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Sacramento LA, Lombana C, Scott P. Malnutrition disrupts adaptive immunity during visceral leishmaniasis by enhancing IL-10 production. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.06.597776. [PMID: 38895324 PMCID: PMC11185680 DOI: 10.1101/2024.06.06.597776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Protein-energy malnutrition (PEM) is a risk factor for developing visceral leishmaniasis (VL). However, the impact on adaptive immunity during infection is unknown. To study the effect of malnutrition on chronic VL, we used a polynutrient-deficient diet (deficient protein, energy, zinc, and iron), which mimics moderate human malnutrition, followed by Leishmania infantum infection. The polynutrient-deficient diet leads to growth stunting and reduced mass of visceral organs. Malnourished-infected mice harbored more parasites in the spleen and liver, had a reduced number of T lymphocytes, reduced production of IFN-γ by T cells, and exhibited enhanced IL-10 production. To test whether IL-10 blockade would lessen disease in the malnourished mice, we treated infected mice with monoclonal antibody α-IL-10R. α-IL-10R treatment reduced the parasite number of malnourished mice, restored the number of T cells producing IFN-γ, and enhanced hepatic granuloma formation. Our results indicate that malnutrition increases VL susceptibility due to a defective IFN-γ-mediated immunity attributable to increased IL-10 production. Author Summary Malnutrition contributes to the development of VL. Despite the advances regarding this association, how malnutrition affects the adaptive immune mechanisms in VL is still unclear. We found that malnutrition disrupts the ability to control parasite replication in the spleen and liver in VL due to defective IFN-γ-mediated immunity, reduced hepatic granuloma formation, and enhanced IL-10 production. Blocking IL-10R signaling restored the protective mechanisms to control parasite replication in the malnourished mice without interfering with the undernutrition state. Thus, we demonstrate that malnutrition disrupts the adaptive immunity against VL due to an aberrant IL-10 production. Understanding the association between malnutrition and VL will provide insights into therapeutic approaches.
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de Alba Alvarado MC, Torres Gutiérrez E, Cabrera Bravo M, Zenteno Galindo E, Villarreal Muñoz JA, Salazar Schettino PM, Bucio Torres MI. Main Cardiac Histopathologic Alterations in the Acute Phase of Trypanosoma cruzi Infection in a Murine Model. Pathogens 2023; 12:1084. [PMID: 37764892 PMCID: PMC10534729 DOI: 10.3390/pathogens12091084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/06/2023] [Accepted: 08/17/2023] [Indexed: 09/29/2023] Open
Abstract
Symptoms in the acute phase of Chagas disease are usually mild and nonspecific. However, after several years, severe complications like dilated heart failure and even death may arise in the chronic phase. Due to the lack of specific symptoms in the acute phase, the aim of this work was to describe and analyze the cardiac histopathology during this phase in a CD1 mouse model by assessing parasitism, fibrotic damage, and the presence and composition of a cellular infiltrate, to determine its involvement in the pathogenesis of lesions in the cardiac tissue. Our results indicate that the acute phase lasts about 62 days post-infection (dpi). A significant increase in parasitemia was observed since 15 dpi, reaching a maximum at 33 dpi (4.1 × 106). The presence of amastigote nests was observed at 15-62 dpi, with a maximum count of 27 nests at 35 dpi. An infiltrate consisting primarily of macrophages and neutrophils was found in the cardiac tissue within the first 30 days, but the abundance of lymphocytes showed an 8 ≥ fold increase at 40-62 dpi. Unifocal interstitial fibrosis was identified after 9 dpi, which subsequently showed a 16 ≥ fold increase at 40-60 dpi, along with a 50% mortality rate in the model under study. The increased area of fibrotic lesions revealed progression in the extent of fibrosis, mainly at 50-62 dpi. The presence of perivasculitis and thrombus circulation disorders was seen in the last days (62 dpi); finally, cases of myocytolysis were observed at 50 and 62 dpi. These histopathological alterations, combined with collagen deposition, seem to lead to the development of interstitial fibrosis and damage to the cardiac tissue during the acute phase of infection. This study provides a more complete understanding of the patterns of histopathological abnormalities involved in the acute phase, which could help the development of new therapies to aid the preclinical tests of drugs for their application in Chagas disease.
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Affiliation(s)
- Mariana C. de Alba Alvarado
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacán, Mexico City 04510, Mexico; (M.C.d.A.A.); (E.T.G.); (M.C.B.)
| | - Elia Torres Gutiérrez
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacán, Mexico City 04510, Mexico; (M.C.d.A.A.); (E.T.G.); (M.C.B.)
| | - Margarita Cabrera Bravo
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacán, Mexico City 04510, Mexico; (M.C.d.A.A.); (E.T.G.); (M.C.B.)
| | - Edgar Zenteno Galindo
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacán, Mexico City 04510, Mexico;
| | - José Antonio Villarreal Muñoz
- División de Investigación, Secretaria General, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacán, Mexico City 04510, Mexico;
| | - Paz María Salazar Schettino
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacán, Mexico City 04510, Mexico; (M.C.d.A.A.); (E.T.G.); (M.C.B.)
| | - Martha Irene Bucio Torres
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacán, Mexico City 04510, Mexico; (M.C.d.A.A.); (E.T.G.); (M.C.B.)
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Sanz CR, Miró G, Sevane N, Reyes-Palomares A, Dunner S. Modulation of Host Immune Response during Leishmania infantum Natural Infection: A Whole-Transcriptome Analysis of the Popliteal Lymph Nodes in Dogs. Front Immunol 2022; 12:794627. [PMID: 35058931 PMCID: PMC8763708 DOI: 10.3389/fimmu.2021.794627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/10/2021] [Indexed: 12/21/2022] Open
Abstract
Leishmania infantum, the etiological agent of canine leishmaniosis (CanL) in Europe, was responsible of the largest outbreak of human leishmaniosis in Spain. The parasite infects and survives within myeloid lineage cells, causing a potentially fatal disease if left untreated. The only treatment option relies on chemotherapy, although immunotherapy strategies are being considered as novel approaches to prevent progression of the disease. To this aim, a deeper characterization of the molecular mechanisms behind the immunopathogenesis of leishmaniosis is necessary. Thus, we evaluated, for the first time, the host immune response during L. infantum infection through transcriptome sequencing of the popliteal lymph nodes aspirates of dogs with CanL. Differential expression and weighted gene co-expression network analyses were performed, resulting in the identification of 5,461 differentially expressed genes (DEGs) and four key modules in sick dogs, compared to controls. As expected, defense response was the highest enriched biological process in the DEGs, with six genes related to immune response against pathogens (CHI3L1, SLPI, ACOD1, CCL5, MPO, BPI) included among the ten most expressed genes; and two of the key co-expression modules were associated with regulation of immune response, which also positively correlated with clinical stage and blood monocyte concentration. In particular, sick dogs displayed significant changes in the expression of Th1, Th2, Th17 and Tr1 cytokines (e. g. TNF-α, IFN-γ, IL-21, IL-17, IL-15), markers of T cell and NK cell exhaustion (e. g. LAG3, CD244, Blimp-1, JUN), and B cell, monocyte and macrophage disrupted functionality (e. g. CD40LG, MAPK4, IL-1R, NLRP3, BCMA). In addition, we found an overexpression of XBP1 and some other genes involved in endoplasmic reticulum stress and the IRE1 branch of the unfolded protein response, as well as one co-expression module associated with these processes, which could be induced by L. infantum to prevent host cell apoptosis and modulate inflammation-induced lymphangiogenesis at lymph nodes. Moreover, 21 lncRNAs were differentially expressed in sick dogs, and one key co-expression module was associated with chromatin organization, suggesting that epigenetic mechanisms could also contribute to dampening host immune response during natural L. infantum infection in the lymph nodes of dogs suffering from clinical leishmaniosis.
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Affiliation(s)
- Carolina R Sanz
- Animal Health Department, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Guadalupe Miró
- Animal Health Department, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Natalia Sevane
- Department of Animal Production, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Armando Reyes-Palomares
- Department of Biochemistry and Molecular Biology, Complutense University of Madrid, Madrid, Spain
| | - Susana Dunner
- Department of Animal Production, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
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Thakur L, Madaan P, Jain A, Shankar V, Negi A, Chauhan SB, Sundar S, Singh OP, Jain M. An Insight Into Systemic Immune Response in Leishmania donovani Mediated Atypical Cutaneous Leishmaniasis in the New Endemic State of Himachal Pradesh, India. Front Immunol 2022; 12:765684. [PMID: 35087516 PMCID: PMC8787830 DOI: 10.3389/fimmu.2021.765684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/16/2021] [Indexed: 11/26/2022] Open
Abstract
Leishmaniasis continues to afflict known and newer endemic sites despite global efforts towards its control and elimination. In this regard, the emergence of newer endemic sites with unusual disease formats is recognized wherein Leishmania donovani complex classically known to cause visceral disease is demonstrated to cause cutaneous manifestation. In this context, atypical cutaneous leishmaniasis (CL) cases caused by L. donovani genetic variants from the newer endemic state of Himachal Pradesh (HP) in India are beginning to be understood in terms of parasite determinants. The atypical CL manifestation further needs to be explored to define host immune correlates with a possible role in driving the unusual disease progression. In the given study, we performed comprehensive systemic-immune profiling of the atypical CL patients from the study area in HP, India, in comparison with the classical visceral leishmaniasis (VL) patients from the northeast region of India. The systemic immune response was studied using ELISA-based assessment of Th1, Th2, Th17, Treg, and Th22 specific plasma cytokine expression pattern and parasite-specific total serum IgG/IgG subclasses. The specified immune correlates are known to exhibit heterogeneous association with the different infecting parasite species, infection load, and co-lateral host immunopathology in classical CL and VL. In the atypical CL patient group, altered expression of IL-10 emerged as the key finding that could potentially fine-tune the Th1/Th17/Th22 effector cytokine axis towards a localized cutaneous manifestation. A reduced expression of IL-10 along with a high IFN-γ/IL-10 ratio as a readout of effective parasite killing defined atypical cutaneous outcome. In contrast, high circulatory IL-10 levels and a depressed IFN-γ/IL-10 ratio were seen in classical VL patients in line with an ineffective parasite-killing cytokine response. Overall, the study highlights new knowledge on host immune correlates in terms of cytokine expression pattern and IgG subclasses that underline atypical disease manifestation such that L. donovani, a generally visceralizing parasite species cause skin localized cutaneous lesions.
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Affiliation(s)
- Lovlesh Thakur
- Department of Zoology, Central University of Punjab, Bathinda, India
| | - Priyanka Madaan
- Department of Biochemistry, Central University of Punjab, Bathinda, India
| | - Aklank Jain
- Department of Zoology, Central University of Punjab, Bathinda, India
| | - Vinay Shankar
- Department of Dermatology, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, India
| | - Ajeet Negi
- Department of Dermatology, Indira Gandhi Medical College, Shimla, India
| | - Shashi Bhushan Chauhan
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Shyam Sundar
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Om Prakash Singh
- Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Manju Jain
- Department of Biochemistry, Central University of Punjab, Bathinda, India
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Volpedo G, Pacheco-Fernandez T, Bhattacharya P, Oljuskin T, Dey R, Gannavaram S, Satoskar AR, Nakhasi HL. Determinants of Innate Immunity in Visceral Leishmaniasis and Their Implication in Vaccine Development. Front Immunol 2021; 12:748325. [PMID: 34712235 PMCID: PMC8546207 DOI: 10.3389/fimmu.2021.748325] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/24/2021] [Indexed: 12/22/2022] Open
Abstract
Leishmaniasis is endemic to the tropical and subtropical regions of the world and is transmitted by the bite of an infected sand fly. The multifaceted interactions between Leishmania, the host innate immune cells, and the adaptive immunity determine the severity of pathogenesis and disease development. Leishmania parasites establish a chronic infection by subversion and attenuation of the microbicidal functions of phagocytic innate immune cells such as neutrophils, macrophages and dendritic cells (DCs). Other innate cells such as inflammatory monocytes, mast cells and NK cells, also contribute to resistance and/or susceptibility to Leishmania infection. In addition to the cytokine/chemokine signals from the innate immune cells, recent studies identified the subtle shifts in the metabolic pathways of the innate cells that activate distinct immune signal cascades. The nexus between metabolic pathways, epigenetic reprogramming and the immune signaling cascades that drive the divergent innate immune responses, remains to be fully understood in Leishmania pathogenesis. Further, development of safe and efficacious vaccines against Leishmaniasis requires a broader understanding of the early interactions between the parasites and innate immune cells. In this review we focus on the current understanding of the specific role of innate immune cells, the metabolomic and epigenetic reprogramming and immune regulation that occurs during visceral leishmaniasis, and the strategies used by the parasite to evade and modulate host immunity. We highlight how such pathways could be exploited in the development of safe and efficacious Leishmania vaccines.
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Affiliation(s)
- Greta Volpedo
- Departments of Pathology and Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Thalia Pacheco-Fernandez
- Departments of Pathology and Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Parna Bhattacharya
- Laboratory of Emerging Pathogens, Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Timur Oljuskin
- Laboratory of Emerging Pathogens, Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Ranadhir Dey
- Laboratory of Emerging Pathogens, Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Sreenivas Gannavaram
- Laboratory of Emerging Pathogens, Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
| | - Abhay R Satoskar
- Departments of Pathology and Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Hira L Nakhasi
- Laboratory of Emerging Pathogens, Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, United States
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Varikuti S, Verma C, Holcomb E, Jha BK, Viana A, Maryala R, Lamenza F, McElwain BK, Doni NY, Papenfuss T, Oghumu S, Gannavaram S, Nakhasi HL, Satoskar AR. MicroRNA-21 Deficiency Promotes the Early Th1 Immune Response and Resistance toward Visceral Leishmaniasis. THE JOURNAL OF IMMUNOLOGY 2021; 207:1322-1332. [PMID: 34341171 DOI: 10.4049/jimmunol.2001099] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 06/03/2021] [Indexed: 12/15/2022]
Abstract
MicroRNA-21 (miR-21) inhibits IL-12 expression and impairs the Th1 response necessary for control of Leishmania infection. Recent studies have shown that Leishmania infection induces miR-21 expression in dendritic cells and macrophages, and inhibition of miR-21 restores IL-12 expression. Because miR-21 is known to be expressed due to inflammatory stimuli in a wide range of hematopoietic cells, we investigated the role of miR-21 in regulating immune responses during visceral leishmaniasis (VL) caused by Leishmania donovani infection. We found that miR-21 expression was significantly elevated in dendritic cells, macrophages, inflammatory monocytes, polymorphonuclear neutrophils, and in the spleen and liver tissues after L. donovani infection, concomitant with an increased expression of disease exacerbating IL-6 and STAT3. Bone marrow dendritic cells from miR-21 knockout (miR-21KO) mice showed increased IL-12 production and decreased production of IL-10. On L. donovani infection, miR-21KO mice exhibited significantly greater numbers of IFN-γ- and TNF-α-producing CD4+ and CD8+ T cells in their organs that was associated with increased production of Th1-associated IFN-γ, TNF-α, and NO from the splenocytes. Finally, miR-21KO mice displayed significantly more developing and mature hepatic granulomas leading to reduction in organ parasitic loads compared with wild type counterparts. Similar results were noted in L. donovani-infected wild type mice after transient miR-21 depletion. These observations indicate that miR-21 plays a critical role in pathogenesis of VL by suppressing IL-12- and Th1-associated IFN-γ and also inducing disease-promoting induction of the IL-6 and STAT-3 signaling pathway. miR-21 could therefore be used as a potential target for developing host-directed treatment for VL.
