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Ferraz R, Cunha CF, Pimentel MI, Lyra MR, Schubach AO, Mendonça SCFD, Da-Cruz AM, Bertho AL. T-cell receptor Vβ repertoire of CD8+ T-lymphocyte subpopulations in cutaneous leishmaniasis patients from the state of Rio de Janeiro, Brazil. Mem Inst Oswaldo Cruz 2015; 110:596-605. [PMID: 26107186 PMCID: PMC4569821 DOI: 10.1590/0074-02760150039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/21/2015] [Indexed: 01/30/2023] Open
Abstract
In human cutaneous leishmaniasis (CL), the immune response is mainly mediated by
T-cells. The role of CD8+ T-lymphocytes, which are related to healing or
deleterious functions, in affecting clinical outcome is controversial. The aim of
this study was to evaluate T-cell receptor diversity in late-differentiated effector
(LDE) and memory CD8+ T-cell subsets in order to create a profile of
specific clones engaged in deleterious or protective CL immune responses. Healthy
subjects, patients with active disease (PAD) and clinically cured patients were
enrolled in the study. Total CD8+ T-lymphocytes showed a disturbance in
the expression of the Vβ2, Vβ9, Vβ13.2, Vβ18 and Vβ23 families. The analyses of
CD8+T-lymphocyte subsets showed high frequencies of LDE
CD8+T-lymphocytes expressing Vβ12 and Vβ22 in PAD, as well as
effector-memory CD8+ T-cells expressing Vβ22. We also observed low
frequencies of effector and central-memory CD8+ T-cells expressing Vβ2 in
PAD, which correlated with a greater lesion size. Particular Vβ expansions point to
CD8+ T-cell clones that are selected during CL immune responses,
suggesting that CD8+ T-lymphocytes expressing Vβ12 or Vβ22 are involved in
a LDE response and that Vβ2 contractions in memory CD8+T-cells are
associated with larger lesions.
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Affiliation(s)
- Raquel Ferraz
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, BR
| | - Clarissa Ferreira Cunha
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, BR
| | - Maria Inês Pimentel
- Laboratório de Vigilância em Leishmaniose, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, BR
| | - Marcelo Rosandiski Lyra
- Laboratório de Vigilância em Leishmaniose, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, BR
| | - Armando Oliveira Schubach
- Laboratório de Vigilância em Leishmaniose, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, BR
| | | | - Alda Maria Da-Cruz
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, BR
| | - Alvaro Luiz Bertho
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, BR
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102
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Duarte A, Queiroz ATL, Tosta R, Carvalho AM, Barbosa CH, Bellio M, de Oliveira CI, Barral-Netto M. Prediction of CD8+ Epitopes in Leishmania braziliensis Proteins Using EPIBOT: In Silico Search and In Vivo Validation. PLoS One 2015; 10:e0124786. [PMID: 25905908 PMCID: PMC4407964 DOI: 10.1371/journal.pone.0124786] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 03/05/2015] [Indexed: 11/18/2022] Open
Abstract
Background Leishmaniasis is caused by intracellular Leishmania parasites that induce a T-cell mediated response associated with recognition of CD4+ and CD8+ T cell Line 1Lineepitopes. Identification of CD8+ antigenic determinants is crucial for vaccine and therapy development. Herein, we developed an open-source software dedicated to search and compile data obtained from currently available on line prediction algorithms. Methodology/Principal Findings We developed a two-phase algorithm and implemented in an open source software called EPIBOT, that consolidates the results obtained with single prediction algorithms, generating a final output in which epitopes are ranked. EPIBOT was initially trained using a set of 831 known epitopes from 397 proteins from IEDB. We then screened 63 Leishmania braziliensis vaccine candidates with the EPIBOT trained tool to search for CD8+ T cell epitopes. A proof-of-concept experiment was conducted with the top eight CD8+ epitopes, elected by EPIBOT. To do this, the elected peptides were synthesized and validated for their in vivo cytotoxicity. Among the tested epitopes, three were able to induce lysis of pulsed-target cells. Conclusion Our results show that EPIBOT can successfully search across existing prediction tools, generating a compiled list of candidate CD8+ epitopes. This software is fast and a simple search engine that can be customized to search over different MHC alleles or HLA haplotypes.
