1
|
Corrêa-Castro G, Silva-Freitas ML, de Paula L, Soares Pereira L, Dutra MRT, Albuquerque HG, Cota G, de Azevedo Martins C, Da-Cruz AM, Gomes-Silva A, Santos-Oliveira JR. A link between circulating immune complexes and acute kidney injury in human visceral leishmaniasis. Sci Rep 2024; 14:9870. [PMID: 38684845 PMCID: PMC11059367 DOI: 10.1038/s41598-024-60209-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 04/19/2024] [Indexed: 05/02/2024] Open
Abstract
Visceral leishmaniasis (VL) is an infectious disease caused by Leishmania infantum. Clinically, VL evolves with systemic impairment, immunosuppression and hyperactivation with hypergammaglobulinemia. Although renal involvement has been recognized, a dearth of understanding about the underlying mechanisms driving acute kidney injury (AKI) in VL remains. We aimed to evaluate the involvement of immunoglobulins (Igs) and immune complexes (CIC) in the occurrence of AKI in VL patients. Fourteen VL patients were evaluated between early treatment and 12 months post-treatment (mpt). Anti-Leishmania Igs, CIC, cystatin C, C3a and C5a were assessed and correlated with AKI markers. Interestingly, high levels of CIC were observed in VL patients up to 6 mpt. Concomitantly, twelve patients met the criteria for AKI, while high levels of cystatin C were observed up to 6 mpt. Plasmatic cystatin C was positively correlated with CIC and Igs. Moreover, C5a was correlated with cystatin C, CIC and Igs. We did not identify any correlation between amphotericin B use and kidney function markers in VL patients, although this association needs to be further explored in subsequent studies. Our data reinforce the presence of an important renal function impairment during VL, suggesting the involvement of Igs, CIC, and C5a in this clinical condition.
Collapse
Affiliation(s)
- Gabriela Corrêa-Castro
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
- Núcleo de Ciências Biomédicas Aplicadas, Instituto Federal de Educação, Ciência e Tecnologia, IFRJ, Rio de Janeiro, Brazil
| | | | - Ludmila de Paula
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais, Minas Gerais, Brazil
| | - Leonardo Soares Pereira
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais, Minas Gerais, Brazil
| | | | | | - Glaucia Cota
- Instituto René Rachou, FIOCRUZ, Minas Gerais, Brazil
| | | | - Alda Maria Da-Cruz
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
- Disciplina de Parasitologia, DMIP, Faculdade de Ciências Médicas, UERJ, Rio de Janeiro, Brazil
- Rede de Pesquisas em Saúde do Estado do Rio de Janeiro, FAPERJ, Rio de Janeiro, Brazil
- Instituto Nacional de Neuroimunomodulação, INCT-NIM-CNPq, Rio de Janeiro, Brazil
| | - Adriano Gomes-Silva
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
- Laboratório de Pesquisa Clínica em Micobacterioses, Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil
| | - Joanna Reis Santos-Oliveira
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil.
- Núcleo de Ciências Biomédicas Aplicadas, Instituto Federal de Educação, Ciência e Tecnologia, IFRJ, Rio de Janeiro, Brazil.
- Instituto Nacional de Neuroimunomodulação, INCT-NIM-CNPq, Rio de Janeiro, Brazil.
| |
Collapse
|
2
|
Catarino JDS, de Oliveira RF, Silva MV, Sales-Campos H, de Vito FB, da Silva DAA, Naves LL, Oliveira CJF, Rodrigues DBR, Rodrigues V. Genetic variation of FcγRIIa induces higher uptake of Leishmania infantum and modulates cytokine production by adherent mononuclear cells in vitro. Front Immunol 2024; 15:1343602. [PMID: 38455048 PMCID: PMC10917923 DOI: 10.3389/fimmu.2024.1343602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/01/2024] [Indexed: 03/09/2024] Open
Abstract
Introduction Single nucleotide variations (SNVs) are specific genetic variations that commonly occur in a population and often do not manifest phenotypically. However, depending on their location and the type of nucleotide exchanged, an SNV can alter or inhibit the function of the gene in which it occurs. Immunoglobulin G (IgG) receptor genes have exhibited several polymorphisms, including rs1801274, which is found in the FcgRIIa gene. The replacement of A with T results in a Histidine (H) to Arginine (R) substitution, altering the affinity of the IgG receptor for IgG subtypes and C-reactive protein (CRP). In this study, we analyzed rs1801274 and its functional implications concerning L. Infantum uptake and cytokine production. Methods We genotyped 201 individuals from an endemic area for visceral leishmaniasis to assess the presence of rs1801274 using Taqman probes for a candidate gene study. Additionally, we included seventy individuals from a non-endemic area for a functional study. Subsequently, we isolated and cultivated one-week adherent mononuclear cells (AMCs) derived from the peripheral blood of participants residing in the non-endemic region in the presence of L. infantum promastigotes, with and without antigen-specific IgG and/or CRP. We analyzed the rate of phagocytosis and the production of nitric oxide (NO), tumor necrosis factor (TNF)-a, interleukin (IL)-10, IL-12 p70, IL-1b, IL- 6, and IL-8 in the culture supernatants. Results and discussion In participants from the endemic region, the A/G (H/R isoform) heterozygous genotype was significantly associated with susceptibility to the disease. Furthermore, SNVs induced a change in the phagocytosis rate in an opsonin-dependent manner. Opsonization with IgG increased the production of IL-10, TNF-a, and IL-6 in AMCs with the H/R isoform, followed by a decrease in NO production. The results presented here suggest that the rs1801274 polymorphism is linked to a higher susceptibility to visceral leishmaniasis.
Collapse
Affiliation(s)
- Jonatas da Silva Catarino
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Rafael Faria de Oliveira
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Marcos Vinicius Silva
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Helioswilton Sales-Campos
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO, Brazil
| | - Fernanda Bernadelli de Vito
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Djalma Alexandre Alves da Silva
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Lucila Langoni Naves
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Carlo José Freire Oliveira
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Denise Bertulucci Rocha Rodrigues
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Virmondes Rodrigues
- Laboratory of Immunology, Institute of Natural and Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
- National Institute of Neuroimmuno Modulation, Rio de Janeiro, Brazil
| |
Collapse
|
3
|
Costa CHN, Chang KP, Costa DL, Cunha FVM. From Infection to Death: An Overview of the Pathogenesis of Visceral Leishmaniasis. Pathogens 2023; 12:969. [PMID: 37513817 PMCID: PMC10384967 DOI: 10.3390/pathogens12070969] [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: 05/13/2023] [Revised: 07/02/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Kala-azar, also known as visceral leishmaniasis (VL), is a disease caused by Leishmania infantum and L. donovani. Patients experience symptoms such as fever, weight loss, paleness, and enlarged liver and spleen. The disease also affects immunosuppressed individuals and has an overall mortality rate of up to 10%. This overview explores the literature on the pathogenesis of preclinical and clinical stages, including studies in vitro and in animal models, as well as complications and death. Asymptomatic infection can result in long-lasting immunity. VL develops in a minority of infected individuals when parasites overcome host defenses and multiply in tissues such as the spleen, liver, and bone marrow. Hepatosplenomegaly occurs due to hyperplasia, resulting from parasite proliferation. A systemic inflammation mediated by cytokines develops, triggering acute phase reactants from the liver. These cytokines can reach the brain, causing fever, cachexia and vomiting. Similar to sepsis, disseminated intravascular coagulation (DIC) occurs due to tissue factor overexpression. Anemia, hypergammaglobulinemia, and edema result from the acute phase response. A regulatory response and lymphocyte depletion increase the risk of bacterial superinfections, which, combined with DIC, are thought to cause death. Our understanding of VL's pathogenesis is limited, and further research is needed to elucidate the preclinical events and clinical manifestations in humans.
Collapse
Affiliation(s)
- Carlos H N Costa
- Centro de Investigações em Agravos Tropicais Emergentes e Negligenciados, Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Rua Artur de Vasconcelos 151-Sul, Teresina 64002-510, PI, Brazil
| | - Kwang-Poo Chang
- Department of Microbiology/Immunology, Center for Cancer Cell Biology, Immunology & Infection, Chicago Medical School, Rosalind Franklin University, North Chicago, IL 60064, USA
| | - Dorcas L Costa
- Centro de Investigações em Agravos Tropicais Emergentes e Negligenciados, Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Rua Artur de Vasconcelos 151-Sul, Teresina 64002-510, PI, Brazil
| | - Francisco Valmor M Cunha
- Departament of Physiotherapy, Centro Universitário Uninovafapi, Rua Vitorino Orthiges Fernandes, 6123-Uruguai, Teresina 64073-505, PI, Brazil
| |
Collapse
|
4
|
de Moraes L, Santos LA, Arruda LB, da Silva MDPP, Silva MDO, Silva JAG, Ramos A, dos Santos MB, Torres FG, Orge C, Teixeira AMDS, Vieira TS, Ramírez L, Soto M, Grassi MFR, de Siqueira IC, Costa DL, Costa CHN, Andrade BDB, Akrami K, de Oliveira CI, Boaventura VS, Barral-Netto M, Barral A, Vandamme AM, Van Weyenbergh J, Khouri R. High seroprevalence of Leishmania infantum is linked to immune activation in people with HIV: a two-stage cross-sectional study in Bahia, Brazil. Front Microbiol 2023; 14:1221682. [PMID: 37601355 PMCID: PMC10436095 DOI: 10.3389/fmicb.2023.1221682] [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: 05/12/2023] [Accepted: 06/28/2023] [Indexed: 08/22/2023] Open
Abstract
Visceral leishmaniasis is an opportunistic disease in HIV-1 infected individuals, unrecognized as a determining factor for AIDS diagnosis. The growing geographical overlap of HIV-1 and Leishmania infections is an emerging challenge worldwide, as co-infection increases morbidity and mortality for both infections. Here, we determined the prevalence of people living with HIV (PWH) with a previous or ongoing infection by Leishmania infantum and investigated the virological and immunological factors associated with co-infection. We adopted a two-stage cross-sectional cohort (CSC) design (CSC-I, n = 5,346 and CSC-II, n = 317) of treatment-naïve HIV-1-infected individuals in Bahia, Brazil. In CSC-I, samples collected between 1998 and 2013 were used for serological screening for leishmaniasis by an in-house Enzyme-Linked Immunosorbent Assay (ELISA) with SLA (Soluble Leishmania infantum Antigen), resulting in a prevalence of previous or ongoing infection of 16.27%. Next, 317 PWH were prospectively recruited from July 2014 to December 2015 with the collection of sociodemographic and clinical data. Serological validation by two different immunoassays confirmed a prevalence of 15.46 and 8.20% by anti-SLA, and anti-HSP70 serology, respectively, whereas 4.73% were double-positive (DP). Stratification of these 317 individuals in DP and double-negative (DN) revealed a significant reduction of CD4+ counts and CD4+/CD8+ ratios and a tendency of increased viral load in the DP group, as compared to DN. No statistical differences in HIV-1 subtype distribution were observed between the two groups. However, we found a significant increase of CXCL10 (p = 0.0076) and a tendency of increased CXCL9 (p = 0.061) in individuals with DP serology, demonstrating intensified immune activation in this group. These findings were corroborated at the transcriptome level in independent Leishmania- and HIV-1-infected cohorts (Swiss HIV Cohort and Piaui Northeast Brazil Cohort), indicating that CXCL10 transcripts are shared by the IFN-dominated immune activation gene signatures of both pathogens and positively correlated to viral load in untreated PWH. This study demonstrated a high prevalence of PWH with L. infantum seropositivity in Bahia, Brazil, linked to IFN-mediated immune activation and a significant decrease in CD4+ levels. Our results highlight the urgent need to increase awareness and define public health strategies for the management and prevention of HIV-1 and L. infantum co-infection.
Collapse
Affiliation(s)
- Laise de Moraes
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Luciane Amorim Santos
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Liã Bárbara Arruda
- Centre for Clinical Microbiology, Division of Infection & Immunity, University College London, London, United Kingdom
| | | | - Márcio de Oliveira Silva
- Centro Estadual Especializado em Diagnóstico, Assistência e Pesquisa, Secretaria de Saúde do Estado da Bahia, Salvador, Brazil
| | - José Adriano Góes Silva
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Centro Estadual Especializado em Diagnóstico, Assistência e Pesquisa, Secretaria de Saúde do Estado da Bahia, Salvador, Brazil
| | - André Ramos
- Centro Estadual Especializado em Diagnóstico, Assistência e Pesquisa, Secretaria de Saúde do Estado da Bahia, Salvador, Brazil
| | | | | | - Cibele Orge
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | | | - Laura Ramírez
- Departamento de Biología Molecular, Facultad de Ciencias, Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, Madrid, Spain
| | - Manuel Soto
- Departamento de Biología Molecular, Facultad de Ciencias, Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, Madrid, Spain
| | - Maria Fernanda Rios Grassi
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | | | - Dorcas Lamounier Costa
- Laboratório de Leishmanioses, Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Teresina, Brazil
| | - Carlos Henrique Nery Costa
- Laboratório de Leishmanioses, Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Teresina, Brazil
| | - Bruno de Bezerril Andrade
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Kevan Akrami
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Camila Indiani de Oliveira
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Viviane Sampaio Boaventura
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Hospital Santa Izabel, Salvador, Brazil
| | - Manoel Barral-Netto
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Aldina Barral
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Anne-Mieke Vandamme
- Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
- Center for Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Johan Van Weyenbergh
- Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
| | - Ricardo Khouri
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
| |
Collapse
|
5
|
de Araujo FF, Lakhal-Naouar I, Koles N, Raiciulescu S, Mody R, Aronson N. Potential Biomarkers for Asymptomatic Visceral Leishmaniasis among Iraq-Deployed U.S. Military Personnel. Pathogens 2023; 12:pathogens12050705. [PMID: 37242376 DOI: 10.3390/pathogens12050705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Abstract
Visceral leishmaniasis (VL) is a chronic infection caused by Leishmania (L.) donovani or L. infantum parasites. Despite having the infection, most individuals never develop the clinical disease and are able to control the parasite and remain asymptomatic. However, some progress to symptomatic VL, leading to death if untreated. The host immune response has a major role in determining the progression and severity of the clinical manifestations in VL; several immune biomarkers of symptomatic VL have been described with interferon-gamma release as a surrogate biomarker of host cellular immunity. However, new biomarkers to identify asymptomatic VL (AVL) are needed for the identification of people at risk for VL activation. In our study, levels of chemokine/cytokine in the supernatants of peripheral mononuclear blood cells (PBMC) from 35 AVL+ Iraq-deployed participants, stimulated in vitro with soluble Leishmania antigen for 72 h, were assessed by a bead-based assay that allows the measurement of multiple analytes. PBMC of AVL-negative military beneficiaries were used as controls. Monocyte Chemoattractant Protein-1, Monokine Induced by Gamma Interferon and Interleukin-8, were detected at high levels in AVL+ stimulated cultures from Iraq deployers compared to uninfected controls. Measurement of chemokine/cytokine levels can identify cellular immune responses in AVL+ asymptomatic individuals.