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Affiliation(s)
- Sanjay Varikuti
- Department of Pathology, The Ohio State University Medical Center, Columbus, OH.,Department of Bioscience and Biotechnology, Banasthali Vidyapith, Banasthali, Rajasthan, India
| | - Chaitenya Verma
- Department of Pathology, The Ohio State University Medical Center, Columbus, OH
| | - Erin Holcomb
- Department of Pathology, The Ohio State University Medical Center, Columbus, OH
| | - Bijay Kumar Jha
- Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Agostinho Viana
- Department of Pathology, The Ohio State University Medical Center, Columbus, OH
| | - Ritvik Maryala
- Department of Pathology, The Ohio State University Medical Center, Columbus, OH
| | - Felipe Lamenza
- Department of Pathology, The Ohio State University Medical Center, Columbus, OH
| | - Bryan K McElwain
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
| | - Nebiye Yentur Doni
- Department of Pathology, The Ohio State University Medical Center, Columbus, OH
| | - Tracey Papenfuss
- College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - Steve Oghumu
- Department of Pathology, The Ohio State University Medical Center, Columbus, OH
| | - Sreenivas Gannavaram
- Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD; and
| | - Hira L Nakhasi
- Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD; and
| | - Abhay R Satoskar
- Department of Pathology, The Ohio State University Medical Center, Columbus, OH; .,Department of Microbiology, The Ohio State University, Columbus, OH
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Modulation of Splenic B Cell Subsets during Experimental Leishmania donovani Infection in BALB/c Mice. Pathogens 2021; 10:pathogens10070814. [PMID: 34209841 PMCID: PMC8308600 DOI: 10.3390/pathogens10070814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/17/2021] [Accepted: 06/25/2021] [Indexed: 11/29/2022] Open
Abstract
Sodium antimonials are one of the major and common drugs used against visceral form leishmaniasis (VL). However, the development of drug resistance makes it difficult to manage this disease. Current work investigates the modulation of splenic B cells during experimental infection with antimony-sensitive and -resistant Leishmania donovani infection. Here we phenotypically characterized splenic B cell subsets in BALB/c mice infected with antimony drug-sensitive and -resistant VL strains using flow-cytometry method. In the splenocytes we noticed increased number of Transitional T3 B cells and B1a B cells in drug-resistant VL strain infection. Besides, we also observed alteration in Follicular B cell population of antimony-resistant strain infected mice. Drug-resistant strain induced secretion of elevated level of IL-10 from B1a B cells and IL-6 from Transitional T3 B cell subsets in the splenocytes. Purified splenic B cells from antimony drug-resistant strain infected mice showed decrease in the Lyn kinase gene expression compared to sensitive strain infected and uninfected mice. The current study provides insight into changes in host splenic B-cell subsets during experimental infection with antimony-sensitive and -resistant L. donovani in murine model.
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Preclinical Assessment of Ursolic Acid Loaded into Nanostructured Lipid Carriers in Experimental Visceral Leishmaniasis. Pharmaceutics 2021; 13:pharmaceutics13060908. [PMID: 34205283 PMCID: PMC8235317 DOI: 10.3390/pharmaceutics13060908] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/08/2021] [Accepted: 06/17/2021] [Indexed: 12/17/2022] Open
Abstract
Ursolic acid, a triterpene produced by plants, displayed leishmanicidal activity in vitro and in vivo; however, the low solubility of this triterpene limits its efficacy. To increase the activity of ursolic acid (UA), this triterpene was entrapped in nanostructured lipid carriers (UA-NLC), physical-chemical parameters were estimated, the toxicity was assayed in healthy golden hamsters, and the efficacy of UA-NLC was studied in experimental visceral leishmanisis. UA-NLC exhibited a spherical shape with a smooth surface with a size of 266 nm. UA-NLC displayed low polydispersity (PDI = 0.18) and good colloidal stability (-29.26 mV). Hamsters treated with UA-NLC did not present morphological changes in visceral organs, and the levels of AST, ALT, urea and creatinine were normal. Animals infected with Leishmania (Leishmania) infantum and treated with UA-NLC showed lower parasitism than the infected controls, animals treated with UA or Amphotericin B (AmB). The therapeutic activity of UA-NLC was associated with the increase in a protective immune response, and it was associated with a high degree of spleen and liver preservation, and the normalization of hepatic and renal functions. These data indicate that the use of lipid nanoparticles as UA carriers can be an interesting strategy for the treatment of leishmaniasis.
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Elmahallawy EK, Alkhaldi AAM, Saleh AA. Host immune response against leishmaniasis and parasite persistence strategies: A review and assessment of recent research. Biomed Pharmacother 2021; 139:111671. [PMID: 33957562 DOI: 10.1016/j.biopha.2021.111671] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 04/18/2021] [Accepted: 04/24/2021] [Indexed: 12/13/2022] Open
Abstract
Leishmaniasis, a neglected parasitic disease caused by a unicellular protozoan of the genus Leishmania, is transmitted through the bite of a female sandfly. The disease remains a major public health problem and is linked to tropical and subtropical regions, with an endemic picture in several regions, including East Africa, the Mediterranean basin and South America. The different causative species display a diversity of clinical presentations; therefore, the immunological data on leishmaniasis are both scarce and controversial for the different forms and infecting species of the parasite. The present review highlights the main immune parameters associated with leishmaniasis that might contribute to a better understanding of the pathogenicity of the parasite and the clinical outcomes of the disease. Our aim was to provide a concise overview of the immunobiology of the disease and the factors that influence it, as this knowledge may be helpful in developing novel chemotherapeutic and vaccine strategies.
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Affiliation(s)
- Ehab Kotb Elmahallawy
- Department of Zoonoses, Faculty of Veterinary Medicine, Sohag University, Sohag 82524, Egypt.
| | | | - Amira A Saleh
- Department of Medical Parasitology, Faculty of Medicine, Zagazig University, Zgazig, Egypt
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Pacheco-Fernandez T, Volpedo G, Gannavaram S, Bhattacharya P, Dey R, Satoskar A, Matlashewski G, Nakhasi HL. Revival of Leishmanization and Leishmanin. Front Cell Infect Microbiol 2021; 11:639801. [PMID: 33816344 PMCID: PMC8010169 DOI: 10.3389/fcimb.2021.639801] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/05/2021] [Indexed: 11/16/2022] Open
Abstract
Leishmaniasis includes a spectrum of diseases ranging from debilitating cutaneous to fatal visceral infections. This disease is caused by the parasitic protozoa of the genus Leishmania that is transmitted by infected sandflies. Over 1 billion people are at risk of leishmaniasis with an annual incidence of over 2 million cases throughout tropical and subtropical regions in close to 100 countries. Leishmaniasis is the only human parasitic disease where vaccination has been successful through a procedure known as leishmanization that has been widely used for decades in the Middle East. Leishmanization involved intradermal inoculation of live Leishmania major parasites resulting in a skin lesion that following natural healing provided protective immunity to re-infection. Leishmanization is however no longer practiced due to safety and ethical concerns that the lesions at the site of inoculation that can last for months in some people. New genome editing technologies involving CRISPR has now made it possible to engineer safer attenuated strains of Leishmania, which induce protective immunity making way for a second generation leishmanization that can enter into human trials. A major consideration will be how the test the efficacy of a vaccine in the midst of the visceral leishmaniasis elimination program. One solution will be to use the leishmanin skin test (LST) that was also used for decades to determine exposure and immunity to Leishmania. The LST involves injection of antigen from Leishmania in the skin dermis resulting in a delayed type hypersensitivity (DTH) immune reaction associated with a Th1 immune response and protection against visceral leishmaniasis. Reintroduction of novel approaches for leishmanization and the leishmanin skin test can play a major role in eliminating leishmaniasis.
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Affiliation(s)
- Thalia Pacheco-Fernandez
- Departments of Pathology and Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Greta Volpedo
- Departments of Pathology and Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Sreenivas Gannavaram
- Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration (FDA), Silver Spring, MD, United States
| | - Parna Bhattacharya
- Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration (FDA), Silver Spring, MD, United States
| | - Ranadhir Dey
- Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration (FDA), Silver Spring, MD, United States
| | - Abhay Satoskar
- Departments of Pathology and Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Greg Matlashewski
- Department of Microbiology and Immunology, McGill University, Montreal, QC, Canada
| | - Hira L Nakhasi
- Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration (FDA), Silver Spring, MD, United States
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Rodrigues RRL, Nunes TAL, de Araújo AR, Marinho Filho JDB, da Silva MV, Carvalho FADA, Pessoa ODL, Freitas HPS, Rodrigues KADF, Araújo AJ. Antileishmanial activity of cordiaquinone E towards Leishmania (Leishmania) amazonensis. Int Immunopharmacol 2020; 90:107124. [PMID: 33168414 DOI: 10.1016/j.intimp.2020.107124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 12/30/2022]
Abstract
Leishmaniasis is caused by several protozoan species of Leishmania, and being endemically present in 98 countries around the world, it is also a severe public-health problem. The available antileishmanial drugs are toxic and yet present risks of recurrent infection. Efforts to find new, effective, and safe oral agents for the treatment of leishmaniasis are continuing throughout the world. This work aimed to evaluate the antileishmania activity of cordiaquinone E (CORe), isolated from the roots of Cordia polycephala (Lam.) I. M. Johnston. Cytotoxicity, and possible mechanisms of action against promastigote and amastigote forms of Leishmania amazonensis were examined. CORe was effective in inhibiting promastigote (IC50 4.5 ± 0.3 µM) and axenic amastigote (IC50 2.89 ± 0.11 µM) growth in concentrations found non-toxic for the host cell (CC50 246.81 ± 14.5 µM). Our results revealed that CORe presents direct activity against the parasite, inducing cell death by apoptosis. CORe present greater activity against intracellular amastigotes (EC50 1.92 ± 0.2 µM), yet with much higher selectivity indexes than the reference drugs, being respectively more benign towards RAW 264.7 macrophages than meglumine antimoniate and amphotericin B, (respectively by 4.68 and 42.84 fold). The antiamastigote activity was associated with increased TNF-α, IL-12, NO, and ROS levels, as well as decreased IL-10 levels. These results encourage the progression of studies on this compound for the development of new leishmanicidal agents.
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Affiliation(s)
- Raiza Raianne Luz Rodrigues
- Laboratório de Doenças Infecciosas, Campus Ministro Reis Velloso, Universidade Federal do Delta do Parnaíba, 64202-020 Parnaíba, PI, Brazil
| | - Thaís Amanda Lima Nunes
- Laboratório de Doenças Infecciosas, Campus Ministro Reis Velloso, Universidade Federal do Delta do Parnaíba, 64202-020 Parnaíba, PI, Brazil
| | - Alyne Rodrigues de Araújo
- Núcleo de Pesquisa em Biodiversidade e Biotecnologia, Campus Ministro Reis Velloso, Universidade Federal do Delta do Parnaíba, 64202-020 Parnaíba, PI, Brazil
| | - José Delano Barreto Marinho Filho
- Laboratório de Cultura de Células do Delta, Campus Ministro Reis Velloso, Universidade Federal do Delta do Parnaíba, 64202-020 Parnaíba, PI, Brazil
| | - Marcos Vinícius da Silva
- Laboratório de Imunologia e Parasitologia, Instituto de Ciências Biológicas e Naturais, Universidade Federal do Triângulo Mineiro, 38025-180 Uberaba, MG, Brazil
| | - Fernando Aécio de Amorim Carvalho
- Núcleo de Pesquisas em Plantas Medicinais, Campus Ministro Petrônio Portella, Universidade Federal do Piauí, Teresina 64049-550, Piauí, Brazil
| | | | | | | | - Ana Jérsia Araújo
- Laboratório de Cultura de Células do Delta, Campus Ministro Reis Velloso, Universidade Federal do Delta do Parnaíba, 64202-020 Parnaíba, PI, Brazil.
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Jafarzadeh A, Jafarzadeh S, Sharifi I, Aminizadeh N, Nozari P, Nemati M. The importance of T cell-derived cytokines in post-kala-azar dermal leishmaniasis. Cytokine 2020; 147:155321. [PMID: 33039255 DOI: 10.1016/j.cyto.2020.155321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 09/18/2020] [Accepted: 09/25/2020] [Indexed: 12/17/2022]
Abstract
Infection with the same species of Leishmania (L)donovani causes different manifestations including visceral leishmaniasis (VL) and post kala-azar dermal leishmaniasis (PKDL), indicating that the host-related immunological parameters perform a decisive role in the pathogenesis of diseases. As PKDL is a reservoir of the parasite, a better understanding of the host immune responses is necessary to restrict the L. donovani transmission. The proper local production of Th1 cell-related cytokines (including IFN-γ, TNF-α and IL-12), Th17 cell-derived cytokines (such as IL-17A, IL-17F and IL-22), and CD8+ cytotoxic T lymphocyte (CTL)-derived IFN-γ are protective against PKDL. However, dominant production of regulatory CD4+ T cell-derived cytokines (such as IL-10 and TGF-β), Th2 cell-derived cytokines (such as IL-4/IL-13), M2 macrophage-derived cytokines (such as IL-4 and IL-10), keratinocyte-derived IL-10, regulatory CD8+ T cell-derived IL-10, and dendritic cell-derived IL-10, IL-27 and IL-21 can contribute to the parasite persistence and PKDL development. Understanding of the T cell-related cytokine network within PKDL lesions gives rise to novel insights concerning the role of each cytokine in the protection or susceptibility to disease. Manipulation of the cytokine network can be considered as an interesting immunotherapeutic strategy for the treatment of L. donovani-mediated PKDL.
