1
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Mor B, Görmez A, Demirci B. Immunopathological investigation of a gerbil model of cutaneous leishmaniasis. Acta Trop 2023; 246:106991. [PMID: 37479161 DOI: 10.1016/j.actatropica.2023.106991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/07/2023] [Accepted: 07/18/2023] [Indexed: 07/23/2023]
Abstract
Leishmaniasis, caused by Leishmania species (intracellular protozoans), is a chronic, systemic disease that causes skin (cutaneous) and internal organ infections (visceral). Its prevalence has increased in recent years. Leishmania species are considered important pathogens that affect public health. After infecting an individual, the pathogen disrupts the immune system, but, there are not enough studies on which immune mechanisms are affected. The aim of this study was to establish a Leishmania major infection model (the causative agent of cutaneous leishmaniasis) in gerbils (Meriones unguiculatus) and to investigate the immune response in this model by examining the expression of important inflammatory genes (IL-1β, IL-2, IL-6, IFN-ɣ and TNF-α). The presence of parasites was confirmed by microscopic examination of samples taken from the lesions and culture studies. The expression of inflammatory cytokine genes was significantly increased in infected gerbils. The changes indicated that both the Th1 and Th2 pathways are activated in cutaneous leishmaniasis infection. Hence, different immunopathological mechanisms should be evaluated in the pathogenesis of the disease.
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Affiliation(s)
- Baycan Mor
- Department of Molecular Biology and Genetics, Faculty of Science, Kafkas University, 36100, Kars, Türkiye.
| | - Arzu Görmez
- Department of Biology, Faculty of Science, Dokuz Eylul University, 35390, Izmir, Turkey
| | - Berna Demirci
- Department of Molecular Biology and Genetics, Faculty of Science, Kafkas University, 36100, Kars, Türkiye
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2
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Wijesinghe HD, Wijesinghe GK, Fernando D, de Silva C. Immunopathology of Cutaneous Leishmaniasis in a Cohort of Sri Lankan
Patients. Clin Med Insights Pathol 2022; 15:2632010X221134804. [PMCID: PMC9634189 DOI: 10.1177/2632010x221134804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction and objectives: Leishmania donovani is the causative organism of
leishmaniasis in Sri Lanka. Studies on the immunopathology of leishmaniasis
due to L. donovani are limited. The objective of this study was to describe
the immunopathological characteristics of cutaneous leishmaniasis in a
cohort of Sri Lankan patients. Methodology: Fifty skin biopsies of cutaneous leishmaniasis confirmed by detection of
organisms by histology, culture, slit-skin smear, and/or polymerase chain
reaction were reviewed. The inflammatory infiltrate was characterized by
immunohistochemical staining for CD4, CD8, CD20, and CD68. Associations and
correlations between immunohistochemical staining pattern and the parasitic
load, and patterns of inflammation were determined. Results: The majority of biopsies showed a CD8+/CD4− T lymphocyte predominant
infiltrate (84%, n = 42). A CD68 predominant infiltrate was seen in
16%(n = 8). The mean percentage of CD8+, CD4+, CD20+, and CD68+ inflammatory
cells in the biopsies were 56.1% (SD = 16.5%), 2.6% (SD = 4.5%), 12.3%
(SD = 10.9%), and 25.7% (SD = 15.8%) respectively. There was no association
between the predominant inflammatory cell and the degree of inflammation
(P = .173), presence of high RPI
(P = .922), MRI(P = .367) or presence of
granuloma (P = .247).The percentage of CD4+ cells showed a
positive correlation with granuloma formation (Correlation
coefficient = .411, P = .03). The percentage of CD20+ cells
in the infiltrate showed a positive correlation with the degree of
inflammation (Correlation coefficient = .491, P = .02) and
the RPI (Correlation coefficient = .334, P = .018). Discussion and Conclusion: Skin biopsies from cutaneous leishmaniasis due to L.
donovani infection showed a CD8+/CD4− predominant infiltrate.
This is similar to the findings of studies on cutaneous leishmaniasis due to
some other species and suggests that the cytotoxic T cell response plays a
role in infections due to L. donovani.
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Affiliation(s)
- Harshima Disvini Wijesinghe
- Department of Pathology, Faculty of
Medicine, University of Colombo, Colombo, Sri Lanka,Harshima Disvini Wijesinghe, Department of
Pathology, Faculty of Medicine, University of Colombo, Kynsey Road, Colombo,
00800, Sri Lanka.
| | | | - Deepika Fernando
- Department of Parasitology, Faculty of
Medicine, University of Kelaniya, Sri Lanka
| | - Chandu de Silva
- Department of Pathology, Faculty of
Medicine, University of Colombo, Colombo, Sri Lanka
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3
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Darzi F, Davoudian R, Nateghi Rostami M. Differential inflammatory responses associated with Leishmania major and L tropica in culture. Parasite Immunol 2021; 43:e12841. [PMID: 33914948 DOI: 10.1111/pim.12841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Anthroponotic cutaneous leishmaniasis (ACL) due to Leishmania tropica and zoonotic CL (ZCL) due to L major have different clinical and epidemiological features. OBJECTIVES To determine whether pro-inflammatory cytokines are involved in diverse pathogenicity of Leishmania species causing CL. PATIENTS/METHODS The capacity of L major/L tropica to modulate expression of IL-1β, IL-8 (CXCL8), IFN-γ, TNF-α and MCP-1 (CCL2) in peripheral blood mononuclear cells (PBMCs) and monocyte-derived macrophages (MDMs) was evaluated by real-time RT-PCR technique. RESULTS PBMCs from both ZCL and ACL cases expressed significantly higher IFN-γ (P < .001) and TNF-α (P < .05) compared with healthy controls (HC). PBMCs from ACL patients expressed significantly higher IL-1β and IL-8 compared with ZCL patients and HC when stimulated with live L major or L tropica promastigotes (P < .001). After 4 and 10 hours, L major-infected MDMs expressed significantly higher IFN-γ (P < .05), and after 10 hours, L tropica-infected MDMs expressed significantly higher IL-1β, IFN-γ and IL-8 compared with noninfected cells (P < .05). CONCLUSIONS This study shows differential parasite-mediated stimulations of the inflammatory response with L major vs L tropica ex vivo. Pro-inflammatory cytokines particularly IL-8 (CXCL8) and IL-1β might contribute in diverse clinical features of CL such as longer duration of lesion persistence in ACL patients.
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Affiliation(s)
- Fatemeh Darzi
- Department of Parasitology, Pasteur Institute of Iran, Tehran, Iran
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4
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Rostami MN, Khamesipour A. Potential biomarkers of immune protection in human leishmaniasis. Med Microbiol Immunol 2021; 210:81-100. [PMID: 33934238 PMCID: PMC8088758 DOI: 10.1007/s00430-021-00703-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/22/2021] [Indexed: 12/30/2022]
Abstract
Leishmaniasis is a vector-borne neglected tropical disease endemic in over 100 countries around the world. Available control measures are not always successful, therapeutic options are limited, and there is no vaccine available against human leishmaniasis, although several candidate antigens have been evaluated over the last decades. Plenty of studies have aimed to evaluate the immune response development and a diverse range of host immune factors have been described to be associated with protection or disease progression in leishmaniasis; however, to date, no comprehensive biomarker(s) have been identified as surrogate marker of protection or exacerbation, and lack of enough information remains a barrier for vaccine development. Most of the current understanding of the role of different markers of immune response in leishmaniasis has been collected from experimental animal models. Although the data generated from the animal models are crucial, it might not always be extrapolated to humans. Here, we briefly review the events during Leishmania invasion of host cells and the immune responses induced against Leishmania in animal models and humans and their potential role as a biomarker of protection against human leishmaniasis.