Collapse
Affiliation(s)
- Fernanda Fortes de Araujo
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Ines Lakhal-Naouar
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Nancy Koles
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA
| | - Sorana Raiciulescu
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Rupal Mody
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Department of Medicine, William Beaumont Army Medical Center, El Paso, TX 79916, USA
| | - Naomi Aronson
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| |
Collapse
|
6
|
Moreira MDL, Borges-Fernandes LO, Pascoal-Xavier MA, Ribeiro ÁL, Pereira VHS, Pediongco T, Araújo MSDS, Teixeira-Carvalho A, de Carvalho AL, Mourão MVA, Campos FA, Borges M, Carneiro M, Chen Z, Saunders E, McConville M, Tsuji M, McCluskey J, Martins-Filho OA, Eckle SBG, Coelho-dos-Reis JGA, Peruhype-Magalhães V. The role of mucosal-associated invariant T cells in visceral leishmaniasis. Front Immunol 2022; 13:926446. [PMID: 36189274 PMCID: PMC9521739 DOI: 10.3389/fimmu.2022.926446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
Mucosal-associated invariant T (MAIT) cells are restricted by MR1 and are known to protect against bacterial and viral infections. Our understanding of the role of MAIT cells in parasitic infections, such as visceral leishmaniasis (VL) caused by protozoan parasites of Leishmania donovani, is limited. This study showed that in response to L. infantum, human peripheral blood MAIT cells from children with leishmaniasis produced TNF and IFN-γ in an MR1-dependent manner. The overall frequency of MAIT cells was inversely correlated with alanine aminotransferase levels, a specific marker of liver damage strongly associated with severe hepatic involvement in VL. In addition, there was a positive correlation between total protein levels and the frequency of IL-17A+ CD8+ MAIT cells, whereby reduced total protein levels are a marker of liver and kidney damage. Furthermore, the frequencies of IFN-γ+ and IL-10+ MAIT cells were inversely correlated with hemoglobin levels, a marker of severe anemia. In asymptomatic individuals and VL patients after treatment, MAIT cells also produced IL-17A, a cytokine signature associated with resistance to visceral leishmaniasis, suggesting that MAIT cells play important role in protecting against VL. In summary, these results broaden our understanding of MAIT-cell immunity to include protection against parasitic infections, with implications for MAIT-cell-based therapeutics and vaccines. At last, this study paves the way for the investigation of putative MAIT cell antigens that could exist in the context of Leishmania infection.
Collapse
Affiliation(s)
- Marcela de Lima Moreira
- René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ-MINAS), Belo Horizonte, Minas Gerais, Brazil
- Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | | | - Marcelo Antônio Pascoal-Xavier
- René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ-MINAS), Belo Horizonte, Minas Gerais, Brazil
- School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ágata Lopes Ribeiro
- René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ-MINAS), Belo Horizonte, Minas Gerais, Brazil
| | | | - Troi Pediongco
- Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | | | - Andréa Teixeira-Carvalho
- René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ-MINAS), Belo Horizonte, Minas Gerais, Brazil
| | - Andrea Lucchesi de Carvalho
- João Paulo II Children’s Hospital, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Flávia Alves Campos
- João Paulo II Children’s Hospital, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marineide Borges
- João Paulo II Children’s Hospital, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Parasitology Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Zhenjun Chen
- Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Eleanor Saunders
- Department of Biochemistry and Molecular Biology, The University of Melbourne, Melbourne, VIC, Australia
| | - Malcolm McConville
- Department of Biochemistry and Molecular Biology, The University of Melbourne, Melbourne, VIC, Australia
| | - Moriya Tsuji
- Aaron Diamond AIDS Research Center, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - James McCluskey
- Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | | | - Sidonia Barbara Guiomar Eckle
- Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Jordana Grazziela Alves Coelho-dos-Reis
- René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ-MINAS), Belo Horizonte, Minas Gerais, Brazil
- Department of Microbiology, Institute for Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- *Correspondence: Vanessa Peruhype-Magalhães, ; ; Jordana Grazziela Alves Coelho-dos-Reis, ;
| | - Vanessa Peruhype-Magalhães
- René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ-MINAS), Belo Horizonte, Minas Gerais, Brazil
- *Correspondence: Vanessa Peruhype-Magalhães, ; ; Jordana Grazziela Alves Coelho-dos-Reis, ;
| |
Collapse
|
7
|
de Mesquita TGR, Junior JDES, da Silva LDO, Silva GAV, de Araújo FJ, Pinheiro SK, Kerr HKA, da Silva LS, de Souza LM, de Almeida SA, Queiroz KLGD, de Souza JL, da Silva CC, Sequera HDG, de Souza MLG, Barbosa AN, Pontes GS, Guerra MVDF, Ramasawmy R. Distinct plasma chemokines and cytokines signatures in Leishmania guyanensis-infected patients with cutaneous leishmaniasis. Front Immunol 2022; 13:974051. [PMID: 36091007 PMCID: PMC9453042 DOI: 10.3389/fimmu.2022.974051] [Citation(s) in RCA: 4] [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: 06/28/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022] Open
Abstract
The immunopathology associated with Leishmaniasis is a consequence of inflammation. Upon infection with Leishmania, the type of host-immune response is determinant for the clinical manifestations that can lead to either self-healing or chronic disease. Multiple pathways may determine disease severity. A comparison of systemic immune profiles in patients with cutaneous leishmaniasis caused by L. guyanensis and healthy individuals with the same socio-epidemiological characteristics coming from the same endemic areas as the patients is performed to identify particular immune profile and pathways associated with the progression of disease development. Twenty-seven plasma soluble circulating factors were evaluated between the groups by univariate and multivariate analysis. The following biomarkers pairs IL-17/IL-9 (ρ=0,829), IL-17/IL-12 (ρ=0,786), IL-6/IL-1ra (ρ=0,785), IL-6/IL-12 (ρ=0,780), IL-1β/G-CSF (ρ=0,758) and IL-17/MIP-1β (ρ=0,754) showed the highest correlation mean among the patient while only INF-γ/IL-4 (ρ=0.740), 17/MIP-1β (ρ=0,712) and IL-17/IL-9 (ρ=0,707) exhibited positive correlation among the control group. The cytokine IL-17 and IL1β presented the greater number of positive pair correlation among the patients. The linear combinations of biomarkers displayed IP-10, IL-2 and RANTES as the variables with the higher discriminatory activity in the patient group compared to PDGF, IL-1ra and eotaxin among the control subjects. IP-10, IL-2, IL-1β, RANTES and IL-17 seem to be predictive value of progression to the development of disease among the Lg-infected individuals.
Collapse
Affiliation(s)
- Tirza Gabrielle Ramos de Mesquita
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Molecular Biology, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil
| | - José do Espírito Santo Junior
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Amazonas, Brazil
- Faculdade de Medicina Nilton Lins, Universidade Nilton Lins, Manaus, Brazil
| | | | - George Allan Villarouco Silva
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Amazonas, Brazil
| | - Felipe Jules de Araújo
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Faculdade de Medicina Nilton Lins, Universidade Nilton Lins, Manaus, Brazil
| | - Suzana Kanawati Pinheiro
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Molecular Biology, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil
| | | | - Lener Santos da Silva
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Molecular Biology, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil
| | - Luciane Macedo de Souza
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
| | | | | | - Josué Lacerda de Souza
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Amazonas, Brazil
- Faculdade de Medicina Nilton Lins, Universidade Nilton Lins, Manaus, Brazil
| | - Cilana Chagas da Silva
- Department of Molecular Biology, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil
| | - Héctor David Graterol Sequera
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Molecular Biology, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil
| | - Mara Lúcia Gomes de Souza
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Molecular Biology, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil
| | | | - Gemilson Soares Pontes
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, Amazonas, Brazil
- Department of Virology, Instituto Nacional de Pesquisas da Amazônia, Manaus, Brazil
- Genomic Health Surveillance Network: Optimization of Assistance and Research in The State of Amazonas – REGESAM, Manaus, Amazonas, Brazil
| | - Marcus Vinitius de Farias Guerra
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Molecular Biology, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil
| | - Rajendranath Ramasawmy
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Molecular Biology, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil
- Faculdade de Medicina Nilton Lins, Universidade Nilton Lins, Manaus, Brazil
- Genomic Health Surveillance Network: Optimization of Assistance and Research in The State of Amazonas – REGESAM, Manaus, Amazonas, Brazil
- *Correspondence: Rajendranath Ramasawmy,
| |
Collapse
|
8
|
A Historic Review of the Role of CD4+ T-Cell Subsets in Development of the Immune Responses against Cutaneous and Visceral Leishmaniases. IRANIAN BIOMEDICAL JOURNAL 2022; 26:99-109. [PMID: 35090305 PMCID: PMC8987415 DOI: 10.52547/ibj.26.2.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The heterogeneity of CD4+ T cells has been investigated since the late 1970s, when their Th1 and Th2 subsets were coined. Later studies on the cutaneous form of the Leishmaniasis were focused on the experimental models of Leishmania major infection using the susceptible BALB/c and the resistant C57BL/6 mice. At the early 21st century, the regulatory T-cells subpopulation was introduced and its role in concomitant immunity, responsible for lifelong resistance of the host to the reinfection was proposed. Subsequent studies, mainly focused on the visceral form of the infection pointed to the role of IL-17, produced by Th17 subset of CD4+ T cells that along the neutrophils were shown to have important yet equivocal functions in protection against or exacerbation of the infection. Altogether, the current knowledge indicates that the above four subsets could orchestrate the immune, the regulatory and the inflammatory responses of the host against different forms of leishmaniases.
Collapse
|
9
|
Teles LDF, Viana AG, Cardoso MS, Pinheiro GRG, Bento GA, Lula JF, Soares TDCM, Fujiwara RT, Carvalho SFGD. Evaluation of medullary cytokine expression and clinical and laboratory aspects in severe human visceral leishmaniasis. Parasite Immunol 2021; 43:e12880. [PMID: 34558674 DOI: 10.1111/pim.12880] [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: 05/05/2021] [Revised: 09/09/2021] [Accepted: 09/20/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Visceral leishmaniasis (VL) is a serious public health problem. The factors that can determine whether VL develops and progresses to severe form have not been fully identified, but a specific cellular immune response appears to play a key role. Therefore, understanding immunopathogenesis can be useful in preventing a serious clinical outcome. MATERIALS AND METHODS Bone marrow samples were collected from patients with severe VL (SVL) or non-severe VL (NSVL). Cytokine levels and parasitic load were analysed by RT-qPCR. There is a statistically significant difference in the leukocyte parameter in patients with SVL and NSVL compared with the control patients (p = .006 and p = .014, respectively). RESULTS Urea, alanine transaminase and albumin parameters had a significant difference p = .036, p = .039 and p = .017, respectively, between SVL and NSVL. Although high levels of IFN-γ, IL-10, IL-6 and TNF-α were present in all groups of individuals with VL, they were not statistically associated with severity. In patients with active VL, IFN-γ and IL-10 were associated, respectively, with a reduction and increase in the parasite load, strong and significant positive association between IFN-γ and IL-10 (rho = .627 and p = .003). CONCLUSION This study demonstrates that VL stimulates an non-dichotomized inflammatory response between Th1/Th2 and that bone marrow is an important tissue for immune regulation.
Collapse
Affiliation(s)
- Leandro de Freitas Teles
- Centro de Pesquisa em Doenças Infecciosas. Hospital, Universitário Clemente de Faria, Universidade Estadual de Montes Claros-MG, Brazil
| | - Agostinho Gonçalves Viana
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais-MG, Brazil
| | - Mariana Santos Cardoso
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais-MG, Brazil
| | | | - Gabriele Ariadine Bento
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais-MG, Brazil
| | - Jamille Fernandes Lula
- Centro de Pesquisa em Doenças Infecciosas. Hospital, Universitário Clemente de Faria, Universidade Estadual de Montes Claros-MG, Brazil
| | - Tânia de Cássia Moreira Soares
- Centro de Pesquisa em Doenças Infecciosas. Hospital, Universitário Clemente de Faria, Universidade Estadual de Montes Claros-MG, Brazil
| | - Ricardo Toshio Fujiwara
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais-MG, Brazil
| | | |
Collapse
|
10
|
Melo MBG, Cunha LCS, Barreto CSP, de Oliveira Mendonça FA, Santos MLB, Sacramento D, de Jesus AR, Almeida RP, Dos Santos PL. Leishmania infantum (syn. L. chagasi) parasites affect the release of soluble CD14 by infected macrophages. Parasitol Res 2021; 120:3325-3330. [PMID: 34351491 DOI: 10.1007/s00436-021-07258-w] [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: 09/29/2020] [Accepted: 07/18/2021] [Indexed: 11/30/2022]
Abstract
Functionally, cluster of differentiation 14 (CD14) is a co-receptor of the complex formed by lipopolysaccharide (LPS) and LPS-binding protein expressed on the membrane of a variety of cells. However, CD14 can be shed from the cell membrane into the circulation as soluble CD14 (sCD14) upon cell activation. Previously, our group reported that elevated sCD14 serum levels were associated with the clinical and laboratory findings in the context of visceral leishmaniasis (VL), but not in the context of LPS stimulation or bacterial infection. In the present study, we investigated the secretion dynamics of sCD14 in the context of Leishmania infantum (syn. L. chagasi) in vitro infection. Macrophages from treated VL patients and delayed-type hypersensitivity positive (DTH+) subjects were infected with L. infantum (syn. L. chagasi) promastigotes, and the infection index was evaluated (number of amastigotes per 100 infected macrophages). Additionally, the levels of sCD14, Inteleukin (IL)10, IL-6 and tumour necrosis factor alpha (TNF-α) were measured in the culture supernatants using the Luminex assay. Interestingly, the release of sCD14 was inversely correlated with the L. infantum (syn. L. chagasi) infection index. Of note, the release of sCD14 was upregulated and downregulated in the context of infected macrophages from DTH+ subjects and treated VL patients, respectively. Additionally, we also observed that the levels of sCD14 in the culture supernatants were positively correlated with the levels of TNF-α, IL-6 and IL-10. Therefore, our data suggest that macrophages from treated VL patients and DTH+ subjects respond differently to L. infantum (syn. L. chagasi) infection in the context of the release of sCD14; therefore, the release of sCD14 may be associated with the outcome of VL.
