Current status of the immunology of blood and tissue Protozoa. I. Leishmania

In-situ proliferation contributes to the accumulation of myeloid cells in the spleen during progressive experimental visceral leishmaniasis

Visceral leishmaniasis (VL) is characterized by expansion of myeloid cells in the liver and spleen, which leads to a severe splenomegaly associated with higher risk of mortality. This increased cellularity is thought to be a consequence of recruitment of cells to the viscera. We studied whether the local proliferation of splenic myeloid cells contributes to increased splenic cellularity. We found that a monocyte-like population of adherent splenic cells from Leishmania donovani-infected hamsters had enhanced replicative capacity ex vivo and in vivo (BrdU incorporation, p<0.0001). In vitro assays demonstrated that proliferation was more pronounced in the proinflammatory M1 environment and that intracellular infection prevented proliferation. Secondary analysis of the published splenic transcriptome in the hamster model of progressive VL revealed a gene expression signature that included division of tumoral cells (Z = 2.0), cell cycle progression (Z = 2.3), hematopoiesis (Z = 2.8), proliferation of stem cells (Z = 2.5) and overexpression of proto-oncogenes. Regulators of myeloid cell proliferation were predicted in-silico (CSF2, TLR4, IFNG, IL-6, IL-4, RTK signaling, and STAT3). The in-silico prediction was confirmed with chemical inhibitors of PI3K/AKT, MAPK and STAT3 which decreased splenic myeloid cell division ex vivo. Hamsters infected with L. donovani treated with a STAT3 inhibitor had reduced in situ splenic myeloid proliferation (p = 0.03) and parasite burden. We conclude that monocyte-like myeloid cells have increased STAT3-dependent proliferation in the spleen of hamsters with visceral leishmaniasis and that inhibition of STAT3 reduces myeloid cell proliferation and parasite burden.

Cysteine proteinases from promastigotes of Leishmania (Viannia) braziliensis

Leishmania (Viannia) braziliensis is the major causative agent of American tegumentary leishmaniasis, a disease that has a wide geographical distribution and is a severe public health problem. The cysteine proteinase B (CPB) from Leishmania spp. represents an important virulence factor. In this study, we characterized and localized cysteine proteinases in L. (V.) braziliensis promastigotes. By a combination of triton X-114 extraction, concanavalin A-affinity, and ion exchange chromatographies, we obtained an enriched fraction of hydrophobic proteins rich in mannose residues. This fraction contained two proteinases of 63 and 43 kDa, which were recognized by a CPB antiserum, and were partially sensitive to E-64 in enzymatic assays with the peptide Glu-Phe-Leu. In confocal microscopy, the CPB homologues localized in the peripheral region of the parasite. This data together with direct agglutination and flow cytometry assays suggest a surface localization of the CPB homologues. The incubation of intact promastigotes with phospholipase C reduced the number of CPB-positive cells, while anti-cross-reacting determinant and anti-CPB antisera recognized two polypeptides (63 and 43 kDa) derived from phospholipase C treatment, suggesting that some CPB isoforms may be glycosylphosphatidylinositol-anchored. Collectively, our results suggest the presence of CPB homologues in L. braziliensis surface and highlight the need for further studies on L. braziliensis cysteine proteinases, which require enrichment methods for enzymatic detection.

Application of direct agglutination test (DAT) and fast agglutination screening test (FAST) for sero-diagnosis of visceral leishmaniasis in endemic area of Minas Gerais, Brazil

Background

The direct agglutination test (DAT) has proved to be a very important sero-diagnostic tool combining high levels of intrinsic validity and ease of performance. Otherwise, fast agglutination screening test (FAST) utilises only one serum dilution making the test very suitable for the screening of large populations.

Results

We have tested FAST and DAT for the detection anti-Leishmania antibodies in serum samples from patients with American visceral (AVL) and cutaneous leishmaniases (ACL) in Minas Gerais State, Brazil. The DAT on serum and blood samples of confirmed AVL patients found all samples positive at a serum dilution of ≥ 1:800. This dilution was subsequently used as cut off value in the study. The blood and serum samples of these confirmed patients could also be clearly read in FAST using a 1:100 dilution with the same high sensitivity. DAT and FAST were not able to detect significant amounts of antibodies in samples from ACL patients and are not suitable for the diagnosis of this manifestation of the disease.

Conclusion

We suggest that both DAT and FAST are very practical diagnostic tools for the sero-diagnosis of AVL under rural conditions as both serological tests do not require sophisticated equipment, a cold chain and are very simple to perform.

Cutaneous leishmaniasis: The prospects for a killed vaccine

Of the various protozoal diseases for which vaccines are under development, cutaneous leishmaniasis (CL), in spite o f its chronic nature, may provide the best candidate for success. Stringent experimental models are available for both new and old world CL, human studies have been conducted for several years, and there is now considerable experience in using both attenuated and killed vaccines. In this article, Chuck Greenblatt discusses this experience, showing how it has led to current WHO-TDR plans for field trials of killed vaccines followed by virulent challenge (as used in Iran in the practice of 'leishmanization').

