DOI: 10.1056/nejmoa1104200] [Citation(s) in RCA: 160] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Stefanie Eyerich
- Center of Allergy and Environment (ZAUM), Technische Universität and Helmholtz Center Munich, Munich, Germany
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122
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Naglik JR, Moyes DL, Wächtler B, Hube B. Candida albicans interactions with epithelial cells and mucosal immunity. Microbes Infect 2011; 13:963-76. [PMID: 21801848 DOI: 10.1016/j.micinf.2011.06.009] [Citation(s) in RCA: 176] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 06/10/2011] [Accepted: 06/10/2011] [Indexed: 12/31/2022]
Abstract
Candida albicans interactions with epithelial cells are critical for commensal growth, fungal pathogenicity and host defence. This review will outline our current understanding of C. albicans-epithelial interactions and will discuss how this may lead to the induction of a protective mucosal immune response.
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Affiliation(s)
- Julian R Naglik
- Department of Oral Immunology, King's College London Dental Institute, King's College London, London SE1 9RT, United Kingdom.
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123
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van de Veerdonk FL, Plantinga TS, Hoischen A, Smeekens SP, Joosten LAB, Gilissen C, Arts P, Rosentul DC, Carmichael AJ, Smits-van der Graaf CAA, Kullberg BJ, van der Meer JWM, Lilic D, Veltman JA, Netea MG. STAT1 mutations in autosomal dominant chronic mucocutaneous candidiasis. N Engl J Med 2011; 365:54-61. [PMID: 21714643 DOI: 10.1056/nejmoa1100102] [Citation(s) in RCA: 487] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Chronic mucocutaneous candidiasis (CMC) is characterized by susceptibility to candida infection of skin, nails, and mucous membranes. Patients with recessive CMC and autoimmunity have mutations in the autoimmune regulator AIRE. The cause of autosomal dominant CMC is unknown. METHODS We evaluated 14 patients from five families with autosomal dominant CMC. We incubated their peripheral-blood mononuclear cells with different combinations of stimuli to test the integrity of pathways that mediate immunity, which led to the selection of 100 genes that were most likely to contain the genetic defect. We used an array-based sequence-capture assay, followed by next-generation sequencing, to identify mutations. RESULTS The mononuclear cells from the affected patients were characterized by poor production of interferon-γ, interleukin-17, and interleukin-22, suggesting that the defect lay within the interleukin-12 receptor and interleukin-23 receptor signaling pathways. We identified heterozygous missense mutations in the DNA sequence encoding the coiled-coil (CC) domain of signal transducer and activator of transcription 1 (STAT1) in the patients. These mutations lead to defective responses in type 1 and type 17 helper T cells (Th1 and Th17). The interferon-γ receptor pathway was intact in these patients. CONCLUSIONS Mutations in the CC domain of STAT1 underlie autosomal dominant CMC and lead to defective Th1 and Th17 responses, which may explain the increased susceptibility to fungal infection. (Funded by the Netherlands Organization for Scientific Research and others.).
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Affiliation(s)
- Frank L van de Veerdonk
- Department of Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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124
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van de Veerdonk FL, Joosten LAB, Shaw PJ, Smeekens SP, Malireddi RKS, van der Meer JWM, Kullberg BJ, Netea MG, Kanneganti TD. The inflammasome drives protective Th1 and Th17 cellular responses in disseminated candidiasis. Eur J Immunol 2011; 41:2260-8. [PMID: 21681738 DOI: 10.1002/eji.201041226] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 04/13/2011] [Accepted: 05/18/2011] [Indexed: 11/08/2022]
Abstract
The Nlrp3 inflammasome has been proposed to play an important role in antifungal host defense. However, studies exploring the role of the inflammasome in antifungal host defense have been limited to the direct effects on IL-1β processing. Although IL-1β has important direct effects on the innate immune response, important effects of the caspase-1-dependent cytokines IL-1β and IL-18 are exerted on the initiation of the adaptive Th1 and Th17 cellular responses. No studies have been employed to assess the impact of the inflammasome on the Th1/Th17 defense mechanisms in vivo during candidiasis. In the present study, we demonstrate an essential role for caspase-1 and ASC (apoptosis-associated speck-like protein containing a caspase recruitment domain) in disseminated candidiasis through regulating antifungal Th1 and Th17 responses. Caspase-1(-/-) and ASC(-/-) mice display diminished Th1/Th17 responses, followed by increased fungal outgrowth and lower survival. These observations identify a critical role for the inflammasome in controlling protective adaptive immune responses during invasive fungal infection.