Collapse
Affiliation(s)
- Michelle Barreto Gomes Melo
- Programa de Pós-Graduação Em Ciências da Saúde, Universidade Federal de Sergipe, 49060-100, Aracaju, Sergipe, Brasil
| | - Luana Celina Seraphim Cunha
- Programa de Pós-Graduação Em Ciências da Saúde, Universidade Federal de Sergipe, 49060-100, Aracaju, Sergipe, Brasil
| | - Cárcia Santana Passos Barreto
- Programa de Pós-Graduação Em Ciências da Saúde, Universidade Federal de Sergipe, 49060-100, Aracaju, Sergipe, Brasil
| | | | - Micheli Luize Barbosa Santos
- Programa de Pós-Graduação Em Ciências da Saúde, Universidade Federal de Sergipe, 49060-100, Aracaju, Sergipe, Brasil
| | - Danielle Sacramento
- Programa de Pós-Graduação Em Ciências da Saúde, Universidade Federal de Sergipe, 49060-100, Aracaju, Sergipe, Brasil
| | - Amélia Ribeiro de Jesus
- Programa de Pós-Graduação Em Ciências da Saúde, Universidade Federal de Sergipe, 49060-100, Aracaju, Sergipe, Brasil.,Instituto de Investigação Em Imunologia, 05403-900, São Paulo, São Paulo, Brasil
| | - Roque Pacheco Almeida
- Programa de Pós-Graduação Em Ciências da Saúde, Universidade Federal de Sergipe, 49060-100, Aracaju, Sergipe, Brasil.,Instituto de Investigação Em Imunologia, 05403-900, São Paulo, São Paulo, Brasil
| | - Priscila Lima Dos Santos
- Programa de Pós-Graduação Em Ciências da Saúde, Universidade Federal de Sergipe, 49060-100, Aracaju, Sergipe, Brasil.
| |
Collapse
|
11
|
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.
Collapse
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.
| |
Collapse
|
12
|
Almeida AC, Elias ABR, Marques MP, de Melo GC, da Costa AG, Figueiredo EFG, Brasil LW, Rodrigues-Soares F, Monteiro WM, de Lacerda MVG, Lanchote VL, Suarez-Kurtz G. Impact of Plasmodium vivax malaria and antimalarial treatment on cytochrome P450 activity in Brazilian patients. Br J Clin Pharmacol 2020; 87:1859-1868. [PMID: 32997351 DOI: 10.1111/bcp.14574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/02/2020] [Accepted: 09/15/2020] [Indexed: 12/26/2022] Open
Abstract
AIMS To investigate the impact of Plasmodium vivax malaria and chloroquine-primaquine chemotherapy on CYP2D6 and CYP2C19 activity in patients from the Brazilian Amazon. METHODS Adult patients (n = 30) were given subtherapeutic doses of CYP2D6 and CYP2C19 phenotypic probes metoprolol (10 mg) and omeprazole (2 mg) in three different stages of vivax malaria illness: acute disease (study phase 1), post chemotherapy (phase 2) and convalescence (stage 3). Plasma concentrations of probes and CYP-hydroxylated metabolites (α-OH metoprolol and 5-OH omeprazole) were measured using LC/MS/MS. Two pharmacokinetic metrics were used to estimate CYP activity: (a) ratio of plasma concentrations of probe/metabolite at 240 minutes after administration of the probes and (b) ratio of areas under the time-concentration curves for probe/metabolite (AUC0-12h ). For statistical analysis, the pharmacokinetic metrics were normalized to the respective values in phase 3. Taqman assays were used for CYP2D6 and CYP2C19 genotyping. Cytokines levels were measured using cytometric bead array. RESULTS Both pharmacokinetic metrics for metoprolol and omeprazole, and plasma concentrations of cytokines IL-6, IL-8 and IL-10 varied significantly across the three study phases (ANOVA P < 0.0001). Post hoc tests showed greater metoprolol:α-OH metoprolol ratios in phases 1 and 2 compared to phase 3, larger omeprazole:5-OH omeprazole ratios in phase 1 than in phases 2 and 3, and higher circulating IL-6, IL-8 and IL-10 in phase 1 than in phases 2 and 3. CONCLUSION P. vivax malaria and treatment altered CYP2D6 and CYP2C19 metabolic phenotypes. CYP2C19 inhibition is attributed to a higher level of circulating proinflammatory cytokines, while suppression of CYP2D6 is ascribed mainly to chloroquine exposure.
Collapse
Affiliation(s)
- Anne Cristine Almeida
- Gerência de Malária, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | | | - Maria Paula Marques
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Gisely Cardoso de Melo
- Gerência de Malária, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Allyson Guimarães da Costa
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.,Departamento de Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Amazonas, Brazil
| | - Erick Frota Gomes Figueiredo
- Gerência de Malária, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Larissa Wanderley Brasil
- Gerência de Malária, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Fernanda Rodrigues-Soares
- Departamento de Patologia, Genética e Evolução, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Wuelton Marcelo Monteiro
- Gerência de Malária, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Marcus Vinicius Guimarães de Lacerda
- Gerência de Malária, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Instituto Leônidas & Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas, Brazil
| | - Vera Lucia Lanchote
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | | |
Collapse
|
13
|
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.
Collapse
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
| | | |
Collapse
|
14
|
Santos MF, Alexandre-Pires G, Pereira MA, Gomes L, Rodrigues AV, Basso A, Reisinho A, Meireles J, Santos-Gomes GM, Pereira da Fonseca I. Immunophenotyping of Peripheral Blood, Lymph Node, and Bone Marrow T Lymphocytes During Canine Leishmaniosis and the Impact of Antileishmanial Chemotherapy. Front Vet Sci 2020; 7:375. [PMID: 32760744 PMCID: PMC7373748 DOI: 10.3389/fvets.2020.00375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/28/2020] [Indexed: 11/30/2022] Open
Abstract
Dogs are a major reservoir of Leishmania infantum, etiological agent of canine leishmaniosis (CanL) a zoonotic visceral disease of worldwide concern. Therapeutic protocols based on antileishmanial drugs are commonly used to treat sick dogs and improve their clinical condition. To better understand the impact of Leishmania infection and antileishmanial drugs on the dog's immune response, this study investigates the profile of CD4+ and CD8+ T cell subsets in peripheral blood, lymph node, and bone marrow of sick dogs and after two different CanL treatments. Two CanL groups of six dogs each were treated with either miltefosine or meglumine antimoniate combined with allopurinol. Another group of 10 clinically healthy dogs was used as control. Upon diagnosis and during the following 3 months of treatment, peripheral blood, popliteal lymph node, and bone marrow mononuclear cells were collected, labeled for surface markers CD45, CD3, CD4, CD8, CD25, and intracellular nuclear factor FoxP3, and T lymphocyte subpopulations were immunophenotyped by flow cytometry. CanL dogs presented an overall increased frequency of CD8+ and CD4+CD8+ double-positive T cells in all tissues and a decreased frequency of CD4+ T cells in the blood. Furthermore, there was a higher frequency of CD8+ T cells expressing CD25+FoxP3+ in the blood and bone marrow. During treatment, these subsets recovered to levels similar to those of healthy dogs. Nevertheless, antileishmanial therapy caused an increase of CD4+CD25+FoxP3+ T cells in all tissues, associated with the decrease of CD8+CD25−FoxP3− T cell percentages. These findings may support previous studies that indicate that L. infantum manipulates the dog's immune system to avoid the development of a protective response, ensuring the parasite's survival and the conditions that allow the completion of Leishmania life cycle. Both treatments used appear to have an effect on the dog's immune response, proving to be effective in promoting the normalization of T cell subsets.
Collapse
Affiliation(s)
- Marcos Ferreira Santos
- CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
| | - Graça Alexandre-Pires
- CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
| | - Maria A Pereira
- GHTM-Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova De Lisbon (UNL), Lisbon, Portugal
| | - Lídia Gomes
- CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
| | - Armanda V Rodrigues
- GHTM-Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova De Lisbon (UNL), Lisbon, Portugal
| | - Alexandra Basso
- CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
| | - Ana Reisinho
- CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
| | - José Meireles
- CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
| | - Gabriela M Santos-Gomes
- GHTM-Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova De Lisbon (UNL), Lisbon, Portugal
| | - Isabel Pereira da Fonseca
- CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
| |
Collapse
|
15
|
Johnstone AM, Kelly J, Ryan S, Romero-Gonzalez R, McKinnon H, Fyfe C, Naslund E, Lopez-Nicolas R, Bosscher D, Bonnema A, Frontela-Saseta C, Ros-Berruezo G, Horgan G, Ze X, Harrold J, Halford J, Gratz SW, Duncan SH, Shirazi-Beechey S, Flint HJ. Nondigestible Carbohydrates Affect Metabolic Health and Gut Microbiota in Overweight Adults after Weight Loss. J Nutr 2020; 150:1859-1870. [PMID: 32510158 DOI: 10.1093/jn/nxaa124] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/16/2019] [Accepted: 04/09/2020] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The composition of diets consumed following weight loss (WL) can have a significant impact on satiety and metabolic health. OBJECTIVE This study was designed to test the effects of including a nondigestible carbohydrate to achieve weight maintenance (WM) following a period of WL. METHODS Nineteen volunteers [11 females and 8 males, aged 20-62 y; BMI (kg/m2): 27-42] consumed a 3-d maintenance diet (15%:30%:55%), followed by a 21-d WL diet (WL; 30%:30%:40%), followed by 2 randomized 10-d WM diets (20%:30%:50% of energy from protein:fat:carbohydrate) containing either resistant starch type 3 (RS-WM; 22 or 26 g/d for females and males, respectively) or no RS (C-WM) in a within-subject crossover design without washout periods. The primary outcome, WM after WL, was analyzed by body weight. Secondary outcomes of fecal microbiota composition and microbial metabolite concentrations and gut hormones were analyzed in fecal samples and blood plasma, respectively. All outcomes were assessed at the end of each dietary period. RESULTS Body weight was similar after the RS-WM and C-WM diets (90.7 and 90.8 kg, respectively), with no difference in subjectively rated appetite. During the WL diet period plasma ghrelin increased by 36% (P < 0.001), glucose-dependent insulinotropic polypeptide (GIP) decreased by 33% (P < 0.001), and insulin decreased by 46% (P < 0.001), but no significant differences were observed during the RS-WM and C-WM diet periods. Fasting blood glucose was lower after the RS-WM diet (5.59 ± 0.31 mmol/L) than after the C-WM diet [5.75 ± 0.49 mmol/L; P = 0.015; standard error of the difference between the means (SED): 0.09]. Dietary treatments influenced the fecal microbiota composition (R2 = 0.054, P = 0.031) but not diversity. CONCLUSIONS The metabolic benefits, for overweight adults, from WL were maintained through a subsequent WM diet with higher total carbohydrate intake. Inclusion of resistant starch in the WM diet altered gut microbiota composition positively and resulted in lower fasting glucose compared with the control, with no apparent change in appetite. This trial was registered at clinicaltrials.gov as NCT01724411.
Collapse
Affiliation(s)
| | - Jennifer Kelly
- Functional and Comparative Genomics, and Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Sheila Ryan
- Functional and Comparative Genomics, and Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | | | - Hannah McKinnon
- The Rowett Institute, University of Aberdeen, Foresterhill, United Kingdom
| | - Claire Fyfe
- The Rowett Institute, University of Aberdeen, Foresterhill, United Kingdom
| | | | - Ruben Lopez-Nicolas
- Department of Food Science and Nutrition, Faculty of Veterinary Sciences, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Murcia, Spain
| | | | | | - Carmen Frontela-Saseta
- Department of Food Science and Nutrition, Faculty of Veterinary Sciences, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Murcia, Spain
| | - Gaspar Ros-Berruezo
- Department of Food Science and Nutrition, Faculty of Veterinary Sciences, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, Murcia, Spain
| | - Graham Horgan
- Biomathematics and Statistics Scotland, Aberdeen, United Kingdom
| | - Xiaolei Ze
- The Rowett Institute, University of Aberdeen, Foresterhill, United Kingdom
| | - Jo Harrold
- Appetite and Obesity Research Group, Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Jason Halford
- Appetite and Obesity Research Group, Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Silvia W Gratz
- The Rowett Institute, University of Aberdeen, Foresterhill, United Kingdom
| | - Sylvia H Duncan
- The Rowett Institute, University of Aberdeen, Foresterhill, United Kingdom
| | - Soraya Shirazi-Beechey
- Functional and Comparative Genomics, and Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Harry J Flint
- The Rowett Institute, University of Aberdeen, Foresterhill, United Kingdom
| |
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
Prospection of immunological biomarkers for characterization and monitoring of asymptomatic Leishmania ( Leishmania) infantum infection. Parasitology 2020; 147:1124-1132. [PMID: 32460936 DOI: 10.1017/s0031182020000852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In areas endemic for Leishmania infantum, an asymptomatic infection may be an indicator of the extent of transmission. The main goal of this study was to evaluate the applicability of measuring circulating immunological biomarkers as an alternative strategy to characterize and monitor L. infantum asymptomatic infections in combination with serological methods. To this end, 179 children from a region endemic for visceral leishmaniasis (VL), aged 1-10 years old, selected from a cross-sectional study, were identified as asymptomatic (n = 81) or uninfected (n = 98) by qPCR and/or serological tests (ELISA using L. infantum soluble antigen and rK39), and, together with serum samples of children diagnosed with VL (n = 43), were subjected to avidity tests and cytokine levels measurement. Avidity rates (AR) ranging from 41 to 70% were found in 29 children (66%) from the asymptomatic group. On the other hand, high AR (above 70%) were observed in 27 children (64%) from the VL group. Logistic Regression and Classification and Regression Tree (CART) analyses demonstrated that lower AR and IFN-γ production associated with higher IL-17A levels were hallmarks in asymptomatic L. infantum infections. Therefore, this study proposes an association of immunological biomarkers that can be used as a complementary strategy for the characterization and monitoring of asymptomatic VL infections in children living in endemic areas.
