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de Mattos Barbosa MG, de Andrade Silva BJ, Assis TQ, da Silva Prata RB, Ferreira H, Andrade PR, da Paixão de Oliveira JA, Sperandio da Silva GM, da Costa Nery JA, Sarno EN, Pinheiro RO. Autophagy Impairment Is Associated With Increased Inflammasome Activation and Reversal Reaction Development in Multibacillary Leprosy. Front Immunol 2018; 9:1223. [PMID: 29915584 PMCID: PMC5994478 DOI: 10.3389/fimmu.2018.01223] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 05/15/2018] [Indexed: 12/15/2022] Open
Abstract
Leprosy reactions are responsible for incapacities in leprosy and represent the major cause of permanent neuropathy. The identification of biomarkers able to identify patients more prone to develop reaction could contribute to adequate clinical management and the prevention of disability. Reversal reaction may occur in unstable borderline patients and also in lepromatous patients. To identify biomarker signature profiles related with the reversal reaction onset, multibacillary patients were recruited and classified accordingly the occurrence or not of reversal reaction during or after multidrugtherapy. Analysis of skin lesion cells at diagnosis of multibacillary leprosy demonstrated that in the group that developed reaction (T1R) in the future there was a downregulation of autophagy associated with the overexpression of TLR2 and MLST8. The autophagy impairment in T1R group was associated with increased expression of NLRP3, caspase-1 (p10) and IL-1β production. In addition, analysis of IL-1β production in serum from multibacillary patients demonstrated that patients who developed reversal reaction have significantly increased concentrations of IL-1β at diagnosis, suggesting that the pattern of innate immune responses could predict the reactional episode outcome. In vitro analysis demonstrated that the blockade of autophagy with 3-methyladenine (3-MA) in Mycobacterium leprae-stimulated human primary monocytes increased the assembly of NLRP3 specks assembly, and it was associated with an increase of IL-1β and IL-6 production. Together, our data suggest an important role for autophagy in multibacillary leprosy patients to avoid exacerbated inflammasome activation and the onset of reversal reaction.
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Affiliation(s)
| | | | - Tayná Quintella Assis
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Helen Ferreira
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | | | | | - Euzenir Nunes Sarno
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Roberta Olmo Pinheiro
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Silva CAM, Belisle JT. Host Lipid Mediators in Leprosy: The Hypothesized Contributions to Pathogenesis. Front Immunol 2018; 9:134. [PMID: 29472920 PMCID: PMC5810268 DOI: 10.3389/fimmu.2018.00134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/16/2018] [Indexed: 12/12/2022] Open
Abstract
The spectrum of clinical forms observed in leprosy and its pathogenesis are dictated by the host's immune response against Mycobacterium leprae, the etiological agent of leprosy. Previous results, based on metabolomics studies, demonstrated a strong relationship between clinical manifestations of leprosy and alterations in the metabolism of ω3 and ω6 polyunsaturated fatty acids (PUFAs), and the diverse set of lipid mediators derived from PUFAs. PUFA-derived lipid mediators provide multiple functions during acute inflammation, and some lipid mediators are able to induce both pro- and anti-inflammatory responses as determined by the cell surface receptors being expressed, as well as the cell type expressing the receptors. However, little is known about how these compounds influence cellular immune activities during chronic granulomatous infectious diseases, such as leprosy. Current evidence suggests that specialized pro-resolving lipid mediators (SPMs) are involved in the down-modulation of the innate and adaptive immune response against M. leprae and that alteration in the homeostasis of pro-inflammatory lipid mediators versus SPMs is associated with dramatic shifts in the pathogenesis of leprosy. In this review, we discuss the possible consequences and present new hypotheses for the involvement of ω3 and ω6 PUFA metabolism in the pathogenesis of leprosy. A specific emphasis is placed on developing models of lipid mediator interactions with the innate and adaptive immune responses and the influence of these interactions on the outcome of leprosy.