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125
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Eyerich S, Wagener J, Wenzel V, Scarponi C, Pennino D, Albanesi C, Schaller M, Behrendt H, Ring J, Schmidt-Weber CB, Cavani A, Mempel M, Traidl-Hoffmann C, Eyerich K. IL-22 and TNF-α represent a key cytokine combination for epidermal integrity during infection with Candida albicans. Eur J Immunol 2011; 41:1894-901. [PMID: 21469124 DOI: 10.1002/eji.201041197] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 02/13/2011] [Accepted: 03/30/2011] [Indexed: 12/21/2022]
Abstract
T cells exercise their full impact on target cells through a combination of secreted cytokines. The recently described T helper cell subset Th22 is characterized by a combinatorial secretion of IL-22 and TNF-α. Here, we demonstrate that IL-22 increases the TNF-α-dependent induction and secretion of several immune-modulatory molecules such as initial complement factors C1r and C1s, antimicrobial peptides S100A7 and HBD-2 (human β defensin 2), and antimicrobial chemokines CXCL-9/-10/-11 in primary human keratinocytes. The synergism of IL-22 and TNF-α is transmitted intracellularly by MAP kinases and downstream by transcription factors of the AP-1 family. The induction of innate immunity is relevant in an in vitro infection model, where keratinocytes stimulated with Th22 supernatants or recombinant IL-22 plus TNF-α effectively inhibit the growth of Candida albicans and maintain survival of epithelia. Accordingly, the combinatorial stimulation of keratinocytes with IL-22 and TNF-α most efficiently conserves the integrity of the epidermal barrier in a three-dimensional skin infection model as compared with IFN-γ, IL-17, IL-22 or TNF-α alone. In summary, we demonstrate that IL-22 and TNF-α represent a potent, synergistic cytokine combination for cutaneous immunity.
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Affiliation(s)
- Stefanie Eyerich
- ZAUM-Center for Allergy and Environment, Technische Universität and Helmholtz Center Munich, Munich, Germany.
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126
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Mucosal immunity and Candida albicans infection. Clin Dev Immunol 2011; 2011:346307. [PMID: 21776285 PMCID: PMC3137974 DOI: 10.1155/2011/346307] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Accepted: 05/27/2011] [Indexed: 02/06/2023]
Abstract
Interactions between mucosal surfaces and microbial microbiota are key to host defense, health, and disease. These surfaces are exposed to high numbers of microbes and must be capable of distinguishing between those that are beneficial or avirulent and those that will invade and cause disease. Our understanding of the mechanisms involved in these discriminatory processes has recently begun to expand as new studies bring to light the importance of epithelial cells and novel immune cell subsets such as T(h)17 T cells in these processes. Elucidating how these mechanisms function will improve our understanding of many diverse diseases and improve our ability to treat patients suffering from these conditions. In our voyage to discover these mechanisms, mucosal interactions with opportunistic commensal organisms such as the fungus Candida albicans provide insights that are invaluable. Here, we review current knowledge of the interactions between C. albicans and epithelial surfaces and how this may shape our understanding of microbial-mucosal interactions.
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127
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Ouyang W, Rutz S, Crellin NK, Valdez PA, Hymowitz SG. Regulation and functions of the IL-10 family of cytokines in inflammation and disease. Annu Rev Immunol 2011; 29:71-109. [PMID: 21166540 DOI: 10.1146/annurev-immunol-031210-101312] [Citation(s) in RCA: 1285] [Impact Index Per Article: 98.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The IL-10 family of cytokines consists of nine members: IL-10, IL-19, IL-20, IL-22, IL-24, IL-26, and the more distantly related IL-28A, IL-28B, and IL-29. Evolutionarily, IL-10 family cytokines emerged before the adaptive immune response. These cytokines elicit diverse host defense mechanisms, especially from epithelial cells, during various infections. IL-10 family cytokines are essential for maintaining the integrity and homeostasis of tissue epithelial layers. Members of this family can promote innate immune responses from tissue epithelia to limit the damage caused by viral and bacterial infections. These cytokines can also facilitate the tissue-healing process in injuries caused by infection or inflammation. Finally, IL-10 itself can repress proinflammatory responses and limit unnecessary tissue disruptions caused by inflammation. Thus, IL-10 family cytokines have indispensable functions in many infectious and inflammatory diseases.
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Affiliation(s)
- Wenjun Ouyang
- Department of Immunology, Genentech, Inc., South San Francisco, California 94080, USA.
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128
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Hanna S, Etzioni A, Etzoni A. New host defense mechanisms against Candida species clarify the basis of clinical phenotypes. J Allergy Clin Immunol 2011; 127:1433-7. [PMID: 21497889 DOI: 10.1016/j.jaci.2011.03.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 03/17/2011] [Accepted: 03/24/2011] [Indexed: 11/22/2022]
Abstract
Chronic Candida species infection of the skin and mucosal membranes is viewed as a group of disorders all sharing a similar clinical condition, the susceptibility to localized fungal infections, which can be isolated or as a feature associated with various other entities. Although the pathogenesis underlying such a tendency had previously been poorly understood, the last decade has witnessed significant progress in revealing the molecular and immunologic mechanisms involved in antifungal immunity. T(H)17 cells and their specific cytokines (IL-17A and IL-17F cytokines and IL-22) are the main players in conferring antifungal protection. Autoimmune polyendocrinopathy and ectodermal dystrophy and hyper-IgE syndrome are 2 entities caused by different genetic mutations affecting distinct immune pathways but eventually share a similar clinical phenotype of Candida species infection. Impaired T(H)17 responses, although mediated by different mechanisms, seem to underlie this common feature: neutralizing autoantibodies against IL-17A and 1L-22 are involved in patients with autoimmune polyendocrinopathy and ectodermal dystrophy syndrome, whereas abnormal T(H)17 proliferation and IL-17 production are observed in the latter. Although various degrees of T(H)17 dysfunction were also observed in most cases of isolated chronic mucocutaneous candidiasis, only in very few families was a distinct mutation detected (caspase recruitment domain family, member 9 [CARD9]), thus indicating certain forms of chronic mucocutaneous candidiasis as monogenic with a Mendelian pattern of inheritance. Hopefully, these data will open the way for further searches for other genes and for introducing new treatment modalities.
