Cellular immunity to toxoplasma and besnoitia in hamsters: specificity and the effects of cortisol

Toxoplasma gondii infection in people with schizophrenia is related to higher hair glucocorticoid levels

Introduction

Toxoplasma gondii (TG) is a common protozoan parasite infecting approximately one third of the human population. Animal studies have shown that this parasite can manipulate its host behavior. Based on this, human studies have assessed if TG can be involved in mental health disorders associated with important behavioral modifications such as schizophrenia. However, results have been discrepant. Given that TG has a strong impact on fear and risk-taking processes in animal studies and that fear and risk-taking behaviors are associated with the human stress response, we tested whether glucocorticoid biomarkers (salivary and hair) differ in people with schizophrenia and controls as a function of TG status.

Methods

We measured TG antibodies in blood samples, as well as salivary and hair glucocorticoid levels in 226 people with schizophrenia (19.9% women, mean age = 39 years old) and 129 healthy individuals (controls) (45.7% women, mean age = 41 years old).

Results

The results showed that people with schizophrenia infected with TG presented significantly higher hair glucocorticoid concentrations than non-infected people with schizophrenia. This effect was not found in control participants. No effect was observed for salivary glucocorticoid levels. Additionally, there were no associations between TG infection and positive psychotic symptoms nor impulsivity.

Discussion

These results show that people with schizophrenia present high levels of hair glucocorticoid levels only when they are infected with TG. Further studies performed in populations suffering from other mental health disorders are needed to determine if this effect is specific to schizophrenia, or whether it is generalized across mental health disorders.

Does exposure to parasites modify relationships between diurnal cortisol and leukocytes among Honduran women?

BACKGROUND

Altered hypothalamic-pituitary-adrenal (HPA) function and related changes in circulating glucocorticoids have been implicated in the pathogenesis of numerous diseases that involve dysregulated immune function. Glucocorticoid hormones have both direct and indirect modulatory effects on both pro- and anti-inflammatory aspects of the immune system, including granulocytic and lymphocytic leukocyte subsets. However, past findings are complicated by inconsistencies across studies in how glucocorticoids and immune markers interact and relate to disease risk. Some incongruencies are likely due to an overreliance on single-unit (e.g., HPA or one immune marker) measures, and a failure to consider ecological exposures that may shape the base levels or correspondence between these systems. Here, we test single-unit and diurnal measures of HPA axis and immune system interactions in a less-industrial ecological setting with relatively high parasite loads.

METHODS

In a sample of 114 Honduran women (mean age = 36 years), morning and evening blood samples were analyzed to quantify granulocytes, lymphocytes, and immunoglobulin-E (IgE). Saliva was collected over 2 days (8 samples per woman) to measure peak cortisol, cumulative cortisol, and slope of decline. These repeated measures of saliva and venous blood were used to investigate associations between single-point and diurnal salivary cortisol and leukocytes, under variable levels of past parasite exposure (proxied by IgE).

RESULTS

Individuals with less of a decline in cortisol (i.e., "flatter" decline) show less of an increase in lymphocytes (2.27% increase in cells/μL/hr; 95% CI: 0.91-7.29; p = .01) across the day compared to those with steeper cortisol decline (7.5% increase in lymphocytes; 95% CI: 5.79-9.34; p < .001). IgE levels did not modify this association. Interestingly, IgE did moderate relationships between measures of cortisol and granulocytes: diurnal cortisol was positively associated with granulocytes, only in individuals with high previous exposure to parasites. There were no consistent relationships between single-unit measures of cortisol, lymphocytes or granulocytes, regardless of past parasite exposure.

DISCUSSION

Results demonstrate that the relationship between HPA function and immune modulation cannot be fully understood without an understanding of local disease ecology. These results highlight the importance of research that seeks to identify etiologies of disease across environmental contexts.

Seroprevalence of toxoplasmosis in diabetic pregnant women in southwestern of Iran

To investigate anti-Toxoplasma gondii IgG and IgM antibodies in diabetic pregnant women in Ahvaz, southwest of Iran this experiment was performed. In current study the sera of 110 diabetic pregnant women as well as 110 non diabetic pregnant women referred to the hospitals affiliated with the Ahvaz Jundishapur University of Medical Sciences were assessed for anti-T. gondii IgG and IgM antibodies by ELISA and IFA methods. The ELISA assessments showed that 47 (42.7 %) and 3 (2.7 %) of diabetic women were positive for IgG and IgM antibodies, respectively. However, in the control group, 24 individuals (21.81 %) were positive for IgG antibody but no detection for IgM antibody. According to IFA method, 46 (41.8 %) and 3 (2.7 %) of diabetic women were positive for IgG and IgM antibodies, respectively, while in control group, 21 individuals (19.09 %) were positive for IgG antibody. In this method, IgM antibody was negative for all samples of control group (0 %). In both methods, the values obtained in the case group were significantly higher than those in the control group (p < 0.05). Prevalence of anti-Toxoplasma IgG and IgM antibodies in diabetic pregnant women was higher than that in non-diabetic pregnant women. It seems that screening tests for seeking patients and teaching the transmission routes should be considered as prenatal cares for diabetic women.