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Affiliation(s)
- Angelo Duarte
- Departmento de Tecnologia, Universidade Estadual de Feira de Santana, Av. Transnordestina, s/n, DTEC-Módulo 3, 44036–900, Feira de Santana, BA, Brazil
| | | | - Rafael Tosta
- Departmento de Tecnologia, Universidade Estadual de Feira de Santana, Av. Transnordestina, s/n, DTEC-Módulo 3, 44036–900, Feira de Santana, BA, Brazil
| | | | - Carlos Henrique Barbosa
- Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro (UFRJ), Avenida Carlos Chagas Filho, 373 Bloco D, sala 35, Cidade Universitária, 21941–902, Rio de Janeiro, RJ, Brazil
| | - Maria Bellio
- Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro (UFRJ), Avenida Carlos Chagas Filho, 373 Bloco D, sala 35, Cidade Universitária, 21941–902, Rio de Janeiro, RJ, Brazil
| | - Camila I. de Oliveira
- CPqGM—FIOCRUZ, R. Waldemar Falcão, 121, 40296–710, Salvador, BA, Brazil
- Instituto de Investigação em Imunologia, São Paulo, Brazil
- * E-mail: (CIO); (MBN)
| | - Manoel Barral-Netto
- CPqGM—FIOCRUZ, R. Waldemar Falcão, 121, 40296–710, Salvador, BA, Brazil
- Instituto de Investigação em Imunologia, São Paulo, Brazil
- * E-mail: (CIO); (MBN)
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103
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Novais FO, Scott P. CD8+ T cells in cutaneous leishmaniasis: the good, the bad, and the ugly. Semin Immunopathol 2015; 37:251-9. [PMID: 25800274 DOI: 10.1007/s00281-015-0475-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 02/25/2015] [Indexed: 11/30/2022]
Abstract
CD8(+) T lymphocytes are components of the adaptive immune response and play an important role in protection against many viral and bacterial infections. However, their role in parasitic infections is less well understood. In leishmaniasis, a disease caused by intracellular protozoan parasites of the genus Leishmania, CD8(+) T cells have been shown to be protective. However, increasing evidence indicates that CD8(+) T cells may also exacerbate disease. In this review, we will describe the situations where CD8(+) T cells are either good or bad for the outcome of the infection and attempt to reconcile the dual role played by CD8(+) T cells in cutaneous leishmaniasis.
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Affiliation(s)
- Fernanda O Novais
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Room 346 Hill Pavilion, 380 S. University Avenue, Philadelphia, PA, 19104-4539, USA,
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Falcão SAC, Weinkopff T, Hurrell BP, Celes FS, Curvelo RP, Prates DB, Barral A, Borges VM, Tacchini-Cottier F, de Oliveira CI. Exposure to Leishmania braziliensis triggers neutrophil activation and apoptosis. PLoS Negl Trop Dis 2015; 9:e0003601. [PMID: 25756874 PMCID: PMC4354905 DOI: 10.1371/journal.pntd.0003601] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 02/06/2015] [Indexed: 11/21/2022] Open
Abstract
Background Neutrophils are the first line of defense against invading pathogens and are rapidly recruited to the sites of Leishmania inoculation. During Leishmania braziliensis infection, depletion of inflammatory cells significantly increases the parasite load whereas co-inoculation of neutrophils plus L. braziliensis had an opposite effect. Moreover, the co-culture of infected macrophages and neutrophils also induced parasite killing leading us to ask how neutrophils alone respond to an L. braziliensis exposure. Herein we focused on understanding the interaction between neutrophils and L. braziliensis, exploring cell activation and apoptotic fate. Methods and Findings Inoculation of serum-opsonized L. braziliensis promastigotes in mice induced neutrophil accumulation in vivo, peaking at 24 h. In vitro, exposure of thyoglycollate-elicited inflammatory or bone marrow neutrophils to L. braziliensis modulated the expression of surface molecules such as CD18 and CD62L, and induced the oxidative burst. Using mCherry-expressing L. braziliensis, we determined that such effects were mainly observed in infected and not in bystander cells. Neutrophil activation following contact with L. braziliensis was also confirmed by the release of TNF-α and neutrophil elastase. Lastly, neutrophils infected with L. braziliensis but not with L. major displayed markers of early apoptosis. Conclusions We show that L. braziliensis induces neutrophil recruitment in vivo and that neutrophils exposed to the parasite in vitro respond through activation and release of inflammatory mediators. This outcome may impact on parasite elimination, particularly at the early stages of infection. Leishmania is the parasite responsible for the disease leishmaniasis, present in all continents. Leishmania parasites are spread through infected sand-flies and, during transmission into the vertebrate host, neutrophils are among the first cells to arrive at the infection site. Since neutrophils are key players at the frontline of defense against invading organisms, we investigated their response to Leishmania braziliensis. Importantly, L. braziliensis causes both Cutaneous and Mucocutaneous Leishmaniasis, two clinical manifestations characterized by their chronic development and by the presence of skin lesions with tissue destruction. Upon inoculation of mice with L. braziliensis, neutrophils rapidly arrive at the site of infection. We then observed that culture of mouse neutrophils with L. braziliensis induced the expression of adhesion molecules, production of Reactive Oxygen Species and secretion of elastase and TNF-α, two important inflammatory mediators. Also, infection with L. braziliensis induced neutrophil apoptosis, a cell death mechanism key for regulating inflammation. Our results show that neutrophils respond to presence of the L. braziliensis parasites by becoming activated and undergoing apoptosis. We suggest that this outcome modifies the local environment at the site of parasite inoculation and thus contributes with parasite killing in the infected host.