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MESH Headings
- Candida/immunology
- Candidiasis/etiology
- Candidiasis/genetics
- Candidiasis/immunology
- Candidiasis, Chronic Mucocutaneous/etiology
- Candidiasis, Chronic Mucocutaneous/genetics
- Candidiasis, Chronic Mucocutaneous/immunology
- Disease Susceptibility
- Genes, Dominant
- Humans
- Immunity, Innate
- Interleukin-12 Subunit p40/deficiency
- Interleukin-12 Subunit p40/genetics
- Interleukin-17/biosynthesis
- Job Syndrome/complications
- Job Syndrome/genetics
- Job Syndrome/immunology
- Mutation
- Phenotype
- Polyendocrinopathies, Autoimmune/complications
- Polyendocrinopathies, Autoimmune/genetics
- Polyendocrinopathies, Autoimmune/immunology
- Receptors, Interleukin-12/deficiency
- Receptors, Interleukin-12/genetics
- STAT3 Transcription Factor/genetics
- Th17 Cells/immunology
- Transcription Factors/genetics
- AIRE Protein
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Affiliation(s)
- Suheir Hanna
- Pediatric Immunology Unit, Meyer's Children's Hospital, Rappaport Medical Faculty, Technion, Haifa, Israel
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129
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Kisand K, Lilic D, Casanova JL, Peterson P, Meager A, Willcox N. Mucocutaneous candidiasis and autoimmunity against cytokines in APECED and thymoma patients: clinical and pathogenetic implications. Eur J Immunol 2011; 41:1517-27. [PMID: 21574164 DOI: 10.1002/eji.201041253] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 03/09/2011] [Accepted: 04/14/2011] [Indexed: 12/16/2023]
Abstract
Much has been learnt about the mechanisms of thymic self-tolerance induction from work on both the rare autosomal recessive disease autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED) and the autoimmune regulator (AIRE) protein mutated in this disease. Normally, AIRE drives low-level expression of huge numbers of peripheral tissue-specific antigens (TSAgs) in medullary thymic epithelial cells (mTECs), leading to the deletion of TSAg-reactive thymocytes maturing nearby. The very recently discovered neutralizing autoantibodies (autoAbs) against Th17-related cells and cytokines in two autoimmunity-related syndromes associated with AIRE-mutant thymi or AIRE-deficient thymomas help to explain the chronic mucocutaneous candidiasis (CMC) seen in both syndromes. The surprising parallels between these syndromes also demand new hypotheses and research into the consequences of AIRE deficiency and the ensuing autoimmunizing pathways, and suggest more appropriate treatment regimens as discussed in this review.
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Affiliation(s)
- Kai Kisand
- Molecular Pathology Group, Institute of General and Molecular Pathology, University of Tartu, Tartu, Estonia.
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130
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Pandiyan P, Conti HR, Zheng L, Peterson AC, Mathern DR, Hernández-Santos N, Edgerton M, Gaffen SL, Lenardo MJ. CD4(+)CD25(+)Foxp3(+) regulatory T cells promote Th17 cells in vitro and enhance host resistance in mouse Candida albicans Th17 cell infection model. Immunity 2011; 34:422-34. [PMID: 21435589 DOI: 10.1016/j.immuni.2011.03.002] [Citation(s) in RCA: 207] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 01/20/2011] [Accepted: 03/02/2011] [Indexed: 12/16/2022]
Abstract
Th17 cells and CD4(+)CD25(+)Foxp3(+) regulatory T (Treg) cells are thought to promote and suppress inflammatory responses, respectively. Here we explore why under Th17 cell polarizing conditions, Treg cells did not suppress, but rather upregulated, the expression of interleukin-17A (IL-17A), IL-17F, and IL-22 from responding CD4(+) T cells (Tresp cells). Upregulation of IL-17 cytokines in Tresp cells was dependent on consumption of IL-2 by Treg cells, especially at early time points both in vitro and in vivo. During an oral Candida albicans infection in mice, Treg cells induced IL-17 cytokines in Tresp cells, which markedly enhanced fungal clearance and recovery from infection. These findings show how Treg cells can promote acute Th17 cell responses to suppress mucosal fungus infections and reveal that Treg cells have a powerful capability to fight infections besides their role in maintaining tolerance or immune homeostasis.