Dual role of the Leishmania major ribosomal protein S3a homologue in regulation of T- and B-cell activation

We have recently characterized a novel Leishmania major gene encoding a polypeptide of 30 kDa that was homologous to mammalian ribosomal protein S3a and was named LmS3a-related protein (LmS3arp). The protein was found to be expressed by all the Leishmania species so far examined (L. infantum, L. amazonensis, and L. mexicana). In the present study we have extended our approach to the analysis of LmS3arp activity on T- and B-cell functions in a murine model. The results presented in this report show that LmS3arp plays a dual role in the regulation of T- and B-cell reactivity. Indeed, we found that injection of the LmS3arp recombinant protein (rLmS3arp) into BALB/c mice induces preferential activation of B cells, as shown by the following criteria: (i) increased expression of CD69 molecules on immunoglobulin M (IgM)-secreting spleen cells, (ii) a considerable increase of IgM-secreting B cells, and (iii) elevated levels of IgM antibodies in the sera of injected animals. Moreover, the IgM antibodies are not specific to the Leishmania antigens but preferentially recognize heterologous antigens like myosin, thyroglobulin, DNA, and keyhole limpet hemocyanin. Furthermore, the strong polyclonal expansion of nonspecific, non-parasite-directed B-cell clones induced by rLmS3arp is concomitant with a marked inhibition of T-cell proliferation. Analysis of cytokine production revealed a significant downregulation of gamma interferon, interleukin-2 (IL-2), and IL-12 secretion. Taken together, our data suggest that rLmS3arp, through direct or indirect action toward B and T cells and cytokine secretion, could participate in the immunoregulatory processes that play a role in the balance of the Th1 and Th2 immune response.

Cell biology of Leishmania

Leishmania are digenetic protozoa which inhabit two highly specific hosts, the sandfly, where they grow as motile flagellated promastigotes in the gut, and the mammalian macrophage, where they survive and grow intracellularly as non-flagellated amastigotes in the phagolysosome. Leishmaniasis is the outcome of an evolutionary 'arms race' between the host's immune system and the parasite's evasion mechanisms, which ensure survival and transmission in the population. The diverse spectrum of patterns and severity of disease reflect the varying contributions of parasite virulence factors and host responses, some of which act in a host protective manner while others exacerbate disease. This chapter describes the interaction of the Leishmania with their hosts, with emphasis on the molecules and mechanisms evolved by the parasites to avoid, subvert or exploit the environments in the sandfly and the macrophage, and to move from one to the other.

Leishmania mexicana: binding of promastigotes to type I collagen

During leishmania infection, parasites are inoculated to the human host through the bite of a sandfly vector into the dermis, where they first interact with tissue components, cells and extracellular matrix molecules. Since collagen is the most abundant component of the skin matrix, we investigated whether there is a specific interaction of Leishmania mexicana promastigotes with this host component. Promastigotes were able to attach to collagen fibrils and move through the matrix of mouse skin sections and to penetrate easily into a type I collagen gel. Denatured type I collagen coated beads (Cytodex 3) readily bound to the parasite surface. The interaction of promastigotes with type I collagen was dose dependent and saturable and was competitively and specifically inhibited with increasing concentrations of gelatin. Biotin-labeled parasite surface molecules were able to associate with both denatured collagen from microcarriers and native type I collagen from bovine kidney. It is suggested that the presence of parasite cell membrane receptors to collagen may confer a specific tropism for the skin, where collagen is the most abundant component of the matrix.

Clinical picture of cutaneous leishmaniasis in Isfahan, Iran

BACKGROUND

Cutaneous leishmaniasis caused by Leishmania tropica is endemic in Iran, being the second most prevalent vector-borne disease in the country (after malaria). From the five most infected provinces, Isfahan is third after Boushehr and Khouzestan.

METHODS

To study the clinical picture of this disease, 1250 patients referred to the Leishmaniasis Training and Treatment Center (affiliated with Isfahan University of Medical Sciences) were studied during a 2-year period.

RESULTS

The disease was more prevalent in the age group of 10-15 years. Nonindigenes had more lesions and their lesions were more acute and more severe than those of indigenes. The face was the most frequent site of involvement (39.7%), followed by the upper (32.4%) and lower extremities (19.4%), whereas only 8.1% of the lesions were found on the trunk. No direct relation was seen with age, sex, and clinical features of the lesions except for the erysipeloid cases that were rare and seen only in middle-aged and elderly women. Noduloulcerative and papular lesions dominated the clinical picture, followed by plaque, impetiginized, and nodular lesions.

CONCLUSIONS

The reason why nonindigenous patients have more severe lesions and in greater number is not clear. It can be postulated that nonindigenous people were more exposed to the vector biting since they were living in more infected areas and that during a long period of time, a mild immunity might have developed in indigenous people.

Selective inability of spleen antigen presenting cells from Leishmania donovani infected hamsters to mediate specific T cell proliferation to parasite antigens

Golden hamsters (Mesocricetus auratus) infected with Leishmania donovani develop a disease similar to human kala-azar. There is conspicuous hypergammaglobulinaemia and their T cells do not respond to stimulation by parasite antigens. The impairment of the cellular immune response seems to be restricted to parasite antigens since infected animals are able to develop a T cell response to the mitogen Concanavalin A (Con-A) and, after sensitization, to the antigens keyhole limpet haemocyanin (KLH) and human serum albumin (DNP-HSA). In the present investigations we studied the role played by infected macrophages in the development of the cellular unresponsiveness present in visceral leishmaniasis. Adherent spleen cells from infected hamsters were unable to present L. donovani antigens to antigen specific T cells, however they were able to present KLH. Conversely, T cells from infected animals did not respond to parasite antigens even when these antigens were presented by normal syngeneic macrophages. Interestingly, lymphocytes from inguinal lymph nodes of infected animals sensitized in their foot pad with parasite antigens proliferated well when stimulated in vitro with L. donovani antigens. These results suggest that the defect in the cellular immune response of the L. donovani infected hamsters is a consequence of a selective inability of their antigen presenting cells to process and present parasite antigens to T cells.