Collapse
|
18
|
Ribeiro CV, Rocha BFB, Oliveira E, Teixeira-Carvalho A, Martins-Filho OA, Murta SMF, Peruhype-Magalhães V. Leishmania infantum induces high phagocytic capacity and intracellular nitric oxide production by human proinflammatory monocyte. Mem Inst Oswaldo Cruz 2020; 115:e190408. [PMID: 32321156 PMCID: PMC7164402 DOI: 10.1590/0074-02760190408] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/14/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The mechanism of resistance to SbIII in Leishmania is complex, multifactorial and involves not only biochemical mechanisms, but also other elements, such as the immune system of the host. OBJECTIVES In this study, putative changes in the immunological profile of human monocytes infected with wild-type (WT) and antimony (SbIII)-resistant Leishmania (Viannia) braziliensis and Leishmania (Leishmania) infantum lines were evaluated. METHODS Susceptibility assays WT and SbIII-resistant L. braziliensis and L. infantum were performed using lines THP-1 human monocytic lineage. Phagocytic capacity, cytokine profile, intracellular nitric oxide (NO) production and surface carbohydrate residues profile were performed in peripheral blood monocytes by flow cytometry. FINDINGS The phagocytic capacity and intracellular NO production by classical (CD14++CD16-) and proinflammatory (CD14++CD16+) monocytes were higher in the presence of L. infantum lines compared to L. braziliensis lines. The results also highlight proinflammatory monocytes as the cellular subpopulation of major relevance in a phagocytosis event and NO expression. It is important to note that L. infantum induced a proinflammatory cytokine profile characterised by higher levels of TNF-α in culture supernatant than L. braziliensis. Conversely, both Leishmania lines induce high levels of IL-6 in culture supernatant. Analysis of the expression profile of surface carbohydrates showed that L. braziliensis presents 4.3-fold higher expression of galactose(β1,4)N-acetylglucosamine than L. infantum line. Interestingly, the expression level of α-N-acetylgalactosamine residues was 2-fold lower in the SbIII-resistant L. braziliensis line than its counterpart WT line, indicating differences in surface glycoconjugates between these lines. MAIN CONCLUSIONS Our results showed that L. braziliensis and L. infantum induce different innate immune responses and a highly inflammatory profile, which is characteristic of infection by L. infantum, the species associated with visceral disease.
Collapse
Affiliation(s)
- Christiana Vargas Ribeiro
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Grupo de Genômica Funcional e Proteômica de Leishmania spp. e Trypanosoma cruzi, Belo Horizonte, MG, Brasil
| | - Bruna Fonte Boa Rocha
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Grupo de Genômica Funcional e Proteômica de Leishmania spp. e Trypanosoma cruzi, Belo Horizonte, MG, Brasil
| | - Edward Oliveira
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Grupo de Genômica Funcional e Proteômica de Leishmania spp. e Trypanosoma cruzi, Belo Horizonte, MG, Brasil
| | - Andrea Teixeira-Carvalho
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brasil
| | - Olindo Assis Martins-Filho
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brasil
| | - Silvane Maria Fonseca Murta
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Grupo de Genômica Funcional e Proteômica de Leishmania spp. e Trypanosoma cruzi, Belo Horizonte, MG, Brasil
| | - Vanessa Peruhype-Magalhães
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brasil
| |
Collapse
|
19
|
Toghueo RMK. Anti-leishmanial and Anti-inflammatory Agents from Endophytes: A Review. NATURAL PRODUCTS AND BIOPROSPECTING 2019; 9:311-328. [PMID: 31564050 PMCID: PMC6814666 DOI: 10.1007/s13659-019-00220-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 09/23/2019] [Indexed: 05/05/2023]
Abstract
Leishmaniases and chronic inflammatory diseases are the cause of millions of deaths in the world each year. The treatment of leishmaniasis is facing serious drawbacks particularly due to the limited number of effective medicines, the resistance, and the toxicity of available drugs. On the other hand, many drugs are used for the management of inflammatory disorders. However, the most commonly prescribed although efficient is highly toxic with multiples side effects. New leads compounds for the development of new anti-leishmanial and anti-inflammatory drugs are needed. Over the past decade, several studies on the potential of endophytes to produce bioactive metabolites have been reported. We are presenting in the present review the status of research from 2000 to 2019 on the anti-leishmanial and anti-inflammatory metabolites isolated from endophytes from diverse habitats. An emphasis was put on existing gaps in the literature to inspire and guide future investigations. We hope that this review will help accelerate the drug discovery against leishmaniases and inflammation-associated disorders.
Collapse
Affiliation(s)
- Rufin Marie Kouipou Toghueo
- Antimicrobial and Biocontrol Agents Unit (AmBcAU), Laboratory for Phytobiochemistry and Medicinal Plants Studies, Department of Biochemistry, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon.
| |
Collapse
|
20
|
Viana AG, Magalhães LMD, Giunchetti RC, Dutra WO, Gollob KJ. Leishmania infantum
induces expression of the negative regulatory checkpoint, CTLA‐4, by human naïve CD8
+
T cells. Parasite Immunol 2019; 41:e12659. [DOI: 10.1111/pim.12659] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/30/2019] [Accepted: 06/02/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Agostinho Gonçalves Viana
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - Luísa Mourão Dias Magalhães
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - Rodolfo Cordeiro Giunchetti
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - Walderez O. Dutra
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas Universidade Federal de Minas Gerais Belo Horizonte Brazil
- INCT‐DT Belo Horizonte Brazil
| | - Kenneth J. Gollob
- INCT‐DT Belo Horizonte Brazil
- International Center for Research AC Camargo Cancer Center São Paulo Brazil
| |
Collapse
|
21
|
Queiroz EA, Medeiros NI, Mattos RT, Carvalho APM, Rodrigues-Alves ML, Dutra WO, Félix-Lana FC, Gomes JAS, Correa-Oliveira R. Immunological biomarkers of subclinical infection in household contacts of leprosy patients. Immunobiology 2019; 224:518-525. [PMID: 31109749 DOI: 10.1016/j.imbio.2019.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/21/2019] [Accepted: 05/07/2019] [Indexed: 10/26/2022]
Abstract
Hansen's disease (or leprosy) still persists as a serious public health issue. Its diagnosis is based primarily on the detection of clinical signs that are characteristic of the disease. Studies have pointed to the selection of a set of serological and cellular biomarkers of subclinical infection that result in an efficient diagnosis. The aim of this study was compare index cases and their household contacts to identify differentially expressed biomarkers of immune response in leprosy that could provide reliable evidence of subclinical infection in household contacts. The study population consisted of index cases with multibacillary form (IC, n = 13) and their household contacts (HC, n = 14). Serum cytokines and chemokines were quantified using the cytometric beads array (CBA) system. The humoral response was assessed by ELISA test. Flow cytometry was used to characterize the cellular immune response. Monocyte and CD4 + T lymphocytes frequency was significantly higher in IC. Both CD4+ and CD8 + T lymphocytes had a reduced CD25 expression in HC. The immunoglobulin (Ig)M profile anti- NDO-HSA, LID-1, and NDOLID antigens was significantly higher in IC. This study points to the monocyte and CD4+ lymphocyte frequency, as well as specific IgM profile, as predictors of subclinical infection in the household contacts.
Collapse
Affiliation(s)
- Edson A Queiroz
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Nayara I Medeiros
- Imunologia Celular e Molecular, Instituto René Rachou, Fundação Oswaldo Cruz - FIOCRUZ, Belo Horizonte, MG, Brazil; Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Rafael T Mattos
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Ana Paula M Carvalho
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Marina L Rodrigues-Alves
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Walderez O Dutra
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | | | - Juliana A S Gomes
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Rodrigo Correa-Oliveira
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Imunologia Celular e Molecular, Instituto René Rachou, Fundação Oswaldo Cruz - FIOCRUZ, Belo Horizonte, MG, Brazil.
| |
Collapse
|
22
|
Dayakar A, Chandrasekaran S, Kuchipudi SV, Kalangi SK. Cytokines: Key Determinants of Resistance or Disease Progression in Visceral Leishmaniasis: Opportunities for Novel Diagnostics and Immunotherapy. Front Immunol 2019; 10:670. [PMID: 31024534 PMCID: PMC6459942 DOI: 10.3389/fimmu.2019.00670] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 03/12/2019] [Indexed: 12/31/2022] Open
Abstract
Leishmaniasis is a parasitic disease of humans, highly prevalent in parts of the tropics, subtropics, and southern Europe. The disease mainly occurs in three different clinical forms namely cutaneous, mucocutaneous, and visceral leishmaniasis (VL). The VL affects several internal organs and is the deadliest form of the disease. Epidemiology and clinical manifestations of VL are variable based on the vector, parasite (e.g., species, strains, and antigen diversity), host (e.g., genetic background, nutrition, diversity in antigen presentation and immunity) and the environment (e.g., temperature, humidity, and hygiene). Chemotherapy of VL is limited to a few drugs which is expensive and associated with profound toxicity, and could become ineffective due to the parasites developing resistance. Till date, there are no licensed vaccines for humans against leishmaniasis. Recently, immunotherapy has become an attractive strategy as it is cost-effective, causes limited side-effects and do not suffer from the downside of pathogens developing resistance. Among various immunotherapeutic approaches, cytokines (produced by helper T-lymphocytes) based immunotherapy has received great attention especially for drug refractive cases of human VL. Therefore, a comprehensive knowledge on the molecular interactions of immune cells or components and on cytokines interplay in the host defense or pathogenesis is important to determine appropriate immunotherapies for leishmaniasis. Here, we summarized the current understanding of a wide-spectrum of cytokines and their interaction with immune cells that determine the clinical outcome of leishmaniasis. We have also highlighted opportunities for the development of novel diagnostics and intervention therapies for VL.
Collapse
Affiliation(s)
| | | | - Suresh V Kuchipudi
- Animal Diagnostic Laboratory, Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Suresh K Kalangi
- Department of Biosciences, School of Sciences, Indrashil University, Mehsana, India
| |
Collapse
|
23
|
Lower levels of leptin are associated with severity parameters in visceral leishmaniasis patients. PLoS One 2019; 14:e0214413. [PMID: 30913261 PMCID: PMC6435192 DOI: 10.1371/journal.pone.0214413] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/12/2019] [Indexed: 01/09/2023] Open
Abstract
Visceral leishmaniasis (VL) is the most severe clinical form of leishmaniasis, and if untreated may be fatal. It affects important organs of the immune system and is characterized by a specific immunosuppression, along with intense cellular activation and cytokine storm. Moreover, VL is now recognized as a systemic inflammatory response syndrome (SIRS), in which multiple cytokines and other pro-inflammatory molecules are released. The action of these inflammatory mediators may be considered risk factors for poor prognosis and death. Leptin, a hormone derived from adipose tissue, has been described with several immunoregulatory functions in vitro and in vivo Leishmania infection models, particularly for enhancing the macrophage microbicidal mechanisms. Considering that evaluation of immunologic parameters that may be associated with this clinical scenario may help to decrease VL lethality, we evaluated whether leptin is associated with VL pathogenesis. Thirty-one patients were recruited in the active phase of VL, of which 22 were followed up until one month after therapy (1mpt). Except for creatinine levels, all clinical parameters were altered in active VL patients, especially leucocyte counts and albumin and hemoglobin levels. Also, elevated levels of lipopolysaccharide (LPS), immunoglobulins (Ig)G1 and G3 anti-Leishmania and interleukins (IL)-6 and -10 were higher than in healthy individuals. In contrast, active VL patients presented diminished serum leptin levels and positive correlation with leukocytes counts and hemoglobin and albumin levels. After 1mpt, VL patients showed a significant increase in leptin levels, reaching values similar to healthy volunteers. As expected, only LPS levels remained elevated after 1mpt. These findings suggest that leptin levels are affected in Leishmania infection and the correlation with important parameters associated with the prognosis of VL points to the involvement of this molecule in VL immunopathogenesis. Additional studies are needed to evaluate the possibility of leptin as a prognostic marker of VL.
Collapse
|
24
|
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.
Collapse
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
| |
Collapse
|
25
|
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.
Collapse
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
| |
Collapse
|
26
|
Sera from Visceral Leishmaniasis Patients Display Oxidative Activity and Affect the TNF- α Production by Macrophages In Vitro. BIOMED RESEARCH INTERNATIONAL 2017; 2017:5861453. [PMID: 29230410 PMCID: PMC5694613 DOI: 10.1155/2017/5861453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 10/08/2017] [Indexed: 02/04/2023]
Abstract
Mammalian protection against leishmanial infection depends on the development of an effective immune response. Zoonotic visceral leishmaniasis (ZVL) patients are usually unable to mount an effective immune response against the parasite and indeed appear to be severely immunosuppressed. This suppression has strong nonspecific and specific components mediated by serum factors and leishmanicidal activity of infected macrophages, respectively. The lipid profile has been shown to be altered in ZVL patients' sera. This work aimed at (i) determining the HDL, Apo A1, LDL, and VLDL concentrations in ZVL patients' sera; (ii) investigating the oxidative effect of ZVL patients' sera on the β-carotene matrix; (iii) measuring IL-10, IL-6, IL-12p40, and tumour necrosis factor-α (TNF-α) concentrations in the macrophage cultures, to which 10% of ZVL patients' serum had been added. Levels of HDL, LDL fraction, and apolipoprotein A1 in ZVL patients' sera were lower than those of healthy individuals' sera, except for the mean level of VLDL. The matrix of β-carotene and linoleic acid system was oxidized in the presence of ZLV patients' sera. The presence of ZVL patients' sera did not modify the cytokine production of IL-6, IL-12p40, and IL-10 by human macrophages in vitro but TNF-α production was altered, probably due to lack of macrophage stimulation by lipoprotein.