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Affiliation(s)
- Pushpa Pandiyan
- Laboratory of Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
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131
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Akdis M, Burgler S, Crameri R, Eiwegger T, Fujita H, Gomez E, Klunker S, Meyer N, O'Mahony L, Palomares O, Rhyner C, Ouaked N, Quaked N, Schaffartzik A, Van De Veen W, Zeller S, Zimmermann M, Akdis CA. Interleukins, from 1 to 37, and interferon-γ: receptors, functions, and roles in diseases. J Allergy Clin Immunol 2011; 127:701-21.e1-70. [PMID: 21377040 DOI: 10.1016/j.jaci.2010.11.050] [Citation(s) in RCA: 518] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 11/11/2010] [Accepted: 11/12/2010] [Indexed: 12/17/2022]
Abstract
Advancing our understanding of mechanisms of immune regulation in allergy, asthma, autoimmune diseases, tumor development, organ transplantation, and chronic infections could lead to effective and targeted therapies. Subsets of immune and inflammatory cells interact via ILs and IFNs; reciprocal regulation and counter balance among T(h) and regulatory T cells, as well as subsets of B cells, offer opportunities for immune interventions. Here, we review current knowledge about ILs 1 to 37 and IFN-γ. Our understanding of the effects of ILs has greatly increased since the discoveries of monocyte IL (called IL-1) and lymphocyte IL (called IL-2); more than 40 cytokines are now designated as ILs. Studies of transgenic or knockout mice with altered expression of these cytokines or their receptors and analyses of mutations and polymorphisms in human genes that encode these products have provided important information about IL and IFN functions. We discuss their signaling pathways, cellular sources, targets, roles in immune regulation and cellular networks, roles in allergy and asthma, and roles in defense against infections.
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Affiliation(s)
- Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland.
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132
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Chronic mucocutaneous candidiasis and congenital susceptibility to Candida. Curr Opin Allergy Clin Immunol 2011; 10:542-50. [PMID: 20859203 DOI: 10.1097/aci.0b013e32833fd74f] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW To give an overview on the clinical spectrum and the molecular background of host defence against Candida. RECENT FINDINGS For many decades the molecular causes and the pathogenesis for an increased susceptibility to Candida - and fungal infections in general - have been elusive. In 2009 and 2010 interesting reports on the genetic background and the pathomechanisms involved in chronic mucocutaneous candidiasis (CMC) have been published. SUMMARY The susceptibility to recurrent Candida infections can be a monogenetic Mendelian trait. The sensing of Candida cell wall components and the consecutive intracellular signalling in myeloid cells via CARD9, but also the role of Th17 cells and their cytokines take centre stage in the human host defence against Candida.
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133
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Glocker EO, Grimbacher B. Mucosal antifungal defence: IL-17 signalling takes centre stage. Immunol Cell Biol 2011; 89:823-5. [PMID: 21577231 DOI: 10.1038/icb.2011.39] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Erik-Oliver Glocker
- Institute of Medical Microbiology and Hygiene University Hospital, Freiburg, Germany.
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134
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Sade K, Fishman G, Kivity S, DeRowe A, Langier S. Expression of Th17 and Treg Lymphocyte Subsets in Hypertrophied Adenoids of Children and its Clinical Significance. Immunol Invest 2011; 40:657-66. [DOI: 10.3109/08820139.2011.575426] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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135
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Cheng SC, van de Veerdonk FL, Lenardon M, Stoffels M, Plantinga T, Smeekens S, Rizzetto L, Mukaremera L, Preechasuth K, Cavalieri D, Kanneganti TD, van der Meer JWM, Kullberg BJ, Joosten LAB, Gow NAR, Netea MG. The dectin-1/inflammasome pathway is responsible for the induction of protective T-helper 17 responses that discriminate between yeasts and hyphae of Candida albicans. J Leukoc Biol 2011; 90:357-66. [PMID: 21531876 PMCID: PMC3513931 DOI: 10.1189/jlb.1210702] [Citation(s) in RCA: 156] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In the mucosa, the immune pathways discriminating between colonizing and invasive Candida, thus inducing tolerance or inflammation, are poorly understood. Th17 responses induced by Candida albicans hyphae are central for the activation of mucosal antifungal immunity. An essential step for the discrimination between yeasts and hyphae and induction of Th17 responses is the activation of the inflammasome by C. albicans hyphae and the subsequent release of active IL-1β in macrophages. Inflammasome activation in macrophages results from differences in cell-wall architecture between yeasts and hyphae and is partly mediated by the dectin-1/Syk pathway. These results define the dectin-1/inflammasome pathway as the mechanism that enables the host immune system to mount a protective Th17 response and distinguish between colonization and tissue invasion by C. albicans.