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Affiliation(s)
- Abdollah Jafarzadeh
- Department of Immunology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran; Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
| | - Sara Jafarzadeh
- Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Najmeh Aminizadeh
- Department of Histology, School of Medicine, Islamic Azad University Branch of Kerman, Kerman, Iran
| | - Parvin Nozari
- Department of Immunology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Nemati
- Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Department of Haematology and Laboratory Sciences, School of Para-Medicine, Kerman University of Medical Sciences, Kerman, Iran
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13
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Tolomeo M, Bonura S, Abbott M, Anastasia A, Colomba C, Cascio A. Good's syndrome and recurrent leishmaniasis: A case report and review of literature. Heliyon 2020; 6:e05061. [PMID: 33024862 PMCID: PMC7527582 DOI: 10.1016/j.heliyon.2020.e05061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/08/2020] [Accepted: 09/17/2020] [Indexed: 10/26/2022] Open
Abstract
We report the case of a 56-year-old Caucasian male affected by thymoma and myasthenia gravis that developed recurrent visceral leishmaniasis 11 years after thymectomy. After treatment of each relapse with liposomal amphotericin B the PCR-Leishmania was negative and the patient showed clinical improvement. An immunologic work-up was performed showing lymphopenia with an important decrease in CD4+ T cells (52 cells/μ) and CD4/CD8 ratio (0.2). HIV test was negative. On the basis of previous thymoma and myasthenia gravis and on the basis of the immunological profile a diagnosis of Good's syndrome was made. Since IFNγ plays a main role in the control of Leishmania infection the production of IFNγ was evaluated. After mitogen stimulation of peripheral blood mononuclear cells the production of IFNγ was lower than normal. This is the second reported case of Good's syndrome with recurrent leishmaniasis and indicates that a definitive cure for leishmaniasis in patients with Good's syndrome is not possible. Immunologic work-up in our patient strongly suggests that relapses could be correlated with the low CD4+ T cell number and with the low IFNγ production. Immunotherapy with IFNγ or with compounds able to block the Th2 interleukin production could be a therapeutic option in these patients.
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Affiliation(s)
- Manlio Tolomeo
- Department of Health Promotion Sciences, Section of Infectious Diseases, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Silvia Bonura
- Department of Health Promotion Sciences, Section of Infectious Diseases, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Michelle Abbott
- Department of Health Promotion Sciences, Section of Infectious Diseases, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Antonio Anastasia
- Department of Health Promotion Sciences, Section of Infectious Diseases, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Claudia Colomba
- Department of Health Promotion Sciences, Section of Infectious Diseases, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Antonio Cascio
- Department of Health Promotion Sciences, Section of Infectious Diseases, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
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França ADO, Soares LS, Pompilio MA, Tozetti IA, Bonin CM, Dorval MEMC. Cytokine profile in Leishmania-positive blood donors. PLoS One 2020; 15:e0238933. [PMID: 32966326 PMCID: PMC7511012 DOI: 10.1371/journal.pone.0238933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/26/2020] [Indexed: 12/03/2022] Open
Abstract
Serum levels of interleukin 2 (IL-2), interleukin 4 (IL-4), interleukin 6 (IL-6), interleukin 10 (IL-10), interleukin 17 (IL-17), interferon gamma (IFN-γ), tumor necrosis factor α (TNF-α), and interleukin 1β (IL-1β), cytokines involved in the immune response, were investigated in 75 Leishmania-positive blood donors living in endemic areas. Based on their status in 2011 and 2015, the subjects were clustered into three groups: positive for at least one diagnostic method in both years, but lacking clinical progression to disease (G1); positive on at least one method in 2011 but negative in 2015 (G2); negative on all methods in both years (G3). Donors were interviewed for sociodemographic data collection and underwent clinical evaluation and laboratory tests. Serum cytokines were quantified using a CBA Flex set (BD Biosciences). Significant differences were found for all the cytokines evaluated, with lower concentrations in consistently Leishmania-negative individuals. The exception was IFN-γ, with similar levels among all donors. No changes consistent with active disease were observed in the laboratory results for Leishmania-positive donors who underwent clinical evaluation, none of whom progressed to disease. This suggests that infection control is associated with serum IL-17 levels. Resolution of Leishmania infection in positive donors may be related to high levels of IL-17 and low levels of IL-10, highlighting the role played by IL-17 in asymptomatic Leishmania-infected individuals.
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Affiliation(s)
- Adriana de Oliveira França
- Laboratory of Clinical Parasitology, Graduate Program in Infectious and Parasitic Diseases, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
- * E-mail:
| | - Luana Silva Soares
- Laboratory of Immunology, Universidade Católica Dom Bosco, Campo Grande, MS, Brazil
| | - Mauricio Antonio Pompilio
- Hélio Mandetta School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Inês Aparecida Tozetti
- Laboratory of Immunobiology, Institute of Biosciences, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Camila Mareti Bonin
- Laboratory of Immunobiology, Institute of Biosciences, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
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Aquino SR, Diniz LFB, Queiroz IT, Cunha MA, Justo AM, Silva ED, Pereira VRA, Medeiros ZM, Carmo RF. Case Report: Severe Visceral Leishmaniasis in a Patient with HIV Coinfection Undergoing Treatment for Erythema Nodosum Leprosum. Am J Trop Med Hyg 2020; 103:2253-2256. [PMID: 32901606 DOI: 10.4269/ajtmh.20-0567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We report a case of visceral leishmaniasis (VL)/HIV coinfection in a patient undergoing regular antiretroviral therapy and treatment with thalidomide for erythema nodosum leprosum. He presented at a health service with high fever, chills, asthenia, pale skin, lower limb edema, hepatomegaly, and splenomegaly. Visceral leishmaniasis was confirmed by direct examination, and serological and molecular tests. Serum levels of Th1/Th2 cytokines were measured. The patient began treatment with liposomal amphotericin B, with good clinical response; however, VL recurred 6 months later. Treatment was reinitiated, maintaining secondary prophylaxis with liposomal amphotericin B. The patient showed clinical improvement with important recovery of CD4+ T-lymphocyte count.
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Affiliation(s)
- Samuel R Aquino
- Hospital Universitário da Universidade Federal do Vale do São Francisco, Petrolina, Brazil.,Programa de Pós-Graduação em Ciências da Saúde e Biológicas, Universidade Federal do Vale do São Francisco, Petrolina, Brazil
| | - Lucyo F B Diniz
- Hospital Universitário da Universidade Federal do Vale do São Francisco, Petrolina, Brazil
| | | | | | - Alda M Justo
- Colegiado de Enfermagem, Universidade de Pernambuco Campus Petrolina, Petrolina, Brazil.,Programa de Pós-Graduação em Ciências da Saúde, Universidade de Pernambuco, Recife, Brazil
| | | | | | - Zulma M Medeiros
- Instituto Aggeu Magalhães, Recife, Brazil.,Programa de Pós-Graduação em Ciências da Saúde, Universidade de Pernambuco, Recife, Brazil
| | - Rodrigo F Carmo
- Programa de Pós-Graduação em Biociências, Universidade Federal do Vale do São Francisco, Petrolina, Brazil.,Programa de Pós-Graduação em Ciências da Saúde e Biológicas, Universidade Federal do Vale do São Francisco, Petrolina, Brazil
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16
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Gedda MR, Singh B, Kumar D, Singh AK, Madhukar P, Upadhyay S, Singh OP, Sundar S. Post kala-azar dermal leishmaniasis: A threat to elimination program. PLoS Negl Trop Dis 2020; 14:e0008221. [PMID: 32614818 PMCID: PMC7332242 DOI: 10.1371/journal.pntd.0008221] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Leishmaniasis remains a public health concern around the world that primarily affects poor folks of the developing world spanning across 98 countries with mortality of 0.2 million to 0.4 million annually. Post kala-azar dermal leishmaniasis (PKDL) is the late skin manifestation of visceral leishmaniasis (VL). It has been reported that about 2.5% to 20% of patients recovered from VL develop PKDL having stilted macular or nodular lesions with parasites. In the Indian subcontinent (ISC), it manifests a few months after recovery from VL, though in Africa it can occur simultaneously with VL or a little later. New cases of PKDL are also observed without prior VL in the ISC. These individuals with PKDL represent an important but largely neglected reservoir of infection that perpetuates anthroponotic Leishmania donovani transmission in the ISC and can jeopardize the VL elimination program as these cases can infect the sand flies and spread the endemic. Therefore, it becomes imperative to eradicate PKDL as a part of the VL elimination program. With the limited treatment options besides little knowledge on PKDL, this review stands out in focusing on different aspects that should be dealt for sustained VL elimination.
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Affiliation(s)
- Mallikarjuna Rao Gedda
- Infectious Disease Research Laboratory, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
- Center for Cellular Engineering, NIH Clinical Center, Bethesda, Maryland, United States of America
| | - Bhawana Singh
- Infectious Disease Research Laboratory, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Dhiraj Kumar
- Infectious Disease Research Laboratory, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
- Department of Zoology, Rameshwar College, BRA Bihar University, Muzaffarpur, India
| | - Abhishek Kumar Singh
- Infectious Disease Research Laboratory, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Prasoon Madhukar
- Infectious Disease Research Laboratory, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Shreya Upadhyay
- Infectious Disease Research Laboratory, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Om Prakash Singh
- Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Shyam Sundar
- Infectious Disease Research Laboratory, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Conversion of asymptomatic infection to symptomatic visceral leishmaniasis: A study of possible immunological markers. PLoS Negl Trop Dis 2020; 14:e0008272. [PMID: 32555598 PMCID: PMC7326279 DOI: 10.1371/journal.pntd.0008272] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 06/30/2020] [Accepted: 04/07/2020] [Indexed: 12/31/2022] Open
Abstract
Introduction Presence of asymptomatic individuals in endemic areas is common. The possible biomarkers in asymptomatic individuals once they get exposed to infection as well as following conversion to symptomatic disease are yet to be identified.We identified asymptomatic Visceral leishmaniasis (VL) infection amongst rK39+sorted direct agglutination test positive (DAT+) endemic healthy population and confirmed it by quantitative PCR(qPCR).The immunological determinants such as Adenosine deaminase (ADA), Interferon gamma (IFN-γ), Tumour Necrosis Factor alpha (TNF-α) and Interleukin 10 (IL-10)were examined to predict probable biomarkers for conversion to symptomatic VL. Methods Sample size was 5794 healthy individuals from VL endemic region. Antibody tests(DAT &rK39) were performed and later a qPCR assay was employed using kDNA specific primers and probes. Immunological biomarkers examined were ADA level by ADA–MTP kit and quantitative cytokines(IFN-γ, IL-10 and TNF-α) by ELISA. Results 120 asymptomatic individuals of 308 rK39 sero-positives were DAT positive comprising of 56 with previous history and 64 with no history of VL. RT-PCR confirmed asymptomatic VL in 42 sero-positives. These were followed up through repeated qPCR and evaluation of immunological determinants. We observed10 symptomatic cases converted from a total of 42 asymptomatic individuals identified at base-line. The level of ADA, IL-10 and IFN-γ remained consistently high in asymptomatic cases and amongst these, ADA and IL-10 but not IFN-γ remained higher at the development of clinical symptoms into active VL. On the contrary, there was no significant change in the mean concentration of TNF-α at both stages of the disease. Discussion We surmise from our data that considerable proportion of asymptomatic cases can be a reservoir and may play a crucial role in transmission of visceral leishmaniasis in endemic areas. The data also suggests that ADA and IL-10 can serve as a potential biomarker during the conversion of asymptomatic into symptomatic VL. The most threatening form of leishmaniasis is human visceral leishmaniasis, which is caused by L. donovani in Indian subcontinent. The disease accounts for huge annual burden of infectious disease in India. Efforts towards disease elimination programme are far beyond satisfaction and there is need to re-strengthen health monitoring, surveillance programme in endemic areas. There is a greater need to identify asymptomatic individuals amongst endemic healthy control by active surveillance programme. Further, except a few, many asymptomatic subjects become sero-negative without developing VL due to strong inherent cellular immunity possessed by them. This study enumerates use of rK39, DAT and quantitative PCR(qPCR) in asymptomatic detection and then evaluate immunological biomarkers(Adenosine deaminase, IFN-γ, TNF-α and IL-10) which help in disease conversion to symptomatic VL, at 6 month follow- up. Follow–up analysis revealed that antibody testing with rK39 (3.24%), DAT (8.33%) had poor agreement with disease conversion. By qPCR, we could identify the level of parasitemia, and collectively with serology, the test detected 23.80% of asymptomatic cases converted into disease. The level of ADA and IL-10 remained consistently high during conversion. IFN-γ became high in asymptomatic infection but became low on conversion, whereas, no significant change in level of TNF-α was observed at both stages of disease. Thus by use of qPCR, concomitantly with DAT over rK39+ sorted endemic healthy control may be employed for early case detection. Adenosine is produced by ecto-nucleotide during L.donovaniinfection, has been previously reported and in parallel to this study we conclude that determination of adenosine deaminase level (ADA) might help identify early cases with more tendency to convert into disease. This will help to boost health monitoring programme to eradicate Kala-azar in Bihar, India.
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TLR4 abrogates the Th1 immune response through IRF1 and IFN-β to prevent immunopathology during L. infantum infection. PLoS Pathog 2020; 16:e1008435. [PMID: 32210480 PMCID: PMC7135367 DOI: 10.1371/journal.ppat.1008435] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 04/06/2020] [Accepted: 02/25/2020] [Indexed: 12/26/2022] Open
Abstract
A striking feature of human visceral leishmaniasis (VL) is chronic inflammation in the spleen and liver, and VL patients present increased production levels of multiple inflammatory mediators, which contribute to tissue damage and disease severity. Here, we combined an experimental model with the transcriptional profile of human VL to demonstrate that the TLR4-IFN-β pathway regulates the chronic inflammatory process and is associated with the asymptomatic form of the disease. Tlr4-deficient mice harbored fewer parasites in their spleen and liver than wild-type mice. TLR4 deficiency enhanced the Th1 immune response against the parasite, which was correlated with an increased activation of dendritic cells (DCs). Gene expression analyses demonstrated that IRF1 and IFN-β were expressed downstream of TLR4 after infection. Accordingly, IRF1- and IFNAR-deficient mice harbored fewer parasites in the target organs than wild-type mice due to having an increased Th1 immune response. However, the absence of TLR4 or IFNAR increased the serum transaminase levels in infected mice, indicating the presence of liver damage in these animals. In addition, IFN-β limits IFN-γ production by acting directly on Th1 cells. Using RNA sequencing analysis of human samples, we demonstrated that the transcriptional signature for the TLR4 and type I IFN (IFN-I) pathways was positively modulated in asymptomatic subjects compared with VL patients and thus provide direct evidence demonstrating that the TLR4-IFN-I pathway is related to the nondevelopment of the disease. In conclusion, our results demonstrate that the TLR4-IRF1 pathway culminates in IFN-β production as a mechanism for dampening the chronic inflammatory process and preventing immunopathology development. Visceral leishmaniasis (VL) is one of the most lethal neglected tropical diseases and is caused by Leishmania parasites. Most subjects infected with Leishmania present subclinical VL symptoms, and their immune response is mediated by Th1 cells and immunoregulatory mechanisms. However, when infection progresses to disease, VL patients present increased levels of inflammatory mediators in the serum which are related to the severity of disease. During infection, Toll-like receptors (TLRs) interact with Leishmania parasites and contribute to the outcome of the disease. Herein, we report that TLR4 signaling hampers the chronic immune response during VL to prevent immunopathology. TLR4 triggers the activation of IRF1 and thus induces the transcription of IFN-β, which in turn acts directly on Th1 cells to limit the production of IFN-γ. In addition, a transcription analysis of human VL samples provides direct evidence demonstrating that the TLR4-IFN-I pathway is related to the asymptomatic form of the disease. Collectively, our findings reveal that TLR4 hampers the Th1 immune response through IRF1 and IFN-β to prevent immunopathology during VL.