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Affiliation(s)
| | - Tiffany Weinkopff
- Department of Biochemistry, and WHO-Immunology Research and Training Center, University of Lausanne, Epalinges, Switzerland
| | - Benjamin P. Hurrell
- Department of Biochemistry, and WHO-Immunology Research and Training Center, University of Lausanne, Epalinges, Switzerland
| | - Fabiana S. Celes
- Centro de Pesquisas Gonçalo Moniz, FIOCRUZ, Salvador, Bahia, Brazil
| | | | - Deboraci B. Prates
- Departamento de Biomorfologia, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Aldina Barral
- Centro de Pesquisas Gonçalo Moniz, FIOCRUZ, Salvador, Bahia, Brazil
- Instituto de Investigação em Imunologia, Salvador, Bahia, Brazil
| | - Valeria M. Borges
- Centro de Pesquisas Gonçalo Moniz, FIOCRUZ, Salvador, Bahia, Brazil
- Instituto de Investigação em Imunologia, Salvador, Bahia, Brazil
| | - Fabienne Tacchini-Cottier
- Department of Biochemistry, and WHO-Immunology Research and Training Center, University of Lausanne, Epalinges, Switzerland
| | - Camila I. de Oliveira
- Centro de Pesquisas Gonçalo Moniz, FIOCRUZ, Salvador, Bahia, Brazil
- Instituto de Investigação em Imunologia, Salvador, Bahia, Brazil
- * E-mail:
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105
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Oliveira PRS, Dessein H, Romano A, Cabantous S, de Brito MEF, Santoro F, Pitta MGR, Pereira V, Pontes-de-Carvalho LC, Rodrigues V, Rafati S, Argiro L, Dessein AJ. IL2RA genetic variants reduce IL-2-dependent responses and aggravate human cutaneous leishmaniasis. THE JOURNAL OF IMMUNOLOGY 2015; 194:2664-72. [PMID: 25672756 DOI: 10.4049/jimmunol.1402047] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The outcome of Leishmania infections varies substantially, depending on the host and the parasite strain; infection may be asymptomatic or cause mild or severe skin ulcers (cutaneous leishmaniasis [CL]), limited or disseminated lesions, or lethal visceral disease. We previously reported an association between IL-2R mutations and susceptibility to visceral leishmaniasis in children infected with Leishmania donovani. In the present study, we evaluated the possible role of IL-2 signaling in human CL. We first showed that the transcripts of several genes of the IL-2 pathway were abundant in skin lesions caused by Leishmania braziliensis. We then carried out a genetic analysis, focusing on major genes of the IL-2 pathway. We used a family-based approach and found that polymorphisms of several genes appeared to be associated with CL in a Brazilian population. Moreover, two polymorphisms of the IL2RA gene were significantly and independently associated with CL. We confirmed this result in a second Brazilian sample (also exposed to L. braziliensis) and in Iranians infected with Leishmania tropica: IL2RA rs10905669 T (Pcombined = 6 × 10(-7)) and IL2RA rs706778 T (Pcombined = 2 × 10(-9)) were associated with greater susceptibility to lesion development. These alleles were also correlated with a poor IFN-γ response and poor FOXP3(+) regulatory T cell activation. Thus, IL-2 plays a crucial role in protection against the cutaneous ulcers caused by Leishmania, and the IL-2 pathway is a potential target for strategies aiming to control Leishmania-related diseases.
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Affiliation(s)
- Pablo R S Oliveira
- Aix Marseille Université, Génétique et Immunologie des Maladies Parasitaires, Unité Mixte de Recherche S906, 13385 Marseille, France; INSERM, Unité 906, 13385 Marseille, France; Laboratory of Pathology and Bio-Intervention, Gonçalo Moniz Research Center, Oswaldo Cruz Foundation, Salvador, Bahia 40296, Brazil
| | - Hélia Dessein
- Aix Marseille Université, Génétique et Immunologie des Maladies Parasitaires, Unité Mixte de Recherche S906, 13385 Marseille, France; INSERM, Unité 906, 13385 Marseille, France
| | - Audrey Romano
- Aix Marseille Université, Génétique et Immunologie des Maladies Parasitaires, Unité Mixte de Recherche S906, 13385 Marseille, France; INSERM, Unité 906, 13385 Marseille, France
| | - Sandrine Cabantous
- Aix Marseille Université, Génétique et Immunologie des Maladies Parasitaires, Unité Mixte de Recherche S906, 13385 Marseille, France; INSERM, Unité 906, 13385 Marseille, France
| | - Maria E F de Brito
- Laboratory of Immunogenetics, Department of Immunology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Recife, Pernambuco 50670 420, Brazil
| | - Ferrucio Santoro
- Aix Marseille Université, Génétique et Immunologie des Maladies Parasitaires, Unité Mixte de Recherche S906, 13385 Marseille, France; INSERM, Unité 906, 13385 Marseille, France
| | - Maira G R Pitta
- Aix Marseille Université, Génétique et Immunologie des Maladies Parasitaires, Unité Mixte de Recherche S906, 13385 Marseille, France; INSERM, Unité 906, 13385 Marseille, France
| | - Valéria Pereira
- Laboratory of Immunogenetics, Department of Immunology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Recife, Pernambuco 50670 420, Brazil
| | - Lain C Pontes-de-Carvalho