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Affiliation(s)
| | - Ali Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, 14155-6383, Tehran, Iran.
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5
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Differential Regulation of l-Arginine Metabolism through Arginase 1 during Infection with Leishmania mexicana Isolates Obtained from Patients with Localized and Diffuse Cutaneous Leishmaniasis. Infect Immun 2020; 88:IAI.00963-19. [PMID: 32312763 DOI: 10.1128/iai.00963-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/31/2020] [Indexed: 01/08/2023] Open
Abstract
l-Arginine metabolism through arginase 1 (Arg-1) and inducible nitric oxide synthase (NOS2) constitutes a fundamental axis for the resolution or progression of leishmaniasis. Infection with Leishmania mexicana can cause two distinct clinical manifestations: localized cutaneous leishmaniasis (LCL) and diffuse cutaneous leishmaniasis (DCL). In this work, we analyzed in an in vivo model the capacity of two L. mexicana isolates, one obtained from a patient with LCL and the other from a patient with DCL, to regulate the metabolism of l-arginine through Arg-1 and NOS2. Susceptible BALB/c mice were infected with L. mexicana isolates from both clinical manifestations, and the evolution of the infection as well as protein presence and activity of Arg-1 and NOS2 were evaluated. The lesions of mice infected with the DCL isolate were bigger, had higher parasite loads, and showed greater protein presence and enzymatic activity of Arg-1 than the lesions of mice infected with the LCL isolate. In contrast, NOS2 protein synthesis was poorly or not induced in the lesions of mice infected with the LCL or DCL isolate. The immunochemistry analysis of the lesions allowed the identification of highly parasitized macrophages positive for Arg-1, while no staining for NOS2 was found. In addition, we observed in lesions of patients with DCL macrophages with higher parasite loads and stronger Arg-1 staining than those in lesions of patients with LCL. Our results suggest that L. mexicana isolates obtained from patients with LCL or DCL exhibit different virulence or pathogenicity degrees and differentially regulate l-arginine metabolism through Arg-1.
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Boussoffara T, Boubaker MS, Ben Ahmed M, Mokni M, Feriani S, Ben Salah A, Louzir H. Activated cytotoxic T cells within zoonotic cutaneous leishmaniasis lesions. IMMUNITY INFLAMMATION AND DISEASE 2019; 7:95-104. [PMID: 30997749 PMCID: PMC6688079 DOI: 10.1002/iid3.240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 11/23/2018] [Indexed: 01/10/2023]
Abstract
Introduction Zoonotic cutaneous leishmaniasis (ZCL), due to infection by Leishmania (L). major, is characterized by polymorphic clinical manifestations which could be attributed to the host's immune response. In this study we investigated the involvement of cytotoxic cells on the outcome of the disease. Methods Expression of granzyme B (GrB), granulysine (Grly), and interferon (IFN)‐γ was evaluated within ZCL lesion specimens using the technique of real‐time quantitative polymerase chain reaction (RT‐qPCR). Immunohistochemical staining was performed using anti‐CD3, CD4, CD8, CD56, GrB, and IFN‐γ antibodies to identify the phenotype of GrB and IFN‐γ‐producing cells. Results GrB and Grly mRNA was detected within 75% and 80% of ZCL lesions, respectively. Statistical analysis demonstrated a significant correlation between levels of GrB and Grly. Interestingly, expression of these molecules correlates negatively with the lesion's age. The highest levels were measured in early lesions (E‐ZCL) (lesion age ≤1 month) comparing to late lesions (L‐ZCL) (lesion age >1 month). Otherwise, IFN‐γ mRNA was detected only within 56% and a positive correlation was found between levels of this cytokine and those of GrB. Immunohistochemical analysis showed that GrB is produced essentially by CD8+T cells whereas IFN‐γ is produced by both CD4+ and CD8+T cells. Conclusion Together our results demonstrate the presence of cytotoxic cells producing GrB and Grly within leishmaniasis cutaneous lesions.
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Affiliation(s)
- Thouraya Boussoffara
- Laboratory of Transmission, Control and Immunobiology of Infections, Pasteur Institute of Tunis, Tunis, Tunisia.,Université de Tunis El Manar, Tunis, Tunisia
| | - Mohamed Samir Boubaker
- Université de Tunis El Manar, Tunis, Tunisia.,Laboratory of Human and Experimental Pathology, Pasteur Institute of Tunis, Tunis, Tunisia.,Faculté de Médecine de Tunis, Tunis, Tunisia
| | - Melika Ben Ahmed
- Laboratory of Transmission, Control and Immunobiology of Infections, Pasteur Institute of Tunis, Tunis, Tunisia.,Université de Tunis El Manar, Tunis, Tunisia
| | - Mourad Mokni
- Faculté de Médecine de Tunis, Tunis, Tunisia.,Department of Dermatology, Hospital La Rabta, Tunis, Tunisia
| | - Salma Feriani
- Laboratory of Human and Experimental Pathology, Pasteur Institute of Tunis, Tunis, Tunisia
| | - Afif Ben Salah
- Laboratory of Transmission, Control and Immunobiology of Infections, Pasteur Institute of Tunis, Tunis, Tunisia.,Université de Tunis El Manar, Tunis, Tunisia.,Department of Family and Community Medicine, College of Medecine and Medical Sciences, Arabian Gulf University (AGU), Manama, Bahrain
| | - Hechmi Louzir
- Laboratory of Transmission, Control and Immunobiology of Infections, Pasteur Institute of Tunis, Tunis, Tunisia.,Université de Tunis El Manar, Tunis, Tunisia
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7
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Christensen SM, Belew AT, El-Sayed NM, Tafuri WL, Silveira FT, Mosser DM. Host and parasite responses in human diffuse cutaneous leishmaniasis caused by L. amazonensis. PLoS Negl Trop Dis 2019; 13:e0007152. [PMID: 30845223 PMCID: PMC6405045 DOI: 10.1371/journal.pntd.0007152] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 01/11/2019] [Indexed: 02/01/2023] Open
Abstract
Diffuse cutaneous leishmaniasis (DCL) is a rare form of leishmaniasis where parasites grow uncontrolled in diffuse lesions across the skin. Meta-transcriptomic analysis of biopsies from DCL patients infected with Leishmania amazonensis demonstrated an infiltration of atypical B cells producing a surprising preponderance of the IgG4 isotype. DCL lesions contained minimal CD8+ T cell transcripts and no evidence of persistent TH2 responses. Whereas localized disease exhibited activated (so-called M1) macrophage presence, transcripts in DCL suggested a regulatory macrophage (R-Mϕ) phenotype with higher levels of ABCB5, DCSTAMP, SPP1, SLAMF9, PPARG, MMPs, and TM4SF19. The high levels of parasite transcripts in DCL and the remarkable uniformity among patients afforded a unique opportunity to study parasite gene expression in this disease. Patterns of parasite gene expression in DCL more closely resembled in vitro parasite growth in resting macrophages, in the absence of T cells. In contrast, parasite gene expression in LCL revealed 336 parasite genes that were differently upregulated, relative to DCL and in vitro macrophage growth, and these transcripts may represent transcripts that are produced by the parasite in response to host immune pressure.