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Chatterjee M, Sengupta R, Mukhopadhyay D, Mukherjee S, Dighal A, Moulik S, Sengupta S. Immune Responses in Post Kala-azar Dermal Leishmaniasis. Indian J Dermatol 2020; 65:452-460. [PMID: 33487699 PMCID: PMC7810083 DOI: 10.4103/ijd.ijd_258_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Kala-azar, commonly known as visceral leishmaniasis (VL), is a neglected tropical disease that has been targeted in South Asia for elimination by 2020. Presently, the Kala-azar Elimination Programme is aimed at identifying new low-endemic foci by active case detection, consolidating vector control measures, and decreasing potential reservoirs, of which Post Kala-azar Dermal Leishmaniasis (PKDL) is considered as the most important. PKDL is a skin condition that occurs after apparently successful treatment of VL and is characterized by hypopigmented patches (macular) or a mixture of papules, nodules, and/or macules (polymorphic). To achieve this goal of elimination, it is important to delineate the pathophysiology so that informed decisions can be made regarding the most appropriate and cost-effective approach. We reviewed the literature with regard to PKDL in Asia and Africa and interpreted the findings in establishing a potential correlation between the immune responses and pathophysiology. The overall histopathology indicated the presence of a dense, inflammatory cellular infiltrate, characterized by increased expression of alternatively activated CD68+ macrophages, CD8+ T cells showing features of exhaustion, CD20+ B cells, along with decreased CD1a+ dendritic cells. Accordingly, this review is an update on the overall immunopathology of PKDL, so as to provide a better understanding of host-parasite interactions and the immune responses generated which could translate into availability of markers that can be harnessed for assessment of disease progression and improvement of existing treatment modalities.
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Affiliation(s)
- Mitali Chatterjee
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Ritika Sengupta
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Debanjan Mukhopadhyay
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Shibabrata Mukherjee
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Aishwarya Dighal
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Srija Moulik
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Shilpa Sengupta
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
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20
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Romanelli MM, da Costa-Silva TA, Cunha-Junior E, Dias Ferreira D, Guerra JM, Galisteo AJ, Pinto EG, Barbosa LRS, Torres-Santos EC, Tempone AG. Sertraline Delivered in Phosphatidylserine Liposomes Is Effective in an Experimental Model of Visceral Leishmaniasis. Front Cell Infect Microbiol 2019; 9:353. [PMID: 31737574 PMCID: PMC6828611 DOI: 10.3389/fcimb.2019.00353] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 09/30/2019] [Indexed: 12/17/2022] Open
Abstract
Liposomes containing phosphatidylserine (PS) has been used for the delivery of drugs into the intramacrophage milieu. Leishmania (L.) infantum parasites live inside macrophages and cause a fatal and neglected viscerotropic disease, with a toxic treatment. Sertraline was studied as a free formulation (SERT) and also entrapped into phosphatidylserine liposomes (LP-SERT) against intracellular amastigotes and in a murine model of visceral leishmaniasis. LP-SERT showed a potent activity against intracellular amastigotes with an EC50 value of 2.5 μM. The in vivo efficacy of SERT demonstrated a therapeutic failure. However, when entrapped into negatively charged liposomes (−58 mV) of 125 nm, it significantly reduced the parasite burden in the mice liver by 89% at 1 mg/kg, reducing the serum levels of the cytokine IL-6 and upregulating the levels of the chemokine MCP-1. Histopathological studies demonstrated the presence of an inflammatory infiltrate with the development of granulomas in the liver, suggesting the resolution of the infection in the treated group. Delivery studies showed fluorescent-labeled LP-SERT in the liver and spleen of mice even after 48 h of administration. This study demonstrates the efficacy of PS liposomes containing sertraline in experimental VL. Considering the urgent need for VL treatments, the repurposing approach of SERT could be a promising alternative.
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Affiliation(s)
| | | | - Edezio Cunha-Junior
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Pavilhão Leonidas Deane, Laboratório de Bioquímica de Tripanosomatídeos, Rio de Janeiro, Brazil
| | | | | | - Andres Jimenez Galisteo
- Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | | | - Leandro R S Barbosa
- Instituto de Física da Universidade de São Paulo, Cidade Universitária, São Paulo, Brazil
| | - Eduardo Caio Torres-Santos
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Pavilhão Leonidas Deane, Laboratório de Bioquímica de Tripanosomatídeos, Rio de Janeiro, Brazil
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Anning AS, Kwakye-Nuako G, Ameyaw EO, Mosore MT, Asare KK. In vitro activity of Erythrophleum ivorense extract against the promastigote stage of cutaneous Leishmania parasite, a member of Leishmania (Mundinia) enriettii complex isolates from Ghana. Access Microbiol 2019; 1:e000050. [PMID: 32974542 PMCID: PMC7481739 DOI: 10.1099/acmi.0.000050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 07/25/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cutaneous leishmaniasis causes physical disfigurement and impairment on affected individuals, however, little attention has been paid to it eradication. The situation of this neglected disease is complicated with the expansion of the non-human pathogenic Leishmania enriettii complex causing infection in humans. We have previously shown that the extract from Erythrophleum ivorense has leishmanicidal activity against promastigote stages of the L. enriettii complex isolate from Ghana and L eishmania donovani. The extract of E. ivorense has shown to have anti-inflammatory, wound-healing ability, antiallergic, antimalarial and antischistosomal activity. However, the concentration threshold of E. ivorense extract required for leishmanicidal activity against the emerging human pathogenic L. enriettii complex isolates is not clear. AIM To test for the concentration threshold of E. ivorense extract required to obtain ideal leishmanicidal activity against the promastigote stage of human pathogenic L. enriettii complex isolates from Ghana. METHOD The ethanolic leaf extract of E. ivorense was serially diluted and tested against the promastigote stage of the L. enriettii complex. Parasite inhibition was measured at 590 nm using a spectrophotometer after staining parasites with trypan blue. To select the threshold concentration for maximum inhibition of the promastigote stage of the L. enriettii complex, the concentration cut-off statistic was used. RESULTS The MIC of E. ivorense extract for L. enriettii promastigote inhibition was 62.3 μg ml-1. The highest promastigote inhibition was observed at 72 h. CONCLUSION We show that a MIC of 62.3 μg ml-1 of E. ivorense leaf extract exhibits an ideal leishmanicidal activity against the promastigote stage of L. enriettii complex isolates.
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Affiliation(s)
- Alberta Serwah Anning
- Department of Biomedical Sciences, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Godwin Kwakye-Nuako
- Department of Biomedical Sciences, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Elvis Ofori Ameyaw
- Department of Biomedical Sciences, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Mba-Tihssommah Mosore
- U. S. Naval Medical Research Unit No. 3 (NAMRU-3), Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Kwame Kumi Asare
- Department of Biomedical Sciences, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Department of Protozoology Institute of Tropical Medicine (NEKKEN), Nagasaki University Sakamoto 1-12-4, Nagasaki 852-8523, Japan
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22
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da Costa-Silva TA, Conserva GAA, Galisteo AJ, Tempone AG, Lago JHG. Antileishmanial activity and immunomodulatory effect of secosubamolide, a butanolide isolated from Nectandra oppositifolia (Lauraceae). J Venom Anim Toxins Incl Trop Dis 2019; 25:e20190008. [PMID: 31467511 PMCID: PMC6707387 DOI: 10.1590/1678-9199-jvatitd-2019-0008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 06/27/2019] [Indexed: 01/15/2023] Open
Abstract
Background: Visceral leishmaniasis is a complex neglected tropical disease caused by
Leishmania donovani complex. Its current treatment
reveals strong limitations, especially high toxicity. In this context,
natural products are important sources of new drug alternatives for VL
therapy. Therefore, the antileishmanial and immunomodulatory activity of
compounds isolated from Nectandra oppositifolia (Lauraceae)
was investigated herein. Methods: The n-hexane extract from twigs of N.
oppositifolia were subjected to HPLC/HRESIMS and
bioactivity-guided fractionation to afford compounds 1 and
2 which were evaluated in vitro against
Leishmania (L.) infantum
chagasi and NCTC cells. Results: The n-hexane extract displayed activity against
L. (L.) infantum
chagasi and afforded isolinderanolide E
(1) and secosubamolide A (2),
which were effective against L. (L.)
infantum chagasi promastigotes, with IC50
values of 57.9 and 24.9 µM, respectively. Compound 2 was
effective against amastigotes (IC50 = 10.5 µM) and displayed
moderate mammalian cytotoxicity (CC50 = 42 µM). The
immunomodulatory studies of compound 2 suggested an
anti-inflammatory activity, with suppression of IL-6, IL-10, TNF with lack
of nitric oxide. Conclusion: This study showed the antileishmanial activity of compounds 1
and 2 isolated from N. oppositifolia.
Furthermore, compound 2 demonstrated an antileishmanial
activity towards amastigotes associated to an immunomodulatory effect.
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Affiliation(s)
- Thais A da Costa-Silva
- Center of Natural Sciences and Humanities, Federal University of ABC (UFBAC), São Paulo, SP, Brazil
| | - Geanne A Alves Conserva
- Center of Natural Sciences and Humanities, Federal University of ABC (UFBAC), São Paulo, SP, Brazil
| | - Andrés J Galisteo
- Institute of Tropical Medicine, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Andre G Tempone
- Centre for Parasitology and Mycology, Adolfo Lutz Institute (IAL), São Paulo, SP, Brazil
| | - João Henrique G Lago
- Center of Natural Sciences and Humanities, Federal University of ABC (UFBAC), São Paulo, SP, Brazil
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23
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Ratnapriya S, Keerti, Sahasrabuddhe AA, Dube A. Visceral leishmaniasis: An overview of vaccine adjuvants and their applications. Vaccine 2019; 37:3505-3519. [PMID: 31103364 DOI: 10.1016/j.vaccine.2019.04.092] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/08/2019] [Accepted: 04/30/2019] [Indexed: 11/25/2022]
Abstract
Although there has been an extensive research on vaccine development over the last decade and some vaccines have been commercialized for canine visceral leishmaniasis (CVL), but as yet no effective vaccine is available for anthroponotic VL which may partly be due to the absence of an appropriate adjuvant system. Vaccines alone yield poor immunity hence requiring an adjuvant which can boost the immunosuppressed state of VL infected individuals by eliciting adaptive immune responses to achieve required immunological enhancement. Recent studies have documented the continuous efforts that are being made in the field of adjuvants research in an attempt to render vaccines more effective. This review article focuses on adjuvants, particularly particulate and non-particulate ones, which have been assessed with VL vaccine candidates in several preclinical and clinical trials outlining the induction of immune responses obtained from these studies. Moreover, we have emphasized the applicability of multiple adjuvants combination for an improvement in the potential of a VL vaccine.
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Affiliation(s)
- Sneha Ratnapriya
- Molecular and Structural Biology Division, CSIR-Central Drug Research Institute, Sector-10, Jankipuram Extension, Sitapur Road, Lucknow 226031, India
| | - Keerti
- Molecular and Structural Biology Division, CSIR-Central Drug Research Institute, Sector-10, Jankipuram Extension, Sitapur Road, Lucknow 226031, India
| | - Amogh A Sahasrabuddhe
- Molecular and Structural Biology Division, CSIR-Central Drug Research Institute, Sector-10, Jankipuram Extension, Sitapur Road, Lucknow 226031, India
| | - Anuradha Dube
- Division of Parasitology, CSIR-Central Drug Research Institute, Sector-10, Jankipuram Extension, Sitapur Road, Lucknow 226031, India.
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24
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Oualha R, Barhoumi M, Marzouki S, Harigua-Souiai E, Ben Ahmed M, Guizani I. Infection of Human Neutrophils With Leishmania infantum or Leishmania major Strains Triggers Activation and Differential Cytokines Release. Front Cell Infect Microbiol 2019; 9:153. [PMID: 31134162 PMCID: PMC6524560 DOI: 10.3389/fcimb.2019.00153] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/24/2019] [Indexed: 12/27/2022] Open
Abstract
Leishmaniases are neglected diseases, caused by intracellular protozoan parasites of the Leishmania (L.) genus. Although the principal host cells of the parasites are macrophages, neutrophils are the first cells rapidly recruited to the site of parasites inoculation, where they play an important role in the early recognition and elimination of the parasites. The nature of early interactions between neutrophils and Leishmania could influence the outcome of infection. Herein we aimed to evaluate whether different Leishmania strains, responsible for distinct clinical manifestations, could influence ex vivo functional activity of neutrophils. Human polymorphonuclear leukocytes were isolated from 14 healthy volunteers and the ex vivo infection of these cells was done with two L. infantum and one L. major strains. Infection parameters were determined and neutrophils activation was assessed by oxidative burst, degranulation, DNA release and apoptosis; cytokine production was measured by a multiplex flow cytometry analysis. Intracellular amastigotes were rescued to determine Leishmania strains survival. The results showed that L. infantum and L. major promastigotes similarly infected the neutrophils. Oxidative burst, neutrophil elastase, myeloperoxidase activity and apoptosis were significantly increased in infected neutrophils but with no differences between strains. The L. infantum-infected neutrophils induced more DNA release than those infected by L. major. Furthermore, Leishmania strains induced high amounts of IL-8 and stimulated the production of IL-1β, TNF-α, and TGF-β by human neutrophils. We observed that only one strain promoted IL-6 release by these neutrophils. The production of TNF-α was also differently induced by the parasites strains. All these results demonstrate that L. infantum and L. major strains were able to induce globally a similar ex vivo activation and apoptosis of neutrophils; however, they differentially triggered cytokines release from these cells. In addition, rescue of intracellular parasites indicated different survival rates further emphasizing on the influence of parasite strains within a species on the fate of infection.