- Laboratory of Pathology and Bio-Intervention, Gonçalo Moniz Research Center, Oswaldo Cruz Foundation, Salvador, Bahia 40296, Brazil
| | - Virmondes Rodrigues
- Laboratory of Immunology, Department of Biological Sciences, Federal University of the Triângulo Mineiro, Uberaba, Mina Gerais 38015 050, Brazil; and
| | - Sima Rafati
- Laboratory of Immunology, Pasteur Institute of Tehran, Tehran 1316943551, Iran
| | - Laurent Argiro
- Aix Marseille Université, Génétique et Immunologie des Maladies Parasitaires, Unité Mixte de Recherche S906, 13385 Marseille, France; INSERM, Unité 906, 13385 Marseille, France
| | - Alain J Dessein
- Aix Marseille Université, Génétique et Immunologie des Maladies Parasitaires, Unité Mixte de Recherche S906, 13385 Marseille, France; INSERM, Unité 906, 13385 Marseille, France;
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106
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Granzyme-mediated regulation of host defense in the liver in experimental Leishmania donovani infection. Infect Immun 2014; 83:702-12. [PMID: 25452549 DOI: 10.1128/iai.02418-14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In the livers of susceptible C57BL/6 (B6) mice infected with Leishmania donovani, CD8(+) T cell mechanisms are required for granuloma assembly, macrophage activation, intracellular parasite killing, and self-cure. Since gene expression of perforin and granzymes A and B (GzmA and GzmB), cytolytic proteins linked to CD8(+) cell effector function, was enhanced in infected liver tissue, B6 mice deficient in these granular proteins were used to gauge host defense roles. Neither perforin nor GzmA was required; however, mice deficient in GzmB (GzmB(-/-), GzmB cluster(-/-), and GzmA×B cluster double knockout [DKO] mice) showed both delayed granuloma assembly and initially impaired control of parasite replication. Since these two defects in B6 mice were limited to early-stage infection, innately resistant 129/Sv mice were also tested. In this genetic setting, expression of both innate and subsequent T (Th1) cell-dependent acquired resistance, including the self-cure phenotype, was entirely derailed in GzmA×B cluster DKO mice. These results, in susceptible B6 mice for GzmB and in resistant 129/Sv mice for GzmA and/or the GzmB cluster, point to granzyme-mediated host defense regulation in the liver in experimental visceral leishmaniasis.
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107
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Campos TM, Passos ST, Novais FO, Beiting DP, Costa RS, Queiroz A, Mosser D, Scott P, Carvalho EM, Carvalho LP. Matrix metalloproteinase 9 production by monocytes is enhanced by TNF and participates in the pathology of human cutaneous Leishmaniasis. PLoS Negl Trop Dis 2014; 8:e3282. [PMID: 25393535 PMCID: PMC4230914 DOI: 10.1371/journal.pntd.0003282] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 09/19/2014] [Indexed: 12/18/2022] Open
Abstract
Introduction Cutaneous leishmaniasis (CL) due to L.braziliensis infection is characterized by a strong inflammatory response with high levels of TNF and ulcer development. Less attention has been given to the role of mononuclear phagocytes to this process. Monocytes constitute a heterogeneous population subdivided into classical, intermediate and non-classical, and are known to migrate to inflammatory sites and secrete inflammatory mediators. TNF participates in the induction of matrix metalloproteinases (MMPs). MMP-9 is an enzyme that degrades basal membrane and its activity is controlled by the tissue inhibitor of metalloproteinase. Methods Mononuclear cells were obtained from ex-vivo labeling sub-populations of monocytes and MMP-9, and the frequency was determined by flow cytometry. Culture was performed during 72 hours, stimulating the cells with SLA, levels of MMP-9 and TIMP-1 in the supernatants were determined by ELISA. Results We observed that cells from CL lesions secrete high amounts of MMP-9 when compared to healthy subjects. Although MMP-9 was produced by monocytes, non-classical ones were the main source of this enzyme. We also observed that TNF produced in high level during CL contributes to MMP-9 production. Conclusions These observations emphasize the role of monocytes, TNF and MMP-9 in the pathogenesis of L. braziliensis infection. To examine the participation of MMP-9 in the pathogenesis of L. braziliensis infection, we realized a cross-sectional study with CL patients in an early phase of the disease or with a classical ulcer, and healthy controls. We evaluated the frequency of MMP-9 in monocyte subsets and its mechanism of production. Our results showed that monocytes were the major cells producing MMP-9. The MMP-9 production by CL patients was presented in higher levels when compared with healthy subjects and early cutaneous leishmaniasis (ECL) patients, and the levels of MMP-9 inhibitor, TIMP-1, were lower in CL patients when compared to healthy subjects. The production of MMP-9 was enhanced by TNF, a cytokine associated with tissue damage in CL patients. Thus, therapeutic modulation of MMP-9 may be a useful approach for improving disease outcome in L. braziliensis patients.
