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Zhang C, Wang H, Aji T, Li Z, Li Y, Ainiwaer A, Rousu Z, Li J, Wang M, Deng B, Duolikun A, Kang X, Zheng X, Yu Q, Shao Y, Zhang W, Vuitton DA, Tian Z, Sun H, Wen H. Targeting myeloid-derived suppressor cells promotes antiparasitic T-cell immunity and enhances the efficacy of PD-1 blockade (15 words). Nat Commun 2024; 15:6345. [PMID: 39068159 PMCID: PMC11283557 DOI: 10.1038/s41467-024-50754-7] [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: 08/02/2023] [Accepted: 07/18/2024] [Indexed: 07/30/2024] Open
Abstract
Immune exhaustion corresponds to a loss of effector function of T cells that associates with cancer or chronic infection. Here, our objective was to decipher the mechanisms involved in the immune suppression of myeloid-derived suppressor cells (MDSCs) and to explore the potential to target these cells for immunotherapy to enhance checkpoint blockade efficacy in a chronic parasite infection. We demonstrated that programmed cell-death-1 (PD-1) expression was significantly upregulated and associated with T-cell dysfunction in advanced alveolar echinococcosis (AE) patients and in Echinococcus multilocularis-infected mice. PD-1 blockade ex vivo failed to reverse AE patients' peripheral blood T-cell dysfunction. PD-1/PD-L1 blockade or PD-1 deficiency had no significant effects on metacestode in mouse model. This was due to the inhibitory capacities of immunosuppressive granulocytic MDSCs (G-MDSCs), especially in the liver surrounding the parasite pseudotumor. MDSCs suppressed T-cell function in vitro in an indoleamine 2, 3 dioxygenase 1 (IDO1)-dependent manner. Although depleting MDSCs alone restored T-cell effector functions and led to some limitation of disease progression in E. multilocularis-infected mice, combination with PD-1 blockade was better to induce antiparasitic efficacy. Our findings provide preclinical evidence in support of targeting MDSC or combining such an approach with checkpoint blockade in patients with advanced AE. (200 words).
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Affiliation(s)
- Chuanshan Zhang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China.
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, P. R. China.
- Key Laboratory of High Incidence Disease Research in Xingjiang, Ministry of Education, Xinjiang Medical University, Urumqi, Xinjiang, P. R. China.
| | - Hui Wang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
- Key Laboratory of High Incidence Disease Research in Xingjiang, Ministry of Education, Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
- Xinjiang Key Laboratory of Echinococcosis, Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, and WHO Collaborating Centre on Prevention and Case Management of Echinococcosis, Urumqi, Xinjiang, P. R. China
| | - Tuerganaili Aji
- Key Laboratory of High Incidence Disease Research in Xingjiang, Ministry of Education, Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
- Department of Hepatic Hydatid and Hepatobiliary Surgery, Digestive and Vascular Surgery Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Zhide Li
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Yinshi Li
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Abidan Ainiwaer
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Zibigu Rousu
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Jing Li
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Maolin Wang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
- Department of Hepatic Hydatid and Hepatobiliary Surgery, Digestive and Vascular Surgery Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Bingqing Deng
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Adilai Duolikun
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Xuejiao Kang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Xuran Zheng
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Qian Yu
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
- Basic Medical College, Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Yingmei Shao
- Department of Hepatic Hydatid and Hepatobiliary Surgery, Digestive and Vascular Surgery Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
| | - Wenbao Zhang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China
- Xinjiang Key Laboratory of Echinococcosis, Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, and WHO Collaborating Centre on Prevention and Case Management of Echinococcosis, Urumqi, Xinjiang, P. R. China
| | - Dominique A Vuitton
- WHO-Collaborating Centre for the Prevention and Treatment of Human Echinococcosis, Department of Parasitology, University Bourgogne Franche-Comté (EA 3181) and University Hospital, Besançon, France
| | - Zhigang Tian
- Hefei National Research Center for Physical Sciences at Microscale, the CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, P. R. China
| | - Haoyu Sun
- Hefei National Research Center for Physical Sciences at Microscale, the CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, P. R. China.
- Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, China.
- Institute of Immunology, University of Science and Technology of China, Hefei, Anhui, P. R. China.
| | - Hao Wen
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University; Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P. R. China.