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Affiliation(s)
- Rafeh Oualha
- Laboratory of Molecular Epidemiology and Experimental Pathology - LR16IPT04, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia.,Faculté des Sciences de Bizerte, Université de Carthage, Tunis, Tunisia
| | - Mourad Barhoumi
- Laboratory of Molecular Epidemiology and Experimental Pathology - LR16IPT04, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia
| | - Soumaya Marzouki
- Laboratory of Transmission, Control and Immunobiology of Infections - LR16IPT02, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia
| | - Emna Harigua-Souiai
- Laboratory of Molecular Epidemiology and Experimental Pathology - LR16IPT04, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia
| | - Melika Ben Ahmed
- Laboratory of Transmission, Control and Immunobiology of Infections - LR16IPT02, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia
| | - Ikram Guizani
- Laboratory of Molecular Epidemiology and Experimental Pathology - LR16IPT04, Institut Pasteur de Tunis, Université de Tunis El Manar, Tunis, Tunisia
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25
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Khatonier R, Khan AM, Sarmah P, Ahmed GU. Role of IL-21 in host pathogenesis in experimental visceral leishmaniasis. J Parasit Dis 2018; 42:500-504. [PMID: 30538346 DOI: 10.1007/s12639-018-1025-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 08/09/2018] [Indexed: 11/26/2022] Open
Abstract
Visceral leishmaniasis (VL) is a major global health problem but still remains one of the neglected tropical diseases. Currently available chemotherapeutics are associated with severe toxicity and increased drug resistance. There is a need to explore for novel therapeutic strategies that could modulate host immune responses or work in synergy with chemotherapy of VL. Therefore, understanding the host immunological changes that play a vital role in disease pathology is a prerequisite for designing any interventions. We have investigated the role of IL-21 during the course of Leishmania donovani infection and after drug treatment. BALB/c mice were used to investigate the mRNA levels of IL-21 during active Leishmania donovani infection and after treatment using real time polymerase chain reaction (RT-PCR). Mice were divided in four groups i.e. Control (Group A), Infected (Group B), Uninfected treated (Group C) and Infected treated (Group D). Animals of Group C and D were treated with Amphotericin B. IL-21 mRNA levels in the spleen were estimated on days 1, 3, 7, 14, 17, 21, 28, 35, 45 and 60 post infection and also during course of treatment. We found that IL-21 mRNA levels was significantly up-regulated in the infected group with a fourfold increase at D60 p.i. (p < 0.001) and it was decreased significantly after the treatment. Our results suggest that IL-21 mRNA is associated with pathogenesis of Leishmania donovani infection and that therapeutics designed to suppress IL-21 could provide promising antileishmanial activity.
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Affiliation(s)
- R Khatonier
- 1Division of Entomology and Filariasis, ICMR-Regional Medical Research Centre, NE Region, Post Box No. 105, Dibrugarh, Assam 786001 India
| | - A M Khan
- 1Division of Entomology and Filariasis, ICMR-Regional Medical Research Centre, NE Region, Post Box No. 105, Dibrugarh, Assam 786001 India
| | - P Sarmah
- 1Division of Entomology and Filariasis, ICMR-Regional Medical Research Centre, NE Region, Post Box No. 105, Dibrugarh, Assam 786001 India
| | - G U Ahmed
- 2Department of Biotechnology, Gauhati University, Guwahati, Assam India
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26
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Rodrigues-Neto JF, Monteiro GR, Keesen TSL, Lacerda HG, Carvalho EM, Jeronimo SMB. CD45RO+ T Cells and T Cell Activation in the Long-Lasting Immunity after Leishmania infantum Infection. Am J Trop Med Hyg 2017; 98:875-882. [PMID: 29280433 DOI: 10.4269/ajtmh.16-0747] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Manifestations of Leishmania infantum infection range from asymptomatic to symptomatic visceral leishmaniasis (VL). People with symptomatic VL (sVL) have suppressed immune responses against Leishmania antigens that are reversed after clinical cure. The intradermal leishmanin skin test (LST) is negative during sVL, but it becomes positive after treatment. The aim of this study was to compare T cell responses in individuals with sVL, recovered VL (RecVL), and endemic controls. Endemic controls were household contacts of a VL case and they were grouped by their LST results, either positive (LST+) or negative (LST-). Mononuclear cells were studied ex vivo or after stimulation with soluble Leishmania antigens (SLA); cell surface markers and cytokines were determined. T cells, ex vivo, from individuals with sVL and from LST+ individuals presented a higher activation for CD4+ and CD8+ cells expressing CD69. However, lymphocytes from sVL stimulated with SLA had lower percentages of CD4+ and CD8+ cells expressing CD69 and CD8+ cells expressing CD25, with no release of interferon-γ or tumor necrosis factor. sVL subjects had lower percentage of memory cells (CD4+ CD45RO+), ex vivo, without SLA stimulation than RecVL, LST+, or LST- (P = 0.0022). However, individuals with sVL had fewer regulatory cells after SLA stimulation (CD4+ CD25HIGH, P = 0.04 and CD4+ FOXP3+, P = 0.02) than RecVL. The decrease in specific memory and activated CD4+ and CD8+ cells, as in response to Leishmania antigens, could explain, in part, the immune impairment during sVL. Finally, protective T cell responses are long lasting because both RecVL or LST+ individuals maintain a specific protective response to Leishmania years after the primary infection.
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Affiliation(s)
- João F Rodrigues-Neto
- Institute of Tropical Medicine of Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,Department of Biochemistry, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Gloria R Monteiro
- Institute of Tropical Medicine of Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Tatjana S L Keesen
- Department of Biochemistry, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Henio G Lacerda
- Department of Infectious Diseases, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,Institute of Tropical Medicine of Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Edgar M Carvalho
- Immunology Service, Federal University of Bahia, Salvador, Bahia, Brazil.,National Institute of Science and Technology of Tropical Diseases (INCT-DT/CNPq), Federal University of Bahia, Salvador, Bahia, Brazil
| | - Selma M B Jeronimo
- National Institute of Science and Technology of Tropical Diseases (INCT-DT/CNPq), Federal University of Bahia, Salvador, Bahia, Brazil.,Institute of Tropical Medicine of Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,Department of Biochemistry, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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27
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Bruno F, Castelli G, Vitale F, Giacomini E, Roberti M, Colomba C, Cascio A, Tolomeo M. Effects of trans-stilbene and terphenyl compounds on different strains of Leishmania and on cytokines production from infected macrophages. Exp Parasitol 2017; 184:31-38. [PMID: 29154845 DOI: 10.1016/j.exppara.2017.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 11/07/2017] [Accepted: 11/12/2017] [Indexed: 01/24/2023]
Abstract
Most of the antileishmanial modern therapies are not satisfactory due to high toxicity or emergence of resistance and high cost of treatment. Previously, we observed that two compounds of a small library of trans-stilbene and terphenyl derivatives, ST18 and TR4, presented the best activity and safety profiles against Leishmania infantum promastigotes and amastigotes. In the present study we evaluated the effects of ST18 and the TR4 in 6 different species of Leishmania and the modifications induced by these two compounds in the production of 8 different cytokines from infected macrophages. We observed that TR4 was potently active in all Leishmania species tested in the study showing a leishmanicidal activity higher than that of ST18 and meglumine antimoniate in the most of the species. Moreover, TR4 was able to decrease the levels of IL-10, a cytokine able to render the host macrophage inactive allowing the persistence of parasites inside its phagolysosome, and increase the levels of IL-1β, a cytokine important for host resistance to Leishmania infection by inducible iNOS-mediated production of NO, and IL-18, a cytokine implicated in the development of Th1-type immune response.
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Affiliation(s)
- Federica Bruno
- National Reference Center for Leishmaniasis (C.Re.Na.L.), Istituto Zooprofilattico Sperimentale della Sicilia, Via Gino Marinuzzi 3, 90129, Palermo, Italy
| | - Germano Castelli
- National Reference Center for Leishmaniasis (C.Re.Na.L.), Istituto Zooprofilattico Sperimentale della Sicilia, Via Gino Marinuzzi 3, 90129, Palermo, Italy
| | - Fabrizio Vitale
- National Reference Center for Leishmaniasis (C.Re.Na.L.), Istituto Zooprofilattico Sperimentale della Sicilia, Via Gino Marinuzzi 3, 90129, Palermo, Italy
| | - Elisa Giacomini
- CompuNet, Istituto Italiano di Tecnologia, via Morego 30, Genova, Italy
| | - Marinella Roberti
- Department of Pharmacy and Biotechnology, University of Bologna, Via Belmeloro 6, 40126, Bologna, Italy
| | - Claudia Colomba
- Department of Health Promotion Sciences, Section of Infectious Diseases, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Antonio Cascio
- Department of Health Promotion Sciences, Section of Infectious Diseases, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Manlio Tolomeo
- Department of Health Promotion Sciences, Section of Infectious Diseases, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
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28
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Kumar R, Chauhan SB, Ng SS, Sundar S, Engwerda CR. Immune Checkpoint Targets for Host-Directed Therapy to Prevent and Treat Leishmaniasis. Front Immunol 2017; 8:1492. [PMID: 29167671 PMCID: PMC5682306 DOI: 10.3389/fimmu.2017.01492] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 10/23/2017] [Indexed: 12/15/2022] Open
Abstract
Leishmaniasis encompasses a group of diseases caused by protozoan parasites belonging to the genus Leishmania. These diseases range from life threatening visceral forms to self-healing cutaneous lesions, and each disease manifestations can progress to complications involving dissemination of parasites to skin or mucosal tissue. A feature of leishmaniasis is the key role host immune responses play in disease outcome. T cells are critical for controlling parasite growth. However, they can also contribute to disease onset and progression. For example, potent regulatory T cell responses can develop that suppress antiparasitic immunity. Alternatively, hyperactivated CD4+ or CD8+ T cells can be generated that cause damage to host tissues. There is no licensed human vaccine and drug treatment options are often limited and problematic. Hence, there is an urgent need for new strategies to improve the efficacy of current vaccine candidates and/or enhance both antiparasitic drug effectiveness and subsequent immunity in treated individuals. Here, we describe our current understanding about host immune responses contributing to disease protection and progression in the various forms of leishmaniasis. We also discuss how this knowledge may be used to develop new strategies for host-directed immune therapy to prevent or treat leishmaniasis. Given the major advances made in immune therapy in the cancer and autoimmune fields in recent years, there are significant opportunities to ride on the back of these successes in the infectious disease domain. Conversely, the rapid progress in our understanding about host immune responses during leishmaniasis is also providing opportunities to develop novel immunotherapy strategies that could have broad applications in diseases characterized by inflammation or immune dysfunction.
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Affiliation(s)
- Rajiv Kumar
- Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Shashi Bhushan Chauhan
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Susanna S. Ng
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Shyam Sundar
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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29
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Gonçalves-de-Albuquerque SDC, Pessoa-e-Silva R, Trajano-Silva LAM, de Goes TC, de Morais RCS, da C. Oliveira CN, de Lorena VMB, de Paiva-Cavalcanti M. The Equivocal Role of Th17 Cells and Neutrophils on Immunopathogenesis of Leishmaniasis. Front Immunol 2017; 8:1437. [PMID: 29163510 PMCID: PMC5670345 DOI: 10.3389/fimmu.2017.01437] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/16/2017] [Indexed: 01/17/2023] Open
Abstract
Advances in the understanding of leishmaniasis progression indicate that cellular interactions more complex than the Th1/Th2 paradigm define the course of infection. Th17 cells are a crucial modulator of adaptive immunity against Leishmania parasites acting mainly on neutrophil recruitment and playing a dual role at the site of infection. This review describes the roles of both these cell types in linking innate defense responses to the establishment of specific immunity. We focus on the Th17-neutrophil interaction as a crucial component of anti-Leishmania immunity, and the clinical evolution of cutaneous or visceral leishmaniasis. To date, information obtained through experimental models and patient evaluations suggests that the influence of the presence of interleukin (IL)-17 (the main cytokine produced by Th17 cells) and neutrophils during Leishmania infections is strictly dependent on the tissue (skin or liver/spleen) and parasite species. Also, the time at which neutrophils are recruited, and the persistence of IL-17 in the infection microenvironment, may also be significant. A clearer understanding of these interactions will enable better measurement of the influence of IL-17 and its regulators, and contribute to the identification of disease/resistance biomarkers.
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Affiliation(s)
| | - Rômulo Pessoa-e-Silva
- Department of Microbiology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil
| | - Lays A. M. Trajano-Silva
- Department of Microbiology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil
| | - Tayná Correia de Goes
- Department of Microbiology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil
| | - Rayana C. S. de Morais
- Department of Microbiology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil
| | - Cíntia N. da C. Oliveira
- Department of Microbiology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil
| | - Virgínia M. B. de Lorena
- Department of Microbiology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil
| | - Milena de Paiva-Cavalcanti
- Department of Microbiology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil
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30
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Disease severity in patients with visceral leishmaniasis is not altered by co-infection with intestinal parasites. PLoS Negl Trop Dis 2017; 11:e0005727. [PMID: 28732017 PMCID: PMC5540614 DOI: 10.1371/journal.pntd.0005727] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 08/02/2017] [Accepted: 06/19/2017] [Indexed: 12/24/2022] Open
Abstract
Visceral leishmaniasis (VL) is a neglected tropical disease that affects the poorest communities and can cause substantial morbidity and mortality. Visceral leishmaniasis is characterized by the presence of Leishmania parasites in the spleen, liver and bone marrow, hepatosplenomegaly, pancytopenia, prolonged fever, systemic inflammation and low body mass index (BMI). The factors impacting on the severity of VL are poorly characterized. Here we performed a cross-sectional study to assess whether co-infection of VL patients with intestinal parasites influences disease severity, assessed with clinical and haematological data, inflammation, cytokine profiles and BMI. Data from VL patients was similar to VL patients co-infected with intestinal parasites, suggesting that co-infection of VL patients with intestinal parasites does not alter disease severity. Visceral leishmaniasis (VL), a disease caused by a parasite, Leishmania, belongs to the most neglected tropical diseases: they mainly occur in low-income countries and affect the poorest populations. The parasites are transmitted via the bite of an insect vector and migrate to the internal organs. When VL occurs, the patients will present with enlarged spleen and liver, a disturbed haematological profile with low blood cell counts, systemic inflammation and malnutrition. This stage of the disease is fatal if left untreated. The factors that influence VL disease severity are poorly characterized. Here, we recruited patients with VL in an area of Ethiopia with a high prevalence of intestinal parasites. Our aim was to assess whether the disease was more severe in VL patients co-infected with intestinal parasites. Our results show that clinical and haematological data, inflammation, cytokine profile and nutritional status of VL patients are similar in VL patients and in VL patients co-infected with intestinal parasites. These results suggest that co-infection of VL patients with intestinal parasites does not impact on disease severity.