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Affiliation(s)
- Shih-Chin Cheng
- Department of Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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136
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Radovanovic I, Mullick A, Gros P. Genetic control of susceptibility to infection with Candida albicans in mice. PLoS One 2011; 6:e18957. [PMID: 21533108 PMCID: PMC3080400 DOI: 10.1371/journal.pone.0018957] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 03/15/2011] [Indexed: 12/17/2022] Open
Abstract
Candida albicans is an opportunistic pathogen that causes acute disseminated infections in immunocompromised hosts, representing an important cause of morbidity and mortality in these patients. To study the genetic control of susceptibility to disseminated C. albicans in mice, we phenotyped a group of 23 phylogenetically distant inbred strains for susceptibility to infection as measured by extent of fungal replication in the kidney 48 hours following infection. Susceptibility was strongly associated with the loss-of-function mutant complement component 5 (C5/Hc) allele, which is known to be inherited by approximately 40% of inbred strains. Our survey identified 2 discordant strains, AKR/J (C5-deficient, resistant) and SM/J (C5-sufficient, susceptible), suggesting that additional genetic effects may control response to systemic candidiasis in these strains. Haplotype association mapping in the 23 strains using high density SNP maps revealed several putative loci regulating the extent of C. albicans replication, amongst which the most significant were C5 (P value = 2.43×10(-11)) and a novel effect on distal chromosome 11 (P value = 7.63×10(-9)). Compared to other C5-deficient strains, infected AKR/J strain displays a reduced fungal burden in the brain, heart and kidney, and increased survival, concomitant with uniquely high levels of serum IFNγ. C5-independent genetic effects were further investigated by linkage analysis in an [A/JxAKR/J]F2 cross (n = 158) where the mutant Hc allele is fixed. These studies identified a chromosome 11 locus (Carg4, Candida albicans resistance gene 4; LOD = 4.59), and a chromosome 8 locus (Carg3; LOD = 3.95), both initially detected by haplotype association mapping. Alleles at both loci were inherited in a co-dominant manner. Our results verify the important effect of C5-deficiency in inbred mouse strains, and further identify two novel loci, Carg3 and Carg4, which regulate resistance to C. albicans infection in a C5-independent manner.
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Affiliation(s)
- Irena Radovanovic
- Biochemistry Department, McGill University, Montréal, Québec, Canada
| | - Alaka Mullick
- Biotechnology Research Institute, Montréal, Québec, Canada
| | - Philippe Gros
- Biochemistry Department, McGill University, Montréal, Québec, Canada
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137
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Vanaudenaerde BM, Verleden SE, Vos R, Vleeschauwer SID, Willems-Widyastuti A, Geenens R, Raemdonck DEV, Dupont LJ, Verbeken EK, Meyts I. Innate and Adaptive Interleukin-17–producing Lymphocytes in Chronic Inflammatory Lung Disorders. Am J Respir Crit Care Med 2011; 183:977-86. [DOI: 10.1164/rccm.201007-1196pp] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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138
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139
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140
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van de Veerdonk FL, Netea MG, Joosten LA, van der Meer JWM, Kullberg BJ. Novel strategies for the prevention and treatment of Candida infections: the potential of immunotherapy. FEMS Microbiol Rev 2011; 34:1063-75. [PMID: 20528948 DOI: 10.1111/j.1574-6976.2010.00232.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Infections caused by Candida spp. continue to be a substantial cause of disease burden, especially in immunocompromised patients. New approaches are needed to improve the outcome of patients suffering from Candida infections, because it seems unlikely that the established standard treatment will drastically lower the morbidity of mucocutaneous Candida infections and the high mortality associated with invasive candidiasis. New insights into the mechanisms of the anti-Candida host response have contributed to the design of novel immunotherapeutic approaches that have been proposed as adjuvant therapy in Candida infections. This review presents an overview of novel strategies in the prevention and treatment of Candida infections, with a special focus on adjuvant immunotherapy.
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Affiliation(s)
- Frank L van de Veerdonk
- Department of Medicine, Radboud University Nijmegen Medical Center, Nijmegen Institute for Infection, Inflammation and Immunity (N4i), Nijmegen, The Netherlands.