Immunocytochemical identification of Leishmania and Trypanosoma cruzi amastigotes in situ with homologous and heterologous polyclonal antibodies

The unlabelled antibody peroxidase-antiperoxidase method was used to study the immunocytochemical properties of Leishmania and Trypanosoma cruzi amastigotes in situ after tissues had been submitted to different fixation procedures. Antisera were obtained from rabbits chronically infected with different strains of T. cruzi or immunized with L. mexicana amazonensis and L. braziliensis guyanensis, and were applied on 5 microns thick sections. T. cruzi antigens were well stained by the three anti-T. cruzi sera and the two anti-Leishmania sera at optimum dilution between 1:1,000 and 1:2,000, regardless the parasite strain. Differently, the leishmanial antigens were revealed by anti-Leishmania sera only at low dilutions (between 1:60-1:160), whereas the anti-T. cruzi sera, at these low dilutions, gave rather weak stainings. Although there is no clear explanation for this immunocytochemical "reverse-monodirectional" cross-reactivity between Leishmania and T. cruzi, the present results show that polyclonal antibodies agains Leishmania species, when used for immunocytochemical detection of these parasites in situ, react more strongly with T. cruzi amastigotes than with the homologous amastigotes.

Leishmania major: histopathological responses before and after topical treatment in experimental animals

The cellular response in the cutaneous leishmaniasis lesion (CL), of BALB/c mice treated topically with an ointment composed of 15% paromomycin and 12% methylbenzethonium chloride (PR-ointment) was studied. In the infected, untreated control group, the lesion showed progressive necrosis with an increase in the number of parasites, macrophages, lymphocytes, and polymorphonuclear cells over a period of 18 weeks. In the PR ointment-treated group, complete healing of the lesion was observed 4 weeks after termination of treatment, but total elimination of the parasites from the lesion was observed only 2 weeks later. A marked reduction in the number of macrophages and polymorphonuclear cells was observed during the healing process. A similar phenomenon was observed with mice inoculated intraperitoneally with paromomycin alone, although total elimination of the parasites from the lesions of these mice was not demonstrated over a period of 18 weeks. Neither L3T4 helper T cells nor Ly2 cytotoxic suppressor T cells were detected in the CL lesion, either before or after treatment.

Immunologic and clinicopathologic evaluation of adult dogs inoculated with Encephalitozoon cuniculi

Beagle dogs inoculated intravenously with 1.75 x 10(9) viable Encephalitozoon cuniculi spores at 12.5 months of age were monitored for 18 months to assess infection in the adult dog. Parameters monitored included packed cell volume, total and differential leukocyte counts, and humoral and cellular responses to infection. Immunoglobulin M and G antibodies directed against the parasite tegument were present throughout the 18 months. Peripheral blood monocytes treated with lymphokines, either antigen specific (E. cuniculi) or nonspecific (concanavalin A), killed E. cuniculi spores in vitro. Pretreatment of E. cuniculi spores with normal dog serum or infected dog serum enhanced the killing of the parasite (normal dog serum less than infected dog serum) by canine monocytes. Histologic examination of selected tissues revealed microfocal plasma cell and lymphocyte aggregates at the renal corticomedullary junction and in the medullary interstitium. The results of these experiments suggest that the adult dog is able to mount an effective defense to infection, to minimize host tissue damage, and to eliminate the parasite through complex interactions between monocytes-macrophages and lymphocytes.

Serological activity against galactosyl-alpha(1-3)galactose in sera from patients with several kinetoplastida infections

Using rabbit erythrocyte-derived neutral glycosphingolipids enriched for a defined ceramide pentasaccharide as antigens, we have detected elevated anti-galactosyl-alpha(1-3)galactose (anti-G alpha G) antibody values in patients with American cutaneous leishmaniasis (ACL), chronic Chagas' disease, and Trypanosoma rangeli infections compared with normal subjects or with patients suffering from any of 15 other infectious diseases. The specificity of the G alpha G antibodies was determined by inhibition enzyme-linked immunosorbent assays, which revealed that several alpha-galactosyl- but not beta-galactosyl-bearing sugars blocked absorption of G alpha G antibodies to the specific antigen used. G alpha G antibodies were mainly distributed between immunoglobulin classes G and M in three Kinetoplastida infections studied, with a lower increase in reactivity detected in immunoglobulin A. Absorption of highly reactive G alpha G antibodies with purified murine laminin and nidogen, two basement membrane proteins, almost abolished G alpha G reactivity, suggesting the identity of anti-G alpha G with laminin and nidogen antibodies previously reported as elevated in Kinetoplastida infections. In ACL, G alpha G antibodies were detected in 71% of patients having skin lesions with a clinical evolution time of 0.5 month. This percentage increased with the time of evolution of skin lesions, reaching 93% in lesions older than 3 months, and tended to decrease inversely to the induration diameter in the skin leishmanin test. It is proposed that similar epitopes may exist on kinetoplast protozoa and that the determination of G alpha G antibodies may be a highly sensitive assay for the detection of humoral responses to Kinetoplastida infections.