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31
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Anti-parasite therapy drives changes in human visceral leishmaniasis-associated inflammatory balance. Sci Rep 2017; 7:4334. [PMID: 28659627 PMCID: PMC5489532 DOI: 10.1038/s41598-017-04595-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 05/17/2017] [Indexed: 12/29/2022] Open
Abstract
Visceral leishmaniasis (VL) remains a major public health problem worldwide. Cytokine balance is thought to play a critical role in the development of this disease. Here, we perform a prospective exploratory study addressing whether simultaneous assessment of circulating levels of different lipid mediators and cytokines could highlight specific pathways involved with VL pathogenesis. VL patients displayed substantial increases in serum levels of Prostaglandin F2α (PGF2α), Leukotriene B4 (LTB4), Resolvin D1 (RvD1), IL-1β, IL-6, IL-8, IL-10, IL-12p70 and TNF-α compared with uninfected endemic control group, while exhibiting decreased levels of TGF-β1. Hierarchical cluster analysis of the prospective changes in the expression level of theses parameters upon anti-Leishmania treatment initiation revealed that the inflammatory profile observed in active disease gradually changed over time and was generally reversed at day 30 of therapy. Furthermore, not only the individual concentrations of most of the inflammatory biomarkers changed upon treatment, but the correlations between those and several biochemical parameters used to characterize VL disease activity were also modified over time. These results demonstrate that an inflammatory imbalance hallmarks active VL disease and open perspective for manipulation of these pathways in future studies examining a potential host-directed therapy against VL.
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Zacarias DA, Rolão N, de Pinho FA, Sene I, Silva JC, Pereira TC, Costa DL, Costa CHN. Causes and consequences of higher Leishmania infantum burden in patients with kala-azar: a study of 625 patients. Trop Med Int Health 2017; 22:679-687. [PMID: 28380279 DOI: 10.1111/tmi.12877] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND An infected host's Leishmania infantum load in blood is considered to be an estimate of his or her total parasite burden. Therefore, the measurement of blood parasite burden is important in the identification of factors involved in parasite control. METHODS Quantitative polymerase chain reaction was performed on blood samples from 625 patients with kala-azar consecutively admitted to a reference hospital in Teresina, Brazil. Primers were used to amplify a segment of kDNA using the TaqMan system. Non-parametric statistical tests were applied. RESULTS The median blood parasite burden was 499.2 amastigote equivalents (AE)/ml. Children <1 year old (yo) had a high parasite burden, which dropped sharply after the first year of life (192.8, AE/ml at 1 < 2 yo) and remained lower until adolescence. Following adolescence, the parasite burden increased with age, peaking among elderly individuals. Men had a higher parasite burden than women. HIV-infected patients had a much higher parasite burden than non-infected patients. The parasite burden of children under 5 years with acute moderate to severe malnourishment (weight-for-age and body mass index z-scores <-2) was almost three times greater than that of better-nourished children. The parasite burden identified in deceased patients was more than twice that of surviving patients; those with a higher risk of death, sepsis, pneumonia and jaundice also had increased parasite burdens. All of these differences were statistically significant at P-values <0.05. CONCLUSIONS These data indicate that the parasite burden in patients with kala-azar was associated with age- and gender-associated factors and with HIV infection status. Acute malnutrition could be either a cause or a consequence of a higher parasite burden. An individual's parasite burden influences his or her clinical profile, disease severity and mortality risk. The best explanation for the presence of a higher parasite burden in individuals with these immunoregulatory conditions and severe disease is the occurrence of acquired immunosuppression followed by heightened innate immunity.
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Affiliation(s)
- Danielle A Zacarias
- Laboratório de Leishmanioses, Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Teresina, Brazil
| | - Nuno Rolão
- Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Flaviane A de Pinho
- Setor de Patologia Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Brazil
| | - Ingridi Sene
- Laboratório de Leishmanioses, Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Teresina, Brazil
| | - Jailthon C Silva
- Laboratório de Leishmanioses, Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Teresina, Brazil
| | - Teresinha C Pereira
- Laboratório de Leishmanioses, Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Teresina, Brazil
| | - Dorcas L Costa
- Departamento Materno-Infantil, Universidade Federal do Piauí, Teresina, Brazil
| | - Carlos H N Costa
- Laboratório de Leishmanioses, Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Teresina, Brazil
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Costa DL, Rocha RL, Chaves EDBF, Batista VGDV, Costa HL, Costa CHN. Predicting death from kala-azar: construction, development, and validation of a score set and accompanying software. Rev Soc Bras Med Trop 2017; 49:728-740. [PMID: 28001220 DOI: 10.1590/0037-8682-0258-2016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 11/09/2016] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Early identification of patients at higher risk of progressing to severe disease and death is crucial for implementing therapeutic and preventive measures; this could reduce the morbidity and mortality from kala-azar. We describe a score set composed of four scales in addition to software for quick assessment of the probability of death from kala-azar at the point of care. METHODS: Data from 883 patients diagnosed between September 2005 and August 2008 were used to derive the score set, and data from 1,031 patients diagnosed between September 2008 and November 2013 were used to validate the models. Stepwise logistic regression analyses were used to derive the optimal multivariate prediction models. Model performance was assessed by its discriminatory accuracy. A computational specialist system (Kala-Cal(r)) was developed to speed up the calculation of the probability of death based on clinical scores. RESULTS: The clinical prediction score showed high discrimination (area under the curve [AUC] 0.90) for distinguishing death from survival for children ≤2 years old. Performance improved after adding laboratory variables (AUC 0.93). The clinical score showed equivalent discrimination (AUC 0.89) for older children and adults, which also improved after including laboratory data (AUC 0.92). The score set also showed a high, although lower, discrimination when applied to the validation cohort. CONCLUSIONS: This score set and Kala-Cal(r) software may help identify individuals with the greatest probability of death. The associated software may speed up the calculation of the probability of death based on clinical scores and assist physicians in decision-making.
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Affiliation(s)
- Dorcas Lamounier Costa
- Departamento Materno-Infantil, Universidade Federal do Piauí, Teresina, Piauí, Brazil.,Instituto de Doenças Tropicais Natan Portella, Teresina, Piauí, Brazil
| | - Regina Lunardi Rocha
- Departamento de Pediatria, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | - Carlos Henrique Nery Costa
- Instituto de Doenças Tropicais Natan Portella, Teresina, Piauí, Brazil.,Departamento de Medicina Comunitária, Universidade Federal do Piauí, Teresina, Piauí, Brazil
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Adenosine generated by ectonucleotidases modulates the host immune system during visceral leishmaniasis. Cytokine 2017; 91:170-179. [DOI: 10.1016/j.cyto.2017.01.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 12/30/2016] [Accepted: 01/02/2017] [Indexed: 11/20/2022]
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Daher EDF, Soares DDS, Filho SLAP, Meneses GC, Freitas TVDS, Leite TT, da Silva Junior GB. Hyponatremia and risk factors for death in human visceral leishmaniasis: new insights from a cross-sectional study in Brazil. BMC Infect Dis 2017; 17:168. [PMID: 28231825 PMCID: PMC5322621 DOI: 10.1186/s12879-017-2257-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 02/10/2017] [Indexed: 12/13/2022] Open
Abstract
Background Visceral leishmaniasis (VL) is an important and potentially fatal neglected tropical disease. The aim of this study was to investigate hyponatremia and risk factors for death among VL patients. Methods This is a cross-sectional study with VL patients admitted to a tertiary hospital in Northeast Brazil, from 2002 to 2009. Patients were divided into two groups: non-survivors and survivors. Hyponatremia was defined as serum sodium < 135 mEq/L. A logistic regression model was done to investigate risk factors for death. Results A total of 285 VL patients were included, with mean age 37 ± 15 years, and 74% were males. Thirty-four patients died (11.9%). Non-survivors had a significantly higher prevalence of dyspnea (38.2 vs. 16.7%, p = 0.003), pulmonary crackles (11.8 vs. 4.0%, p = 0.049), dehydration (23.5 vs. 10.8%, p = 0.033), oliguria (8.8 vs. 0.8%, p = 0.001) and jaundice (47.1 vs. 14.3%, p < 0.001). They also presented higher prevalence of hyponatremia (41.9 vs. 24.1%, p = 0.035), thrombocytopenia (91.2 vs. 65.3%, p = 0.002) and severe hypoalbuminemia (78.3 vs. 35.3%, p < 0.001). In multivariate analysis, moderate/severe hyponatremia (OR = 2.278, 95% CI = 1.046–4.962), thrombocytopenia (OR = 5.482, 95% CI = 1.629–18.443), jaundice (OR = 5.133, 95% CI = 1.793–14.696) and severe hypoalbuminemia (OR = 6.479, 95% CI = 2.124–19.766) were predictors of death. Conclusion Higher prevalence of dehydration, oliguria, pulmonary symptoms and liver involvement was found in non-survivors VL patients. Hypoalbuminemia and hyponatremia were frequent and significantly associated with mortality.
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Affiliation(s)
- Elizabeth De Francesco Daher
- Department of Internal Medicine, School of Medicine, Federal University of Ceará, Rua Vicente Linhares, 1198, Fortaleza, CE, CEP: 60270-135, Brazil. .,Medical Sciences Graduate Program, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Rua Vicente Linhares, 1198, Fortaleza, CE, CEP: 60270-135, Brazil.
| | - Douglas de Sousa Soares
- Department of Internal Medicine, School of Medicine, Federal University of Ceará, Rua Vicente Linhares, 1198, Fortaleza, CE, CEP: 60270-135, Brazil
| | - Sérgio Luiz Arruda Parente Filho
- Department of Internal Medicine, School of Medicine, Federal University of Ceará, Rua Vicente Linhares, 1198, Fortaleza, CE, CEP: 60270-135, Brazil
| | - Gdayllon Cavalcante Meneses
- Pharmacology Graduate Program, Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Tainá Veras de Sandes Freitas
- Department of Internal Medicine, School of Medicine, Federal University of Ceará, Rua Vicente Linhares, 1198, Fortaleza, CE, CEP: 60270-135, Brazil
| | - Tacyano Tavares Leite
- Department of Internal Medicine, School of Medicine, Federal University of Ceará, Rua Vicente Linhares, 1198, Fortaleza, CE, CEP: 60270-135, Brazil
| | - Geraldo Bezerra da Silva Junior
- School of Medicine, Public Health Graduate Program, Health Sciences Center, University of Fortaleza, Fortaleza, Ceará, Brazil
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Splenic CD4+ T Cells in Progressive Visceral Leishmaniasis Show a Mixed Effector-Regulatory Phenotype and Impair Macrophage Effector Function through Inhibitory Receptor Expression. PLoS One 2017; 12:e0169496. [PMID: 28103263 PMCID: PMC5245871 DOI: 10.1371/journal.pone.0169496] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 12/16/2016] [Indexed: 01/19/2023] Open
Abstract
Visceral leishmaniasis (VL), caused by infection with the intracellular protozoan Leishmania donovani, is a chronic progressive disease with a relentlessly increasing parasite burden in the spleen, liver and bone marrow. The disease is characterized by fever, splenomegaly, cachexia, and pancytopenia, and progresses to death if not treated. Control of Leishmania infection is mediated by Th1 (IFNγ-producing) CD4+ T cells, which activate macrophages to produce nitric oxide and kill intracellular parasites. However, despite expansion of CD4+ T cells and increased IFNγ expression in the spleen, humans with active VL do not control the infection. We used an experimental model of chronic progressive VL in hamsters, which mimics clinical and pathological features seen in humans, to better understand the mechanisms that lead to progressive disease. Transcriptional profiling of the spleen during chronic infection revealed expression of markers of both T cell activation and inhibition. CD4+ T cells isolated from the spleen during chronic progressive VL showed mixed expression of Th1 and Th2 cytokines and chemokines, and were marginally effective in controlling infection in an ex vivo T cell-macrophage co-culture system. Splenic CD4+ T cells and macrophages from hamsters with VL showed increased expression of inhibitory receptors and their ligands, respectively. Blockade of the inhibitory receptor PD-L2 led to a significant decrease in parasite burden, revealing a pathogenic role for the PD-1 pathway in chronic VL. PD-L2 blockade was associated with a dramatic reduction in expression of host arginase 1, but no change in IFNγ and inducible nitric oxide synthase. Thus, the expression of counter-regulatory molecules on splenic CD4+ T cells and macrophages promotes a more permissive macrophage phenotype and attenuates intracellular parasite control in chronic progressive VL. Host-directed adjunctive therapy targeting the PD-1 regulatory pathway may be efficacious for VL.
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Cunha-Júnior EF, Andrade-Neto VV, Lima ML, da Costa-Silva TA, Galisteo Junior AJ, Abengózar MA, Barbas C, Rivas L, Almeida-Amaral EE, Tempone AG, Torres-Santos EC. Cyclobenzaprine Raises ROS Levels in Leishmania infantum and Reduces Parasite Burden in Infected Mice. PLoS Negl Trop Dis 2017; 11:e0005281. [PMID: 28045892 PMCID: PMC5234845 DOI: 10.1371/journal.pntd.0005281] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 01/13/2017] [Accepted: 12/21/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The leishmanicidal action of tricyclic antidepressants has been studied and evidences have pointed that their action is linked to inhibition of trypanothione reductase, a key enzyme in the redox metabolism of pathogenic trypanosomes. Cyclobenzaprine (CBP) is a tricyclic structurally related to the antidepressant amitriptyline, differing only by the presence of a double bond in the central ring. This paper describes the effect of CBP in experimental visceral leishmaniasis, its inhibitory effect in trypanothione reductase and the potential immunomodulatory activity. METHODOLOGY/PRINCIPAL FINDINGS In vitro antileishmanial activity was determined in promastigotes and in L. infantum-infected macrophages. For in vivo studies, L. infantum-infected BALB/c mice were treated with CBP by oral gavage for five days and the parasite load was estimated. Trypanothione reductase activity was assessed in the soluble fraction of promastigotes of L. infantum. For evaluation of cytokines, L. infantum-infected macrophages were co-cultured with BALB/c splenocytes and treated with CBP for 48 h. The supernatant was analyzed for IL-6, IL-10, MCP-1, IFN-γ and TNF-α. CBP demonstrated an IC50 of 14.5±1.1μM and an IC90 of 74.5±1.2 μM in promastigotes and an IC50 of 12.6±1.05 μM and an IC90 of 28.7±1.3 μM in intracellular amastigotes. CBP also reduced the parasite load in L. infantum-infected mice by 40.4±10.3% and 66.7±10.5% in spleen at 24.64 and 49.28 mg/kg, respectively and by 85.6±5.0 and 89.3±4.8% in liver at 24.64 and 49.28mg/kg, after a short-term treatment. CBP inhibited the trypanothione reductase activity with a Ki of 86 ± 7.7 μM and increased the ROS production in promastigotes. CBP inhibited in 53% the production of IL-6 in infected macrophages co-culture. CONCLUSION/SIGNIFICANCE To the best of our knowledge, this study is the first report of the in vivo antileishmanial activity of the FDA-approved drug CBP. Modulation of immune response and induction of oxidative stress in parasite seem to contribute to this efficacy.