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141
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Saunus JM, Wagner SA, Matias MA, Hu Y, Zaini ZM, Farah CS. Early activation of the interleukin-23-17 axis in a murine model of oropharyngeal candidiasis. Mol Oral Microbiol 2011; 25:343-56. [PMID: 20883223 DOI: 10.1111/j.2041-1014.2010.00570.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Candida albicans is an oral commensal yeast that causes oropharyngeal candidiasis (OPC) in immunocompromised individuals. The immunological pathways involved in OPC have been revisited after the interleukin-17 (IL-17) pathway was implicated in fungal immunity. We studied immediate (<24 h) and adaptive (3-6 day) IL-12 and IL-23-17 pathway activation in naive p40(-/-) mice, which lack IL-12 and IL-23 and develop severe, chronic OPC upon oral inoculation with C. albicans. Macrophages from p40(-/-) mice were less efficient than C57BL/6J controls at killing C. albicans in vitro but very low numbers in the oral mucosae of infected C57BL/6J mice suggest that they are not critical in vivo, at least in this strain. Migration of macrophages to regional lymph nodes of infected p40(-/-) mice was impaired; however, dendritic cell migration was not affected. Recombinant IL-12 therapy provided only temporary relief from OPC, suggesting that IL-23 is required for full protection. In C57BL/6J mice, but not p40(-/-) mice, messenger RNAs encoding IL-23p19 and IL-17 were induced in the oral mucosa within 24 h of infection (6 ± 0.6 and 12 ± 2.7-fold). By day 6 of infection in C57BL/6J mice, IL-17A messenger RNA level had increased 5.1 ± 1.8 and 83 ± 21-fold in regional lymph nodes and oral tissues respectively. Ablation of p40 was associated with delayed or abrogated induction of IL-17A pathway targets (monocyte chemoattractant protein-1, IL-6 and macrophage inflammatory protein-2), and a lack of organized recruitment of neutrophils to the infected oral mucosa. Overall our data show that the IL-23-17A axis is activated early in the oral mucosae of immunologically naive mice with OPC.
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Affiliation(s)
- J M Saunus
- School of Dentistry, the University of Queensland, Brisbane, Australia
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142
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Brereton CF, Blander JM. The unexpected link between infection-induced apoptosis and a TH17 immune response. J Leukoc Biol 2011; 89:565-76. [PMID: 21248151 DOI: 10.1189/jlb.0710421] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Microbial pathogens can initiate MOMP in host cells and as such, initiate the mitochondrial pathway of apoptosis. Innate immune recognition of cells dying in this way by infection-induced apoptosis would involve recognition of ligands derived from the apoptotic host cell simultaneously with those derived from the infecting pathogen. The resultant signal transduction pathways engaged direct DCs to concomitantly synthesize TGF-β and IL-6, two cytokines that subsequently favor the differentiation of naïve CD4 T cells into T(h)17 cells. Citrobacter rodentium is one rodent pathogen that targets mitochondria and induces apoptosis, and blockade of apoptosis during enteric Citrobacter infection impairs the characteristic T(h)17 response in the intestinal LP. Here, we review these original findings. We discuss microbial infections other than Citrobacter that have been shown to induce T(h)17 responses, and we examine what is known about the ability of those pathogens to induce apoptosis. We also consider types of cell death other than apoptosis that can be triggered by microbial infection, and we highlight how little we know about the impact of various forms of cell death on the ensuing adaptive immune response.
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Affiliation(s)
- Corinna F Brereton
- Mount Sinai School of Medicine, Immunology Institute, Department of Medicine, 1425 Madison Ave., 12-20D, New York, NY 10029, USA
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143
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Abstract
PURPOSE OF REVIEW Disseminated candidiasis remains a life-threatening disease in the ICU. The development of invasive disease with Candida albicans is dependent on multiple factors, such as colonization and efficient host defense at the mucosa. In the present review, we describe the host defense mechanisms against Candida that are responsible for counteracting mucosal invasion, and eliminating the pathogen once invasion has taken place. RECENT FINDINGS The newly described T-helper subset Th17 is critical for mucosal anti-Candida host defense and plays a major role in controlling C. albicans colonization, whereas the Th1 response and monocyte-dependent cytokines such as IL-1 and TNF are predominantly responsible for activation of neutrophils and macrophages during disseminated candidiasis. SUMMARY This knowledge provides the basis of exploring new treatment options in the fight against invasive candidiasis. Reports of beneficial effects of recombinant cytokine therapy in fungal infections, renders them prime candidates for adjuvant immunotherapy in Candida sepsis.
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144
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Ahlgren KM, Moretti S, Lundgren BA, Karlsson I, Ahlin E, Norling A, Hallgren A, Perheentupa J, Gustafsson J, Rorsman F, Crewther PE, Rönnelid J, Bensing S, Scott HS, Kämpe O, Romani L, Lobell A. Increased IL-17A secretion in response to Candida albicans in autoimmune polyendocrine syndrome type 1 and its animal model. Eur J Immunol 2011; 41:235-45. [PMID: 21182094 DOI: 10.1002/eji.200939883] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Revised: 08/17/2010] [Accepted: 10/07/2010] [Indexed: 02/04/2023]
Abstract
Autoimmune polyendocrine syndrome type 1 (APS-1) is a multiorgan autoimmune disease caused by mutations in the autoimmune regulator (AIRE) gene. Chronic mucocutaneous candidiasis, hypoparathyroidism and adrenal failure are hallmarks of the disease. The critical mechanisms causing chronic mucocutaneous candidiasis in APS-1 patients have not been identified although autoantibodies to cytokines are implicated in the pathogenesis. To investigate whether the Th reactivity to Candida albicans (C. albicans) and other stimuli was altered, we isolated PBMC from APS-1 patients and matched healthy controls. The Th17 pathway was upregulated in response to C. albicans in APS-1 patients, whereas the IL-22 secretion was reduced. Autoantibodies against IL-22, IL-17A and IL-17F were detected in sera from APS-1 patients by immunoprecipitation. In addition, Aire-deficient (Aire(0/0) ) mice were much more susceptible than Aire(+/+) mice to mucosal candidiasis and C. albicans-induced Th17- and Th1-cell responses were increased in Aire(0/0) mice. Thus an excessive IL-17A reactivity towards C. albicans was observed in APS-1 patients and Aire(0/0) mice.