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Affiliation(s)
- Stephen M. Christensen
- Department of Cell Biology and Molecular Genetics and the Maryland Pathogen Research Institute, University of Maryland, College Park, MD United States of America
| | - Ashton T. Belew
- Department of Cell Biology and Molecular Genetics and the Maryland Pathogen Research Institute, University of Maryland, College Park, MD United States of America
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, MD United States of America
| | - Najib M. El-Sayed
- Department of Cell Biology and Molecular Genetics and the Maryland Pathogen Research Institute, University of Maryland, College Park, MD United States of America
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, MD United States of America
| | - Wagner L. Tafuri
- Departamento de Patologia Geral, Universidade Federal de Minas Geras, Belo Horizonte, Brazil
| | - Fernando T. Silveira
- Evandro Chagas Institute, Tropical Medicine Nucleus, Federal University of Pará, Belém, PA Brazil
| | - David M. Mosser
- Department of Cell Biology and Molecular Genetics and the Maryland Pathogen Research Institute, University of Maryland, College Park, MD United States of America
- * E-mail:
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8
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Boussoffara T, Chelif S, Ben Ahmed M, Mokni M, Ben Salah A, Dellagi K, Louzir H. Immunity Against Leishmania major Infection: Parasite-Specific Granzyme B Induction as a Correlate of Protection. Front Cell Infect Microbiol 2018; 8:397. [PMID: 30483482 PMCID: PMC6243638 DOI: 10.3389/fcimb.2018.00397] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/22/2018] [Indexed: 11/13/2022] Open
Abstract
Zoonotic cutaneous leishmaniasis (ZCL) caused by Leishmania (L.) major infection is characterized by different clinical presentations which depend in part on the host factors. In attempt to investigate the impact of the host's immune response in the outcome of the disease, we conducted a prospective study of 453 individuals living in endemic foci of L. major transmission in Central Tunisia. Several factors were assessed at the baseline including (i) the presence of typical scars of ZCL, (ii) in vivo hypersensitivity reaction to leishmanin, and (iii) the in vitro release of granzyme B (Grz B) by peripheral blood mononuclear cells (PBMC) in response to stimulation with live L. major promastigotes. After one season of parasite's transmission, repeated clinical examinations allowed us to diagnose the new emerging ZCL cases. Heterogeneity was observed in terms of number of lesions developed by each individual as well as their size and spontaneous outcome, which led us to establish the parameter “severity of the disease.” The efficacy of the presence of typical ZCL scar, the leishmanin skin test (LST) positive reactivity and the high levels of Grz B (≥2 ng/ml), in the protection against the development of ZCL were 29, 15, and 22%, respectively. However, these factors were more efficient against development of intermediate or severe forms of ZCL. Levels of Grz B >2 ng/ml showed the best efficacy of protection (equals to 72.8%) against development of these forms of ZCL. The association of such parameter with the positivity of the LST exhibited a better efficacy (equals to 83.6%). In conclusion, our results support the involvement of Leishmania-specific cytotoxic cellular immune response in host protection against Leishmania-infection. This factor could be of great interest in monitoring the success of vaccination against human leishmaniasis.
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Affiliation(s)
- Thouraya Boussoffara
- Laboratory of Transmission, Control and Immunobiology of Infections, Pasteur Institute of Tunis, Tunis, Tunisia.,Université de Tunis El Manar, Tunis, Tunisia
| | - Sadok Chelif
- Laboratory of Transmission, Control and Immunobiology of Infections, Pasteur Institute of Tunis, Tunis, Tunisia.,Université de Tunis El Manar, Tunis, Tunisia
| | - Melika Ben Ahmed
- Laboratory of Transmission, Control and Immunobiology of Infections, Pasteur Institute of Tunis, Tunis, Tunisia.,Université de Tunis El Manar, Tunis, Tunisia
| | - Mourad Mokni
- Department of Dermatology, Hospital La Rabta, Tunis, Tunisia
| | - Afif Ben Salah
- Laboratory of Transmission, Control and Immunobiology of Infections, Pasteur Institute of Tunis, Tunis, Tunisia.,Université de Tunis El Manar, Tunis, Tunisia
| | - Koussay Dellagi
- Laboratory of Transmission, Control and Immunobiology of Infections, Pasteur Institute of Tunis, Tunis, Tunisia.,Université de Tunis El Manar, Tunis, Tunisia
| | - Hechmi Louzir
- Laboratory of Transmission, Control and Immunobiology of Infections, Pasteur Institute of Tunis, Tunis, Tunisia.,Université de Tunis El Manar, Tunis, Tunisia
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9
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Conceição-Silva F, Leite-Silva J, Morgado FN. The Binomial Parasite-Host Immunity in the Healing Process and in Reactivation of Human Tegumentary Leishmaniasis. Front Microbiol 2018; 9:1308. [PMID: 29971054 PMCID: PMC6018218 DOI: 10.3389/fmicb.2018.01308] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/29/2018] [Indexed: 01/09/2023] Open
Abstract
Leishmaniasis is a vector-borne infectious disease caused by different species of protozoa from the Leishmania genus. Classically, the disease can be classified into two main clinical forms: Visceral (VL) and Tegumentary (TL) leishmaniasis. TL is a skin/mucosal granulomatous disease that manifests mainly as cutaneous localized or disseminated ulcers, papules diffusely distributed, mucosal lesions or atypical lesions. Once the etiology of the infection is confirmed, treatment can take place, and different drugs can be administered. It has already been shown that, even when the scar is clinically evident, inflammation is still present in the native tissue, and the decrease of the inflammatory process occurs slowly during the 1st years after clinical healing. The maintenance of residual parasites in the scar tissue is also well documented. Therefore, it is no longer a surprise that, under some circumstances, therapeutic failure and/or lesion reactivation occurs. All over the years, an impressive amount of data on relapses, treatment resistance and lesion reactivation after healing has been collected, and several factors have been pointed out as having a role in the process. Different factors such as Leishmania species, parasite variability, Leishmania RNA virus 1, parasite load, parasite persistence, age, nutritional status, gender, co-morbidities, co-infection, pregnancy, immunosuppression, lesion duration, number and localization of lesions, drug metabolism, irregular treatment and individual host cellular immune response were described and discussed in the present review. Unfortunately, despite this amount of information, a conclusive understanding remains under construction. In addition, multifactorial influence cannot be discarded. In this context, knowing why leishmaniasis has been difficult to treat and control can help the development of new approaches, such as drugs and immunotherapy in order to improve healing maintenance. In this sense, we would like to highlight some of the findings that may influence the course of Leishmania infection and the therapeutic response, with an emphasis on TL.
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Affiliation(s)
- Fatima Conceição-Silva
- Laboratory of Immunoparasitology, Oswaldo Cruz Institute (Fiocruz), Rio de Janeiro, Brazil
| | - Jessica Leite-Silva
- Laboratory of Immunoparasitology, Oswaldo Cruz Institute (Fiocruz), Rio de Janeiro, Brazil
| | - Fernanda N. Morgado
- Laboratory of Leishmaniasis Research, Oswaldo Cruz Institute (Fiocruz), Rio de Janeiro, Brazil
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10
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Maspi N, Abdoli A, Ghaffarifar F. Pro- and anti-inflammatory cytokines in cutaneous leishmaniasis: a review. Pathog Glob Health 2016; 110:247-260. [PMID: 27660895 DOI: 10.1080/20477724.2016.1232042] [Citation(s) in RCA: 142] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is caused by different species of the genus Leishmania. Pro- and anti-inflammatory cytokines play different roles in resistance/susceptibility and the immunopathogenesis of Leishmania infection. The balance and dynamic changes in cytokines may control or predict clinical outcome. T helper 1 (Th1) inflammatory cytokines (especially interferon-γ, tumor necrosis factor-α and interleukin-12) are the crucial factors in the initiation of protective immunity against L. major infection, whereas T helper 2 cytokines including IL-5, IL-4, and IL-13 facilitate the persistence of parasites by downregulating the Th1 immune response. On the other hand, aggravation of inflammatory reactions leads to collateral tissue damage and formation of ulcer. For this reason, immunity system such as T regulatory cells produce regulatory cytokines such as transforming growth factor-β and IL-10 to inhibit possible injures caused by increased inflammatory responses in infection site. In this article, we review the role of pro- and anti-inflammatory cytokines in the immunoprotection and immunopathology of CL.