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Petrone L, Najafi-Fard S, Falasca L, Sbarra S, Teggi A, Nicastri E, Grillo LR, Burocchi M, Ettorre GM, Ludovisi A, Colombo D, Del Nonno F, Goletti D. Evaluation of the Local and Peripheral Immune Responses in Patients with Cystic Echinococcosis. Pathogens 2024; 13:477. [PMID: 38921775 PMCID: PMC11206897 DOI: 10.3390/pathogens13060477] [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: 03/25/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) cysts may persist for decades because of immune modulation mechanisms. Here, we characterize the cysts and the blood immune responses in patients with CE. METHODS We enrolled 61 patients with CE and 19 control subjects. We received tissue samples from seven patients with CE and a control subject requiring liver cystectomy. The immunohistochemistry evaluation of the immune cell subtypes and cytokines in the pericysts and surrounding liver and the antigen B (AgB)-specific response analysis of whole blood were performed. RESULTS In CE, the pericyst and the surrounding liver parenchyma showed aggregates of CD3+ T lymphocytes, mainly CD4+. B lymphocyte aggregates were present in the liver tissue. Monocytes/granulocytes were rarely observed. Th2 cytokine expression was scarce, whereas IFN-γ expression was present in the CE tissues. The control subject did not show an inflammatory infiltrate. The IL-4-specific response to AgB was increased in the patients with CE compared to the control, and this result was confirmed in a larger cohort (p = 0.003), whereas the IFN-γ-response was similar between the two groups (p = 0.5570). CONCLUSION In patients with CE, CD4+ lymphocytes infiltrate the pericyst and the surrounding liver tissue with a low IL-4/IL-13 expression level and a moderate IFN-γ expression level; moreover, an IL-4 parasite-specific response is detected in the periphery. These results support adventitia involvement in CE immunopathogenesis.
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Affiliation(s)
- Linda Petrone
- Translational Research Unit, National Institute for Infectious Diseases (INMI) “Lazzaro Spallanzani”—IRCCS, 00149 Rome, Italy
| | - Saeid Najafi-Fard
- Translational Research Unit, National Institute for Infectious Diseases (INMI) “Lazzaro Spallanzani”—IRCCS, 00149 Rome, Italy
| | - Laura Falasca
- Laboratory of Electron Microscopy, National Institute for Infectious Diseases “Lazzaro Spallanzani”—IRCCS, 00149 Rome, Italy
| | - Settimia Sbarra
- Translational Research Unit, National Institute for Infectious Diseases (INMI) “Lazzaro Spallanzani”—IRCCS, 00149 Rome, Italy
| | - Antonella Teggi
- Department of Infectious and Tropical Diseases, Sant’Andrea Hospital University of Rome “Sapienza”, 00189 Rome, Italy
| | - Emanuele Nicastri
- Clinical Division of Infectious Diseases, National Institute for Infectious Diseases “Lazzaro Spallanzani”—IRCCS, 00149 Rome, Italy
| | | | - Mirco Burocchi
- Division of General Surgery and Liver Transplantation, San Camillo-Forlanini Hospital, 00152 Rome, Italy
| | - Giuseppe Maria Ettorre
- Division of General Surgery and Liver Transplantation, San Camillo-Forlanini Hospital, 00152 Rome, Italy
| | - Alessandra Ludovisi
- Foodborne and Neglected Parasitoses Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Daniele Colombo
- Pathology Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”—IRCCS, 00149 Roma, Italy
| | - Franca Del Nonno
- Pathology Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”—IRCCS, 00149 Roma, Italy
| | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases (INMI) “Lazzaro Spallanzani”—IRCCS, 00149 Rome, Italy
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Siles-Lucas M, Uchiumi L, Tamarozzi F. 'No cyst, no echinococcosis': a scoping review update on the diagnosis of cystic echinococcosis after the issue of the WHO-IWGE Expert Consensus and current perspectives. Curr Opin Infect Dis 2023; 36:333-340. [PMID: 37466103 PMCID: PMC10487401 DOI: 10.1097/qco.0000000000000941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
PURPOSE OF REVIEW In 2010, the WHO-Informal Working Group on Echinococcosis (IWGE) published an Expert Consensus on the diagnosis and treatment of echinococcal infections. We provide an update on the diagnosis of cystic echinococcosis through a scoping review of the literature published after the release of the WHO-IWGE document. RECENT FINDINGS Ultrasound accurately and reliably depicts the pathognomonic signs of cystic echinococcosis (CE) stages compared with other imaging techniques. Among these, T2-wighted MRI is to be preferred to computed tomography, which has poor performance for the etiological diagnosis of CE. A negative serology cannot exclude the diagnosis of CE, while a positive serology, applied after the visualization of a CE-compatible lesion, may confirm a CE diagnosis. Serology alone must not be used to define 'CE' nor as 'screening' tool for infection. Other imaging and laboratory techniques did not show clinically applicable performances. SUMMARY In the absence of a focal lesion compatible with a CE cyst, no diagnosis of CE should be attempted. There is urgent need to achieve univocal CE case definitions and consensus diagnostic algorithm, as well as standardization of diagnostic methods and issue of a Target Product Profile of CE diagnostics, as advocated by the WHO in the 2021-2030 roadmap for neglected tropical diseases (NTDs).