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Affiliation(s)
- Kerstin M Ahlgren
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
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145
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Differential effects of IL-17 pathway in disseminated candidiasis and zymosan-induced multiple organ failure. Shock 2010; 34:407-11. [PMID: 20160669 DOI: 10.1097/shk.0b013e3181d67041] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The role of the IL-17 pathway in antifungal host defense is controversial. Several studies suggested that IL-17 is crucial for the protection against Candida infection, whereas other studies reported that IL-17 may contribute to inflammatory pathology and worsening of fungal disease. To address these discrepancies, we assessed the differential role of IL-17 pathway in two models of fungal sepsis: intravenous infection with live Candida albicans, in which fungal growth is the main cause of mortality, and zymosan-induced multiple organ failure, in which the inflammatory pathology drives the mortality. First, IL-17 receptor-deficient (IL-17RA) mice showed increased mortality and higher fungal loads in the kidneys in the model of disseminated candidiasis, partly caused by lower neutrophil recruitment in the IL-17RA mice. Second, IL-17RA mice were not protected against the multiorgan failure induced by zymosan. These data demonstrate that IL-17 does not have a major contribution to the inflammatory pathology leading to organ failure in fungal sepsis and support the concept that the IL-17 pathway is protective in antifungal host defense.
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146
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van der Meer JWM, van de Veerdonk FL, Joosten LAB, Kullberg BJ, Netea MG. Severe Candida spp. infections: new insights into natural immunity. Int J Antimicrob Agents 2010; 36 Suppl 2:S58-62. [PMID: 21129931 DOI: 10.1016/j.ijantimicag.2010.11.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Invasive infections caused by Candida spp. are associated with high mortality. Colonisation by Candida spp. and the capacity of the host to recognise them as potential pathogens are essential steps in the development of these infections. The major pathogen-associated molecular patterns of Candida are mannoproteins, glucans and chitins, which are recognised by C-type lectin pattern recognition receptors such as the mannose receptor, dectin-1 and dectin-2. By the secretion of proteases and toxins, and the formation of hyphae and biofilms, Candida spp. are able to enhance their virulence and pathogenicity. Studies in patients with relatively rare immunodeficiencies, such as dectin-1 deficiency, CARD9 deficiency, chronic mucocutaneous candidiasis, hyper-IgE/Job's syndrome and chronic granulomatous disease, have shown the role of dectin-1 and its signalling pathway, which involves interleukins 17 and 22, defensins and phagocytic cells, in defence against Candida. These studies also provide insights into how acquired risk factors for fungal infection operate, and may lead to new approaches for immunotherapy.
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Affiliation(s)
- Jos W M van der Meer
- Department Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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147
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Abstract
It has been long appreciated that protective immunity against fungal pathogens is dependent on activation of cellular adaptive immune responses represented by T lymphocytes. The T-helper (Th)1/Th2 paradigm has proven to be essential for the understanding of protective adaptive host responses. Studies that have examined the significance of regulatory T cells in fungal infection, and the recent discovery of a new T-helper subset called Th17 have provided crucial information for understanding the complementary roles played by the various T-helper lymphocytes in systemic versus mucosal antifungal host defense. This review provides an overview of the role of the various T-cell subsets during fungal infections and the reciprocal regulation between the T-cell subsets contributing to the tailored host response against fungal pathogens.