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Affiliation(s)
- Nahid Maspi
- a Faculty of Medical Sciences, Department of Parasitology , Tarbiat Modares University , Tehran , Iran
| | - Amir Abdoli
- a Faculty of Medical Sciences, Department of Parasitology , Tarbiat Modares University , Tehran , Iran
| | - Fathemeh Ghaffarifar
- a Faculty of Medical Sciences, Department of Parasitology , Tarbiat Modares University , Tehran , Iran
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11
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Al-Qadhi BN, Musa IS, Al-Mulla Hummadi YMK. Comparative immune study on cutaneous leishmaniasis patients with single and multiple sores. J Parasit Dis 2015; 39:361-70. [PMID: 26345036 PMCID: PMC4554559 DOI: 10.1007/s12639-013-0368-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 10/18/2013] [Indexed: 11/26/2022] Open
Abstract
Ninety-five Iraqi patients with cutaneous leishmaniasis (CL) caused by Leishmania tropica at AL-Karama Hospital in Baghdad were included in this study. Sixty patients were with single sore and the remaining with multiple sores. The study also included 10 atopic patients and 30 healthy individuals as a control group. Cellular and humoral immune response at different stages of the disease activity (early and late) were evaluated by estimation of serum IFN-γ, IL-4 and total IgE antibodies using ELISA kits while, the detection of specific anti leishmanial IgE antibodies was done manually. Specific IgE antibodies were only detected in early CL (<2 months) patients 68 (71.57 %) while, were not detected in late CL, atopic and healthy controls 30 (100 %). The results also showed a positive relationship between this antibody and the number of sores. Th-2 predominates during the early stage of the disease then shifts to Th-1 that proceed in the late stage, but both cytokines increased in CL patients in comparison to control group. The immune response of CL infection is possibly regulated by both Th-1 and Th-2. Multiple sores patients showed an increase of anti leishmanial IgE (0.120 ± 0.014), total IgE (120.7 ± 39.58 IU/ml), IFN-γ (87.4 ± 30.52 pg/ml) and IL-4 (63.70 ± 20.32 pg/ml) levels than single sore patients with mean value of 0.108 ± 0.14, 92.3 ± 35.23 IU/ml, 47.2 ± 27.80 pg/ml and 51.04 ± 15.0 pg/ml respectively. It can be presented also as ratio of INF-γ/IL-4 = 1.37 which is greater than those for single sore 0.9. These results indicated that the immune response of multiple sores patient's is higher than that with single sores.
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Affiliation(s)
- Ban Noori Al-Qadhi
- Biology Department, College of Science, University of Baghdad, Baghdad, Iraq
| | - Israa Salim Musa
- Biology Department, College of Science, University of Baghdad, Baghdad, Iraq
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12
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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: 54] [Impact Index Per Article: 6.0] [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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13
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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: 29] [Impact Index Per Article: 2.9] [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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Rafati S, Modabber F. Cutaneous Leishmaniasis in Middle East and North Africa. NEGLECTED TROPICAL DISEASES 2014. [DOI: 10.1007/978-3-7091-1613-5_5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Rethi B, Eidsmo L. FasL and TRAIL signaling in the skin during cutaneous leishmaniasis - implications for tissue immunopathology and infectious control. Front Immunol 2012; 3:163. [PMID: 22723798 PMCID: PMC3377931 DOI: 10.3389/fimmu.2012.00163] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Accepted: 05/31/2012] [Indexed: 01/09/2023] Open
Abstract
Cutaneous leishmaniasis (CL) is associated with chronic inflammation and ulceration of the skin. Tissue macrophages serve as host cells and immune activation is necessary for parasite clearance. The balance between immune-mediated tissue destruction and successful clearance of infection is delicate and ulceration has been proposed to be a result of infiltration of activated immune cells into the skin. FasL and TRAIL play a dual role in skin homeostasis through induction of apoptosis as well as proinflammatory signaling. During leishmaniasis, dysregulation of both FasL and TRAIL has been described by us and others but the resulting pathogenic effects in the skin during human leishmaniasis are not fully elucidated. Targeting disease specific immune deviations has proven to be a promising new approach for the therapy of autoimmune diseases. Potentially, targeting FasL or TRAIL in combination with microcidals could offer a future treatment strategy to reduce the disfiguring immunopathology associated with CL. In this mini review we will discuss how FasL and TRAIL-induced signaling may influence on the extent of tissue inflammation and the efficacy of parasite clearance in leishmaniasis.
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Affiliation(s)
- Bence Rethi
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
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16
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Stäger S, Rafati S. CD8(+) T cells in leishmania infections: friends or foes? Front Immunol 2012; 3:5. [PMID: 22566891 PMCID: PMC3342007 DOI: 10.3389/fimmu.2012.00005] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 01/09/2012] [Indexed: 01/10/2023] Open
Abstract
Host protection against several intracellular pathogens requires the induction of CD8+ T cell responses. CD8+ T cells are potent effector cells that can produce high amounts of pro-inflammatory cytokines and kill infected target cells efficiently. However, a protective role for CD8+ T cells during Leishmania infections is still controversial and largely depends on the infection model. In this review, we discuss the role of CD8+ T cells during various types of Leishmania infections, following vaccination, and as potential immunotherapeutic targets.
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Affiliation(s)
- Simona Stäger
- Institut National de la Recherche Scientifique, Institut Armand Frappier, Université du Québec Laval, QC, Canada
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Oliveira F, Bafica A, Rosato AB, Favali CBF, Costa JM, Cafe V, Barral-Netto M, Barral A. Lesion size correlates with Leishmania antigen-stimulated TNF-levels in human cutaneous leishmaniasis. Am J Trop Med Hyg 2011; 85:70-3. [PMID: 21734128 DOI: 10.4269/ajtmh.2011.10-0680] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a worldwide disease endemic in several regions of the globe. The hallmark of CL is skin ulcers likely driven by efforts of the immune system to control Leishmania growth. Cytokines, such as tumor necrosis factor (TNF) and interferon-gamma can control disease progression in animal models. Nevertheless, the impact of these cytokines in CL ulcer outcome is not well established in humans. In this study, 96 CL patients from an endemic area of Leishmania braziliensis were enrolled for a follow-up study that consisted of clinical and immunological evaluations in a 2-year period. Statistical analysis revealed that healing time (P = 0.029), age (P = 0.002), and TNF levels (P = 0.0002) positively correlate with ulcer size at the time of the first clinical evaluation. Our findings suggest that ulcer size correlates with healing time and TNF levels support the use of TNF inhibitors combined with standard therapy to improve healing in CL patients with severe lesions.
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Affiliation(s)
- Fabiano Oliveira
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil.