The correlation between delayed hypersensitivity, lymphocyte activation and protective immunity in experimental murine leishmaniasis

The growth of Leishmania major and Leishmania mexicana lesions and the concomitant development of delayed-type hypersensitivity (DTH) to homologous or heterologous soluble antigen was studied in BALB/c and CBA/Ca mice. Although CBA/Ca mice are highly susceptible to L. mexicana, developing non-healing lesions, they are resistant to L. major; while BALB/c mice develop non-healing lesions when infected with either species. The development of resistance was associated with the acquisition of DTH which peaked at 48 h (L. major infected CBA/Ca mice). Non healing lesions were associated with either negative DTH (L. major infected BALB/c mice) or DTH that peaked at 24 h but had significantly subsided by 48 h (L. mexicana infected CBA/Ca and BALB/c mice). The latter response was associated with basophilic infiltration of the skin test site. Pre-irradiating (600 rad) CBA/Ca and BALB/c mice induced resistance against L. mexicana and L. major respectively in conjunction with the appearance of 48 h DTH to the homologous antigen. There was clear dissociation in the skin reactivity produced by the heterologous antigen. Thus L. major-derived antigen failed to produce DTH in L. mexicana infected mice of either strain. L. mexicana-derived antigen on the other hand produced a quicker response and of greater magnitude than the homologous antigen in L. major infected CBA/Ca mice. This correlated well with the strong cross-immunity induced by L. major in these mice to L. mexicana infection.

Immune complex glomerulonephritis in experimental kala-azar

In the present work we demonstrate that hamsters infected with L. donovani eliminate large quantities of immunoglobulins in the urine. This alteration is clearly a consequence of a conspicuous immune complex glomerulonephritis readily detectable 7 days after the beginning of infection. L. donovani antigens and hamsters immunoglobulins (Igs) were revealed as granular deposits in the mesangial areas and contiguous loops of the glomeruli. Histopathological alterations such as focal mesangial proliferation with progression to diffuse proliferation were observed in the first 3 weeks of infection. From day 35 onwards, all diseased animals presented large deposits of amyloid material of predominantly glomerular localization. In consonance with these alterations, Igs were detected in the urine by day 21 of infection and their concentration increased substantially with the progression of disease. In contrast, serum Igs increased until day 21, when their concentration dropped steadily.

Topical treatment of cutaneous leishmaniasis

Sixty-seven patients, 19 females and 48 males, 4-66 years old, suffering from lesions of cutaneous leishmaniasis were treated topically with an ointment comprising 15% paromomycin sulfate and 12% methylbenzethonium chloride in white soft paraffin (P-ointment, U.K. patent GB117237A). After 10 days of treatment, twice daily, the lesions in 72% of the treated patients were free of parasites, 15% became free within an additional 20 days, without further treatment, and 13% failed to respond. Pigmentation developed in 18% of the treated lesions and inflammation of varying degree was associated with the treatment. These developments did not affect the clinical healing process which was generally completed in a period of 10-30 days after termination of treatment. In addition, 94% of the treated lesions healed with little or no scarring. No adverse clinical or laboratory side effects were observed except for a burning sensation at the site of treatment. Parasites isolated from patients who failed to respond to topical treatment were found to be susceptible to PR-MBCl in both in vitro infected macrophages and in vivo in experimentally infected BALB/c mice.

Leishmania major: solid phase radioimmunoassay for antibody detection in human cutaneous leishmaniasis

A radioimmunoassay for the quantitative determination of antileishmanial antibody in sera from patients suffering from cutaneous leishmaniasis was developed. The assay, using as antigen either the soluble fraction from freeze-thawed sonicated Leishmania major (LRC-L137) promastigotes or a carbohydrate-lipid containing fraction obtained by extraction with hexane-isopropanol, was shown to be sensitive and reproducible. The sera of 95 patients were examined. These were from patients with cutaneous leishmaniasis (26 from the Jordan Valley and 13 from Sinai), kala-azar (9), malaria (24), schistosomiasis (10), toxoplasmosis (5), and leprosy (8); controls were 37 normal human sera. No significant antigen dependent differences were observed using sera from cutaneous leishmaniasis patients, although differences in the immunological response were observed between the two populations of these patients. Antileishmanial activity was not detected in sera from patients with malaria, schistosomiasis, or toxoplasmosis. Although sera from leprosy patients crossreacted with the carbohydrate-lipid containing fraction, it was nevertheless more strain specific than freeze thawed sonicated L. major.

Leishmania donovani: cellular and humoral immune responses after primary and challenge infections in squirrel monkeys, Saimiri sciureus

Cellular and humoral immune responses were studied in squirrel monkeys after primary and challenge infection with a Khartoum strain (WR 378) of Leishmania donovani. Each of 7 squirrel monkeys, Saimiri sciureus, was inoculated intravenously with 5 X 10(7) amastigotes/kg body weight, and one other monkey (control) was inoculated with uninfected hamster spleen homogenate. Five infected monkeys recovered from visceral leishmaniasis and two infected monkeys died. Three of the five squirrel monkeys which recovered from the primary infection demonstrated acquired resistance when challenged with an intravenous inoculation of 1.0 X 10(8) amastigotes of L. donovani/kg of body weight. Each of these same three monkeys, the two remaining monkeys which recovered from the primary infection and an uninfected control monkey, were challenged subsequently with an intradermal injection of 2.2 X 10(7) promastigotes of L. braziliensis panamensis (WR539) and developed cutaneous lesions. The reactivity of peripheral blood leukocytes from infected squirrel monkeys to phytohemagglutinin was depressed 2 to 10 weeks after infection, and the reactivity to concanavalin A was not affected. Data on responses to pokeweed mitogen were inconclusive. Reactivity to leishmanial antigens was detected at 12 weeks after infection, which coincided with a marked decrease or disappearance of parasites in liver imprints. Two of five surviving squirrel monkeys developed weak delayed skin test responses to leishmanin antigens after 23 weeks; the three remaining monkeys were anergic during the primary infection but developed strong delayed skin test responses to leishmanin antigens at 7 weeks after a challenge with L. donovani. All squirrel monkeys inoculated with L. donovani developed a hyperproteinemia, hypergammaglobulinemia, hypoalbuminemia, and a reversal of the albumin/globulin ratio between 4 to 18 weeks after infection. Plasma IgM and IgG levels were increased between 2 to 18 weeks after infection; much of this increase was due to IgG. Class-specific antileishmanial antibodies, with generally low IgM and high IgG titers, reached a maximum after 14 and 16 weeks, respectively. A correlation was observed between concentration of gamma-globulins and plasma IgM and IgG levels, but not gamma-globulin concentrations and maximum titers of class-specific antileishmanial antibodies. Squirrel monkeys challenged with L. donovani again developed hyperproteinemia, hypergammaglobulinemia, and increased concentrations of plasma IgM and IgG which correlated with high titers of IgG class-specific antileishmanial antibody 4 weeks after reinoculation.(ABSTRACT TRUNCATED AT 400 WORDS)