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Affiliation(s)
- Taís M. Campos
- Serviço de Imunologia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Sara T. Passos
- Serviço de Imunologia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Instituto Nacional de Ciências e Tecnologia – Doenças Tropicais, Salvador, Bahia, Brazil
| | - Fernanda O. Novais
- Department of Pathobiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Daniel P. Beiting
- Department of Pathobiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Rúbia S. Costa
- Serviço de Imunologia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Adriano Queiroz
- Serviço de Imunologia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - David Mosser
- Department of Cell Biology and Molecular Genetics, University of Maryland, College Park, Maryland, United States of America
| | - Phillip Scott
- Department of Pathobiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Edgar M. Carvalho
- Serviço de Imunologia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Instituto Nacional de Ciências e Tecnologia – Doenças Tropicais, Salvador, Bahia, Brazil
| | - Lucas P. Carvalho
- Serviço de Imunologia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Instituto Nacional de Ciências e Tecnologia – Doenças Tropicais, Salvador, Bahia, Brazil
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- * E-mail:
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108
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da Silva Santos C, Brodskyn CI. The Role of CD4 and CD8 T Cells in Human Cutaneous Leishmaniasis. Front Public Health 2014; 2:165. [PMID: 25325049 PMCID: PMC4178373 DOI: 10.3389/fpubh.2014.00165] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 09/13/2014] [Indexed: 12/23/2022] Open
Abstract
Leishmaniasis, caused by infection with parasites of the Leishmania genus, affects millions of individuals worldwide. This disease displays distinct clinical manifestations ranging from self-healing skin lesions to severe tissue damage. The control of Leishmania infection is dependent on cellular immune mechanisms, and evidence has shown that CD4 and CD8 T lymphocytes play different roles in the outcome of leishmaniasis. Although the presence of CD4 T cells is important for controlling parasite growth, the results in the literature suggest that the inflammatory response elicited by these cells could contribute to the pathogenesis of lesions. However, recent studies on CD8 T lymphocytes show that these cells are mainly involved in tissue damage through cytotoxic mechanisms. In this review, we focus on the recent advances in the study of the human adaptive immunological response in the pathogenesis of tegumentary leishmaniasis.
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Affiliation(s)
- Claire da Silva Santos
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (Fiocruz) Bahia , Salvador , Brazil
| | - Cláudia Ida Brodskyn
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (Fiocruz) Bahia , Salvador , Brazil ; Faculdade de Medicina da Universidade Federal da Bahia , Salvador , Brazil ; Instituto de Investigação em Imunologia - Instituto Nacional de Ciência e Tecnologia (iii-INCT) , Salvador , Brazil
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109
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da Silva Santos C, Attarha S, Saini RK, Boaventura V, Costa J, Khouri R, Barral-Netto M, Brodskyn CI, Souchelnytskyi S. Proteome profiling of human cutaneous leishmaniasis lesion. J Invest Dermatol 2014; 135:400-410. [PMID: 25207817 PMCID: PMC4291685 DOI: 10.1038/jid.2014.396] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 07/29/2014] [Accepted: 08/07/2014] [Indexed: 11/09/2022]
Abstract
In this study, we used proteomics and biological network analysis to evaluate the potential biological processes and components present in the identified proteins of biopsies from cutaneous leishmaniasis (CL) patients infected by Leishmania braziliensis in comparison with normal skin. We identified 59 proteins differently expressed in samples from infected and normal skin. Biological network analysis employing identified proteins showed the presence of networks that may be involved in the cell death mediated by cytotoxic T lymphocytes. After immunohistochemical analyses, the expression of caspase-9, caspase-3, and granzyme B was validated in the tissue and positively correlated with the lesion size in CL patients. In conclusion, this work identified differentially expressed proteins in the inflammatory site of CL, revealed enhanced expression of caspase-9, and highlighted mechanisms associated with the progression of tissue damage observed in lesions.
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Affiliation(s)
| | - Sanaz Attarha
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Ravi Kanth Saini
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Viviane Boaventura
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Jackson Costa
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Ricardo Khouri
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Manoel Barral-Netto
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil; Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil; Instituto de Investigação em Imunologia, São Paulo, Brazil
| | - Cláudia Ida Brodskyn
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil; Instituto de Investigação em Imunologia, São Paulo, Brazil; Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.
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110
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Passos S, Carvalho LP, Costa RS, Campos TM, Novais FO, Magalhães A, Machado PRL, Beiting D, Mosser D, Carvalho EM, Scott P. Intermediate monocytes contribute to pathologic immune response in Leishmania braziliensis infections. J Infect Dis 2014; 211:274-82. [PMID: 25139016 DOI: 10.1093/infdis/jiu439] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Ulcer development in patients with cutaneous leishmaniasis (CL) caused by Leishmania braziliensis is associated with high levels of tumor necrosis factor (TNF). We found that early after infection, before ulcer development, the frequency of CD16(+) (both intermediate [CD14(+)CD16(+)] and nonclassical [CD14(dim)CD16(+)]) monocytes was increased in the peripheral blood of patients with L. braziliensis, compared with uninfected controls. These results suggest that CD16(+) monocytes might promote disease. Also, we found that intermediate monocytes expressed CCR2 and that increased levels of CCL2 protein were present in lesions from patients, suggesting that intermediate monocytes are more likely than nonclassical monocytes to migrate to the lesion site. Finally, we found that the intermediate monocytes produced TNF. Our results show that intermediate monocytes are increased in frequency soon after infection; express CCR2, which would promote their migration into the lesions; and, owing to their production of TNF, can enhance the inflammatory response.