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Affiliation(s)
- Carlos A. M. Silva
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, United States
| | - John T. Belisle
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, United States
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Silva BJDA, Barbosa MGDM, Andrade PR, Ferreira H, Nery JADC, Côrte-Real S, da Silva GMS, Rosa PS, Fabri M, Sarno EN, Pinheiro RO. Autophagy Is an Innate Mechanism Associated with Leprosy Polarization. PLoS Pathog 2017; 13:e1006103. [PMID: 28056107 PMCID: PMC5215777 DOI: 10.1371/journal.ppat.1006103] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 11/29/2016] [Indexed: 01/04/2023] Open
Abstract
Leprosy is a chronic infectious disease that may present different clinical forms according to the immune response of the host. Levels of IFN-γ are significantly raised in paucibacillary tuberculoid (T-lep) when compared with multibacillary lepromatous (L-lep) patients. IFN-γ primes macrophages for inflammatory activation and induces the autophagy antimicrobial mechanism. The involvement of autophagy in the immune response against Mycobacterium leprae remains unexplored. Here, we demonstrated by different autophagic assays that LC3-positive autophagosomes were predominantly observed in T-lep when compared with L-lep lesions and skin-derived macrophages. Accumulation of the autophagic receptors SQSTM1/p62 and NBR1, expression of lysosomal antimicrobial peptides and colocalization analysis of autolysosomes revealed an impairment of the autophagic flux in L-lep cells, which was restored by IFN-γ or rapamycin treatment. Autophagy PCR array gene-expression analysis revealed a significantly upregulation of autophagy genes (BECN1, GPSM3, ATG14, APOL1, and TPR) in T-lep cells. Furthermore, an upregulation of autophagy genes (TPR, GFI1B and GNAI3) as well as LC3 levels was observed in cells of L-lep patients that developed type 1 reaction (T1R) episodes, an acute inflammatory condition associated with increased IFN-γ levels. Finally, we observed increased BCL2 expression in L-lep cells that could be responsible for the blockage of BECN1-mediated autophagy. In addition, in vitro studies demonstrated that dead, but not live M. leprae can induce autophagy in primary and lineage human monocytes, and that live mycobacteria can reduce the autophagy activation triggered by dead mycobacteria, suggesting that M. leprae may hamper the autophagic machinery as an immune escape mechanism. Together, these results indicate that autophagy is an important innate mechanism associated with the M. leprae control in skin macrophages. Leprosy is an interesting model to study immune responses in humans due to the dichotomy observed among the poles of the disease. While in the self-limited tuberculoid form (T-lep) there are high systemic levels of the cytokine IFN-γ, in the clinically progressive lepromatous form (L-lep) low IFN-γ levels are found. IFN-γ activates an antimicrobial mechanism called autophagy, which has been implicated in control of Mycobacterium tuberculosis infection. However, the role played by autophagy in the immunopathogenesis of leprosy remains unknown. Here we show that autophagy was differentially regulated in T-lep and L-lep patients. In T-lep skin lesion cells autophagy contributes for bacilli control, whereas in L-lep cells the BCL2-mediated block of autophagy promotes the mycobacterial persistence. We also observed that IFN-γ may counteract the inhibition of autophagy triggered by M. leprae infection in L-lep macrophages. In addition, the levels of autophagy were restored in L-lep patients who developed the reversal reaction, an inflammatory state associated with augmented IFN-γ, which is the most important cause of nerve damage and deformities in leprosy. These findings suggest that the modulation of autophagy has the potential to be useful in the treatment of the disease, and provides new insights to prevent leprosy reactional episodes.