Collapse
|
27
|
Melo GD, Goyard S, Lecoeur H, Rouault E, Pescher P, Fiette L, Boissonnas A, Minoprio P, Lang T. New insights into experimental visceral leishmaniasis: Real-time in vivo imaging of Leishmania donovani virulence. PLoS Negl Trop Dis 2017; 11:e0005924. [PMID: 28945751 PMCID: PMC5629011 DOI: 10.1371/journal.pntd.0005924] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/05/2017] [Accepted: 09/01/2017] [Indexed: 12/26/2022] Open
Abstract
Visceral leishmaniasis is an insidious neglected disease with worldwide distribution. It is caused by parasites from the Leishmania donovani complex, which are able to be transmitted by different species of phlebotomine sand flies and to infect numerous mammal hosts. Despite the high number of people infected or at risk, and the remarkable quantity of studies focusing on this disease, a proper experimental model to efficiently decipher the infectious process of visceral leishmaniasis taking into account the nuances of parasite’s virulence and the duration of the infection is still lacking. Therefore, using golden Syrian hamsters and BALB/c mice, state-of-the-art genetic manipulation applied on a fully virulent L. donovani strain and in vivo imaging approaches, we describe herein three benefits for experimental visceral leishmaniasis: (i) the development of a double transfected bioluminescent (firefly luciferase) and fluorescent (E2-crimson) virulent strain of L. donovani (Ld1S_luci_E2-crimson), favoring a wide range of both in vivo and in vitro investigations, (ii) the establishment of a non-invasive mouse model to evaluate the infectious process during visceral leishmaniasis and the parasite’s virulence in real time, allowing longitudinal studies with the same animals, and (iii) the elaboration of a suitable method to reinstate (and verify anew) the virulence in a population of attenuated parasites, by recovering persistent parasites from chronic infected mice. Consequently, these results open up new perspectives on the study of visceral leishmaniasis, especially in the fields of therapeutics and vaccinology, since the model described herein renders now possible long-lasting follow up studies, with easy and accurate day-by-day verifications of the infection status along with a reduced number of laboratory animals. TRIAL REGISTRATION ClinicalTrials.gov 2013-0047.
Collapse
Affiliation(s)
- Guilherme D. Melo
- Institut Pasteur, Laboratoire des Processus Infectieux à Trypanosomatidés, Département Infection et Epidémiologie, 25–28 rue du Dr Roux, Paris, France
| | - Sophie Goyard
- Institut Pasteur, Laboratoire des Processus Infectieux à Trypanosomatidés, Département Infection et Epidémiologie, 25–28 rue du Dr Roux, Paris, France
| | - Hervé Lecoeur
- Institut Pasteur, Laboratoire des Processus Infectieux à Trypanosomatidés, Département Infection et Epidémiologie, 25–28 rue du Dr Roux, Paris, France
| | - Eline Rouault
- Institut Pasteur, Laboratoire des Processus Infectieux à Trypanosomatidés, Département Infection et Epidémiologie, 25–28 rue du Dr Roux, Paris, France
| | - Pascale Pescher
- Institut Pasteur, Unité de Parasitologie Moléculaire et Signalisation, Département de Parasites et Insectes Vecteurs, 25–28 rue du Dr Roux, Paris, France
| | - Laurence Fiette
- Institut Pasteur, Unité d’Histopathologie Humaine et Modèles Animaux, Département Infection et Epidémiologie, 25–28 rue du Dr Roux, Paris, France
| | - Alexandre Boissonnas
- Sorbonne Universités, UPMC Univ Paris 06, Inserm, UMR 1135, CNRS, ERL 8255, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), 91 Boulevard de l'Hôpital, Paris, France
| | - Paola Minoprio
- Institut Pasteur, Laboratoire des Processus Infectieux à Trypanosomatidés, Département Infection et Epidémiologie, 25–28 rue du Dr Roux, Paris, France
| | - Thierry Lang
- Institut Pasteur, Laboratoire des Processus Infectieux à Trypanosomatidés, Département Infection et Epidémiologie, 25–28 rue du Dr Roux, Paris, France
| |
Collapse
|
28
|
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.
Collapse
|
29
|
Cassirer-Costa F, Medeiros NI, Chaves AT, Lyon S, Coelho-Dos-Reis JGA, Ribeiro-Junior AF, Correa-Oliveira R, Rocha MOC, Gomes JAS. Cytokines as biomarkers to monitoring the impact of multidrug therapy in immune response of leprosy patients. Cytokine 2017; 97:42-48. [PMID: 28570932 DOI: 10.1016/j.cyto.2017.05.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 05/22/2017] [Accepted: 05/23/2017] [Indexed: 11/16/2022]
Abstract
Leprosy or Hansen's disease is a chronic infectious disease of the skin and nerves, caused by the intracellular bacilli Mycobacterium leprae. It is characterized by a spectrum of clinical forms depending on the host's immune response to M. leprae. Patients with tuberculoid (TT) leprosy have strong cell-mediated immunity (CMI) with elimination of the bacilli, whereas patients with lepromatous (LL) leprosy exhibit defective CMI to M. leprae. Despite advances in the understanding of the pathogenesis of leprosy and the development of new therapeutic strategies, there is a need for the identification of biomarkers which be used for early diagnosis and to discrimination between different forms of the disease, as prognostic markers. Here, we analyzed the serum levels of IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-17A, IFN-γ and TNF in order to address the contribution of these cytokines in late phase of M. leprae infection, and the impact of multidrug therapy (MDT). Our results demonstrated that patients of LL group presented higher expression of serum levels of inflammatory cytokines before MDT, while TT patients presented a balance between inflammatory and regulatory cytokines. MDT changes the profile of serum cytokines in M. leprae infected patients, as evidenced by the cytokine network, especially in TT patients. LL patients displayed a multifaceted cytokine system characterized by strong connecting axes involving inflammatory/regulatory molecules, while TT patients showed low involvement of regulatory cytokines in network overall. Cytokines can be identified as good biomarkers of the impact of MDT on the immune system and the effectiveness of treatment.
Collapse
Affiliation(s)
- Fábio Cassirer-Costa
- Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Nayara I Medeiros
- Imunologia Celular e Molecular, Centro de Pesquisa René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil; Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana T Chaves
- Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sandra Lyon
- Departamento de Dermatologia, Fundação Hospitalar do Estado de Minas Gerais, Hospital Eduardo de Menezes, Belo Horizonte, Brazil
| | - Jordana G A Coelho-Dos-Reis
- Grupo Integrado de Pesquisa em Biomarcadores, Centro de Pesquisa René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil
| | - Atvaldo F Ribeiro-Junior
- Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rodrigo Correa-Oliveira
- Imunologia Celular e Molecular, Centro de Pesquisa René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais - INCT-DT, Brazil
| | - Manoel O C Rocha
- Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Juliana A S Gomes
- Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| |
Collapse
|
30
|
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.
Collapse
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
| |
Collapse
|
31
|
Coelho-dos-Reis JG, Peruhype-Magalhães V, Pascoal-Xavier MA, de Souza Gomes M, do Amaral LR, Cardoso LM, Jonathan-Gonçalves J, Ribeiro ÁL, Starling ALB, Ribas JG, Gonçalves DU, de Freitas Carneiro-Proietti AB, Teixeira-Carvalho A, Martins-Filho OA. Flow cytometric-based protocols for assessing anti-MT-2 IgG1 reactivity: High-dimensional data handling to define predictors for clinical follow-up of Human T-cell Leukemia virus type-1 infection. J Immunol Methods 2017; 444:36-46. [DOI: 10.1016/j.jim.2017.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/18/2017] [Accepted: 02/13/2017] [Indexed: 12/14/2022]
|
32
|
Campi-Azevedo AC, Costa-Pereira C, Antonelli LR, Fonseca CT, Teixeira-Carvalho A, Villela-Rezende G, Santos RA, Batista MA, Campos FM, Pacheco-Porto L, Melo Júnior OA, Hossell DMSH, Coelho-dos-Reis JG, Peruhype-Magalhães V, Costa-Silva MF, de Oliveira JG, Farias RH, Noronha TG, Lemos JA, von Doellinger VDR, Simões M, de Souza MM, Malaquias LC, Persi HR, Pereira JM, Martins JA, Dornelas-Ribeiro M, Vinhas ADA, Alves TR, Maia MDL, Freire MDS, Martins RDM, Homma A, Romano APM, Domingues CM, Tauil PL, Vasconcelos PF, Rios M, Caldas IR, Camacho LA, Martins-Filho OA. Booster dose after 10 years is recommended following 17DD-YF primary vaccination. Hum Vaccin Immunother 2016; 12:491-502. [PMID: 26360663 PMCID: PMC5049740 DOI: 10.1080/21645515.2015.1082693] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
A single vaccination of Yellow Fever vaccines is believed to confer life-long protection. In this study, results of vaccinees who received a single dose of 17DD-YF immunization followed over 10 y challenge this premise. YF-neutralizing antibodies, subsets of memory T and B cells as well as cytokine-producing lymphocytes were evaluated in groups of adults before (NVday0) and after (PVday30-45, PVyear1-4, PVyear5-9, PVyear10-11, PVyear12-13) 17DD-YF primary vaccination. YF-neutralizing antibodies decrease significantly from PVyear1-4 to PVyear12-13 as compared to PVday30-45, and the seropositivity rates (PRNT≥2.9Log10mIU/mL) become critical (lower than 90%) beyond PVyear5-9. YF-specific memory phenotypes (effector T-cells and classical B-cells) significantly increase at PVday30-45 as compared to naïve baseline. Moreover, these phenotypes tend to decrease at PVyear10-11 as compared to PVday30-45. Decreasing levels of TNF-α+ and IFN-γ+ produced by CD4+ and CD8+ T-cells along with increasing levels of IL-10+CD4+T-cells were characteristic of anti-YF response over time. Systems biology profiling represented by hierarchic networks revealed that while the naïve baseline is characterized by independent micro-nets, primary vaccinees displayed an imbricate network with essential role of central and effector CD8+ memory T-cell responses. Any putative limitations of this cross-sectional study will certainly be answered by the ongoing longitudinal population-based investigation. Overall, our data support the current Brazilian national immunization policy guidelines that recommend one booster dose 10 y after primary 17DD-YF vaccination.
Collapse
Affiliation(s)
| | | | - Lis R Antonelli
- a Centro de Pesquisas René Rachou; FIOCRUZ ; Minas Gerais , Brazil
| | | | | | | | - Raiany A Santos
- a Centro de Pesquisas René Rachou; FIOCRUZ ; Minas Gerais , Brazil
| | | | | | | | | | | | | | | | | | | | - Roberto H Farias
- b Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos-FIOCRUZ ; Rio de Janeiro , Brazil
| | - Tatiana G Noronha
- b Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos-FIOCRUZ ; Rio de Janeiro , Brazil
| | - Jandira A Lemos
- c Secretaria de Estado de Saúde; Governo do Estado de Minas Gerais; Belo Horizonte ; Minas Gerais , Brazil
| | | | - Marisol Simões
- b Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos-FIOCRUZ ; Rio de Janeiro , Brazil
| | - Mirian M de Souza
- b Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos-FIOCRUZ ; Rio de Janeiro , Brazil
| | - Luiz C Malaquias
- d Universidade Federal de Alfenas ; Alfenas , Minas Gerais , Brazil
| | - Harold R Persi
- e Instituto de Biologia do Exército ; Rio de Janeiro , Brazil
| | - Jorge M Pereira
- e Instituto de Biologia do Exército ; Rio de Janeiro , Brazil
| | - José A Martins
- e Instituto de Biologia do Exército ; Rio de Janeiro , Brazil
| | | | | | - Tatiane R Alves
- e Instituto de Biologia do Exército ; Rio de Janeiro , Brazil
| | - Maria de L Maia
- f Assessoria Clínica de Bio-Manguinhos; FIOCRUZ ; Rio de Janeiro , Brazil
| | - Marcos da S Freire
- b Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos-FIOCRUZ ; Rio de Janeiro , Brazil
| | - Reinaldo de M Martins
- b Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos-FIOCRUZ ; Rio de Janeiro , Brazil
| | - Akira Homma
- f Assessoria Clínica de Bio-Manguinhos; FIOCRUZ ; Rio de Janeiro , Brazil
| | | | | | - Pedro L Tauil
- h Universidade de Brasília ; Distrito Federal , Brazil
| | | | - Maria Rios
- j Center for Biologics Evaluation and Research-CBER; US Food and Drug Administration (FDA) ; Silver Spring , MD , USA
| | - Iramaya R Caldas
- k Diretoria Regional de Brasília-Direb; FIOCRUZ ; Brasília , Brazil
| | - Luiz A Camacho
- l Escola Nacional de Saúde Pública; FIOCRUZ ; Rio de Janeiro , Brazil
| | | |
Collapse
|
33
|
B-1 cells contribute to susceptibility in experimental infection with Leishmania (Leishmania) chagasi. Parasitology 2016; 142:1506-15. [PMID: 26416198 DOI: 10.1017/s0031182015000943] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The immune response to leishmaniasis is complex, and the result of infection depends on both the genetic composition of the Leishmania species and the immunity of the host. Clinical and experimental evidence suggest that the activation of B cells leads to exacerbation of visceral leishmaniasis. However, the role of B-1 cells (a subtype of B lymphocytes) in the pathogenesis of experimental visceral leishmaniasis has not yet been elucidated. In this study, we investigated the importance of B-1 cells in experimental infection with Leishmania. (L.) chagasi. Our results showed that BALB/XID mice (X-linked immunodeficient mice which are genetically deficient in B-1 cells) infected with L. (L.) chagasi for 45 days had a significant reduction in parasite load in the spleen when compared with control mice. Cytokine analysis showed that the BALB/XID mice had lower amounts of IL-10 in their sera compared with control group. In addition, the transfer of B-1 cells from wild type mice into IL-10KO animals led to an increase in susceptibility to L. (L.) chagasi infection in the IL-10KO mice, suggesting that the IL-10 produced by these cells is important in experimental infection. Our results suggest that B-1 cells may play an important role in susceptibility to L. (L.) chagasi.