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18
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Nateghi Rostami M, Keshavarz H, Edalat R, Sarrafnejad A, Shahrestani T, Mahboudi F, Khamesipour A. CD8+ T cells as a source of IFN-γ production in human cutaneous leishmaniasis. PLoS Negl Trop Dis 2010; 4:e845. [PMID: 20967288 PMCID: PMC2953482 DOI: 10.1371/journal.pntd.0000845] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 09/09/2010] [Indexed: 12/16/2022] Open
Abstract
Background In human leishmaniasis Th1/Th2 dichotomy similar to murine model is not clearly defined and surrogate marker(s) of protection is not yet known. In this study, Th1/Th2 cytokines (IL-5, IL-10, IL-13 and IFN-γ) profile induced by purified CD4+/CD8+ T cells in response to Leishmania antigens were assessed at transcript and protein levels in 14 volunteers with a history of self-healing cutaneous leishmaniasis (HCL) and compared with 18 healthy control volunteers. Methodology/Principal Findings CD4+/CD8+/CD14+ cells were purified from peripheral blood using magnetic beads; CD4+/CD8+ T cells were co-cultured with autologous CD14+ monocytes in the presence of soluble Leishmania antigens (SLA). Stimulation of either CD4+ T cells or CD8+ T cells of HCL volunteers with SLA induced a significantly (P<0.05) higher IFN-γ production compared with the cells of controls. Upregulation of IFN-γ gene expression in CD4+ cells (P<0.001) and CD8+ cells (P = 0.006) of HCL volunteers was significantly more than that of controls. Significantly (P<0.05) higher fold-expression of IFN-γ gene was seen in CD4+ cells than in CD8+ cells. In HCL volunteers a significantly (P = 0.014) higher number of CD4+ cells were positive for intracellular IFN-γ production than CD8+ cells. Conclusions/Significance Collectively, the volunteers have shown maintenance of specific long-term immune responses characterized by a strong reaction to leishmanin skin test and IFN-γ production. The dominant IFN-γ response was the result of expansion of both CD4+ and CD8+ T cells. The results suggested that immune response in protected individuals with a history of zoonotic cutaneous leishmaniasis (ZCL) due to L. major is mediated not only through the expansion of antigen-specific IFN-γ producing CD4+ Th1 cells, but also through IFN-γ producing CD8+ T cells. Cutaneous leishmaniasis (CL) is usually a self-healing skin lesion caused by different species of Leishmania parasite. Resistance and susceptibility of mice to Leishmania major infection is associated with two types of CD4+ T lymphocytes development: Th1 type response with production of cytokine IFN-γ is associated with resistance, whereas Th2 type response with production of cytokines IL-4 and IL-5 is associated with susceptibility. A clear Th1/Th2 dichotomy similar to murine model is not defined in human leishmaniasis and we need as much information as possible to define marker(s) of protection. We purified CD4+/CD8+ T cells, stimulated them with Leishmania antigens and analysed gene and protein expression of Th1/Th2 cytokines in volunteers with a history of self-healing CL who are presumed to be protected against further Leishmania infection. We have seen significant upregulation of IFN-γ gene expression and high IFN-γ production in the Leishmania stimulated CD4+ T cells and CD8+ T cells. We concluded that both antigen-specific IFN-γ producing CD4+ Th1 cells and IFN-γ producing CD8+ T cells contribute to the long term protection in individuals with a history of CL. This proves the importance of CD8+ T cells as a source of IFN-γ in Th1-like immune responses.
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Affiliation(s)
- Mahmoud Nateghi Rostami
- Medical Parasitology and Mycology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - Hossein Keshavarz
- Medical Parasitology and Mycology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Rosita Edalat
- Biotechnology Department, Pasteur Institute of Iran, Tehran, Iran
| | - Abdolfattah Sarrafnejad
- Immunology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Shahrestani
- Immunology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Mahboudi
- Immunology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail:
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NATEGHI ROSTAMI M, KESHAVARZ VALIAN H, ESKANDARI SE, MIRAMIN MOHAMMADI A, SHAHRESTANI ST, SARRAF-NEJAD A, KHAMESIPOUR A. Differentialin vitroCD4+/CD8+T-cell response to live vs. killedLeishmania major. Parasite Immunol 2010; 32:101-10. [DOI: 10.1111/j.1365-3024.2009.01164.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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20
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Defective γδ T-cell function and granzyme B gene polymorphism in a cohort of newly diagnosed breast cancer patients. Exp Hematol 2009; 37:838-48. [DOI: 10.1016/j.exphem.2009.04.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Revised: 03/09/2009] [Accepted: 04/14/2009] [Indexed: 11/21/2022]
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21
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22
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Eidsmo L, Fluur C, Rethi B, Eriksson Ygberg S, Ruffin N, De Milito A, Akuffo H, Chiodi F. FasL and TRAIL induce epidermal apoptosis and skin ulceration upon exposure to Leishmania major. THE AMERICAN JOURNAL OF PATHOLOGY 2007; 170:227-39. [PMID: 17200196 PMCID: PMC1762690 DOI: 10.2353/ajpath.2007.060068] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Receptor-mediated apoptosis is proposed as an important regulator of keratinocyte homeostasis in human epidermis. We have previously reported that Fas/FasL interactions in epidermis are altered during cutaneous leishmaniasis (CL) and that keratinocyte death through apoptosis may play a pathogenic role for skin ulceration. To further investigate the alterations of apoptosis during CL, a keratinocyte cell line (HaCaT) and primary human epidermal keratinocytes were incubated with supernatants from Leishmania major-infected peripheral blood mononuclear cells. An apoptosis-specific microarray was used to assess mRNA expression in HaCaT cells exposed to supernatants derived from L. major-infected cultures. Fas and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) mRNA and protein expression were significantly up-regulated, and apoptosis was detected in both HaCaT and human epidermal keratinocyte cells. The keratinocyte apoptosis was partly inhibited through blocking of Fas or FasL and even more efficiently through TRAIL neutralization. Up-regulation of Fas on keratinocytes in epidermis and the presence of FasL-expressing macrophages and T cells in dermis were previously reported by us. In this study, keratinocytes expressing TRAIL, as well as the proapoptotic receptor TRAIL-R2, were detected in skin biopsies from CL cases. We propose that activation of Fas and TRAIL apoptosis pathways, in the presence of inflammatory mediators at the site of infection, leads to tissue destruction and ulceration during CL.
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Affiliation(s)
- Liv Eidsmo
- Department of Microbiology, Karolinska Institutet, MTC, 171 77 Stockholm, Sweden.
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23
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Abstract
Leishmania are digenetic protozoan parasites that are inoculated into the skin by vector sand flies, are taken up by macrophages, and produce a spectrum of chronic diseases in their natural reservoir and susceptible human hosts. During the early establishment of infection in the skin and lymphoid organs, Leishmania produce multiple effects on macrophage and dendritic cell functions that inhibit their innate anti-microbial defenses and impair their capacity to initiate T-helper 1 cell immunity. In addition, the skin is a site preconditioned for early parasite survival by virtue of a high frequency of steady-state, natural CD25+Foxp3+ regulatory T cells (Tregs) that function to suppress the generation of unneeded immune responses to infectious and non-infectious antigens to which the skin is regularly exposed. In murine models of infection, antigen-induced CD25+/-Foxp3-interleukin (IL)-10+ Treg cells act during the effector phase of the immune response to control immunopathology and may also delay or prevent healing. Finally, following resolution of infection in healed mice, CD25+Foxp3+ Tregs function in an IL-10-dependent manner to prevent sterile cure and establish a long-term state of functional immune privilege in the skin.