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Affiliation(s)
| | | | - Priscila Ribeiro Andrade
- Leprosy Laboratory; Oswaldo Cruz Institute; Oswaldo Cruz Foundation, FIOCRUZ; Rio de Janeiro, Brazil
| | - Helen Ferreira
- Leprosy Laboratory; Oswaldo Cruz Institute; Oswaldo Cruz Foundation, FIOCRUZ; Rio de Janeiro, Brazil
| | | | - Suzana Côrte-Real
- Structural Biology Laboratory; Oswaldo Cruz Institute; Oswaldo Cruz Foundation, FIOCRUZ; Rio de Janeiro, Brazil
| | | | | | - Mario Fabri
- Department of Dermatology; University of Cologne; Cologne, Germany
- Center for Molecular Medicine; University of Cologne; Cologne, Germany
| | - Euzenir Nunes Sarno
- Leprosy Laboratory; Oswaldo Cruz Institute; Oswaldo Cruz Foundation, FIOCRUZ; Rio de Janeiro, Brazil
| | - Roberta Olmo Pinheiro
- Leprosy Laboratory; Oswaldo Cruz Institute; Oswaldo Cruz Foundation, FIOCRUZ; Rio de Janeiro, Brazil
- * E-mail:
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Batista-Silva LR, Rodrigues LS, Vivarini ADC, Costa FDMR, Mattos KAD, Costa MRSN, Rosa PS, Toledo-Pinto TG, Dias AA, Moura DF, Sarno EN, Lopes UG, Pessolani MCV. Mycobacterium leprae-induced Insulin-like Growth Factor I attenuates antimicrobial mechanisms, promoting bacterial survival in macrophages. Sci Rep 2016; 6:27632. [PMID: 27282338 PMCID: PMC4901318 DOI: 10.1038/srep27632] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 05/19/2016] [Indexed: 02/07/2023] Open
Abstract
Mycobacterium leprae (ML), the etiologic agent of leprosy, can subvert macrophage antimicrobial activity by mechanisms that remain only partially understood. In the present study, the participation of hormone insulin-like growth factor I (IGF-I) in this phenomenum was investigated. Macrophages from the dermal lesions of the disseminated multibacillary lepromatous form (LL) of leprosy expressed higher levels of IGF-I than those from the self-limited paucibacillary tuberculoid form (BT). Higher levels of IGF-I secretion by ML-infected macrophages were confirmed in ex vivo and in vitro studies. Of note, the dampening of IGF-I signaling reverted the capacity of ML-infected human and murine macrophages to produce antimicrobial molecules and promoted bacterial killing. Moreover, IGF-I was shown to inhibit the JAK/STAT1-dependent signaling pathways triggered by both mycobacteria and IFN-γ most probably through its capacity to induce the suppressor of cytokine signaling-3 (SOCS3). Finally, these in vitro findings were corroborated by in vivo observations in which higher SOCS3 expression and lower phosphorylation of STAT1 levels were found in LL versus BT dermal lesions. Altogether, our data strongly suggest that IGF-I contributes to the maintenance of a functional program in infected macrophages that suits ML persistence in the host, reinforcing a key role for IGF-I in leprosy pathogenesis.
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Affiliation(s)
- L R Batista-Silva
- Laboratory of Cellular Microbiology, Oswaldo Cruz Institute, Rio de Janeiro, 21040-900, RJ, Brazil
| | - Luciana Silva Rodrigues
- Laboratory of Cellular Microbiology, Oswaldo Cruz Institute, Rio de Janeiro, 21040-900, RJ, Brazil
| | - Aislan de Carvalho Vivarini
- Laboratory of Molecular Parasitology, Carlos Chagas Filho Institute, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, 21940-590, RJ, Brazil
| | | | | | | | | | - T G Toledo-Pinto
- Leprosy Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, 21040-900, RJ, Brazil
| | - André Alves Dias
- Laboratory of Cellular Microbiology, Oswaldo Cruz Institute, Rio de Janeiro, 21040-900, RJ, Brazil
| | | | - Euzenir Nunes Sarno
- Leprosy Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, 21040-900, RJ, Brazil
| | - Ulisses Gazos Lopes
- Laboratory of Molecular Parasitology, Carlos Chagas Filho Institute, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, 21940-590, RJ, Brazil