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Affiliation(s)
- Mar Siles-Lucas
- Laboratory of Helminth Parasites of Zoonotic Importance (ATENEA), Institute of Natural Resources and Agrobiology of Salamanca (IRNASA-CSIC), Salamanca, Spain
| | - Leonardo Uchiumi
- Ramon Carrillo Hospital, Bariloche, Río Negro Province, Argentina
| | - Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, WHO Collaborating Centre on Strongyloidiasis and other Neglected Tropical Diseases, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
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Salah EB, Barrera C, Mosbahi S, Gottstein B, Siles-Lucas M, Belhassen S, Nouri A, Babba H, Millon L, Sakly W. Promising proteins detected by Western blot from Echinococcus granulosus protoscoleces for predicting early post-surgical outcomes in CE-affected Tunisian children. Parasit Vectors 2021; 14:180. [PMID: 33781311 PMCID: PMC8008569 DOI: 10.1186/s13071-021-04679-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/11/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) affects predominantly young patients in highly endemic areas. Improved serological methods are needed for the follow-up of CE cases, especially given the high rates of post-surgical relapse that require detection as soon as possible. METHODS We designed a study to investigate the value of antigenic proteins extracted from Echinococcus granulosus (E. granulosus) protoscoleces, and of recombinant B2t and 2B2t proteins, for assessing the efficacy of surgical treatment carried out on CE-affected children. This study was performed on 278 plasma samples collected from 59 Tunisian children surgically treated for CE and monitored for 3 years post-surgery. The patients were classified according to post-surgical outcomes into a "non-relapsed" (NRCE) and a "relapsed" (RCE) group. We performed in-house ELISAs to measure anti-B2t and anti-2B2t IgG and immunoblotting for the detection of IgG against SDS-PAGE-resolved E. granulosus protoscoleces-specific antigens. The Wilcoxon test was applied to assess anti-B2t and anti-2B2t IgG levels. We applied the Cochran Q test to compare the distribution of immunoblotting antigenic bands between 1-month and 1-year post-surgery. RESULTS The probability of being "relapse-free" when a decrease in antibody titers occurred between 1 month and 1 year post-surgery was 81% and 75%, respectively, for anti-B2t and anti-2B2t IgG. We identified five protoscolex protein bands of 20, 26/27, 30, 40 and 46 kDa as highly immunoreactive by immunoblot for both RCE and NRCE patients at 1 month post-surgery, and significantly lower immunoreactivity after 1 year (p < 10-4) for NRCE compared to RCE patients. The proteins at 26/27 and 40 kDa displayed the best performance in predicting the outcome, with an 84% probability of being relapse-free when the reactivity against the 40 kDa antigen, the doublet at 26/27 kDa, or both was absent or disappeared between 1 month and 1 year post-surgery, and a 93% probability of being relapsed when both bands remained reactive or increased in intensity between the two time points. CONCLUSIONS The B2t protein could be useful for the prediction of CE early post-surgical outcomes. The proteins of E. granulosus protoscoleces, especially the doublet P26/27 and P40, could be promising predictive biomarkers for the post-surgical follow-up of CE cases as well.
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Affiliation(s)
- Eya Ben Salah
- Département de Biologie Clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale Et Moléculaire, LR12ES08, Université de Monastir, 1 Rue Avicenne, 5000, Monastir, Tunisie
| | - Coralie Barrera
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, Besançon, France
| | - Sana Mosbahi
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Medical School , Monastir, Tunisia
| | - Bruno Gottstein
- Institute for Infectious Diseases, Faculty of Medicine, University of Bern, 3001, Bern, Switzerland
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales Y Agrobiología de Salamanca (IRNASA-CSIC), 37008, Salamanca, España
| | - Samia Belhassen
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Medical School , Monastir, Tunisia
| | - Abdellatif Nouri
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Medical School , Monastir, Tunisia
| | - Hamouda Babba
- Département de Biologie Clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale Et Moléculaire, LR12ES08, Université de Monastir, 1 Rue Avicenne, 5000, Monastir, Tunisie
| | - Laurence Millon
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, Besançon, France
| | - Wahiba Sakly
- Département de Biologie Clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale Et Moléculaire, LR12ES08, Université de Monastir, 1 Rue Avicenne, 5000, Monastir, Tunisie.
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