Collapse
|
34
|
Silva-Freitas ML, Cota GF, Machado-de-Assis TS, Giacoia-Gripp C, Rabello A, Da-Cruz AM, Santos-Oliveira JR. Immune Activation and Bacterial Translocation: A Link between Impaired Immune Recovery and Frequent Visceral Leishmaniasis Relapses in HIV-Infected Patients. PLoS One 2016; 11:e0167512. [PMID: 27907136 PMCID: PMC5132299 DOI: 10.1371/journal.pone.0167512] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 11/15/2016] [Indexed: 01/31/2023] Open
Abstract
The maintenance of chronic immune activation due to leishmaniasis or even due to microbial translocation is associated with immunosenescence and may contribute to frequent relapses. Our aim was to investigate whether patients with HIV-associated visceral leishmaniasis (VL/HIV) who experience a single episode of VL have different immunological behaviors in comparison to those who experience frequent relapses. VL/HIV patients were allocated to non-relapsing (NR, n = 6) and relapsing (R, n = 11) groups and were followed from the active phase of VL up to 12 months post-treatment (mpt). The patients were receiving highly active antiretroviral therapy (HAART) and secondary prophylaxis after VL therapy. During active VL, the two groups were similar in all immunological parameters, including the parasite load. At 6 and 12 mpt, the NR group showed a significant gain of CD4+ T cells, a reduction of lymphocyte activation, and lower soluble CD14 and anti-Leishmania IgG3 levels compared to the R group. The viral load remained low, without correlation with the activation. The two groups showed elevated but similar percentages of senescent T cells. These findings suggest a decreased ability of the R group to downmodulate immune activation compared to the NR group. Such functional impairment of the effector response may be a useful indicator for predicting clinical prognosis and recommending starting or stopping secondary prophylaxis.
Collapse
Affiliation(s)
- Maria Luciana Silva-Freitas
- Laboratório Interdisciplinar de Pesquisas Médicas – Instituto Oswaldo Cruz – FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Glaucia Fernandes Cota
- Laboratório de Pesquisas Clinicas e Políticas Públicas em Doenças Infecciosas e Parasitárias – Centro de Pesquisas René Rachou – FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
- Hospital Eduardo de Menezes – Fundação Hospitalar do Estado de Minas Gerais-FHEMIG, Belo Horizonte, Minas Gerais, Brazil
| | - Talia S. Machado-de-Assis
- Laboratório de Pesquisas Clinicas e Políticas Públicas em Doenças Infecciosas e Parasitárias – Centro de Pesquisas René Rachou – FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
- Hospital Eduardo de Menezes – Fundação Hospitalar do Estado de Minas Gerais-FHEMIG, Belo Horizonte, Minas Gerais, Brazil
| | - Carmem Giacoia-Gripp
- Laboratório de AIDS e Imunologia – Instituto Oswaldo Cruz – FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Rabello
- Laboratório de Pesquisas Clinicas e Políticas Públicas em Doenças Infecciosas e Parasitárias – Centro de Pesquisas René Rachou – FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - Alda M. Da-Cruz
- Laboratório Interdisciplinar de Pesquisas Médicas – Instituto Oswaldo Cruz – FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Joanna R. Santos-Oliveira
- Laboratório Interdisciplinar de Pesquisas Médicas – Instituto Oswaldo Cruz – FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
- Núcleo de Ciências Biomédicas Aplicadas, Instituto Federal de Educação, Ciência e Tecnologia – IFRJ, Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
| |
Collapse
|
35
|
Gardinassi LG, Garcia GR, Costa CHN, Costa Silva V, de Miranda Santos IKF. Blood Transcriptional Profiling Reveals Immunological Signatures of Distinct States of Infection of Humans with Leishmania infantum. PLoS Negl Trop Dis 2016; 10:e0005123. [PMID: 27828962 PMCID: PMC5102635 DOI: 10.1371/journal.pntd.0005123] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 10/23/2016] [Indexed: 12/04/2022] Open
Abstract
Visceral leishmaniasis (VL) can be lethal if untreated; however, the majority of human infections with the etiological agents are asymptomatic. Using Illumina Bead Chip microarray technology, we investigated the patterns of gene expression in blood of active VL patients, asymptomatic infected individuals, patients under remission of VL and controls. Computational analyses based on differential gene expression, gene set enrichment, weighted gene co-expression networks and cell deconvolution generated data demonstrating discriminative transcriptional signatures. VL patients exhibited transcriptional profiles associated with pathways and gene modules reflecting activation of T lymphocytes via MHC class I and type I interferon signaling, as well as an overall down regulation of pathways and gene modules related to myeloid cells, mainly due to differences in the relative proportions of monocytes and neutrophils. Patients under remission of VL presented heterogeneous transcriptional profiles associated with activation of T lymphocytes via MHC class I, type I interferon signaling and cell cycle and, importantly, transcriptional activity correlated with activation of Notch signaling pathway and gene modules that reflected increased proportions of B cells after treatment of disease. Asymptomatic and uninfected individuals presented similar gene expression profiles, nevertheless, asymptomatic individuals exhibited particularities which suggest an efficient regulation of lymphocyte activation and a strong association with a type I interferon response. Of note, we validated a set of target genes by RT-qPCR and demonstrate the robustness of expression data acquired by microarray analysis. In conclusion, this study profiles the immune response during distinct states of infection of humans with Leishmania infantum with a novel strategy that indicates the molecular pathways that contribute to the progression of the disease, while also providing insights into transcriptional activity that can drive protective mechanisms. Infections of humans with the protozoan parasites L. donvani and L. infantum can lead to the development of the disease visceral leishmaniasis, but also to an asymptomatic status. However, the mechanisms that result in these clinical outcomes after infection are poorly understood. In this study, we applied a data-driven approach to obtain insights into the immunological processes linked to the progression of the disease or to protective mechanisms. For this purpose, we evaluated the patterns of expression for genes that code proteins from the entire human genome in the peripheral blood from patients with visceral leishmaniasis, from individuals who remained asymptomatic after infections with L. infantum, from patients who were recovering from disease after treatment and from uninfected individuals. By employing computational analysis to evaluate the blood transcriptional activity of each group, we identified transcriptional signatures that correlate with previous findings obtained through different analytical methods. Moreover, our analyses uncovered hitherto unidentified molecular pathways and gene networks associated with the transcriptional profiles of individuals recovering from disease or that did not develop symptoms after infection. This suggests that activation of protective responses can be useful targets for the development of new therapies for visceral leishmaniasis.
Collapse
Affiliation(s)
- Luiz Gustavo Gardinassi
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Gustavo Rocha Garcia
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carlos Henrique Nery Costa
- Department of Community Medicine, Natan Portela Institute for Tropical Diseases, Federal University of Piauí, Teresina, Brazil
| | - Vladimir Costa Silva
- Department of Community Medicine, Natan Portela Institute for Tropical Diseases, Federal University of Piauí, Teresina, Brazil
| | | |
Collapse
|
36
|
Kaushal H, Bras‐Gonçalves R, Avishek K, Kumar Deep D, Petitdidier E, Lemesre J, Papierok G, Kumar S, Ramesh V, Salotra P. Evaluation of cellular immunological responses in mono- and polymorphic clinical forms of post-kala-azar dermal leishmaniasis in India. Clin Exp Immunol 2016; 185:50-60. [PMID: 26948150 PMCID: PMC4908291 DOI: 10.1111/cei.12787] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2016] [Indexed: 11/28/2022] Open
Abstract
Post-kala-azar dermal leishmaniasis (PKDL) is a chronic dermal complication that occurs usually after recovery from visceral leishmaniasis (VL). The disease manifests into macular, papular and/or nodular clinical types with mono- or polymorphic presentations. Here, we investigated differences in immunological response between these two distinct clinical forms in Indian PKDL patients. Peripheral blood mononuclear cells of PKDL and naive individuals were exposed in vitro to total soluble Leishmania antigen (TSLA). The proliferation index was evaluated using an enzyme-linked immunosorbent assay (ELISA)-based lymphoproliferative assay. Cytokines and granzyme B levels were determined by cytometric bead array. Parasite load in tissue biopsy samples of PKDL was quantified by quantitative polymerase chain reaction (qPCR). The proportion of different lymphoid subsets in peripheral blood and the activated T cell population were estimated using flow cytometry. The study demonstrated heightened cellular immune responses in the polymorphic PKDL group compared to the naive group. The polymorphic group showed significantly higher lymphoproliferation, increased cytokines and granzyme B levels upon TSLA stimulation, and a raised proportion of circulating natural killer (NK) T cells against naive controls. Furthermore, the polymorphic group showed a significantly elevated proportion of activated CD4(+) and CD8(+) T cells upon in-vitro TSLA stimulation. Thus, the polymorphic variants showed pronounced cellular immunity while the monomorphic form demonstrated a comparatively lower cellular response. Additionally, the elevated level of both activated CD4(+) and CD8(+) T cells, coupled with high granzyme B secretion upon in-vitro TSLA stimulation, indicated the role of cytotoxic cells in resistance to L. donovani infection in polymorphic PKDL.
Collapse
MESH Headings
- Adolescent
- Adult
- Antigens, Protozoan/pharmacology
- CD4-Positive T-Lymphocytes/immunology
- CD4-Positive T-Lymphocytes/parasitology
- CD4-Positive T-Lymphocytes/pathology
- CD8-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/parasitology
- CD8-Positive T-Lymphocytes/pathology
- Cell Proliferation
- Cytokines/genetics
- Cytokines/immunology
- Cytotoxicity, Immunologic
- Female
- Flow Cytometry
- Gene Expression
- Granzymes/genetics
- Granzymes/immunology
- Humans
- Immunophenotyping
- India
- Killer Cells, Natural/immunology
- Killer Cells, Natural/parasitology
- Killer Cells, Natural/pathology
- Leishmania donovani/immunology
- Leishmania donovani/pathogenicity
- Leishmaniasis, Cutaneous/diagnosis
- Leishmaniasis, Cutaneous/immunology
- Leishmaniasis, Cutaneous/parasitology
- Leishmaniasis, Cutaneous/pathology
- Leishmaniasis, Visceral/diagnosis
- Leishmaniasis, Visceral/immunology
- Leishmaniasis, Visceral/parasitology
- Leishmaniasis, Visceral/pathology
- Leukocytes, Mononuclear/immunology
- Leukocytes, Mononuclear/parasitology
- Leukocytes, Mononuclear/pathology
- Lymphocyte Activation
- Male
- Parasite Load
- Primary Cell Culture
- Skin/immunology
- Skin/parasitology
- Skin/pathology
Collapse
Affiliation(s)
- H. Kaushal
- National Institute of Pathology (ICMR), Safdarjung Hospital CampusNew DelhiIndia
| | | | - K. Avishek
- National Institute of Pathology (ICMR), Safdarjung Hospital CampusNew DelhiIndia
| | - D. Kumar Deep
- National Institute of Pathology (ICMR), Safdarjung Hospital CampusNew DelhiIndia
| | | | - J.‐L. Lemesre
- Institut de Recherche pour le DéveloppementMontpellier
| | | | - S. Kumar
- Department of Biological SciencesBirla Institute of Technology and SciencePilaniIndia
| | - V Ramesh
- Department of DermatologyVMMC and Safdarjung HospitalNew DelhiIndia
| | - P. Salotra
- National Institute of Pathology (ICMR), Safdarjung Hospital CampusNew DelhiIndia
| |
Collapse
|
37
|
de Freitas EO, Leoratti FMDS, Freire-de-Lima CG, Morrot A, Feijó DF. The Contribution of Immune Evasive Mechanisms to Parasite Persistence in Visceral Leishmaniasis. Front Immunol 2016; 7:153. [PMID: 27148272 PMCID: PMC4840207 DOI: 10.3389/fimmu.2016.00153] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/08/2016] [Indexed: 01/06/2023] Open
Abstract
Leishmania is a genus of protozoan parasites that give rise to a range of diseases called Leishmaniasis that affects annually an estimated 1.3 million people from 88 countries. Leishmania donovani and Leishmania (L.) infantum chagasi are responsible to cause the visceral leishmaniasis. The parasite can use assorted strategies to interfere with the host homeostasis to establish persistent infections that without treatment can be lethal. In this review, we highlight the mechanisms involved in the parasite subversion of the host protective immune response and how alterations of host tissue physiology and vascular remodeling during VL could affect the organ-specific immunity against Leishmania parasites.
Collapse
Affiliation(s)
| | | | | | - Alexandre Morrot
- Laboratorio de Biologia do Sistema Imune, Departmento de Imunologia, Instituto de Microbiologia, Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil
| | - Daniel Ferreira Feijó
- Laboratório Integrado de Microbiologia e Imunoregulação, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ) , Salvador , Brazil
| |
Collapse
|
38
|
Serum Cytokine Responses over the Entire Clinical-Immunological Spectrum of Human Leishmania (L.) infantum chagasi Infection. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6937980. [PMID: 27051668 PMCID: PMC4802012 DOI: 10.1155/2016/6937980] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 01/19/2016] [Accepted: 02/04/2016] [Indexed: 01/13/2023]
Abstract
The clinical-immunological spectrum of human Leishmania (L.) infantum chagasi infection in Amazonian Brazil was recently reviewed based on clinical, DTH, and IFAT (IgG) evaluations that identified five profiles: three asymptomatic (asymptomatic infection, AI; subclinical resistant infection, SRI; and indeterminate initial infection, III) and two symptomatic (symptomatic infection, SI; American visceral leishmaniasis, AVL; and subclinical oligosymptomatic infection, SOI). TNF-α, IL-4, IL-6, and IL-10 serum cytokines were analyzed using multiplexed Cytometric Bead Array in 161 samples from endemic areas in the Brazilian Amazon: SI [AVL] (21 cases), III (49), SRI (19), SOI (12), AI (36), and a control group [CG] (24). The highest IL-6 serum levels were observed in the SI profile (AVL); higher IL-10 serum levels were observed in SI than in SOI or CG and in AI and III than in SOI; higher TNF-α serum levels were seen in SI than in CG. Positive correlations were found between IL-6 and IL-10 serum levels in the SI and III profiles and between IL-6 and TNF-α and between IL-4 and TNF-α in the III profile. These results provide strong evidence for associating IL-6 and IL-10 with the immunopathogenesis of AVL and help clarify the role of these cytokines in the infection spectrum.