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Silva SRB, Illarramendi X, Tempone AJ, Silva PHL, Nery JAC, Monteiro AMV, Pessolani MCV, Boasquevisque E, Sarno EN, Pereira GMB, Esquenazi D. Downregulation of PHEX in multibacillary leprosy patients: observational cross-sectional study. J Transl Med 2015; 13:296. [PMID: 26362198 PMCID: PMC4566286 DOI: 10.1186/s12967-015-0651-5] [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: 06/20/2015] [Accepted: 08/25/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Peripheral nerve injury and bone lesions, well known leprosy complications, lead to deformities and incapacities. The phosphate-regulating gene with homologies to endopeptidase on the X chromosome (PHEX) encodes a homonymous protein (PHEX) implicated in bone metabolism. PHEX/PHEX alterations may result in bone and cartilage lesions. PHEX expression is downregulated by intracellular Mycobacterium leprae (M. leprae) in cultures of human Schwann cells and osteoblasts. M. leprae in vivo effect on PHEX/PHEX is not known. METHODS Cross-sectional observational study of 36 leprosy patients (22 lepromatous and 14 borderline-tuberculoid) and 20 healthy volunteers (HV). The following tests were performed: PHEX flow cytometric analysis on blood mononuclear cells, cytokine production in culture supernatant, 25-hydroxyvitamin D (OHvitD) serum levels and (99m)Tc-MDP three-phase bone scintigraphy, radiography of upper and lower extremities and blood and urine biochemistry. RESULTS Significantly lower PHEX expression levels were observed in lepromatous patients than in the other groups (χ(2) = 16.554, p < 0.001 for lymphocytes and χ(2) = 13.933, p = 0.001 for monocytes). Low levels of 25-(OHvitD) were observed in HV (median = 23.0 ng/mL) and BT patients (median = 27.5 ng/mL) and normal serum levels were found in LL patients (median = 38.6 ng/mL). Inflammatory cytokines, such as TNF, a PHEX transcription repressor, were lower after stimulation with M. leprae in peripheral blood mononuclear cells from lepromatous in comparison to BT patients and HV (χ(2) = 10.820, p < 0.001). CONCLUSION Downregulation of PHEX may constitute an important early component of bone loss and joint damage in leprosy. The present results suggest a direct effect produced by M. leprae on the osteoarticular system that may use this mechanism.
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Affiliation(s)
- Sandra R Boiça Silva
- Disciplina de Patologia Geral e Laboratório de Imunopatologia, Departamento de Patologia e Laboratórios, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Av Professor Manuel de Abreu 444, Vila Isabel, Rio de Janeiro, RJ, 20550-170, Brazil.
| | - Ximena Illarramendi
- Laboratório de Hanseníase, Instituto Oswaldo Cruz (IOC) - Oswaldo Cruz Foundation (FIOCRUZ), Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-360, Brazil.
| | - Antonio J Tempone
- Laboratório de Biologia Molecular de Parasitas e Vetores, Instituto Oswaldo Cruz (IOC) - Oswaldo Cruz Foundation (FIOCRUZ), Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-360, Brazil.
| | - Pedro H L Silva
- Laboratório de Hanseníase, Instituto Oswaldo Cruz (IOC) - Oswaldo Cruz Foundation (FIOCRUZ), Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-360, Brazil.
| | - José A C Nery
- Laboratório de Hanseníase, Instituto Oswaldo Cruz (IOC) - Oswaldo Cruz Foundation (FIOCRUZ), Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-360, Brazil.
| | - Alexandra M V Monteiro
- Serviço de Medicina Nuclear, Departamento de Radiologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Av. Prof. Manuel de Abreu 444, Vila Isabel, Rio de Janeiro, RJ, 20550-170, Brazil.
| | - Maria Cristina V Pessolani
- Laboratório de Microbiologia Celular, Instituto Oswaldo Cruz (IOC) - Oswaldo Cruz Foundation (FIOCRUZ), Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-360, Brazil.
| | - Edson Boasquevisque
- Serviço de Medicina Nuclear, Departamento de Radiologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Av. Prof. Manuel de Abreu 444, Vila Isabel, Rio de Janeiro, RJ, 20550-170, Brazil.
| | - Euzenir N Sarno
- Laboratório de Hanseníase, Instituto Oswaldo Cruz (IOC) - Oswaldo Cruz Foundation (FIOCRUZ), Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-360, Brazil.
| | - Geraldo M B Pereira
- Laboratório de Microbiologia Celular, Instituto Oswaldo Cruz (IOC) - Oswaldo Cruz Foundation (FIOCRUZ), Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-360, Brazil. .,Disciplina de Patologia Geral e Laboratório de Imunopatologia, Departamento de Patologia e Laboratórios, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Av Professor Manuel de Abreu 444, Vila Isabel, Rio de Janeiro, RJ, 20550-170, Brazil.
| | - Danuza Esquenazi
- Laboratório de Hanseníase, Instituto Oswaldo Cruz (IOC) - Oswaldo Cruz Foundation (FIOCRUZ), Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21040-360, Brazil. .,Disciplina de Patologia Geral e Laboratório de Imunopatologia, Departamento de Patologia e Laboratórios, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Av Professor Manuel de Abreu 444, Vila Isabel, Rio de Janeiro, RJ, 20550-170, Brazil.