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Affiliation(s)
- Sara Passos
- Serviço de Imunologia, Complexo Hospitalar Prof. Edgard Santos Instituto Nacional de Ciências e Tecnologia-Doenças Tropicais, Salvador, Brazil
| | - Lucas P Carvalho
- Serviço de Imunologia, Complexo Hospitalar Prof. Edgard Santos Instituto de Ciências da Saúde, Universidade Federal da Bahia Instituto Nacional de Ciências e Tecnologia-Doenças Tropicais, Salvador, Brazil
| | - Rúbia S Costa
- Serviço de Imunologia, Complexo Hospitalar Prof. Edgard Santos
| | - Taís M Campos
- Serviço de Imunologia, Complexo Hospitalar Prof. Edgard Santos
| | - Fernanda O Novais
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia
| | | | - Paulo R L Machado
- Serviço de Imunologia, Complexo Hospitalar Prof. Edgard Santos Instituto Nacional de Ciências e Tecnologia-Doenças Tropicais, Salvador, Brazil
| | - Daniel Beiting
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia
| | - David Mosser
- Department of Cell Biology and Molecular Genetics, University of Maryland, College Park
| | - Edgar M Carvalho
- Serviço de Imunologia, Complexo Hospitalar Prof. Edgard Santos Instituto Nacional de Ciências e Tecnologia-Doenças Tropicais, Salvador, Brazil
| | - Phillip Scott
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia
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111
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Novais FO, Carvalho LP, Passos S, Roos DS, Carvalho EM, Scott P, Beiting DP. Genomic profiling of human Leishmania braziliensis lesions identifies transcriptional modules associated with cutaneous immunopathology. J Invest Dermatol 2014; 135:94-101. [PMID: 25036052 PMCID: PMC4268311 DOI: 10.1038/jid.2014.305] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 04/23/2014] [Accepted: 05/06/2014] [Indexed: 11/24/2022]
Abstract
The host immune response plays a critical role not only in protection from human leishmaniasis, but also in promoting disease severity. Although candidate gene approaches in mouse models of leishmaniasis have been extremely informative, a global understanding of the immune pathways active in lesions from human patients is lacking. To address this issue, genome-wide transcriptional profiling of Leishmania braziliensis-infected cutaneous lesions and normal skin controls was carried out. A signature of the L. braziliensis skin lesion was defined that includes over 2,000 differentially regulated genes. Pathway-level analysis of this transcriptional response revealed key biological pathways present in cutaneous lesions, generating a testable ‘metapathway’ model of immunopathology, and providing new insights for treatment of human leishmaniasis.
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Affiliation(s)
- Fernanda O Novais
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lucas P Carvalho
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais-INCT-DT(CNPq/MCT), Serviço de Imunologia, Hospital Universitario Prof. Edgard Santos, Universidade Federal da Bahia Salvador, Bahia, Brazil
| | - Sara Passos
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais-INCT-DT(CNPq/MCT), Serviço de Imunologia, Hospital Universitario Prof. Edgard Santos, Universidade Federal da Bahia Salvador, Bahia, Brazil
| | - David S Roos
- Department of Biology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Edgar M Carvalho
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais-INCT-DT(CNPq/MCT), Serviço de Imunologia, Hospital Universitario Prof. Edgard Santos, Universidade Federal da Bahia Salvador, Bahia, Brazil
| | - Phillip Scott
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
| | - Daniel P Beiting
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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112
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Pigott DM, Bhatt S, Golding N, Duda KA, Battle KE, Brady OJ, Messina JP, Balard Y, Bastien P, Pratlong F, Brownstein JS, Freifeld CC, Mekaru SR, Gething PW, George DB, Myers MF, Reithinger R, Hay SI. Global distribution maps of the leishmaniases. eLife 2014; 3:e02851. [PMID: 24972829 PMCID: PMC4103681 DOI: 10.7554/elife.02851] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 06/26/2014] [Indexed: 11/13/2022] Open
Abstract
The leishmaniases are vector-borne diseases that have a broad global distribution throughout much of the Americas, Africa, and Asia. Despite representing a significant public health burden, our understanding of the global distribution of the leishmaniases remains vague, reliant upon expert opinion and limited to poor spatial resolution. A global assessment of the consensus of evidence for leishmaniasis was performed at a sub-national level by aggregating information from a variety of sources. A database of records of cutaneous and visceral leishmaniasis occurrence was compiled from published literature, online reports, strain archives, and GenBank accessions. These, with a suite of biologically relevant environmental covariates, were used in a boosted regression tree modelling framework to generate global environmental risk maps for the leishmaniases. These high-resolution evidence-based maps can help direct future surveillance activities, identify areas to target for disease control and inform future burden estimation efforts.