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Affiliation(s)
- Nathan Peters
- Laboratory of Parasitic Diseases, NIAID, Bethesda, MD 20892-0425, USA
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24
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Bertholet S, Goldszmid R, Morrot A, Debrabant A, Afrin F, Collazo-Custodio C, Houde M, Desjardins M, Sher A, Sacks D. LeishmaniaAntigens Are Presented to CD8+T Cells by a Transporter Associated with Antigen Processing-Independent Pathway In Vitro and In Vivo. THE JOURNAL OF IMMUNOLOGY 2006; 177:3525-33. [PMID: 16951311 DOI: 10.4049/jimmunol.177.6.3525] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CD8+ T cells are generated in response to Leishmania major (Lm) or Toxoplasma gondii parasitic infections, indicating that exogenously delivered Ag can be processed for presentation by MHC class I molecules. We show that presentation of Lm nucleotidase (NT)-OVA is TAP independent in vivo and in vitro, and is inhibited by chloroquine, but not by proteasome inhibitors. In contrast, the presentation of T. gondii P30-OVA relies on the TAP/proteasome pathway. Presentation of OVA- or rNT-OVA-coated beads also bypassed TAP requirement above a certain Ag threshold. TAP was also dispensable for the presentation of wild-type Lm Ags to primed CD8+ T cells in vitro. Finally, in vivo priming of CD8+ T cells involved in acquired resistance to Lm was not compromised in TAP-deficient mice. Thus, Leishmania Ags appear to be confined to an intraphagosomal processing pathway that requires higher concentrations of Ags, suggesting that these parasites may have evolved strategies to impair the efficient endoplasmic reticulum-based, TAP-dependent cross-presentation pathway to avoid or delay CD8+ T cell priming.
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Affiliation(s)
- Sylvie Bertholet
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-0425, USA
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Mege JL, Meghari S, Honstettre A, Capo C, Raoult D. The two faces of interleukin 10 in human infectious diseases. THE LANCET. INFECTIOUS DISEASES 2006; 6:557-69. [PMID: 16931407 DOI: 10.1016/s1473-3099(06)70577-1] [Citation(s) in RCA: 195] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Resolution of infections depends on the host's ability to mount a protective immune response. However, an exacerbated response to infections may result in deleterious lesions. Consequently, immunoregulatory mechanisms are needed to control immune response and prevent infection-associated lesions. Interleukin 10 may be a major regulator of innate and adaptive immunity in vitro and in animals, but its role in human infections is still unclear. Review of the published work reveals wide involvement of interleukin 10 in two major features of infectious diseases. On one hand, interleukin 10 prevents the development of immunopathological lesions that result from exacerbated protective immune response to acute and chronic infections. On the other hand, it is critically involved in persistence of bacteria and viruses by interfering with innate and adaptive protective immunity. Moreover, infections induce the expansion of interleukin-10-producing regulatory cells that are involved in protection against allergic diseases.
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Affiliation(s)
- Jean-Louis Mege
- Unité des Rickettsies, Centre National de la Recherche Scientifique Unité Mixte de Recherche 6020, Institut Fédératif de Recherche 48, Université de la Méditerranée, Faculté de Médecine, Marseille, France
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26
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Bertholet S, Debrabant A, Afrin F, Caler E, Mendez S, Tabbara KS, Belkaid Y, Sacks DL. Antigen requirements for efficient priming of CD8+ T cells by Leishmania major-infected dendritic cells. Infect Immun 2005; 73:6620-8. [PMID: 16177338 PMCID: PMC1230980 DOI: 10.1128/iai.73.10.6620-6628.2005] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
CD4(+) and CD8(+) T-cell responses have been shown to be critical for the development and maintenance of acquired resistance to infections with the protozoan parasite Leishmania major. Monitoring the development of immunodominant or clonally restricted T-cell subsets in response to infection has been difficult, however, due to the paucity of known epitopes. We have analyzed the potential of L. major transgenic parasites, expressing the model antigen ovalbumin (OVA), to be presented by antigen-presenting cells to OVA-specific OT-II CD4(+) or OT-I CD8(+) T cells. Truncated OVA was expressed in L. major as part of a secreted or nonsecreted chimeric protein with L. donovani 3' nucleotidase (NT-OVA). Dendritic cells (DC) but not macrophages infected with L. major that secreted NT-OVA could prime OT-I T cells to proliferate and release gamma interferon. A diminished T-cell response was observed when DC were infected with parasites expressing nonsecreted NT-OVA or with heat-killed parasites. Inoculation of mice with transgenic parasites elicited the proliferation of adoptively transferred OT-I T cells and their recruitment to the site of infection in the skin. Together, these results demonstrate the possibility of targeting heterologous antigens to specific cellular compartments in L. major and suggest that proteins secreted or released by L. major in infected DC are a major source of peptides for the generation of parasite-specific CD8(+) T cells. The ability of L. major transgenic parasites to activate OT-I CD8(+) T cells in vivo will permit the analysis of parasite-driven T-cell expansion, differentiation, and recruitment at the clonal level.
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Affiliation(s)
- Sylvie Bertholet
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA
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27
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Eidsmo L, Nylen S, Khamesipour A, Hedblad MA, Chiodi F, Akuffo H. The contribution of the Fas/FasL apoptotic pathway in ulcer formation during Leishmania major-induced cutaneous Leishmaniasis. THE AMERICAN JOURNAL OF PATHOLOGY 2005; 166:1099-108. [PMID: 15793290 PMCID: PMC1602394 DOI: 10.1016/s0002-9440(10)62330-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cutaneous leishmaniasis (CL), caused by the intracellular protozoan Leishmania major, is characterized by lesion formation and ulceration at the site of infection. The mechanism of ulcer formation during CL is not fully understood. The expression of Fas and FasL and the levels of apoptosis in skin biopsies and in restimulated blood mononuclear cells from patients with 1 to 7 months of L. major-induced CL were analyzed using immunohistochemistry and fluorescence-activated cell sorting analysis. The levels of soluble Fas and FasL were also analyzed by enzyme-linked immunosorbent assay. A substantial number of apoptotic keratinocytes were observed mainly in the superficial epidermis of morphologically active and healing CL skin samples. Fas expression was increased on epidermis in active CL, whereas Fas expression was similar in healing and healthy epidermis. FasL-expressing macrophages and T cells were found in subepidermal infiltrate, mainly in active disease. When CL peripheral blood mononuclear cells were restimulated with L. major, Fas was up-regulated on effector T cells, and high levels of sFasL were secreted. Supernatants from restimulated cultures induced apoptosis in human keratinocytes (HaCaT), possibly through Fas/FasL interactions. Our results indicate that FasL-expressing effector T cells and macrophages may act to induce apoptosis and ulcer formation in Fas-expressing keratinocytes during L. major infection.
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Affiliation(s)
- Liv Eidsmo
- Microbiology and Tumor Biology Center, Karolinska Institutet, Box 280, 171 77 Stockholm, Sweden.
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28
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Meymandi S, Dabiri S, Dabiri D, Crawford RI, Kharazmi A. A quantitative study of epidermal Langerhans cells in cutaneous leishmaniasis caused by Leishmania tropica. Int J Dermatol 2004; 43:819-23. [PMID: 15533064 DOI: 10.1111/j.1365-4632.2004.02359.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to characterize the number and distribution of epidermal Langerhans cells in different clinical forms of dry-type cutaneous leishmaniasis (CL). METHODS Sixteen cases of dry-type cutaneous leishmaniasis caused by Leishmania tropica were studied. These cases were classified clinically as five cases of acute leishmaniasis with indurated papules, nodules and plaques with central crust formation and duration < 2 years, six cases of lupoid leishmaniasis with characteristic papules around previous scars of cutaneous leishmaniasis with duration > 2 years, and five cases of chronic nonlupoid type with nonhealing lesions of duration > 2 years. Paraffin-embedded blocks were stained with hematoxylin and eosin (H&E) and stained immunohistochemically for CD1a. RESULTS The number of Langerhans cells per millimeter length of epidermis was increased in acute cases compared to chronic and lupoid cases. CONCLUSIONS Lesions of acute leishmaniasis contain the greatest amounts of antigen for presentation, so Langerhans cells increase in number and in trafficking to present antigens derived from Leishman bodies to the cellular immune system. In chronic leishmaniasis, the Langerhans cell population is reduced, perhaps because of exhaustion of the source of Langerhans cells, or because of reduced response to modified antigen.