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Mattos KA, Oliveira VCG, Berrêdo-Pinho M, Amaral JJ, Antunes LCM, Melo RCN, Acosta CCD, Moura DF, Olmo R, Han J, Rosa PS, Almeida PE, Finlay BB, Borchers CH, Sarno EN, Bozza PT, Atella GC, Pessolani MCV. Mycobacterium leprae intracellular survival relies on cholesterol accumulation in infected macrophages: a potential target for new drugs for leprosy treatment. Cell Microbiol 2014; 16:797-815. [PMID: 24552180 PMCID: PMC4262048 DOI: 10.1111/cmi.12279] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 02/10/2014] [Accepted: 02/10/2014] [Indexed: 12/19/2022]
Abstract
We recently showed that Mycobacterium leprae (ML) is able to induce lipid droplet formation in infected macrophages. We herein confirm that cholesterol (Cho) is one of the host lipid molecules that accumulate in ML-infected macrophages and investigate the effects of ML on cellular Cho metabolism responsible for its accumulation. The expression levels of LDL receptors (LDL-R, CD36, SRA-1, SR-B1, and LRP-1) and enzymes involved in Cho biosynthesis were investigated by qRT-PCR and/or Western blot and shown to be higher in lepromatous leprosy (LL) tissues when compared to borderline tuberculoid (BT) lesions. Moreover, higher levels of the active form of the sterol regulatory element-binding protein (SREBP) transcriptional factors, key regulators of the biosynthesis and uptake of cellular Cho, were found in LL skin biopsies. Functional in vitro assays confirmed the higher capacity of ML-infected macrophages to synthesize Cho and sequester exogenous LDL-Cho. Notably, Cho colocalized to ML-containing phagosomes, and Cho metabolism impairment, through either de novo synthesis inhibition by statins or depletion of exogenous Cho, decreased intracellular bacterial survival. These findings highlight the importance of metabolic integration between the host and bacteria to leprosy pathophysiology, opening new avenues for novel therapeutic strategies to leprosy.
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Affiliation(s)
- Katherine A Mattos
- Laboratório de Microbiologia Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, 21040-900, RJ, Brazil
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Adams LB, Pena MT, Sharma R, Hagge DA, Schurr E, Truman RW. Insights from animal models on the immunogenetics of leprosy: a review. Mem Inst Oswaldo Cruz 2013; 107 Suppl 1:197-208. [PMID: 23283472 DOI: 10.1590/s0074-02762012000900028] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 06/05/2012] [Indexed: 11/21/2022] Open
Abstract
A variety of host immunogenetic factors appear to influence both an individual's susceptibility to infection with Mycobacterium leprae and the pathologic course of the disease. Animal models can contribute to a better understanding of the role of immunogenetics in leprosy through comparative studies helping to confirm the significance of various identified traits and in deciphering the underlying mechanisms that may be involved in expression of different disease related phenotypes. Genetically engineered mice, with specific immune or biochemical pathway defects, are particularly useful for investigating granuloma formation and resistance to infection and are shedding new light on borderline areas of the leprosy spectrum which are clinically unstable and have a tendency toward immunological complications. Though armadillos are less developed in this regard, these animals are the only other natural hosts of M. leprae and they present a unique opportunity for comparative study of genetic markers and mechanisms associable with disease susceptibility or resistance, especially the neurological aspects of leprosy. In this paper, we review the recent contributions of genetically engineered mice and armadillos toward our understanding of the immunogenetics of leprosy.
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Affiliation(s)
- Linda B Adams
- Department of Health and Human Services, Health Resources and Services Administration, Bureau of Primary Health Care, National Hansen's Disease Programs, Baton Rouge, LA, USA.