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Affiliation(s)
| | - Valter Viana Andrade-Neto
- Laboratório de Bioquímica de Tripanosomatídeos, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brasil
| | - Marta Lopes Lima
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Centro de Parasitologia e Micologia, Instituto Adolfo Lutz, São Paulo, São Paulo, Brazil
| | | | | | - Maria A. Abengózar
- Centro de Investigaciones Biológicas (CSIC), Unidad Asociada Interacciones, Metabolismo y Bioanálisis CSIC-CEU, Madrid, Spain
| | - Coral Barbas
- Center for Metabolomics and Bioanalysis (CEMBIO), Faculty of Pharmacy, Universidad CEU San Pablo, Madrid, Spain
| | - Luis Rivas
- Centro de Investigaciones Biológicas (CSIC), Unidad Asociada Interacciones, Metabolismo y Bioanálisis CSIC-CEU, Madrid, Spain
| | | | - Andre Gustavo Tempone
- Centro de Parasitologia e Micologia, Instituto Adolfo Lutz, São Paulo, São Paulo, Brazil
| | - Eduardo Caio Torres-Santos
- Laboratório de Bioquímica de Tripanosomatídeos, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brasil
- * E-mail:
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Martins LF, Mesquita JT, Pinto EG, Costa-Silva TA, Borborema SET, Galisteo Junior AJ, Neves BJ, Andrade CH, Shuhaib ZA, Bennett EL, Black GP, Harper PM, Evans DM, Fituri HS, Leyland JP, Martin C, Roberts TD, Thornhill AJ, Vale SA, Howard-Jones A, Thomas DA, Williams HL, Overman LE, Berlinck RGS, Murphy PJ, Tempone AG. Analogues of Marine Guanidine Alkaloids Are in Vitro Effective against Trypanosoma cruzi and Selectively Eliminate Leishmania (L.) infantum Intracellular Amastigotes. JOURNAL OF NATURAL PRODUCTS 2016; 79:2202-2210. [PMID: 27586460 DOI: 10.1021/acs.jnatprod.6b00256] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Synthetic analogues of marine sponge guanidine alkaloids showed in vitro antiparasitic activity against Leishmania (L.) infantum and Trypanosoma cruzi. Guanidines 10 and 11 presented the highest selectivity index when tested against Leishmania. The antiparasitic activity of 10 and 11 was investigated in host cells and in parasites. Both compounds induced depolarization of mitochondrial membrane potential, upregulation of reactive oxygen species levels, and increased plasma membrane permeability in Leishmania parasites. Immunomodulatory assays suggested an NO-independent effect of guanidines 10 and 11 on macrophages. The same compounds also promoted anti-inflammatory activity in L. (L.) infantum-infected macrophages cocultived with splenocytes, reducing the production of cytokines MCP-1 and IFN-γ. Guanidines 10 and 11 affect the bioenergetic metabolism of Leishmania, with selective elimination of parasites via a host-independent mechanism.
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Affiliation(s)
- Ligia F Martins
- Centre for Parasitology and Mycology, Instituto Adolfo Lutz , Avenida Dr. Arnaldo, 351, 8° andar, 01246-000 São Paulo, SP, Brazil
| | - Juliana T Mesquita
- Centre for Parasitology and Mycology, Instituto Adolfo Lutz , Avenida Dr. Arnaldo, 351, 8° andar, 01246-000 São Paulo, SP, Brazil
| | - Erika G Pinto
- Centre for Parasitology and Mycology, Instituto Adolfo Lutz , Avenida Dr. Arnaldo, 351, 8° andar, 01246-000 São Paulo, SP, Brazil
- Instituto de Medicina Tropical, Universidade de São Paulo , Avenida Dr. Enéas de Carvalho Aguiar, 470, 05403-000 São Paulo, SP, Brazil
| | - Thais A Costa-Silva
- Centre for Parasitology and Mycology, Instituto Adolfo Lutz , Avenida Dr. Arnaldo, 351, 8° andar, 01246-000 São Paulo, SP, Brazil
| | - Samanta E T Borborema
- Centre for Parasitology and Mycology, Instituto Adolfo Lutz , Avenida Dr. Arnaldo, 351, 8° andar, 01246-000 São Paulo, SP, Brazil
| | - Andres J Galisteo Junior
- Instituto de Medicina Tropical, Universidade de São Paulo , Avenida Dr. Enéas de Carvalho Aguiar, 470, 05403-000 São Paulo, SP, Brazil
| | - Bruno J Neves
- LabMol, Laboratory for Molecular Modeling and Drug Design, Faculdade de Farmácia, Universidade Federal de Goiás , Goiânia, Brazil
| | - Carolina H Andrade
- LabMol, Laboratory for Molecular Modeling and Drug Design, Faculdade de Farmácia, Universidade Federal de Goiás , Goiânia, Brazil
| | - Zainab Al Shuhaib
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Elliot L Bennett
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Gregory P Black
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Philip M Harper
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Daniel M Evans
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Hisham S Fituri
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - John P Leyland
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Claire Martin
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Terence D Roberts
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Andrew J Thornhill
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Stephen A Vale
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Andrew Howard-Jones
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Dafydd A Thomas
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Harri L Williams
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Larry E Overman
- University of California, Irvine , 4042A Frederick Reines Hall, Irvine, California 92697, United States
| | - Roberto G S Berlinck
- Instituto de Química de São Carlos, Universidade de São Paulo , CP 780, CEP 13560-970, São Carlos, SP, Brazil
| | - Patrick J Murphy
- School of Chemistry, Bangor University , Bangor, Gwynedd, Wales, U.K. LL57 2UW
| | - Andre G Tempone
- Centre for Parasitology and Mycology, Instituto Adolfo Lutz , Avenida Dr. Arnaldo, 351, 8° andar, 01246-000 São Paulo, SP, Brazil
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Mansueto P, Vitale G, Di Lorenzo G, Rini GB, Mansueto S, Cillari E. Immunopathology of Leishmaniasis: An Update. Int J Immunopathol Pharmacol 2016; 20:435-45. [PMID: 17880757 DOI: 10.1177/039463200702000302] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Leishmaniasis represents a severe, increasing, public health problem. The perspective of its control is highly dependent on research progress, on therapeutic manipulations of the immune system, and on vaccine development. There is a correlation between the clinical outcome of Leishmania infection and the cytokine response profile. While a protective immune response against Leishmania has been clearly identified to be related to the influence of a type-1 response and IFN-γ production, the precise role of T helper (TH) 2 cytokines in non-healing infections requires further exploration. IL-4 and IL-13 (TH2 cytokines) can promote disease progression in cutaneous leishmaniasis, whereas IL-4 would appear to enhance protective type-1 responses in visceral leishmaniasis. Thus, the TH1/TH2 paradigm of resistance/susceptibility to intracellular parasites is probably an oversimplification of a more complicated network of regulatory/counter regulatory interactions. Moreover, the presence of antigen specific regulatory T cell subsets may provide an environment that contributes to the balance between TH1 and TH2 cells. Finally, the involvement of CD8+ T cells has been described, but the modality of their function in this kind of infection has not been so far elucidated.
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Affiliation(s)
- P Mansueto
- Dipartimento di Medicina Clinica e delle Patologie Emergenti, University of Palermo, Palermo, Italy
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Elevated Serum ADA Activity as a Marker for Diagnosis and Prognosis of Visceral Leishmaniasis and Post Kala-Azar Dermal Leishmaniasis in Indian Patients. PLoS One 2016; 11:e0154117. [PMID: 27186641 PMCID: PMC4871472 DOI: 10.1371/journal.pone.0154117] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/08/2016] [Indexed: 11/18/2022] Open
Abstract
Serum adenosine deaminase (ADA) activity increases in diseases where cellular immunity is involved. Since cell-mediated immune responses play a paramount role in the pathogenesis and healing of the visceral leishmaniasis, therefore, the present study was undertaken to evaluate the serum ADA activity in different pathological conditions. Adenosine deaminase was determined in sera of active visceral leishmaniasis (VL) patients (n = 39), active postkala-azar dermal leishmaniasis (PKDL) cases (n = 34) at the point of diagnosis and after treatment stages along with healthy controls (n = 30), endemic healthy subjects (n = 34) and endemic asymptomatic subjects (n = 34).Our in-vitro result revealed that monocytes secrete significant ADA level in response to Leishmania donovani (L.donovani) stimulation. The serum ADA activity in active VL and PKDL subjects were found to be significantly higher than that of respective treated cases and healthy controls. We also observed a marginal number (17.6%) of endemic asymptomatic subjects showed elevated serum ADA activity. Further, the ADA activity in PKDL was found to be decreased gradually during the different phases of treatment. Interestingly, 2 out of 32 treated VL cases found to have high serum ADA activity during follow up period were relapsed within few days. These results suggest the possibility of ADA as a marker of clinical pathogenesis and can be used as a surrogate marker in the diagnosis and prognosis of VL and PKDL.
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Bhattacharya P, Ghosh S, Ejazi SA, Rahaman M, Pandey K, Ravi Das VN, Das P, Goswami RP, Saha B, Ali N. Induction of IL-10 and TGFβ from CD4+CD25+FoxP3+ T Cells Correlates with Parasite Load in Indian Kala-azar Patients Infected with Leishmania donovani. PLoS Negl Trop Dis 2016; 10:e0004422. [PMID: 26829554 PMCID: PMC4735109 DOI: 10.1371/journal.pntd.0004422] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 01/11/2016] [Indexed: 01/01/2023] Open
Abstract
Background Visceral leishmaniasis (VL) is distinguished by a complex interplay of immune response and parasite multiplication inside host cells. However, the direct association between different immunological correlates and parasite numbers remains largely unknown. Methodology/Principal Findings We examined the plasma levels of different disease promoting/protective as well as Th17 cytokines and found IL-10, TGFβ and IL-17 to be significantly correlated with parasite load in VL patients (r = 0.52, 0.53 and 0.51 for IL-10, TGFβ and IL-17, respectively). We then extended our investigation to a more antigen-specific response and found leishmanial antigen stimulated levels of both IL-10 and TGFβ to be significantly associated with parasite load (r = 0.71 and 0.72 for IL-10 and TGFβ respectively). In addition to cytokines we also looked for different cellular subtypes that could contribute to cytokine secretion and parasite persistence. Our observations manifested an association between different Treg cell markers and disease progression as absolute numbers of CD4+CD25+ (r = 0.55), CD4+CD25hi (r = 0.61) as well as percentages of CD4+CD25+FoxP3+ T cells (r = 0.68) all correlated with parasite load. Encouraged by these results, we investigated a link between these immunological components and interestingly found both CD4+CD25+ and CD4+CD25+FoxP3+ Treg cells to secrete significantly (p<0.05) higher amounts of not only IL-10 but also TGFβ in comparison to corresponding CD25- T cells. Conclusions/Significance Our findings shed some light on source(s) of TGFβ and suggest an association between these disease promoting cytokines and Treg cells with parasite load during active disease. Moreover, the direct evidence of CD4+CD25+FoxP3+ Treg cells as a source of IL-10 and TGFβ during active VL could open new avenues for immunotherapy towards cure of this potentially fatal disease. Visceral leishmaniasis (VL) is one of the most widespread parasitic diseases worldwide and is caused by kinetoplastid protozoa of the Leishmania donovani complex. The disease begins with internalization of L. donovani parasites and their multiplication within host macrophages followed subsequently by immune suppression. However, the immunological factors responsible for disease progression and their association with parasite dynamics are not completely understood. Herein, we investigated the correlation of different immune components (cytokines and cellular subsets) with parasite load and their involvement in the course of VL. Our study revealed a significant positive correlation between parasite load and plasma as well as antigen specific levels of IL-10 and TGFβ. In addition to cytokines, cellular subsets could also contribute to disease pathogenesis through their regulatory mechanisms. Our results indicate different Treg cell markers (absolute numbers of CD4+CD25+ and CD4+CD25hi and percentages of CD4+CD25+FoxP3+) to be strongly correlated with parasite load. Exploring an association between these immunological correlates revealed Treg cells to be the source of these cytokines during VL. Therefore, this study points to a significant role of IL-10, TGFβ and Treg cells in parasite load and active VL, providing evidence which could be helpful in devising new immunotherapeutic strategies against this disease.
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Affiliation(s)
- Pradyot Bhattacharya
- Infectious Diseases and Immunology Division, Indian Institute of Chemical Biology, Kolkata, West Bengal, India
| | - Smriti Ghosh
- Infectious Diseases and Immunology Division, Indian Institute of Chemical Biology, Kolkata, West Bengal, India
| | - Sarfaraz Ahmad Ejazi
- Infectious Diseases and Immunology Division, Indian Institute of Chemical Biology, Kolkata, West Bengal, India
| | - Mehebubar Rahaman
- Department of Tropical Medicine, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Krishna Pandey
- Department of Clinical Medicine, Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India
| | - Vidya Nand Ravi Das
- Department of Clinical Medicine, Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India
| | - Pradeep Das
- Department of Molecular Biology, Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India
| | - Rama Prosad Goswami
- Department of Tropical Medicine, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Bibhuti Saha
- Department of Tropical Medicine, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Nahid Ali
- Infectious Diseases and Immunology Division, Indian Institute of Chemical Biology, Kolkata, West Bengal, India
- * E-mail:
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Pereira AV, de Barros G, Pinto EG, Tempone AG, Orsi RDO, Dos Santos LD, Calvi S, Ferreira RS, Pimenta DC, Barraviera B. Melittin induces in vitro death of Leishmania (Leishmania) infantum by triggering the cellular innate immune response. J Venom Anim Toxins Incl Trop Dis 2016; 22:1. [PMID: 26752985 PMCID: PMC4706697 DOI: 10.1186/s40409-016-0055-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 01/04/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Apis mellifera venom, which has already been recommended as an alternative anti-inflammatory treatment, may be also considered an important source of candidate molecules for biotechnological and biomedical uses, such as the treatment of parasitic diseases. METHODS Africanized honeybee venom from Apis mellifera was fractionated by RP-C18-HPLC and the obtained melittin was incubated with promastigotes and intracellular amastigotes of Leishmania (L.) infantum. Cytotoxicity to mice peritoneal macrophages was evaluated through mitochondrial oxidative activity. The production of anti- and pro-inflammatory cytokines, NO and H2O2 by macrophages was determined. RESULTS Promastigotes and intracellular amastigotes were susceptible to melittin (IC50 28.3 μg.mL(-1) and 1.4 μg.mL(-1), respectively), but also showed mammalian cell cytotoxicity with an IC50 value of 5.7 μg.mL(-1). Uninfected macrophages treated with melittin increased the production of IL-10, TNF-α, NO and H2O2. Infected melittin-treated macrophages increased IL-12 production, but decreased the levels of IL-10, TNF-α, NO and H2O2. CONCLUSIONS The results showed that melittin acts in vitro against promastigotes and intracellular amastigotes of Leishmania (L.) infantum. Furthermore, they can act indirectly on intracellular amastigotes through a macrophage immunomodulatory effect.