Collapse
|
39
|
Rodrigues V, Cordeiro-da-Silva A, Laforge M, Silvestre R, Estaquier J. Regulation of immunity during visceral Leishmania infection. Parasit Vectors 2016; 9:118. [PMID: 26932389 PMCID: PMC4774109 DOI: 10.1186/s13071-016-1412-x] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 01/20/2016] [Indexed: 12/24/2022] Open
Abstract
Unicellular eukaryotes of the genus Leishmania are collectively responsible for a heterogeneous group of diseases known as leishmaniasis. The visceral form of leishmaniasis, caused by L. donovani or L. infantum, is a devastating condition, claiming 20,000 to 40,000 lives annually, with particular incidence in some of the poorest regions of the world. Immunity to Leishmania depends on the development of protective type I immune responses capable of activating infected phagocytes to kill intracellular amastigotes. However, despite the induction of protective responses, disease progresses due to a multitude of factors that impede an optimal response. These include the action of suppressive cytokines, exhaustion of specific T cells, loss of lymphoid tissue architecture and a defective humoral response. We will review how these responses are orchestrated during the course of infection, including both early and chronic stages, focusing on the spleen and the liver, which are the main target organs of visceral Leishmania in the host. A comprehensive understanding of the immune events that occur during visceral Leishmania infection is crucial for the implementation of immunotherapeutic approaches that complement the current anti-Leishmania chemotherapy and the development of effective vaccines to prevent disease.
Collapse
Affiliation(s)
| | - Anabela Cordeiro-da-Silva
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal. .,Departamento de Ciências Biológicas, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal.
| | | | - Ricardo Silvestre
- School of Health Sciences, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal. .,ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal.
| | - Jérôme Estaquier
- CNRS FR3636, Université Paris-Descartes, Paris, France. .,Centre de Recherche en Infectiologie, Université Laval, Québec, Canada.
| |
Collapse
|
40
|
dos Santos PL, de Oliveira FA, Santos MLB, Cunha LCS, Lino MTB, de Oliveira MFS, Bomfim MOM, Silva AM, de Moura TR, de Jesus AR, Duthie MS, Reed SG, de Almeida RP. The Severity of Visceral Leishmaniasis Correlates with Elevated Levels of Serum IL-6, IL-27 and sCD14. PLoS Negl Trop Dis 2016; 10:e0004375. [PMID: 26814478 PMCID: PMC4729473 DOI: 10.1371/journal.pntd.0004375] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/18/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is a severe disease caused by infection with protozoa of the genus Leishmania. Classic VL is characterized by a systemic infection of phagocytic cells and an intense activation of the inflammatory response. It is unclear why 90% of infected individuals do not develop the disease while a minority develop the classical form. Furthermore, among those that develop disease, a small group progresses to more severe form that is unresponsive to treatment. The presence of inflammatory mediators in serum could theoretically help to control the infection. However, there is also a release of anti-inflammatory mediators that could interfere with the control of parasite multiplication. In this study, we took advantage of the spectrum of outcomes to test the hypothesis that the immune profile of individuals infected with Leishmania (L.) infantum is associated with the development and severity of disease. METHODOLOGY/PRINCIPAL FINDINGS Sera from patients with confirmed diagnosis of VL were evaluated for the presence of numerous molecules, and levels compared with healthy control and asymptomatic infected individuals. CONCLUSIONS/PRINCIPAL FINDINGS Although differences were not observed in LPS levels, higher levels of sCD14 were detected in VL patients. Our data suggest that L. infantum may activate the inflammatory response via CD14, stimulating a generalized inflammatory response with production of several cytokines and soluble molecules, including IFN-γ, IL-27, IL-10, IL-6 and sCD14. These molecules were strongly associated with hepatosplenomegaly, neutropenia and thrombocytopenia. We also observed that IL-6 levels greater than 200 pg/ml were strongly associated with death. Together our data reinforce the close relationship of IFN-γ, IL-10, IL-6, TNF-α and IL-27 in the immune dynamics of VL and suggest the direct participation of sCD14 in the activation of the immune response against L. infantum.
Collapse
Affiliation(s)
- Priscila L. dos Santos
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Fabrícia A. de Oliveira
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Micheli Luize B. Santos
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Luana Celina S. Cunha
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Michelle T. B. Lino
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Michelle F. S. de Oliveira
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Manuela O. M. Bomfim
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Angela Maria Silva
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Tatiana R. de Moura
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Amélia R. de Jesus
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
- Instituto de Investigação em Imunologia, São Paulo, Brazil
| | - Malcolm S. Duthie
- Infectious Diseases Research Institute (IDRI), Seattle, Washington, United States of America
| | - Steven G. Reed
- Infectious Diseases Research Institute (IDRI), Seattle, Washington, United States of America
| | - Roque P. de Almeida
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
- Instituto de Investigação em Imunologia, São Paulo, Brazil
- * E-mail:
| |
Collapse
|
41
|
Starling ALB, Coelho-dos-Reis JGA, Peruhype-Magalhães V, Pascoal-Xavier MA, Gonçalves DU, Béla SR, Lambertucci JR, Labanca L, Souza Pereira SR, Teixeira-Carvalho A, Ribas JG, Trindade BC, Faccioli LH, Carneiro-Proietti ABF, Martins-Filho OA. Immunological signature of the different clinical stages of the HTLV-1 infection: establishing serum biomarkers for HTLV-1-associated disease morbidity. Biomarkers 2015; 20:502-12. [DOI: 10.3109/1354750x.2015.1094141] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ana Lúcia Borges Starling
- Centro De Pesquisas René Rachou – FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil,
- Fundação Centro De Hematologia E Hemoterapia De Minas Gerais – HEMOMINAS, Santa Efigênia, Minas Gerais, Brazil,
- Programa De Pós-Graduação Em Infectologia E Medicina Tropical – Faculdade De Medicina Da Universidade Federal De Minas Gerais, Belo Horizonte, Minas Gerais, Brazil,
| | | | | | - Marcelo Antônio Pascoal-Xavier
- Programa De Pós-Graduação Em Infectologia E Medicina Tropical – Faculdade De Medicina Da Universidade Federal De Minas Gerais, Belo Horizonte, Minas Gerais, Brazil,
- Department of Anatomic Pathology, Medicine School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil,
| | - Denise Utsch Gonçalves
- Programa De Pós-Graduação Em Infectologia E Medicina Tropical – Faculdade De Medicina Da Universidade Federal De Minas Gerais, Belo Horizonte, Minas Gerais, Brazil,
| | - Samantha Ribeiro Béla
- Centro De Pesquisas René Rachou – FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil,
| | - José Roberto Lambertucci
- Programa De Pós-Graduação Em Infectologia E Medicina Tropical – Faculdade De Medicina Da Universidade Federal De Minas Gerais, Belo Horizonte, Minas Gerais, Brazil,
| | - Ludimila Labanca
- Programa De Pós-Graduação Em Infectologia E Medicina Tropical – Faculdade De Medicina Da Universidade Federal De Minas Gerais, Belo Horizonte, Minas Gerais, Brazil,
| | - Silvio Roberto Souza Pereira
- Programa De Pós-Graduação Em Infectologia E Medicina Tropical – Faculdade De Medicina Da Universidade Federal De Minas Gerais, Belo Horizonte, Minas Gerais, Brazil,
| | | | | | - Bruno Caetano Trindade
- Centro De Pesquisas René Rachou – FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil,
- Laboratório De Inflamação E Imunologia Das Parasitoses, Faculdade De Ciências Farmacêuticas De Ribeirão Preto, Universidade De São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lucia Helena Faccioli
- Laboratório De Inflamação E Imunologia Das Parasitoses, Faculdade De Ciências Farmacêuticas De Ribeirão Preto, Universidade De São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | | |
Collapse
|
42
|
Bastos MS, Coelho-Dos-Reis JG, Zauli DAG, Naveca FG, Monte RL, Pimentel JP, Macário VMK, da Silva NL, Peruhype-Magalhães V, Pascoal-Xavier MA, Guimaraes A, Carvalho AT, Malheiro A, Martins-Filho OA, Mourão MPG. Divergent cerebrospinal fluid cytokine network induced by non-viral and different viral infections on the central nervous system. BMC Infect Dis 2015; 15:345. [PMID: 26286516 PMCID: PMC4541733 DOI: 10.1186/s12879-015-1035-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 07/16/2015] [Indexed: 11/23/2022] Open
Abstract
Background Meningoencephalitis is one of the most common disorders of the central nervous system (CNS) worldwide. Viral meningoencephalitis differs from bacterial meningitis in several aspects. In some developing countries, bacterial meningitis has appropriate clinical management and chemotherapy is available. Virus-associated and virus not detected meningoencephalitis are treatable, however, they may cause death in a few cases. The knowledge of how mediators of inflammation can induce disease would contribute for the design of affordable therapeutic strategies, as well as to the diagnosis of virus not detected and viral meningoencephalitis. Cytokine-induced inflammation to CNS requires several factors that are not fully understood yet. Methods Considering this, several cytokines were measured in the cerebrospinal fluid (CSF) of patients with undiagnosed and viral meningoencephalitis, and these were correlated with cellularity in the CSF. Results The results demonstrate that an altered biochemical profile alongside increased cellularity in the cerebrospinal fluid is a feature of patients with meningoencephalitis that are not associated with the detection of virus in the CNS (P < 0.05). Moreover, HIV-positive patients (n = 10) that evolve with meningoencephalitis display a distinct biochemical/cytological profile (P < 0.05) in the cerebrospinal fluid. Meningoencephalitis brings about a prominent intrathecal cytokine storm regardless of the detection of virus as presumable etiological agent. In the case of Enterovirus infection (n = 13), meningoencephalitis elicits robust intrathecal pro-inflammatory cytokine pattern and elevated cellularity when compared to herpesvirus (n = 15) and Arbovirus (n = 5) viral infections (P < 0.05). Conclusion Differences in the cytokine profile of the CSF may be unique if distinct, viral or presumably non-viral pathways initially trigger the inflammatory response in the CNS.
Collapse
Affiliation(s)
| | - Jordana Grazziela Coelho-Dos-Reis
- Laboratory of Biomarkers for Diagnosis and Monitoring, René Rachou Research Center, FIOCRUZ, Av. Augusto de Lima 1715, Barro Preto, Belo Horizonte, Minas Gerais, CEP 30190-002, Brazil.
| | - Danielle Alves Gomes Zauli
- Laboratory of Biomarkers for Diagnosis and Monitoring, René Rachou Research Center, FIOCRUZ, Av. Augusto de Lima 1715, Barro Preto, Belo Horizonte, Minas Gerais, CEP 30190-002, Brazil. .,Instituto Hermes Pardini, Belo Horizonte, MG, Brazil.
| | | | | | | | | | | | - Vanessa Peruhype-Magalhães
- Laboratory of Biomarkers for Diagnosis and Monitoring, René Rachou Research Center, FIOCRUZ, Av. Augusto de Lima 1715, Barro Preto, Belo Horizonte, Minas Gerais, CEP 30190-002, Brazil.
| | | | - Allyson Guimaraes
- Hematology and Hemotherapic Foundation of Amazonas, Manaus, AM, Brazil.
| | - Andréa Teixeira Carvalho
- Laboratory of Biomarkers for Diagnosis and Monitoring, René Rachou Research Center, FIOCRUZ, Av. Augusto de Lima 1715, Barro Preto, Belo Horizonte, Minas Gerais, CEP 30190-002, Brazil.
| | - Adriana Malheiro
- Hematology and Hemotherapic Foundation of Amazonas, Manaus, AM, Brazil.
| | - Olindo Assis Martins-Filho
- Laboratory of Biomarkers for Diagnosis and Monitoring, René Rachou Research Center, FIOCRUZ, Av. Augusto de Lima 1715, Barro Preto, Belo Horizonte, Minas Gerais, CEP 30190-002, Brazil.
| | - Maria Paula Gomes Mourão
- Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, AM, Brazil. .,Amazonas State University, Manaus, AM, Brazil.
| |
Collapse
|
43
|
Araújo IR, Ferrari TCA, Teixeira-Carvalho A, Campi-Azevedo AC, Rodrigues LV, Guimarães Júnior MH, Barros TLS, Gelape CL, Sousa GR, Nunes MCP. Cytokine Signature in Infective Endocarditis. PLoS One 2015. [PMID: 26225421 PMCID: PMC4520569 DOI: 10.1371/journal.pone.0133631] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Infective endocarditis (IE) is a severe disease with high mortality rate. Cytokines participate in its pathogenesis and may contribute to early diagnosis improving the outcome. This study aimed to evaluate the cytokine profile in IE. Serum concentrations of interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12 and tumor necrosis factor (TNF)-α were measured by cytometric bead array (CBA) at diagnosis in 81 IE patients, and compared with 34 healthy subjects and 30 patients with non-IE infections, matched to the IE patients by age and gender. Mean age of the IE patients was 47±17 years (range, 15–80 years), and 40 (50%) were male. The IE patients had significantly higher serum concentrations of IL-1β, IL-6, IL-8, IL-10 and TNF-α as compared to the healthy individuals. The median levels of IL-1β, TNF-α and IL-12 were higher in the IE than in the non-IE infections group. TNF-α and IL-12 levels were higher in staphylococcal IE than in the non-staphylococcal IE subgroup. There was a higher proportion of both low IL-10 producers and high producers of IL-1β, TNF-α and IL-12 in the staphylococcal IE than in the non-staphylococcal IE subgroup. This study reinforces a relationship between the expression of proinflammatory cytokines, especially IL-1β, IL-12 and TNF-α, and the pathogenesis of IE. A lower production of IL-10 and impairment in cytokine network may reflect the severity of IE and may be useful for risk stratification.