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Moura DF, de Mattos KA, Amadeu TP, Andrade PR, Sales JS, Schmitz V, Nery JAC, Pinheiro RO, Sarno EN. CD163 favors Mycobacterium leprae survival and persistence by promoting anti-inflammatory pathways in lepromatous macrophages. Eur J Immunol 2012; 42:2925-36. [DOI: 10.1002/eji.201142198] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 07/03/2012] [Accepted: 07/26/2012] [Indexed: 12/18/2022]
Affiliation(s)
- Danielle F. Moura
- Leprosy Laboratory; Oswaldo Cruz Institute; Fiocruz, Rio de Janeiro Brazil
| | - Katherine A. de Mattos
- Cellular Microbiology Laboratory; Oswaldo Cruz Institute; Fiocruz, Rio de Janeiro Brazil
| | - Thaís P. Amadeu
- Leprosy Laboratory; Oswaldo Cruz Institute; Fiocruz, Rio de Janeiro Brazil
| | | | | | - Verônica Schmitz
- Leprosy Laboratory; Oswaldo Cruz Institute; Fiocruz, Rio de Janeiro Brazil
| | | | | | - Euzenir N. Sarno
- Leprosy Laboratory; Oswaldo Cruz Institute; Fiocruz, Rio de Janeiro Brazil
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de Souza Sales J, Lara FA, Amadeu TP, de Oliveira Fulco T, da Costa Nery JA, Sampaio EP, Pinheiro RO, Sarno EN. The role of indoleamine 2, 3-dioxygenase in lepromatous leprosy immunosuppression. Clin Exp Immunol 2011; 165:251-63. [PMID: 21592112 DOI: 10.1111/j.1365-2249.2011.04412.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
To elucidate further the possible role of the tryptophan, rate-limiting enzyme indoleamine 2, 3-dioxygenase (IDO) in leprosy, the distribution of IDO-positive cells and IDO activity in the skin biopsies and sera of these patients representing the entire spectrum of the disease were studied. An increased number of macrophages/dendritic cells (DC-lineage IDO(+) cells were found in lepromatous (LL) compared to tuberculoid (BT) and reversal reaction (RR) patients. IDO-positive cells showing CD68 and CD86 surface markers predominated in LL lesions, while higher levels of IDO activity were observed in the sera of LL versus BT patients. Tests revealed an increased IDO message in Mycobacterium leprae-stimulated peripheral blood mononuclear cells (PBMC) by real-time polymerase chain reaction (PCR) and increased IDO expression in M. leprae-stimulated CD14(+) cells of both healthy controls (HC) and LL patients, as evaluated via flow cytometry. Increased M. leprae-induced IDO-protein synthesis was also confirmed by Western blot. Based on our in vitro studies, it was confirmed that M. leprae up-regulated IDO expression and activity in HC and LL monocytes. Interferon (IFN)-γ synergized with M. leprae in promoting IDO expression and activity in monocytes. IDO expression induced by both IFN-γ and M. leprae was abrogated by 1-methyltryptophan (1-MT). Our data suggest that M. leprae chronic infection activates the suppressive molecule IDO which, in turn, contributes to the specific immunosuppression observed in LL leprosy.
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Affiliation(s)
- J de Souza Sales
- Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz - Rio de Janeiro, Brazil
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Pinheiro RO, de Souza Salles J, Sarno EN, Sampaio EP. Mycobacterium leprae-host-cell interactions and genetic determinants in leprosy: an overview. Future Microbiol 2011; 6:217-30. [PMID: 21366421 PMCID: PMC3123826 DOI: 10.2217/fmb.10.173] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Leprosy, also known as Hansen's disease, is a chronic infectious disease caused by Mycobacterium leprae in which susceptibility to the mycobacteria and its clinical manifestations are attributed to the host immune response. Even though leprosy prevalence has decreased dramatically, the high number of new cases indicates active transmission. Owing to its singular features, M. leprae infection is an attractive model for investigating the regulation of human immune responses to pathogen-induced disease. Leprosy is one of the most common causes of nontraumatic peripheral neuropathy worldwide. The proportion of patients with disabilities is affected by the type of leprosy and delay in diagnosis. This article briefly reviews the clinical features as well as the immunopathological mechanisms related to the establishment of the different polar forms of leprosy, the mechanisms related to M. leprae-host cell interactions and prophylaxis and diagnosis of this complex disease. Host genetic factors are summarized and the impact of the development of interventions that prevent, reverse or limit leprosy-related nerve impairments are discussed.