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Affiliation(s)
- David M Pigott
- Spatial Ecology and Epidemiology Group, Department of
Zoology, University of
Oxford, Oxford, United
Kingdom
| | - Samir Bhatt
- Spatial Ecology and Epidemiology Group, Department of
Zoology, University of
Oxford, Oxford, United
Kingdom
| | - Nick Golding
- Spatial Ecology and Epidemiology Group, Department of
Zoology, University of
Oxford, Oxford, United
Kingdom
| | - Kirsten A Duda
- Spatial Ecology and Epidemiology Group, Department of
Zoology, University of
Oxford, Oxford, United
Kingdom
| | - Katherine E Battle
- Spatial Ecology and Epidemiology Group, Department of
Zoology, University of
Oxford, Oxford, United
Kingdom
| | - Oliver J Brady
- Spatial Ecology and Epidemiology Group, Department of
Zoology, University of
Oxford, Oxford, United
Kingdom
| | - Jane P Messina
- Spatial Ecology and Epidemiology Group, Department of
Zoology, University of
Oxford, Oxford, United
Kingdom
| | - Yves Balard
- Laboratoire de
Parasitologie–Mycologie, UFR
Médecine, Université Montpellier 1 and UMR
‘MiVEGEC’, CNRS 5290/IRD 224,
Montpellier,
France
| | - Patrick Bastien
- Laboratoire de
Parasitologie–Mycologie, UFR
Médecine, Université Montpellier 1 and UMR
‘MiVEGEC’, CNRS 5290/IRD 224,
Montpellier,
France
- Departement de
Parasitologie–Mycologie,
CHRU de Montpellier, Centre National de Référence des
Leishmanioses, Montpellier,
France
| | - Francine Pratlong
- Laboratoire de
Parasitologie–Mycologie, UFR
Médecine, Université Montpellier 1 and UMR
‘MiVEGEC’, CNRS 5290/IRD 224,
Montpellier,
France
- Departement de
Parasitologie–Mycologie,
CHRU de Montpellier, Centre National de Référence des
Leishmanioses, Montpellier,
France
| | - John S Brownstein
- Department of Pediatrics,
Harvard Medical School, Boston, United
States
- Children's Hospital Informatics Program,
Boston Children's Hospital,
Boston, United States
| | - Clark C Freifeld
- Children's Hospital Informatics Program,
Boston Children's Hospital,
Boston, United States
- Department of Biomedical Engineering,
Boston University, Boston, United
States
| | - Sumiko R Mekaru
- Children's Hospital Informatics Program,
Boston Children's Hospital,
Boston, United States
| | - Peter W Gething
- Spatial Ecology and Epidemiology Group, Department of
Zoology, University of
Oxford, Oxford, United
Kingdom
| | - Dylan B George
- Fogarty International Center,
National Institutes of Health,
Bethesda, United
States
| | - Monica F Myers
- Spatial Ecology and Epidemiology Group, Department of
Zoology, University of
Oxford, Oxford, United
Kingdom
| | | | - Simon I Hay
- Spatial Ecology and Epidemiology Group, Department of
Zoology, University of
Oxford, Oxford, United
Kingdom
- Fogarty International Center,
National Institutes of Health,
Bethesda, United
States
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113
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Hartley MA, Drexler S, Ronet C, Beverley SM, Fasel N. The immunological, environmental, and phylogenetic perpetrators of metastatic leishmaniasis. Trends Parasitol 2014; 30:412-22. [PMID: 24954794 DOI: 10.1016/j.pt.2014.05.006] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 05/23/2014] [Accepted: 05/24/2014] [Indexed: 02/07/2023]
Abstract
Cutaneous leishmaniases have persisted for centuries as chronically disfiguring parasitic infections affecting millions of people across the subtropics. Symptoms range from the more prevalent single, self-healing cutaneous lesion to a persistent, metastatic disease, where ulcerations and granulomatous nodules can affect multiple secondary sites of the skin and delicate facial mucosa, even sometimes diffusing throughout the cutaneous system as a papular rash. The basis for such diverse pathologies is multifactorial, ranging from parasite phylogeny to host immunocompetence and various environmental factors. Although complex, these pathologies often prey on weaknesses in the innate immune system and its pattern recognition receptors. This review explores the observed and potential associations among the multifactorial perpetrators of infectious metastasis and components of the innate immune system.
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Affiliation(s)
- Mary-Anne Hartley
- Department of Biochemistry, University of Lausanne, 1066 Epalinges, Switzerland
| | - Stefan Drexler
- Department of Biochemistry, University of Lausanne, 1066 Epalinges, Switzerland
| | - Catherine Ronet
- Department of Biochemistry, University of Lausanne, 1066 Epalinges, Switzerland
| | - Stephen M Beverley
- Department of Molecular Microbiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Nicolas Fasel
- Department of Biochemistry, University of Lausanne, 1066 Epalinges, Switzerland.
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114
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Novais FO, Nguyen BT, Beiting DP, Carvalho LP, Glennie ND, Passos S, Carvalho EM, Scott P. Human classical monocytes control the intracellular stage of Leishmania braziliensis by reactive oxygen species. J Infect Dis 2014; 209:1288-96. [PMID: 24403561 PMCID: PMC3969552 DOI: 10.1093/infdis/jiu013] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 10/30/2013] [Indexed: 12/22/2022] Open
Abstract
Leishmania braziliensis are intracellular parasites that cause unique clinical forms of cutaneous leishmaniasis. Previous studies with other leishmania species demonstrated that reactive oxygen species (ROS) control promastigotes, the infective stage of the parasite, but not the amastigote form that exists in the mammalian host. Here we show that ROS inhibits growth of L. braziliensis amastigotes in resting monocytes, and that classical monocytes are primarily responsible for this control. ROS, but not nitric oxide, also contributed to killing of L. braziliensis by IFN-γ activated monocytes. Furthermore, by gene expression profiling of human lesions we found greater expression of genes associated with ROS, but not nitric oxide, compared to normal skin. This study shows that ROS are important for control of L. braziliensis both at the initial stages of infection, as well as at later time points, and highlights that monocyte subsets may play different roles during leishmaniasis.