Pathophysiology of experimental leishmaniasis: pattern of development of metastatic disease in the susceptible host

A clear understanding of the etiology of the various forms of leishmaniasis will require knowledge of how physiological properties of the parasite and host immunity influence the pattern of development of the disease. Of particular importance are how these factors affect the growth rate of Leishmania spp. at the site of inoculation in the skin, their capacity to disseminate to visceral and distant cutaneous sites, and their capacity to multiply once there. This paper details the pattern of development of disseminated Leishmania major infection in susceptible BALB/c nu/+ and BALB/c nu/nu mice. It was found that the parasite disseminates from the hind footpad to distant cutaneous sites soon after metastatic foci are established in the liver and spleen. Both mononuclear phagocytes and neutrophils may be the vehicles for the transport of the parasite in the blood. Once visceral and cutaneous metastases are established, the parasites in those foci increase in number progressively. L. major has the capacity to multiply at visceral and cutaneous sites at the same rate. Despite the presence of viable parasites in a number of skin sites, cutaneous metastatic lesions developed almost exclusively on the feet and the tail. Furthermore, these lesions appeared to develop preferentially at sites near joints, suggesting that factors other than temperature may influence the development of cutaneous metastatic lesions.

[Interaction of Leishmania donovani promastigotes with peritoneal exudate cells of mice as affected by chymotrypsin]

Se hace un estudio de la interacción de promastigotes de Leishmania donovani con células de exudado peritoneal de ratón (c e p) mediante la influencia de la quimotripsina. La adhesión de los promastigotes a las c e p fue terminal y marginal, y en observaciones hechas a partir de los 10 minutos de enfrentamiento, esta adhesión fue nula hasta los 30 minutos en el grupo tratado, y sólo a las das horas hubo un pequeño incremento (2.4%) con respecto al control. Se observa marcada disminución en todos los parámetro medidos, tales como enlace, penetración, multiplicación intracelular, división de formas flageladas, en el grupo tratado. La quimotripsina favorece la formación de formas intermedias flageladas, heciendose el parásito piriforme y esférico, apareciendo una forma aberrante de extremo anterior cilindrico que semeja a una forma coanoflagelada. Se sospecha que la enzima reduce efectivamente fragmentos proteicos o péptidos, los cuales pueden haber sido tan pequeños como para esconder a otros ligandos relacionados con la adhesión macrófago-parásito.

The localization of a lectin-like component on the Leishmania cell surface

The binding between macrophage-like cells J774G8 and Leishmania braziliensis (NR) promastigotes was studied 'in vitro' by a radioisotopic assay under various conditions in the absence of serum. Different sugars, N-acetyl-D-glucosamine, D-glucose, D-mannose, D-galactose, and chitin, diminished the binding of the parasite, whereas other sugars, D-arabinose, D-fucose and D-xylose, did not affect the binding. The presence of a lectin-like ligand specific for N-acetyl-D-glucosamine has been detected on the cell surface of the Leishmania braziliensis (NR) by fluorescence microscopy. These data suggest that the binding of the parasite to the host's cell is a ligand-receptor interaction which involves the participation of a lectin-like component on the parasite cell surface.

Immunization with Leishmania receptor for macrophages protects mice against cutaneous leishmaniasis

The Leishmania major receptor for macrophages is a lipid-containing glycoconjugate that is recognized by the monoclonal antibody WIC-79.3. When L. major promastigotes were incubated with Fab fragments of WIC-79.3 prior to injection into genetically susceptible mice, their infectivity was decreased. Fab fragments from an irrelevant control antibody of the same class had no effect. The L. major glycolipid was purified from detergent-solubilized promastigotes by affinity chromatography on immobilized WIC-79.3 and used to vaccinate mice that are genetically resistant or susceptible to disease. Genetically resistant mice could be protected totally from cutaneous disease with as little as 5 micrograms of glycolipid. A high but not absolute level of resistance was also induced in the susceptible mice, in which the disease is otherwise fatal. No protection was obtained with the carbohydrate fragment of the glycolipid alone or by injection of the glycolipid in the absence of adjuvant. Genetically susceptible mice, immunized and protected from disease as a result of multiple injections of live avirulent cloned promastigotes of L. major, produced antibodies to the glycolipid of L. major. No antibodies were detected in serum from chronically diseased mice. The data suggest that this functionally important antigen of L. major is a candidate vaccine against cutaneous leishmaniasis.

Solubilization and partial purification of a cell surface component of Leishmania braziliensis

A simple procedure that allowed the extraction and partial purification of a component of 65,000 mol.wt. from the surface of Leishmania braziliensis promastigotes is described. Iodinated cell surface membrane fractions were solubilized using Triton X-100 followed by Nonidet P-40. The macromolecular components were then freed of the detergents by passage of the extracts through a column of DE52 cellulose. The component of 65,000 mol.wt. was eluted from the column with 1 m NaCl. This component in whole parasites was immunoprecipitated by sera from patients with cutaneous, mucocutaneous, and diffuse cutaneous leishmaniasis and kala-azar. None of the major surface determinants reacted with sera from normal individuals with antibovine rabbit serum. The relevance and the possible applications on the immunoprophylaxis of the disease are briefly discussed.

