Abstract
Background
Leishmania (L.) species are the causative agent of leishmaniasis. Due to the lack of efficient vaccine candidates, drug therapies are the only option to deal with cutaneous leishmaniasis. Unfortunately, chemotherapeutic interventions show high toxicity in addition to an increased risk of dissemination of drug-resistant parasites. An appropriate laboratory animal based model is still missing which allows testing of new drug strategies in the context of human immune cells in vivo.
Methodology/Principal Findings
Humanized mice were infected subcutaneously with stationary phase promastigote L. major into the footpad. The human immune response against the pathogen and the parasite host interactions were analyzed. In addition we proved the versatility of this new model to conduct drug research studies by the inclusion of orally given Miltefosine. We show that inflammatory human macrophages get infected with Leishmania parasites at the site of infection. Furthermore, a Leishmania-specific human-derived T cell response is initiated. However, the human immune system is not able to prevent systemic infection. Thus, we treated the mice with Miltefosine to reduce the parasitic load. Notably, this chemotherapy resulted in a reduction of the parasite load in distinct organs. Comparable to some Miltefosine treated patients, humanized mice developed severe side effects, which are not detectable in the classical murine model of experimental leishmaniasis.
Conclusions/Significance
This study describes for the first time L. major infection in humanized mice, characterizes the disease development, the induction of human adaptive and innate immune response including cytokine production and the efficiency of Miltefosine treatment in these animals. In summary, humanized mice might be beneficial for future preclinical chemotherapeutic studies in systemic (visceral) leishmaniasis allowing the investigation of human immune response, side effects of the drug due to cytokine production of activated humane immune cells and the efficiency of the treatment to eliminate also not replicating (“hiding”) parasites.
As many as 12 million people suffer from Leishmania (L.) infection worldwide with about one to two million newly infected people every year. Due to the lack of vaccine strategies, the only option is chemotherapeutic intervention which can cause serious side effects. Therefore, new prevention or treatment strategies are urgently needed in addition to an appropriate animal model for testing. We infected humanized mice in the footpad with stationary phase promastigote L. major and analyzed the human innate and adaptive immune response by flow cytometry, histology, and quantitative PCR. Infected macrophages were detectable at the site of infection and in lymphoid organs. Additionally, we were able to measure Leishmania-specific T cell priming in humanized mice. However, these human immune defense mechanisms were not sufficient to prevent systemic spreading and lethality. By the inclusion of Miltefosine, we tested this novel model for its versatility in conducting drug studies. The oral treatment was able to reduce parasitic load but also revealed side effects which are described in humans but not in mice. Therefore, we propose humanized mice as a novel model, which offers the opportunity to study new therapy strategies in chronic leishmaniasis in the context of a human immune system.
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