Collapse
Affiliation(s)
- Izabella Rodrigues Araújo
- Programa de Pós-Graduação em Infectologia e Medicina Tropical, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Teresa Cristina Abreu Ferrari
- Programa de Pós-Graduação em Infectologia e Medicina Tropical, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Andréa Teixeira-Carvalho
- Fundação Oswaldo Cruz, Centro de Pesquisas René Rachou, Laboratório de Biomarcadores de Diagnóstico e Monitoração, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Carolina Campi-Azevedo
- Fundação Oswaldo Cruz, Centro de Pesquisas René Rachou, Laboratório de Biomarcadores de Diagnóstico e Monitoração, Belo Horizonte, Minas Gerais, Brazil
| | - Luan Vieira Rodrigues
- Programa de Pós-Graduação em Infectologia e Medicina Tropical, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Milton Henriques Guimarães Júnior
- Programa de Pós-Graduação em Infectologia e Medicina Tropical, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thais Lins Souza Barros
- Programa de Pós-Graduação em Infectologia e Medicina Tropical, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Cláudio Léo Gelape
- Departamento de Cirurgia, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Giovane Rodrigo Sousa
- Programa de Pós-Graduação em Infectologia e Medicina Tropical, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Carmo Pereira Nunes
- Programa de Pós-Graduação em Infectologia e Medicina Tropical, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
| |
Collapse
|
44
|
Lanchote VL, Almeida R, Barral A, Barral-Netto M, Marques MP, Moraes NV, da Silva AM, Souza TMV, Suarez-Kurtz G. Impact of visceral leishmaniasis and curative chemotherapy on cytochrome P450 activity in Brazilian patients. Br J Clin Pharmacol 2015; 80:1160-8. [PMID: 25940755 DOI: 10.1111/bcp.12677] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/11/2015] [Accepted: 04/29/2015] [Indexed: 01/03/2023] Open
Abstract
AIMS The aim of the present study was to investigate the impact of human visceral leishmaniasis (VL) and curative chemotherapy on the activity of cytochrome P450 (CYP) 3A, CYP2C9 and CYP2C19 in patients from an endemic region in Brazil. METHODS Adult patients with parasitologically confirmed VL were given a CYP phenotyping cocktail, comprising midazolam, omeprazole and losartan, immediately before (Study phase 1), 2-3 days (phase 2) and 3-6 months (phase 3) after curative VL chemotherapy. CYP activity was assessed by the apparent clearance of midazolam (CYP3A), omeprazole/5-hydroxyomeprazol ratio in plasma (CYP2C19) and losartan/E3174 ratio in urine (CYP2C9). RESULTS Mean values (95% confidence interval) in phases 1, 2 and 3 were, respectively: log apparent midazolam clearance, 1.21 (1.10-1.31), 1.45 (1.32-1.57) and 1.35 (1.26-1.44) ml min(-1) kg(-1) ; omeprazole/5-hydroxyomeprazole ratio, 0.78 (0.61-0.94), 0.45 (0.27-0.63) and 0.37 (0.20-0.55); losartan/E3174 ratio, 0.66 (0.39-0.92), 0.35 (0.20-0.50) and 0.35 (0.16-0.53). Analysis of variance revealed significant differences in CYP3A (P = 0.018) and CYP2C19 (P = 0.008), but not CYP2C9 (P = 0.11) phenotypic activity, across the three study phases. CONCLUSION The phenotypic activities of CYP3A4 and CYP2C19 were significantly reduced during acute VL compared with post-chemotherapy. We propose that increased plasma concentrations of proinflammatory cytokines during active disease account for the suppression of CYP activity. The failure to detect significant changes in CYP2C9 activity in the overall cohort may reflect differential effects of the inflammatory process on the expression of CYP isoforms, although the possibility of insufficient statistical power cannot be dismissed.
Collapse
Affiliation(s)
- Vera Lucia Lanchote
- Laboratório de Farmacocinética e Metabolismo, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Roque Almeida
- Universidade Federal de Sergipe, Hospital Universitário, Aracaju, Sergipe, Brazil
| | - Aldina Barral
- Centro de Pesquisas Gonçalo Moniz (CPqGM), Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Manoel Barral-Netto
- Centro de Pesquisas Gonçalo Moniz (CPqGM), Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Maria Paula Marques
- Laboratório de Farmacocinética e Metabolismo, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Natália V Moraes
- Laboratório de Farmacocinética e Metabolismo, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Angela M da Silva
- Universidade Federal de Sergipe, Hospital Universitário, Aracaju, Sergipe, Brazil
| | - Tania M V Souza
- Universidade Federal de Sergipe, Hospital Universitário, Aracaju, Sergipe, Brazil
| | | |
Collapse
|
45
|
CD11c+CD123Low dendritic cell subset and the triad TNF-α/IL-17A/IFN-γ integrate mucosal and peripheral cellular responses in HIV patients with high-grade anal intraepithelial neoplasia: a systems biology approach. J Acquir Immune Defic Syndr 2015; 68:112-22. [PMID: 25590266 DOI: 10.1097/qai.0000000000000412] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The incidence of anal cancer has increased over the past 25 years, and HIV/HPV coinfection is the most important risk factor for anal squamous cell carcinoma. In this study, we demonstrated that the evaluation of systemic and compartmentalized anal mucosa immune response is relevant to differentiating HIV(+) patients at risk of anal intraepithelial neoplasia (AIN). METHODS A systems biology approach was used to integrate different immunological parameters from anal mucosal tissue and peripheral blood assessed by phenotypic and intracytoplasmic analysis of lymphocytes and dendritic cell subsets. RESULTS Our data demonstrated that anal mucosal mononuclear cells from AIN(+)HIV(+) patients showed a robust capacity in producing proinflammatory/regulatory cytokines, mainly mTNF-α > IL-4 > IL-10 > IL-6 = IL-17A. Mucosal TNF-α/IFN-γ/IL-17A are selective high-grade squamous intraepithelial lesion (HSIL)-related biomarkers. Higher levels of circulating CD11cCD123cells and CD1a cells along with elevated levels of IFN-γCD4 T cells are major features associated with HSIL in AIN(+)HIV(+) patients. Regardless of the presence of AIN, HIV(+) patients presented a complex biomarker network, rich in negative connections. Among those patients, however, HSIL+ patients displayed stronger positive links between peripheral blood and anal mucosa environments, exemplified by the subnet of IL-17A/TNF-α/CD4IFN-γ/CD11cCD123 cells. CONCLUSIONS The significant association between HSIL and the levels of TNF-α/IL-17A/IFN-γ along with the different subsets of DCs present in the anal mucosa milieu should be studied in more detail as a way to identify and categorize HIV(+) patients vis à vis the high risk of anal cancer outcome.
Collapse
|
46
|
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.
Collapse
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
| |
Collapse
|
47
|
Casado JL, Abad-Fernández M, Moreno S, Pérez-Elías MJ, Moreno A, Bernardino JI, Vallejo A. Visceral leishmaniasis as an independent cause of high immune activation, T-cell senescence, and lack of immune recovery in virologically suppressed HIV-1-coinfected patients. HIV Med 2015; 16:240-8. [PMID: 25604328 DOI: 10.1111/hiv.12206] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Different immune alterations have been described in HIV-infected patients with visceral leishmaniasis (VL). We aimed to identify the immunological factors involved in the lack of immunological recovery and VL relapses in HIV-infected patients with VL, by comparison with other HIV-infected patients. METHODS We carried out a cross-sectional study of 55 patients receiving suppressive combination antiretroviral therapy (cART) for at least 1 year: nine with previous relapsing VL, 20 with an immunodiscordant response (IDR) to cART (CD4 count < 200 cells/μL) and no previous VL, and 26 with a concordant response (CR) to cART (CD4 count > 350 cells/μL) without VL. Immunosenescence was investigated by analysing CD57(+) CD28(-) levels, immune activation by analysing CD38(+) HLA-DR(+) levels, inflammation by analysing interleukin (IL)-6 levels, and microbial translocation by analysing lipopolysaccharide (LPS) and soluble CD14 (sCD14) levels. RESULTS In VL patients, the median time since VL diagnosis was 42 months, and all patients had had at least one relapse despite suppressive cART for a median time of 43 months. Patients with previously diagnosed VL had a higher CD8 T-cell activation level (P < 0.001) than those with IDR. Also, levels of IL-6, LPS and especially sCD14, associated with bacterial translocation and additional monocyte activation, were significantly increased in patients with previous VL compared with patients with IDR (P = 0.048, P = 0.049 and P < 0.001, respectively). In addition, patients with previous VL had higher levels of CD8 T-cell senescence. Notably, the levels of immune activation and inflammation in patients with previous VL were not related to the time of VL diagnosis, the number of VL relapses, or hepatitis C virus (HCV) coinfection. CONCLUSIONS Our data demonstrate that VL patients had an even worse immunological status than patients with IDR, which was probably associated with increased microbial translocation and additional monocyte/macrophage activation. These data explain the observed lack of immunological recovery and the occurrence of VL relapses in HIV-infected patients with previous VL.
Collapse
Affiliation(s)
- J L Casado
- Department of Infectious Diseases, Ramon y Cajal Hospital, Madrid, Spain
| | | | | | | | | | | | | |
Collapse
|
48
|
Kaushal H, Bras-Gonçalves R, Negi NS, Lemesre JL, Papierok G, Salotra P. Role of CD8(+) T cells in protection against Leishmania donovani infection in healed Visceral Leishmaniasis individuals. BMC Infect Dis 2014; 14:653. [PMID: 25471494 PMCID: PMC4258298 DOI: 10.1186/s12879-014-0653-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 10/29/2014] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Majority of individuals with history of visceral leishmaniasis (VL) exhibit strong immunity to re-infection, however, the mechanism of resistance is poorly understood. It is unclear whether CD8(+) T cells contribute to protection against Leishmania donovani infection through cytotoxic activity. The present study aims to evaluate immunological mechanism associated with resistance to the disease in healed VL (HVL) individuals and further, the contribution of CD8(+) T cells in the protective immunity. METHODS Peripheral blood mononuclear cells (PBMCs) from VL, HVL and naive groups were exposed in vitro to total soluble Leishmania antigen (TSLA) from L. donovani. The proliferation index was determined by ELISA based lymphoproliferative assay. Cytokines and granzyme B levels were measured by CBA. Activated T-cell populations were estimated using flow cytometry. RESULTS We observed significantly higher lymphoproliferation, cytokines and granzyme B levels in HVL group compared to naive or VL group. More strikingly, we found a strong association (rs = 0.895, P < 0.0001) between proliferation index (PI) and granzyme B level, with a significant proportion of activated CD8(+) T cells in HVL group. CONCLUSIONS Leishmania immune group (HVL) exhibited durable and strong cellular immune response to TSLA in terms of lymphoproliferation as well as production of Th1 cytokines and granzyme B. Additionally, the elevated level of activated CD8(+) T cells and stimulation of cytotoxic activity through granzyme B production, indicated a possible role of CD8(+) T cells in resistance to L. donovani infection in the HVL group.
Collapse
Affiliation(s)
- Himanshu Kaushal
- />National Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, 110029 India
| | - Rachel Bras-Gonçalves
- />Institut de Recherche pour le Développement, UMR177 IRD/CIRAD “INTERTRYP”, Montpellier, France
| | | | - Jean-Loup Lemesre
- />Institut de Recherche pour le Développement, UMR177 IRD/CIRAD “INTERTRYP”, Montpellier, France
| | | | - Poonam Salotra
- />National Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, 110029 India
| |
Collapse
|
49
|
Clinical severity of visceral leishmaniasis is associated with changes in immunoglobulin g fc N-glycosylation. mBio 2014; 5:e01844. [PMID: 25467439 PMCID: PMC4324239 DOI: 10.1128/mbio.01844-14] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Visceral leishmaniasis (VL) has a high fatality rate if not treated; nevertheless, the majority of human infections with the causative agent, Leishmania infantum chagasi, are asymptomatic. Although VL patients often present with increased levels of serum immunoglobulins, the contribution of antibodies to resistance or progression to disease remains unknown. Effector and regulatory functions of antibodies rely on their interactions with type I and II Fc receptors, and these interactions are tuned by the patterns of antibody Fc N-glycosylation. In view of these facts, we applied a robust method of IgG Fc N-glycopeptide profiling of serum samples from 187 patients with VL, 177 asymptomatic individuals, 116 endemic controls (individuals residing in areas where VL is endemic) and 43 nonendemic controls (individuals living in an area where VL is not endemic). We show that, in comparison to the overall IgG Fc N-glycan profiles of asymptomatic or uninfected healthy individuals, those of patients with VL are profoundly altered. These changes correlate with levels of serum cytokines and the inflammation marker C-reactive protein. We also fitted univariate and multivariate ordinal logistic regression models to demonstrate the ability of IgG Fc N-glycosylation features and immunity regulators present in serum to predict disease severity in VL patients. Importantly, we show that Fc N-glycosylation profiles change after treatment of VL. This study introduces important concepts contributing to the understanding of antibody responses in infections with Leishmania parasites and provides new insights into the pathology of human VL. Immunoglobulins (Ig) have been shown to present pro- and anti-inflammatory functions according to the profile of carbohydrates attached to their Fc region. Glycosylation features of serum IgG have been examined in relation to several autoimmune and infectious diseases and provide a mechanistic basis for the protective or pathogenic role of antibodies. Leishmania infantum chagasi is the causative agent of visceral leishmaniasis (VL) in South America, and we show that VL patients produce IgG with patterns of Fc glycans similar to those found in other inflammatory conditions. Specific Fc N-glycosylation features and levels of serum cytokines and C-reactive protein are significantly associated with the development of severe clinical symptoms and, notably, Fc glycosylation changes after treatment. The modifications detected in the N-glycosylation features of IgG Fc from VL patients raise new perspectives on the effector or regulatory role of antibodies in immune responses elicited by infection with Leishmania parasites.
Collapse
|
50
|
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.
Collapse
|