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Affiliation(s)
- Simin Meymandi
- Department of Dermatology, Afzalipour Medical School, Kerman, Iran.
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29
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Sacks D, Anderson C. Re-examination of the immunosuppressive mechanisms mediating non-cure of Leishmania infection in mice. Immunol Rev 2004; 201:225-38. [PMID: 15361244 DOI: 10.1111/j.0105-2896.2004.00185.x] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The interleukin (IL)-4 driven, polarized T-helper 2 cell (Th2) response that controls non-healing infection with Leishmania major in BALB/c mice has long been embraced as the underlying principle with which to consider the pathogenesis of non-healing and systemic forms of leishmaniasis in humans. The inability, however, to reveal a Th2 polarity associated with non-curing clinical disease has suggested that alternative cells and cytokines are involved in susceptibility. In this review, various mouse models of non-curing infection with L. major and other Leishmania species are re-examined in the context of the suppression mediated by IL-10 and regulatory T (Treg) cells. These activities are revealed in L. major-infected BALB/c IL-4 knockout (KO) and IL-4Ralpha KO mice and especially in non-cure resistant mice that do not default to a Th2 pathway as a result of inherent defects in Th1 differentiation. In contrast to the extreme BALB/c susceptibility arising from an aberrant Th2 response, non-cure in resistant mice arises from an imbalance in Treg cells that are activated in the context of an ongoing Th1 response and whose primary function may be to suppress the immunopathology associated with persistent antiparasite responses in infected tissues.
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Affiliation(s)
- David Sacks
- Laboratory of Parasitic Diseases, NIAID, Bethesda, MD, USA.
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30
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Weiss E, Mamelak AJ, La Morgia S, Wang B, Feliciani C, Tulli A, Sauder DN. The role of interleukin 10 in the pathogenesis and potential treatment of skin diseases. J Am Acad Dermatol 2004; 50:657-75; quiz 676-8. [PMID: 15097948 DOI: 10.1016/j.jaad.2003.11.075] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
UNLABELLED Interleukin 10 (IL-10) is a key cytokine produced by a multitude of immune effector cells and possesses distinct regulatory effects on immune functioning in the skin. In this article we report the current understanding of the immunobiology of IL-10 and identify the role of IL-10 in cutaneous infection as well as in autoimmune and neoplastic processes. We reviewed the literature to examine the function of IL-10 in different cutaneous disorders. IL-10 can influence and potentially treat T1/T2 differentiation, antigen-presenting cell functioning, antigen-presenting cell-mediated T-cell activation, and T-cell, B-cell, and mast cell growth and differentiation that is aberrant in various disease processes. The literature consensus is that the multitude of effects of IL-10 contribute to the pathogenesis of different skin disorders. In certain circumstances IL-10 could represent novel therapeutic approaches to treating cutaneous diseases. LEARNING OBJECTIVE At the conclusion of this learning activity, participants should be acquainted with the role of IL-10 in many infectious diseases, autoimmune skin disease, inflammatory processes, and malignancy. Its possible role in the resolution of various skin diseases should be better understood.
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Affiliation(s)
- Elliot Weiss
- Department of Dermatology, Johns Hopkins University, Baltimore, MD 21287, USA
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31
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Sacks D, Noben-Trauth N. The immunology of susceptibility and resistance to Leishmania major in mice. Nat Rev Immunol 2002; 2:845-58. [PMID: 12415308 DOI: 10.1038/nri933] [Citation(s) in RCA: 853] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Established models of T-helper-2-cell dominance in BALB/c mice infected with Leishmania major -- involving the early production of interleukin-4 by a small subset of Leishmania-specific CD4+ T cells -- have been refined by accumulating evidence that this response is not sufficient and, under some circumstances, not required to promote susceptibility. In addition, more recent studies in L. major-resistant mice have revealed complexities in the mechanisms responsible for acquired immunity, which necessitate the redesign of vaccines against Leishmania and other pathogens that require sustained cell-mediated immune responses.
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Affiliation(s)
- David Sacks
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA.
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Belkaid Y, Von Stebut E, Mendez S, Lira R, Caler E, Bertholet S, Udey MC, Sacks D. CD8+ T cells are required for primary immunity in C57BL/6 mice following low-dose, intradermal challenge with Leishmania major. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2002; 168:3992-4000. [PMID: 11937556 DOI: 10.4049/jimmunol.168.8.3992] [Citation(s) in RCA: 245] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Standard murine models of cutaneous leishmaniasis, involving s.c. inoculation of large numbers of Leishmania major promastigotes, have not supported an essential role for CD8(+) T cells in the control of primary infection. Recently, a L. major model combining two main features of natural transmission, low parasite dose and inoculation into a dermal site, has been established in resistant C57BL/6 mice. In the present studies, C57BL/6 mice with CD8(+) T cell deficiencies, including CD8(-/-) and CD8-depleted mice, failed to control the growth of L. major following inoculation of 100 metacyclic promastigotes into the ear dermis. The resulting dermal pathology was minor and delayed. Lesion formation in wild-type mice was coincident with the killing of parasites in the inoculation site. Both events were associated with the accumulation of CD8(+) T lymphocytes in the skin and with the capacity of CD8(+) T cells recovered from draining lymph nodes or infected dermis to release IFN-gamma following coculture with infected dendritic cells. Reconstitution of resistance to L. major in RAG(-/-) mice using T cells from naive donors was optimal when both CD4(+) and CD8(+) T cells were transferred. Primed CD8(+) T lymphocytes obtained from C57BL/6 mice during the acute stage of infection were able to mediate both pathology and immunity when transferred alone. The low dose, intradermal challenge model reveals that CD8(+) T cells play an essential role in both pathogenesis of and immunity to primary infection with L. major in the skin.
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MESH Headings
- Animals
- Antigen-Presenting Cells/immunology
- Antigens, Protozoan/administration & dosage
- Antigens, Protozoan/immunology
- CD4-Positive T-Lymphocytes/immunology
- CD4-Positive T-Lymphocytes/pathology
- CD4-Positive T-Lymphocytes/transplantation
- CD8-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/pathology
- CD8-Positive T-Lymphocytes/transplantation
- Cell Movement/genetics
- Cell Movement/immunology
- DNA Nucleotidyltransferases/deficiency
- DNA Nucleotidyltransferases/genetics
- Dermis/immunology
- Dermis/pathology
- Dose-Response Relationship, Immunologic
- Ear, External
- Epitopes, T-Lymphocyte/immunology
- Immunity, Cellular/genetics
- Immunity, Innate/genetics
- Injections, Intradermal
- Interferon-gamma/biosynthesis
- Leishmania major/growth & development
- Leishmania major/immunology
- Leishmaniasis, Cutaneous/immunology
- Leishmaniasis, Cutaneous/parasitology
- Leishmaniasis, Cutaneous/pathology
- Lymph Nodes/immunology
- Lymph Nodes/pathology
- Lymphocyte Activation/genetics
- Lymphocyte Depletion
- Mice
- Mice, Inbred C57BL/genetics
- Mice, Inbred C57BL/immunology
- Mice, Knockout
- VDJ Recombinases
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Affiliation(s)
- Yasmine Belkaid
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, and Dermatology Branch, Division of Clinical Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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33
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Sousa-Atta MLB, Salamé GS, D'Oliveira A, Almeida RP, Atta AM, Carvalho EM. Immunoglobulin E antileishmanial antibody response in cutaneous leishmaniasis. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2002; 9:101-4. [PMID: 11777837 PMCID: PMC119873 DOI: 10.1128/cdli.9.1.101-104.2002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
High levels of antileishmanial immunoglobulin E (IgE) antibodies are associated with disease activity in visceral leishmaniasis. Herein, we report our observations about the relationship between antileishmanial IgE antibodies and clinical aspects of cutaneous leishmaniasis. This study was carried out with 45 patients (29 male and 16 female), with ages ranging from 11 to 48 years. All subjects were from an area to which leishmaniasis is endemic, Corte de Pedra (Bahia, Brazil), and the duration of the illness was </=30 days. The patients were classified as positive or negative for IgE serology in enzyme-linked immunosorbent assay with leishmanial antigens. IgE antibodies were detected in 18 patients (optical density, 0.421 +/- 0.30; 95% confidence interval, 0.27 to 0.57), and only 3 (17%) had more than one ulcer. In this group the diameter of Montenegro's reaction was 18 +/- 12.2 mm. In the group with negative IgE serology, 11 of 27 patients (48%) presented two or more cutaneous ulcers, and the mean of the skin test result was 9 +/- 6.9 mm. There was a positive correlation between IgE antibody levels and Montenegro's reaction size and an inverse correlation between IgE antileishmanial antibodies and the number of skin ulcers. The presence of antileishmanial IgE antibodies in cutaneous leishmaniasis may be a result of immunoregulatory events with clinical implications.