Cell-mediated reactivity against human and Trypanosoma cruzi antigens according to clinical status in Chagas' disease patients

The presence of cellular reactivity against homologous tissues and subcellular fractions of Trypanosoma cruzi was investigated in Chagas' disease patients (CDP). CDP were grouped in asymptomatic (CDP-1) and with probable (CDP-2) and overt (CDP-3) cardiomyopathy. Healthy and non-Chagasic cardiomyopathic subjects were studied as controls. Lymphoproliferative reactions against heart tissue extracts were detected in 42% of 72 CDP studied, with similar prevalence of positive reactions in all groups, and correlated with reactivity to both liver and kidney homologous tissues (P less than 0.001). These results confirm the existence of cellular immune reactivity against tissues in CDP, and indicate the lack of organ specificity of this reaction as well as the absence of relation with the clinical state of patients. Cellular reactivity to subcellular fractions of T. cruzi showed a definite pattern according to the clinical status of CDP. Although prevalence of T. cruzi stimulation appeared similar in all groups (70% in CDP-1, 82% in CDP-2 and 75% in CDP-3), CDP-3 showed a significantly higher reactivity to flagellar (69%) and cytosol (63%) fractions than CDP-1 (38 and 27%, respectively). These findings suggest a variable modulation of immune response according to the clinical state of T. cruzi infected subjects.

Cytotoxicity of human serum for Leishmania donovani amastigotes: antibody facilitation of alternate complement pathway-mediated killing

Mechanisms that mediate recovery from leishmanial infection have not been fully characterized but are generally believed to involve interactions between T lymphocytes and macrophages. A major role for serum-mediated effector mechanisms in the protection of humans from reinfection with Leishmania, however, has not been ruled out. In this report, amastigotes of L. donovani were incubated with dilutions of serum from normal subjects and from patients with kala-azar. Normal serum was cytotoxic for parasites at a dilution of greater than or equal to 1:20. Cytotoxicity did not occur in the presence of EDTA, was abolished by heating serum to 56 degrees C for 30 min, and was not diminished by prior adsorption of normal serum with parasites at 0 degree C. Killing proceeded normally in the presence of magnesium-ethylene glycol-bis(beta-aminoethyl ether)-N, N-tetraacetic acid, however, and was fully effected by C2-deficient serum. These studies indicated that killing of amastigotes, unlike that of promastigotes, was mediated via the alternate pathway of serum complement. In further studies, cytotoxicity of normal serum was enhanced three- to fivefold by factors in patient serum. This enhanced cytotoxicity also proceeded via the alternate complement pathway. Factors that enhanced cytotoxicity were characterized as parasite-specific immunoglobulin G: they eluted with immunoglobulin G on column chromatography, were adsorbed by immobilized staphylococcal protein A, and were not removed from the parasite surface by extensive washing. Thus, infection of individuals with L. donovani resulted in the production of a new, qualitatively and quantitatively distinct immune mechanism directed against the amastigote form of the parasite, namely, antibody-directed, alternate complement pathway-mediated cytotoxicity. These results provide a mechanistic framework for a role of humoral factors in human resistance to reinfection with L. donovani.

Leishmania braziliensis guyanensis dermal leishmaniasis: cell-mediated immunity related to clinical features

The non-specific and specific cellular immune responses in vitro were investigated in 26 patients infected with Leishmania braziliensis guyanensis and compared with those of 12 healthy donors. An absence of marked suppression of lymphocyte proliferation in vitro to Con A, PHA and PWM mitogens, and a high variability in the cellular responsiveness to Leishmania antigens were detected in the infected patient group. The occurrence of relapses seemed to be associated with a lower lymphocyte transformation assay and a high number of lesions. The influence of delayed type hypersensitivity responses on the pattern of infection is considered.

Leishmania chagasi and L. donovani: experimental infections in domestic cats

The susceptibility of domestic cats to visceral leishmaniasis was examined by inoculating cats with amastigotes of Leishmania donovani and L. chagasi by the intravenous route, and with promastigotes of L. chagasi by the intradermal route. Parasites were recovered from intravenously inoculated cats as long as 16 weeks after inoculation, but parasites apparently did not locate in the viscera in cats inoculated intradermally. Parasites were not detected in intravenously inoculated cats killed at 24 weeks of infection. All cats developed significantly elevated serum antibody titers to Leishmania spp., but none developed the symptoms usually associated with visceral leishmaniasis in humans.

Host-protective immunity and its suppression in a parasitic disease: murine cutaneous leishmaniasis

The accumulation of knowledge on the cellular immunology of host parasite relationships can be very rapid when infection of mice with a human parasite causes a disease resembling that seen in man. This is so of Old World cutaneous leishmaniasis ('oriental sore'). As must be the case in all chronic infectious diseases, manifestations of the clinical disease spectrum in cutaneous leishmaniosis reflect both host and parasite factors. In this article Graham Mitchell describes how this spectrum can be exploited in inbred mice injected with isolates of Leishmania trop ica major (L. major) for detailed analysis of interactions between host and parasite.