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Affiliation(s)
- Andreia Vieira Pereira
- Graduate Program in Tropical Diseases, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu, SP Brazil
| | - Gustavo de Barros
- Graduate Program in Tropical Diseases, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu, SP Brazil
| | - Erika Gracielle Pinto
- Department of Parasitology, Adolfo Lutz Institute, São Paulo, SP Brazil ; Laboratory of Protozoology, Institute for Tropical Medicine, University of São Paulo (USP), São Paulo, SP Brazil
| | | | - Ricardo de Oliveira Orsi
- Department of Animal Production, School of Veterinary Medicine and Animal Husbandry, São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu, SP Brazil ; Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP - Univ Estadual Paulista), Rua José Barbosa de Barros, 1780, 18610-307 Botucatu, SP Brazil
| | - Lucilene Delazari Dos Santos
- Graduate Program in Tropical Diseases, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu, SP Brazil ; Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP - Univ Estadual Paulista), Rua José Barbosa de Barros, 1780, 18610-307 Botucatu, SP Brazil
| | - Sueli Calvi
- Graduate Program in Tropical Diseases, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu, SP Brazil ; Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP - Univ Estadual Paulista), Rua José Barbosa de Barros, 1780, 18610-307 Botucatu, SP Brazil
| | - Rui Seabra Ferreira
- Graduate Program in Tropical Diseases, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu, SP Brazil ; Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP - Univ Estadual Paulista), Rua José Barbosa de Barros, 1780, 18610-307 Botucatu, SP Brazil
| | | | - Benedito Barraviera
- Graduate Program in Tropical Diseases, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu, SP Brazil ; Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (UNESP - Univ Estadual Paulista), Rua José Barbosa de Barros, 1780, 18610-307 Botucatu, SP Brazil
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43
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Farooq F, Bergmann-Leitner ES. Immune Escape Mechanisms are Plasmodium's Secret Weapons Foiling the Success of Potent and Persistently Efficacious Malaria Vaccines. Clin Immunol 2015; 161:136-43. [PMID: 26342537 DOI: 10.1016/j.clim.2015.08.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 08/27/2015] [Indexed: 10/23/2022]
Abstract
Despite decades of active research, an efficacious vaccine mediating long-term protection is still not available. This review highlights various mechanisms and the different facets by which the parasites outsmart the immune system. An understanding of how the parasites escape immune recognition and interfere with the induction of a protective immune response that provides sterilizing immunity will be crucial to vaccine design.
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Affiliation(s)
- Fouzia Farooq
- Malaria Vaccine Branch, U.S. Military Malaria Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910
| | - Elke S Bergmann-Leitner
- Malaria Vaccine Branch, U.S. Military Malaria Research Program, Walter Reed Army Institute of Research, Silver Spring, MD 20910.
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IL10 Variant g.5311A Is Associated with Visceral Leishmaniasis in Indian Population. PLoS One 2015; 10:e0124559. [PMID: 25941808 PMCID: PMC4420251 DOI: 10.1371/journal.pone.0124559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 03/16/2015] [Indexed: 12/20/2022] Open
Abstract
Background Visceral leishmaniasis (VL) is a multifactorial disease, where the host genetics play a significant role in determining the disease outcome. The immunological role of anti-inflammatory cytokine, Interleukin 10 (IL10), has been well-documented in parasite infections and considered as a key regulatory cytokine for VL. Although VL patients in India display high level of IL10 in blood serum, no genetic study has been conducted to assess the VL susceptibility / resistance. Therefore, the aim of this study is to investigate the role of IL10 variations in Indian VL; and to estimate the distribution of disease associated allele in diverse Indian populations. Methodology All the exons and exon-intron boundaries of IL10 were sequenced in 184 VL patients along with 172 ethnically matched controls from VL endemic region of India. Result and Discussion Our analysis revealed four variations; rs1518111 (2195 A>G, intron), rs1554286 (2607 C>T, intron), rs3024496 (4976 T>C, 3’ UTR) and rs3024498 (5311 A>G, 3’ UTR). Of these, a variant g.5311A is significantly associated with VL (χ2=18.87; p =0.00001). In silico approaches have shown that a putative micro RNA binding site (miR-4321) is lost in rs3024498 mRNA. Further, analysis of the above four variations in 1138 individuals from 34 ethnic populations, representing different social and linguistic groups who are inhabited in different geographical regions of India, showed variable frequency. Interestingly, we have found, majority of the tribal populations have low frequency of VL (‘A’ of rs3024498); and high frequency of leprosy (‘T’ of rs1554286), and Behcet’s (‘A’ of rs1518111) associated alleles, whereas these were vice versa in castes. Our findings suggest that majority of tribal populations of India carry the protected / less severe allele against VL, while risk / more severe allele for leprosy and Behcet’s disease. This study has potential implications in counseling and management of VL and other infectious diseases.
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da Costa-Silva TA, Grecco SS, de Sousa FS, Lago JHG, Martins EGA, Terrazas CA, Varikuti S, Owens KL, Beverley SM, Satoskar AR, Tempone AG. Immunomodulatory and Antileishmanial Activity of Phenylpropanoid Dimers Isolated from Nectandra leucantha. JOURNAL OF NATURAL PRODUCTS 2015; 78:653-7. [PMID: 25835647 PMCID: PMC4730870 DOI: 10.1021/np500809a] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Three phenylpropanoid dimers (1-3) including two new metabolites were isolated from the extract of the twigs of Nectandra leucantha using antileishmanial bioassay-guided fractionation. The in vitro antiparasitic activity of the isolated compounds against Leishmania donovani parasites and mammalian cytotoxicity and immunomodulatory effects were evaluated. Compounds 1-3 were effective against the intracellular amastigotes within macrophages, with IC50 values of 26.7, 17.8, and 101.9 μM, respectively. The mammalian cytotoxicity, given by the 50% cytotoxic concentration (CC50), was evaluated against peritoneal macrophages. Compounds 1 and 3 were not toxic up to 290 μM, whereas compound 2 demonstrated a CC50 value of 111.2 μM. Compounds 1-3 also suppressed production of disease exacerbatory cytokines IL-6 and IL-10 but had minimal effect on nitric oxide production in L. donovani-infected macrophages, indicating that antileishmanial activity of these compounds is mediated via an NO-independent mechanism. Therefore, these new natural products could represent promising scaffolds for drug design studies for leishmaniasis.
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Affiliation(s)
| | - Simone S. Grecco
- Center of Natural Sciences and Humanities, Federal University of ABC, São Paulo, Brazil
| | - Fernanda S. de Sousa
- Institute of Environmental, Chemical and Pharmaceutical Sciences, Federal University of São Paulo, São Paulo, Brazil
| | - João Henrique G. Lago
- Institute of Environmental, Chemical and Pharmaceutical Sciences, Federal University of São Paulo, São Paulo, Brazil
| | - Euder G. A. Martins
- Department of Botany, Institute of Biosciences, University of São Paulo, São Paulo, Brazil
| | - César A. Terrazas
- Departments of Pathology and Microbiology, Ohio State University, Columbus, Ohio, United States
| | - Sanjay Varikuti
- Departments of Pathology and Microbiology, Ohio State University, Columbus, Ohio, United States
| | - Katherine L. Owens
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Stephen M. Beverley
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Abhay R. Satoskar
- Departments of Pathology and Microbiology, Ohio State University, Columbus, Ohio, United States
| | - Andre G. Tempone
- Center for Parasitology and Mycology, Instituto Adolfo Lutz, São Paulo, Brazil
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Gatto M, de Abreu MM, Tasca KI, de Assis Golim M, da Silva LDM, Simão JC, Fortaleza CMCB, de Campos Soares ÂMV, Calvi SA. The involvement of TLR2 and TLR4 in cytokine and nitric oxide production in visceral leishmaniasis patients before and after treatment with anti-leishmanial drugs. PLoS One 2015; 10:e0117977. [PMID: 25706930 PMCID: PMC4338033 DOI: 10.1371/journal.pone.0117977] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 01/06/2015] [Indexed: 12/14/2022] Open
Abstract
Toll-like receptors (TLRs) have significant involvement in Leishmania infection, although little is known about the relationship between these receptors, cytokines and nitric oxide (NO) in patients with visceral leishmaniasis (VL) before or after treatment with anti-leishmanial drugs. The goal of this study was to evaluate the expression of TLR2 and TLR4 in CD3+ and CD14+ cells and the production of TNF-α, IFN-γ, IL-17, IL-10, TGF-β and NO in peripheral blood mononuclear cells (PBMCs) from VL patients pre- and post-treatment with anti-leishmanial drugs. In addition, we investigated whether these receptors were involved in the production of these cytokines and NO. In the active VL patients, increased TLR2 and TLR4 expression in lymphocytes and monocytes, increased production of TNF-α, IL-10 and TGF-β and decreased production of IFN-γ, IL-17 and NO were observed. After treatment, TLR2 and TLR4 were still expressed in lymphocytes and monocytes, the TNF-α and IL-10 levels were lower, the production of IFN-γ, IL-17 and NO was higher, and the TGF-β level remained high. Before treatment, the production of TNF-α and NO was associated with TLR2 and TLR4 expression, while IL-10 production was only associated with TLR2 expression. After treatment, both receptors were associated with the production of TNF-α, IFN-γ, IL-10 and NO, while the production of IL-17 was associated only with TLR4 expression. The results presented in this study suggest that both TLR2 and TLR4 participate in the modulation of cytokine and NO production in VL patients, contributing to the pathogenesis of VL prior to treatment and the protective immune response after treatment.
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Affiliation(s)
- Mariana Gatto
- Tropical Diseases Department, Botucatu School of Medicine—UNESP, Botucatu, São Paulo, Brazil
| | | | - Karen Ingrid Tasca
- Tropical Diseases Department, Botucatu School of Medicine—UNESP, Botucatu, São Paulo, Brazil
| | - Marjorie de Assis Golim
- Flow Cytometry Laboratory, Hemocenter, Botucatu School of Medicine—UNESP, Botucatu, São Paulo, Brazil
| | | | - José Cláudio Simão
- Ward of Infectious Diseases, State Hospital of Bauru, Bauru, São Paulo, Brazil
| | | | | | - Sueli Aparecida Calvi
- Tropical Diseases Department, Botucatu School of Medicine—UNESP, Botucatu, São Paulo, Brazil
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Gollob KJ, Viana AG, Dutra WO. Immunoregulation in human American leishmaniasis: balancing pathology and protection. Parasite Immunol 2014; 36:367-76. [PMID: 24471648 DOI: 10.1111/pim.12100] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 01/22/2014] [Indexed: 12/18/2022]
Abstract
Leishmaniasis covers a broad spectrum of diseases with distinct, and sometimes overlapping, characteristics. The common thread in all forms of leishmaniasis is the infection by the parasite Leishmania belonging to the genus Leishmania. Upon infection of humans, there can be at least three outcomes, (i) control of Leishmania by the host immune response resulting in asymptomatic disease, (ii) patent infection and development of a relatively mild form of leishmaniasis and (iii) patent infection and development of severe clinical forms. The factors that determine the outcome of an initial inoculation with Leishmania are many, with the species of Leishmania representing one of the strongest predictive factors for the development of a given clinical form of disease. This is seen with L. braziliensis and L. amazonensis, infection leading mostly to tegumentary forms of disease, and L. infantum with the potential to induce visceral disease. However, it is also clear that the host immune response is a key factor in disease progression, not only responsible for control of Leishmania, but also playing an important role in disease progression and pathology. This duality between protective and pathogenic immune responses in individuals infected with Leishmania in the Americas is the focus of this review.
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Affiliation(s)
- K J Gollob
- Graduate Program in Medicine and Biomedicine, Institute for Education and Research, Hospital Santa Casa, Belo Horizonte, MG, Brazil; National Institute for Science and Technology - Tropical Diseases (INCT-DT), Belo Horizonte, MG, Brazil
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Systematic review of biomarkers to monitor therapeutic response in leishmaniasis. Antimicrob Agents Chemother 2014; 59:1-14. [PMID: 25367913 DOI: 10.1128/aac.04298-14] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Recently, there has been a renewed interest in the development of new drugs for the treatment of leishmaniasis. This has spurred the need for pharmacodynamic markers to monitor and compare therapies specifically for visceral leishmaniasis, in which the primary recrudescence of parasites is a particularly long-term event that remains difficult to predict. We performed a systematic review of studies evaluating biomarkers in human patients with visceral, cutaneous, and post-kala-azar dermal leishmaniasis, which yielded a total of 170 studies in which 53 potential pharmacodynamic biomarkers were identified. In conclusion, the large majority of these biomarkers constituted universal indirect markers of activation and subsequent waning of cellular immunity and therefore lacked specificity. Macrophage-related markers demonstrate favorable sensitivity and times to normalcy, but more evidence is required to establish a link between these markers and clinical outcome. Most promising are the markers directly related to the parasite burden, but future effort should be focused on optimization of molecular or antigenic targets to increase the sensitivity of these markers. In general, future research should focus on the longitudinal evaluation of the pharmacodynamic biomarkers during treatment, with an emphasis on the correlation of studied biomarkers and clinical parameters.
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Hajilooi M, Sardarian K, Dadmanesh M, Matini M, Lotfi P, Bazmani A, Tabatabaiefar MA, Arababadi MK, Momeni M. Is the IL-10 -819 polymorphism associated with visceral leishmaniasis? Inflammation 2014; 36:1513-8. [PMID: 23912644 DOI: 10.1007/s10753-013-9693-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Previous investigations demonstrated that immune responses play critical roles in the defense against visceral leishmaniasis (VL). A key regulator of immune responses is the cytokine, IL-10 and polymorphisms within its promoter which could alter its expression. Thus, the aim of this study was to examine the correlation between polymorphism at the -819 position of the IL-10 gene and VL in a selected Iranian population. This cross-sectional study was performed on 100 patients with clinical presentation of VL and seropositive for the leishmania (group 1), 62 patients without clinical presentation but seropositive (group 2), and 128 healthy controls (group 3). The IL-10 -819 polymorphism was evaluated using the PCR-RFLP technique. The anti-leishmania antibody titration was assessed using an immunofluorescence assay. Our results showed that the polymorphism at IL-10 -819 (C/T) position was significantly associated with VL, and C/T genotype was significantly higher in VL patients when compared to groups 2 and 3 (p < 0.001). However, the results demonstrated that the C and T alleles were not associated with VL (p = 0.855). The data presented here confirm the results of previous reports that polymorphisms at the -819 position of the IL-10 gene can influence susceptibility to VL suggesting that the C/T genotype may be considered as a risk factor for the disease.
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Affiliation(s)
- Mehrdad Hajilooi
- Department of Immunology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Abstract
Visceral leishmaniasis is a chronic parasitic disease associated with severe immune dysfunction. Treatment options are limited to relatively toxic drugs, and there is no vaccine for humans available. Hence, there is an urgent need to better understand immune responses following infection with Leishmania species by studying animal models of disease and clinical samples from patients. Here, we review recent discoveries in these areas and highlight shortcomings in our knowledge that need to be addressed if better treatment options are to be developed and effective vaccines designed.
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