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Affiliation(s)
- Roberta Olmo Pinheiro
- Leprosy Laboratory, Oswaldo Cruz Institute, FIOCRUZ, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, Brazil, 21040-21360
| | - Jorgenilce de Souza Salles
- Leprosy Laboratory, Oswaldo Cruz Institute, FIOCRUZ, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, Brazil, 21040-21360
| | - Euzenir Nunes Sarno
- Leprosy Laboratory, Oswaldo Cruz Institute, FIOCRUZ, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, Brazil, 21040-21360
| | - Elizabeth Pereira Sampaio
- Leprosy Laboratory, Oswaldo Cruz Institute, FIOCRUZ, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ, Brazil, 21040-21360
- Immunopathogenesis Section, Laboratory of Clinical Infectious Diseases, LCID, National Institutes of Health, NIH, 9000 Rockville Pike, Bethesda, MD, 20892-21684, USA
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Quaresma JAS, Lima LWDO, Fuzii HT, Libonati RMF, Pagliari C, Duarte MIS. Immunohistochemical evaluation of macrophage activity and its relationship with apoptotic cell death in the polar forms of leprosy. Microb Pathog 2010; 49:135-40. [PMID: 20510345 DOI: 10.1016/j.micpath.2010.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2009] [Revised: 05/02/2010] [Accepted: 05/04/2010] [Indexed: 11/19/2022]
Abstract
The objective of the present study was to investigate the correlation between macrophage activity and apoptosis in the polar forms of leprosy because the immunopathological phenomena involved in these forms are still poorly understood. For this purpose, 29 skin biopsy samples obtained from patients with the polar forms of leprosy were analyzed. Macrophage activity and apoptosis were evaluated by immunohistochemistry using lysozyme, CD68, iNOS and caspase 3 as markers. The nonparametric Mann-Whitney test and Spearman's linear correlation test were used for statistical analysis. The results suggest that the apoptosis rate is under the direct influence of macrophage activity in lesions of patients with the tuberculoid form. In contrast, in lepromatous lesions other factors seem to induce programmed cell death, possibly TGF-beta. Further studies are necessary to identify additional factors involved in the immunopathogenesis of leprosy.
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High matrix metalloproteinase production correlates with immune activation and leukocyte migration in leprosy reactional lesions. Infect Immun 2009; 78:1012-21. [PMID: 20008541 DOI: 10.1128/iai.00896-09] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Gelatinases A and B (matrix metalloproteinase 2 [MMP-2] and MMP-9, respectively) can induce basal membrane breakdown and leukocyte migration, but their role in leprosy skin inflammation remains unclear. In this study, we analyzed clinical specimens from leprosy patients taken from stable, untreated skin lesions and during reactional episodes (reversal reaction [RR] and erythema nodosum leprosum [ENL]). The participation of MMPs in disease was suggested by (i) increased MMP mRNA expression levels in skin biopsy specimens correlating with the expression of gamma interferon (IFN-gamma) and tumor necrosis factor alpha (TNF-alpha), (ii) the detection of the MMP protein and enzymatic activity within the inflammatory infiltrate, (iii) increased MMP levels in patient sera, and (iv) the in vitro induction of MMP-9 by Mycobacterium leprae and/or TNF-alpha. It was observed that IFN-gamma, TNF-alpha, MMP-2, and MMP-9 mRNA levels were higher in tuberculoid than lepromatous lesions. In contrast, interleukin-10 and tissue inhibitor of MMP (TIMP-1) message were not differentially modulated. These data correlated with the detection of the MMP protein evidenced by immunohistochemistry and confocal microscopy. When RR and ENL lesions were analyzed, an increase in TNF-alpha, MMP-2, and MMP-9, but not TIMP-1, mRNA levels was observed together with stronger MMP activity (zymography/in situ zymography). Moreover, following in vitro stimulation of peripheral blood cells, M. leprae induced the expression of MMP-9 (mRNA and protein) in cultured cells. Overall, the present data demonstrate an enhanced MMP/TIMP-1 ratio in the inflammatory states of leprosy and point to potential mechanisms for tissue damage. These results pave the way toward the application of new therapeutic interventions for leprosy reactions.
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Research Snippets. J Invest Dermatol 2007. [DOI: 10.1038/sj.jid.5701066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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