The effect of protein restriction on the development of protective immunity to Leishmania mexicana

Protein deprived C57BL/6 mice infected with 10(3) amastigotes of Leishmania mexicana showed early arrest of lesion progression during the first 5 weeks of infection with subsequent development of progressive non-healing lesions. In contrast, well nourished mice similarly infected developed gradual healing lesions. The early resistance of malnourished mice to 10(3) amastigotes was overcome by a larger dose. After a primary inoculation with 10(3) amastigotes protein deprived mice failed to express protective immunity to a challenge inoculum given at 5 weeks of infection. When challenge was delayed until 10 weeks, protein deprived mice developed lesions at the site of challenge which tended to regress but were unable to manifest the high level of protective immunity seen in normally nourished reinfected controls. A challenge infection given at 5 or 10 weeks prejudiced the control of primary lesions particularly in the group of protein deprived mice challenged at 10 weeks. Equivalent levels of specific delayed hypersensitivity responses were found in protein deprived and normally nourished uninfected mice immunized with killed parasites which imply that the impaired protective immunity observed in protein deprived mice is not due to a deleterious effect of protein deprivation on the ability of the host to develop cellular responses such as delayed type hypersensitivity to Leishmania antigens.

Leishmania major: identification of stage-specific antigens and antigens shared by promastigotes and amastigotes

A battery of antisera to Leishmania major was used to identify stage-specific antigens, or antigens expressed predominantly in amastigotes or promastigotes. At least 30 protein antigens common to amastigotes and promastigotes could be detected in 35S-methionine labelled preparations. They ranged in molecular weight from 25 000 to 165 000. Two amastigote specific antigens and five antigens expressed predominantly in the amastigote were detected in biosynthetically-labelled preparations. Five promastigote specific antigens were also identified. Antibodies from hyperimmunized mice that were resistant to reinfection with L. major recognized mainly antigens shared by the two life-cycle stages of the parasite. Analysis of parasite antigens on 'western blots' provided a different picture from that obtained by immunoprecipitation and gel electrophoresis of 35S-methionine labelled polypeptides. Only 19 antigens were detected and they were all shared by the two parasite forms. However, the abundance and immunogenicity of some of these antigens may be different in the two life-cycle stages of the parasite. Using the various sera, seven shared membrane antigens were identified in radio-iodinated preparations. Antibodies from hyperimmunized resistant mice that recognized shared antigens in 35S-methionine labelled preparations, detected four amastigote membrane antigens not detected by other sera. The function of the stage-specific antigens remains to be established. It is expected that individual antigens produced by recombinant DNA technology will allow these studies to proceed.

Visceral leishmaniasis in the German shepherd dog. I. Infection, clinical disease, and clinical pathology

Two groups of three German shepherd dogs each were inoculated with Leishmania chagasi or Leishmania donovani amastigotes and the infection was followed for 82 days. The dogs developed a persistent infection, became thin, and developed splenomegaly and lymphadenomegaly by 55 days after inoculation. All dogs developed a normocytic, normochromic anemia of increasing severity. Thrombocytopenia and leukopenia occasionally occurred. Blood tryptophan levels were decreased significantly in infected dogs. Increased total serum protein, with hypergammaglobulinemia and hypoalbuminemia, was present in all dogs to various degrees. There was a marked increase in gamma globulins, with smaller increases in alpha and beta globulins. Many of the clinicopathologic changes observed in these dogs were similar to the disease as it occurs in man. The German shepherd dog may be a useful laboratory model for the study of visceral leishmaniasis.

Recurrent cutaneous leishmaniasis

A patient is presented who has a 71-year history of recurrent cutaneous leishmaniasis, despite treatment with antimonials, antituberculous drugs, and surgery. Classification and treatment of cutaneous leishmaniasis are discussed.

The cellular and humoral immune response in subjects vaccinated against cutaneous leishmaniasis using Leishmania tropica major promastigotes

In vitro lymphocyte transformation was studied in 24 subjects 12 months after vaccination with live Leishmania tropica major vaccine, in 10 normal control subjects and in three controls residing in an endemic area. The vaccines had lesions in various stages of clinical development. Lymphocytes from all the subjects were studied for their response to stimulation with L. tropical major promastigotes. Lymphocytes of vaccinated subjects responded to low concentrations of antigen whereas the lymphocyte response of the controls tended to be depressed by the same concentration of the antigen. Serum from each subject was subjected to a study of the humoral antibody titre against L. tropica major and L. donovani using indirect immunofluorescence. A humoral response to L. donovani was present in a majority of vaccinees who had developed a positive lesion whereas no such responses was present in any of the controls. The data suggest that high humoral responses were accompanied by relatively low cell-mediated responses and vice versa. No significant humoral response to L. tropica major could be demonstrated in any of the subjects. A combination of both the cell-mediated and humoral mechanisms may participate in the immune response although their usefulness in the assessment of the protectivity of leishmania vaccines has not been established.

Murine encephalitozoonosis model for studying the host-parasite relationship of a chronic infection

Encephalitozoon cuniculi caused chronic nonlethal infections in euthymic BALB/cAnN mice, whereas athymic BALB/cAnN-nu mice died from infection. Specific, anamnestic, transferable, and acquired responses against E. cuniculi were expressed by infected euthymic mice. Resistance to lethal disease appears to be T-cell dependent. Immune serum failed to protect infected athymic mice, whereas the transfer of T-enriched spleen cells from E. cuniculi-sensitized euthymic donors prevented lethal E. cuniculi infections in athymic mice. These findings indicate that murine encephalitozoonosis may be an excellent system for studies of a chronic infection in an immunologically well-characterized host.