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Affiliation(s)
- Frank L. van de Veerdonk
- Department of Medicine (463), Radboud University Nijmegen Medical Center, Geert Grooteplein Zuid 8, Nijmegen, 6525 GA The Netherlands
| | - Mihai G. Netea
- Department of Medicine (463), Radboud University Nijmegen Medical Center, Geert Grooteplein Zuid 8, Nijmegen, 6525 GA The Netherlands
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148
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Ng WF, von Delwig A, Carmichael AJ, Arkwright PD, Abinun M, Cant AJ, Jolles S, Lilic D. Impaired T(H)17 responses in patients with chronic mucocutaneous candidiasis with and without autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. J Allergy Clin Immunol 2010; 126:1006-15, 1015.e1-4. [PMID: 20934207 DOI: 10.1016/j.jaci.2010.08.027] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Revised: 07/13/2010] [Accepted: 08/12/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND Accumulating evidence implicates T(H)17 cytokines in protection against Candida species infections, but the clinical relevance is not clear. Chronic mucocutaneous candidiasis (CMC) is a heterogeneous syndrome with the unifying feature of selective susceptibility to chronic candidiasis. Different subgroups with distinct clinical features are recognized, including autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), CMC with hypothyroidism, and isolated CMC. Understanding immune defects in patients with CMC will define cellular and molecular mechanisms crucial for protection against Candida species in human subjects. OBJECTIVES We sought to determine whether impaired T(H)17 responses underlie susceptibility to Candida species infections and whether the same defect is present in different CMC subgroups. METHODS We assessed T(H)17 responses of PBMCs to Candida and non-Candida species stimuli by measuring IL-17, IL-22, IL-21, IL-6, IL-23, and IFN-γ cytokine production using cytokine arrays and intracellular cytokine-producing cell numbers and proliferation with flow cytometry. PBMCs from healthy subjects and unaffected family members served as controls. RESULTS In patients with CMC with hypothyroidism, T(H)17 cells demonstrated decreased proliferation and IL-17 production in response to Candida species. In contrast, in patients with APECED, T(H)17 cell proliferation and IL-17 production were normal unless exposed to APECED plasma, which inhibited both functions in both APECED and normal PBMCs. Candida species-stimulated IL-22 production was impaired in all patients with CMC, whereas IL-6 and IL-23 responses were unaltered. CONCLUSION An impaired T(H)17 response to Candida species, although mediated by different mechanisms, was present in all CMC subgroups studied and might be a common factor predisposing to chronic candidiasis.
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Affiliation(s)
- Wan-Fai Ng
- Musculoskeletal Research Group, Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
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149
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Kagami S, Rizzo HL, Kurtz SE, Miller LS, Blauvelt A. IL-23 and IL-17A, but not IL-12 and IL-22, are required for optimal skin host defense against Candida albicans. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2010; 185:5453-62. [PMID: 20921529 PMCID: PMC3076054 DOI: 10.4049/jimmunol.1001153] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IL-23 and Th17 cells play important roles in host defense against systemic infections with extracellular bacteria and fungi, although their roles in immunity against localized skin infections are less well defined. Here, the contributions of IL-23 and Th17 cytokines in host defense against cutaneous Candida albicans infection were evaluated. Mice deficient in IL-23 or IL-17A demonstrated delayed healing and decreased IL-17A production after skin infection with C. albicans compared with wild-type mice or mice deficient in IL-12 or IL-22. Histologic examination revealed epidermal hyperplasia overlying infected dermis four days postinoculation in wild-type mice. In IL-23-deficient mice, fungal burden was greater in skin, neither IL-17A nor IL-22 mRNAs were expressed postinfection, and these mice demonstrated only minimal epidermal hyperplasia. Exogenous recombinant IL-17A injected at the site of skin infection promoted more rapid healing of candidiasis in both wild-type mice and mice deficient in IL-23 and IL-12. Taken together, these results demonstrate that IL-23 and IL-17A, but not IL-12 and IL-22, are required for optimal host defense against cutaneous candidiasis. In addition, recombinant IL-17A may serve as a potential therapy to enhance healing in individuals with chronic cutaneous candidiasis.
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Affiliation(s)
- Shinji Kagami
- Department of Dermatology Oregon Health and Science University
| | | | - Stephen E. Kurtz
- Dermatology Service, Veterans Affairs Medical Center, Portland, OR 97239
| | - Lloyd S. Miller
- Division of Dermatology, Department of Medicine, University of California at Los Angeles, Los Angeles, CA 90024
| | - Andrew Blauvelt
- Department of Dermatology Oregon Health and Science University
- Department of Molecular Microbiology and Immunology, Oregon Health and Science University
- Dermatology Service, Veterans Affairs Medical Center, Portland, OR 97239
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150
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The role of the IL-12 cytokine family in directing T-cell responses in oral candidosis. Clin Dev Immunol 2010; 2011:697340. [PMID: 20981280 PMCID: PMC2963117 DOI: 10.1155/2011/697340] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 09/03/2010] [Indexed: 12/24/2022]
Abstract
Candida albicans is an opportunistic fungal pathogen that normally exists as a harmless commensal in humans. In instances where host debilitation occurs, Candida can cause a range of clinical infections, and whilst these are primarily superficial, effecting mucosal membranes, systemic infections can develop in severely immunocompromised individuals. The mechanism of host immunity during commensal carriage of C. albicans has been intensively studied. In this paper, we present the most recent information concerning host recognition of C. albicans leading to cytokine production and the subsequent T-cell responses generated in response to C. albicans. Particular focus is given to the role of the IL-12 cytokine family including IL-12, IL-23, IL-27, and IL-35, in host immunity to Candida. CD4+ T-cells are considered crucial in the regulation of immunity and inflammation. In this regard, the role of Th1/2, helper cells, together with the recently identified Th17 and Treg cells in candidosis will be discussed. Understanding the detailed mechanisms that underlie host immunity to Candida not only will be of benefit in terms of the infections caused by this organism but could also be exploited in the development of therapeutic interventions for other diseases.
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