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Affiliation(s)
- Maria L B Sousa-Atta
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia da Universidade Federal da Bahia, 40110-160 Salvador, Bahia, Brazil
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Amaral VF, Teva A, Porrozzi R, Silva AJ, Pereira MS, Oliveira-Neto MP, Grimaldi G. Leishmania (Leishmania) major-infected rhesus macaques (Macaca mulatta) develop varying levels of resistance against homologous re-infections. Mem Inst Oswaldo Cruz 2001; 96:795-804. [PMID: 11562705 DOI: 10.1590/s0074-02762001000600010] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Seven rhesus macaques were infected intradermally with 10(7) promastigotes of Leishmania (Leishmania) major. All monkeys developed a localized, ulcerative, self-healing nodular skin lesion at the site of inoculation of the parasite. Non-specific chronic inflammation and/or tuberculoid-type granulomatous reaction were the main histopathological manifestations of the disease. Serum Leishmania-specific antibodies (IgG and IgG1) were detected by ELISA in all infected animals; immunoblot analyses indicated that numerous antigens were recognized. A very high degree of variability was observed in the parasite-specific cell-mediated immune responses [as detected by measuring delayed-type hypersensitivity (DTH) reaction, in vitro lymphocyte proliferation, and gamma interferon (IFN-gamma) production] for individuals over time post challenge. From all the recovered monkeys (which showed resolution of the lesions after 11 weeks of infection), 57.2% (4/7) and 28.6% (2/7) animals remained susceptible to secondary and tertiary infections, respectively, but the disease severity was altered (i.e. lesion size was smaller and healed faster than in the primary infection). The remaining monkeys exhibited complete resistance (i.e. no lesion) to each rechallenge. Despite the inability to consistently detect correlates of cell-mediated immunity to Leishmania or correlation between resistance to challenge and DTH, lymphocyte transformation or IFN-gamma production, partial or complete acquired resistance was conferred by experimental infection. This primate model should be useful for measuring vaccine effectiveness against the human disease.
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Affiliation(s)
- V F Amaral
- Departamento de Imunologia, Instituto Oswaldo Cruz-Fiocruz, 21045-900 Rio de Janeiro, RJ, Brasil
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Abstract
Cutaneous leishmaniasis (CL) in Sudan is caused by Leishmania major, zymodeme LON-1. The disease is endemic in many parts of the country. The vector is Phlebotomus papatasi and the animal reservoir is probably the Nile rat Arvicanthis niloticus. Clinically, patients usually present with papules, nodules, or nodulo-ulcerative lesions, mainly on the exposed parts of the skin. In 20% of cases the parasite disseminates through the lymphatics, producing sporotrichoid-like lesions. The pathology of the lesion is described. Langerhans cells are the main antigen-presenting cells in CL. They pickup antigen from the dermis and migrate to regional lymph nodes where they present it to T cells. Antigen-specific activated T cells home to the dermis where they stimulate macrophages to eliminate the parasite. Peripheral blood mononuclear cells (PBMC) proliferate in response to Leishmania antigen in vitro and produce cytokines. PBMC of patients with mild and severe disease produce Th1- and Th2-like cytokine patterns, respectively. The criteria for the clinical diagnosis of CL are described. The diagnosis is confirmed by the demonstration of parasites in slit smears in 50-70% of cases and in histological sections in 70%. With primers specific for L. major, the polymerase chain reaction is positive in 86% of cases. Since CL is a self-limiting disease, treatment is confined to patients with severe disease.
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Affiliation(s)
- A M el-Hassan
- Department of Immunology and Clinical Pathology, Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan.
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Belkaid Y, Mendez S, Lira R, Kadambi N, Milon G, Sacks D. A natural model of Leishmania major infection reveals a prolonged "silent" phase of parasite amplification in the skin before the onset of lesion formation and immunity. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2000; 165:969-77. [PMID: 10878373 DOI: 10.4049/jimmunol.165.2.969] [Citation(s) in RCA: 297] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A model of Leishmania major infection in C57BL/6 mice has been established that combines two main features of natural transmission: low dose (100 metacyclic promastigotes) and inoculation into a dermal site (the ear dermis). The evolution of the dermal lesion could be dissociated into two distinct phases. The initial "silent" phase, lasting 4-5 wk, favored establishment of the peak load of parasites in the dermis in the absence of lesion formation or any overt histopathologic changes in the site. The second phase corresponds to the development of a lesion associated with an acute infiltration of neutrophils, macrophages, and eosinophils into the dermis and was coincident with the killing of parasites in the site. The onset of immunity/pathology was correlated with the appearance of cells staining for IL-12p40 and IFN-gamma in the epidermal compartment, and an expansion of T cells capable of producing IFN-gamma in the draining lymph node. Parasite growth was not enhanced over the first 4.5 wk in anti-CD4-treated mice, SCID mice, or C57BL/6 mice deficient in IL-12p40, IFN-gamma, CD40 ligand, or inducible NO synthase. These mice all failed to ultimately control infection in the site, but in some cases (anti-CD4 treated, IL-12p40-/-, CD40 ligand-/-, and SCID) high dermal parasite loads were associated with little or no pathology. These results extend to a natural infection model a role for Th1 cells in both acquired resistance and lesion formation, and document the remarkable avoidance of this response during a prolonged phase of parasite amplification in the skin.
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MESH Headings
- Animals
- Cells, Cultured
- Cytokines/biosynthesis
- Ear, External
- Epidermis/immunology
- Epidermis/metabolism
- Epidermis/parasitology
- Epidermis/pathology
- Immunity, Innate
- Immunologic Deficiency Syndromes/immunology
- Immunologic Deficiency Syndromes/parasitology
- Immunologic Deficiency Syndromes/pathology
- Leishmania major/growth & development
- Leishmania major/immunology
- Leishmania major/pathogenicity
- Leishmaniasis, Cutaneous/immunology
- Leishmaniasis, Cutaneous/parasitology
- Leishmaniasis, Cutaneous/pathology
- Leishmaniasis, Cutaneous/transmission
- Lymph Nodes/immunology
- Lymph Nodes/metabolism
- Lymph Nodes/parasitology
- Lymph Nodes/pathology
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Mice, SCID
- Skin/immunology
- Skin/parasitology
- Time Factors
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Affiliation(s)
- Y Belkaid
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
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