Characterization of the cellular immune response in American cutaneous leishmaniasis

The in vitro and in vivo cellular immune reactivity of 49 patients with American cutaneous leishmaniasis (ACL) was evaluated using mitogens and parasite antigens. Patients were examined before treatment and were classified on the basis of clinical and histopathological criteria as suffering localized cutaneous leishmaniasis (LCL, 32 patients) or mucocutaneous leishmaniasis (MCL, 11 patients). A small group (6 patients) of treated diffuse cutaneous leishmaniasis (DCL) patients was also examined. The lymphocyte proliferative responses to PHA were significantly lower than those of controls (87 individuals, from either endemic or nonendemic zones) in LCL, and particularly MCL. Con A responses were, however, effectively normal in these patients. Both in vivo and in vitro cellular immune responses to leishmanial antigens were significantly greater in MCL and LCL patients than in the controls, the intensity of the reactions being by far the greatest in MCL. DCL patients demonstrated a complete absence of specific immune responsiveness both in vivo and in vitro. The significance of these results in the mechanisms leading to the resolution of the infection or production of pathologic lesions is discussed.

Leishmanial infections: a consideration in travellers returning from abroad

Seven cases of leishmaniasis, including a fatal case of visceral leishmaniasis and 6 cases of dermal leishmaniasis, were seen in Boston over a four-year period. Diagnosis was made by isolation of organisms in culture or by identification of organisms in stained preparations of tissue. Proper management of patients with leishmanial infections requires an appreciation of the geographical strain differences of each species.

Cell-mediated killing of protozoa

Cell-mediated immunity represents an important host defence mechanism against protozoal infections. The effector cells directly involved are neutrophils, macrophages and, ultimately, activated macrophages. Within this simple scheme there are, however, considerable variations in activity. Effector cells from different animal species, and even from different strains of the same species, may be more or less effective in controlling a certain protozoal infection. Different protozoa differ in their susceptibility to cell-mediated killing according to genus, species, strain and morphological form. The most susceptible morphological form is that which occurs in the insect vector, and which has not yet adapted to protect itself from the vertebrate host. Epimastigotes of Trypanosoma and promastigotes of Leishmania are readily killed by phagocytic cells, while the corresponding trypomastigote and amastigote forms are considerably more resistant. Protozoa which live in macrophages, such as amastigotes of Leishmania, endozoites (tachyzoites) of Toxoplasma and amastigotes of reticulotropic strains of T. cruzi, have developed a remarkable resistance to the microbicidal activity of the host cell. Conversely, amastigotes of myotropic strains of T. cruzi, which live in muscle cells, have not developed this resistance to cell-mediated killing by macrophages. Readily accessible protozoa, such as T. brucei trypomastigotes and Plasmodium merozoites in the bloodstream, while they lack the marked resistance developed by reticulotropic protozoa, have a partial protection since they are attacked by phagocytic cells only when specific antibody is present. Granulocyte-mediated killing can be largely attributed to neutrophils. Eosinophils appear to play only a minor role and compete ineffectually when neutrophils are also present. The only group of protozoal species which may be significantly controlled by eosinophils are the stercorarian species of Trypanosoma. In vitro experiments show that antibody-coated trypomastigotes of T. cruzi can be killed by eosinophils, although there is little evidence that this occurs in vivo. Interestingly, this is the only species that has been reported to be susceptible to the major basic protein of eosinophils, a toxic component of the lysosomal granules which is very active against helminths. Neutrophils are not very active against endozoites of Toxoplasma gondii, Trypanosoma, trypomastigotes of salivarian Trypanosoma, free merozoites of Plasmodium, and promastigotes and amastigotes of Leishmania.(ABSTRACT TRUNCATED AT 400 WORDS)

Frozen stored Leishmania tropica vaccine: the effects of dose, route of administration and storage on the evolution of the clinical lesion. Two field trials in the Israel Defense Forces

The first field trial of frozen vaccine against cutaneous leishmaniasis yielded a 100% take rate and a high ulceration rate at a dose of four million units. Two further trials were designed to investigate differences in response rates on the basis of duration of storage, sex of vaccinee, vaccination dose and method of administration. 257 soliders (151 males and 106 females) were inoculated in 1978 with an isolate of Leishmania tropica major that had been stored at the temperature of liquid nitrogen for 11 months before use. Those inoculated with an intradermal jet injector and those receiving half a million units by conventional injection yielded very low take rates. For those receiving two million and one million units, no difference in response was demonstrated between males and females or between doses. The over-all take rate for these groups after six months of follow-up was 71.6% with an ulceration rate of only 23.7%. In a subsequent trial in 1979, 131 men were inoculated with one of two frozen isolates of L. tropica major that had been stored for 11 and 18 months, respectively, at doses of either two million or four million units. The take rate after 12 months of follow-up was 91% and 93% for the four and two million units dose, respectively. The corresponding ulceration rates were 39.5% and 25%. The lesions produced by the higher dose developed more rapidly than those produced by the lower dose. The ability of the parasites to produce lesions rapidly with high ulceration rates appears to decline during prolonged storage, even in the frozen state.

Polyclonal B cell activation in hamsters infected with parasites of the genus Leishmania

Mesocricetus auratus (golden hamsters) infected with leishmania developed characteristic B cell immune responses that depended on the infecting species of leishmania. Thus, hamsters infected with viscerotropic leishmania (Leishmania donovani) developed antileishmania antibodies and hypergammaglobulinemia due to polyclonal activation of B cells as measured by reverse hemolytic plaque assay. In contrast, dermotropic leishmanias (L. braziliensis braziliensis and L. mexicana amazonensis) stimulated antileishmania antibodies with no increase in either serum immunoglobulin concentration or in the number of antibody-forming cells per spleen. The dermotropic leishmanias were unable to stimulate polyclonal activation even in hamsters in which visceralization had occurred with high splenic parasitization. These findings suggest that species-specific leishmania antigens (or factors) might be the modulators of the altered immune response present in these diseases.