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Affiliation(s)
- Fernanda O. Novais
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ba T. Nguyen
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Daniel P. Beiting
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lucas P. Carvalho
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais-INCT-DT(CNPq/MCT), Serviço de Imunologia, Hospital Universitario Prof. Edgard Santos, Universidade Federal da Bahia Salvador, Bahia, Brazil
| | - Nelson D. Glennie
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sara Passos
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais-INCT-DT(CNPq/MCT), Serviço de Imunologia, Hospital Universitario Prof. Edgard Santos, Universidade Federal da Bahia Salvador, Bahia, Brazil
| | - Edgar M. Carvalho
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais-INCT-DT(CNPq/MCT), Serviço de Imunologia, Hospital Universitario Prof. Edgard Santos, Universidade Federal da Bahia Salvador, Bahia, Brazil
| | - Phillip Scott
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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115
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A Listeria monocytogenes-based vaccine that secretes sand fly salivary protein LJM11 confers long-term protection against vector-transmitted Leishmania major. Infect Immun 2014; 82:2736-45. [PMID: 24733091 DOI: 10.1128/iai.01633-14] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Cutaneous leishmaniasis is a sand fly-transmitted disease characterized by skin ulcers that carry significant scarring and social stigmatization. Over the past years, there has been cumulative evidence that immunity to specific sand fly salivary proteins confers a significant level of protection against leishmaniasis. In this study, we used an attenuated strain of Listeria monocytogenes as a vaccine expression system for LJM11, a sand fly salivary protein identified as a good vaccine candidate. We observed that mice were best protected against an intradermal needle challenge with Leishmania major and sand fly saliva when vaccinated intravenously. However, this protection was short-lived. Importantly, groups of vaccinated mice were protected long term when challenged with infected sand flies. Protection correlated with smaller lesion size, fewer scars, and better parasite control between 2 and 6 weeks postchallenge compared to the control group of mice vaccinated with the parent L. monocytogenes strain not expressing LJM11. Moreover, protection correlated with high numbers of CD4(+), gamma interferon-positive (IFN-γ(+)), tumor necrosis factor alpha-positive/negative (TNF-α(+/-)), interleukin-10-negative (IL-10(-)) cells and low numbers of CD4(+) IFN-γ(+/-) TNF-α(-) IL-10(+) T cells at 2 weeks postchallenge. Overall, our data indicate that delivery of LJM11 by Listeria is a promising vaccination strategy against cutaneous leishmaniasis inducing long-term protection against ulcer formation following a natural challenge with infected sand flies.
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116
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Crosby EJ, Goldschmidt MH, Wherry EJ, Scott P. Engagement of NKG2D on bystander memory CD8 T cells promotes increased immunopathology following Leishmania major infection. PLoS Pathog 2014; 10:e1003970. [PMID: 24586170 PMCID: PMC3937277 DOI: 10.1371/journal.ppat.1003970] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 01/17/2014] [Indexed: 02/07/2023] Open
Abstract
One of the hallmarks of adaptive immunity is the development of a long-term pathogen specific memory response. While persistent memory T cells certainly impact the immune response during a secondary challenge, their role in unrelated infections is less clear. To address this issue, we utilized lymphocytic choriomeningitis virus (LCMV) and Listeria monocytogenes immune mice to investigate whether bystander memory T cells influence Leishmania major infection. Despite similar parasite burdens, LCMV and Listeria immune mice exhibited a significant increase in leishmanial lesion size compared to mice infected with L. major alone. This increased lesion size was due to a severe inflammatory response, consisting not only of monocytes and neutrophils, but also significantly more CD8 T cells. Many of the CD8 T cells were LCMV specific and expressed gzmB and NKG2D, but unexpectedly expressed very little IFN-γ. Moreover, if CD8 T cells were depleted in LCMV immune mice prior to challenge with L. major, the increase in lesion size was lost. Strikingly, treating with NKG2D blocking antibodies abrogated the increased immunopathology observed in LCMV immune mice, showing that NKG2D engagement on LCMV specific memory CD8 T cells was required for the observed phenotype. These results indicate that bystander memory CD8 T cells can participate in an unrelated immune response and induce immunopathology through an NKG2D dependent mechanism without providing increased protection. Cutaneous leishmaniasis has a wide spectrum of clinical presentations, from mild self-healing lesions to severe chronic infections. Differences in each individual's response are related to pathogen dose and the genetic and physiological status of the host, but exactly what causes the broad spectrum of disease is not well understood. Here we show that previous infection with a viral or bacterial pathogen led to increased immunopathology associated with L. major infection. This increase in immunopathology was not associated with any changes in parasite control and was characterized by an exaggerated inflammatory infiltrate into the site of infection. Ultimately, this increase in immunopathology was dependent on the presence of memory CD8 T cells from the previous infection and their expression of the NK cell receptor NKG2D, as depletion of these cells prior to infection with L. major or blockade of this receptor during infection ameliorated the disease. Our work suggests that the immunological history of a patient may be playing an underlying role in the pathology associated with leishmania infection and could be an important consideration for the understanding and treatment of this and other human diseases. This work also identifies the NKG2D pathway as a potential new target for therapeutic intervention.
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Affiliation(s)
- Erika J. Crosby
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Michael H. Goldschmidt
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - E. John Wherry
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Phillip Scott
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
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