Bovine besnoitiosis and its effect on the male reproductive system

Besnoitia besnoiti and several species of the genus have been reported in a variety of domestic and wild animals in many parts of the world (1, 2, 3, 4, 5). Cutaneous besnoitiosis in cattle has been described as a serious skin condition characterized by painful swellings, alopecia and thickening of the skin (6). It is a chronic, debilitating and occasionally fatal disease with both cutaneous and systemic manifestations (6, 7, 8). Besnoitia cysts and lesions have been observed in the testes, epididymes and blood vessels of bulls (9). The possibility of abortion in cows and sterility in bulls with besnoitiosis has been reported (6). Spontaneous clinical besnoitiosis in cattle with accompanying systemic manifestations has not been fully documented, and the effect of scrotal besnoitiosis on spermatogenesis in bulls has not been previously reported in Nigeria. Case report : Outbreaks of babesiosis, heartwater and suspected cutaneous besnoitiosis were observed in a government farm in the Kano State of Nigeria in March, 1979. The cattle population was over 1500, consisting of exotic (Bos taurus ) and indigenous (Bos indicus ) breeds and their crosses. Clinical Examination : All stages of clinical besnoitiosis were initially observed in 14 bulls and 1 cow in a period of 4 months. The farm was visited bi-weekly for 1 year, during which time 58 bulls and 2 cows showed the lesions. Most of the animals affected with this disease were 3-way crosses of Australian Draughtmaster x Rahaji x Niger Azwak (DM x Rh x AZ). Table 1 summarises the distribution of clinicial cases of besnoitiosis.

Macrophage migration inhibitory factor is up-regulated in human first-trimester placenta stimulated by soluble antigen of Toxoplasma gondii, resulting in increased monocyte adhesion on villous explants

Considering the potential role of macrophage migration inhibitory factor (MIF) in the inflammation process in placenta when infected by pathogens, we investigated the production of this cytokine in chorionic villous explants obtained from human first-trimester placentas stimulated with soluble antigen from Toxoplasma gondii (STAg). Parallel cultures were performed with villous explants stimulated with STAg, interferon-gamma (IFN-gamma), or STAg plus IFN-gamma. To assess the role of placental MIF on monocyte adhesiveness to human trophoblast, explants were co-cultured with human myelomonocytic THP-1 cells in the presence or absence of supernatant from cultures treated with STAg (SPN), SPN plus anti-MIF antibodies, or recombinant MIF. A significantly higher concentration of MIF was produced and secreted by villous explants treated with STAg or STAg plus IFN-gamma after 24-hour culture. Addition of SPN or recombinant MIF was able to increase THP-1 adhesion, which was inhibited after treatment with anti-MIF antibodies. This phenomenon was associated with intercellular adhesion molecule expression by villous explants. Considering that the processes leading to vertical dissemination of T. gondii remain widely unknown, our results demonstrate that MIF production by human first-trimester placenta is up-regulated by parasite antigen and may play an essential role as an autocrine/paracrine mediator in placental infection by T. gondii.

BeWo Trophoblasts are Unable to Control Replication of Toxoplasma gondii, Even in the Presence of Exogenous IFN-γ

The ability of RH strain of Toxoplasma gondii to invade and grow into BeWo cells was investigated in the present study using IFN-gamma, l-tryptophan, or alpha-methyl-tryptophan treatments. HeLa cells were used in the same conditions for comparison purposes. It was demonstrated that BeWo cells are more permissive to T. gondii infection, making them more susceptible to this pathogen when compared to HeLa cells. Infection rates of BeWo cells do not show any significant alteration in different protocols using IFN-gamma. In addition, BeWo treated with l-tryptophan was unable to significantly increase parasite growth. In contrast, HeLa cells treated with IFN-gamma or IFN-gamma plus l-tryptophan are able to impair or increase, respectively, parasite replication, providing evidence that this indoleamine-2,3-dioxygenase-dependent phenomenon is operant in these cells, whereas it is inactive in BeWo. Therefore, our data support the hypothesis that the immunological mechanisms controlling infection at the maternal-fetal interface are different from those occurring in the periphery. At the same time that operating regulatory mechanisms work inside and outside the cells located at that microenvironment to prevent maternal rejection of the concept, these events might facilitate the progression of infection caused by intracellular pathogens, as T. gondii.

Pathophysiology of toxoplasmosis

Toxoplasma infection in most adult animals and humans is asymptomatic because of effective protective immunity; this involves antibody acting extracellularly, and T-cell factors acting intracellularly. Whenever immunity is not acquired in a timely fashion, tachyzoites continue to multiply, destroying an excessive number of cells, producing lesions in several organs, with pneumonia and encephalitis the prominent causes of illness and death. However, immunity is insufficient to destroy the slowly multiplying bradyzoites persisting in tissue cysts in many organs - a parasite adaptation to await ingestion of one host by another. Toxoplasma cysts produce lesions when they disintegrate, because of the delayed type of hypersensitivity accompanying infections. In the presence of immunity, the released bradyzoites are destroyed, but when protective immunity fails, the bradyzoites can develop again into actively multiplying tachyzoites parasitizing and destroying cells in expanding foci, usually in the brain. In this review J.K. Frenkel discusses the complex interplay of immunological and parasite factors participating in the various lesions associated with acute and chronic Toxoplasma infections.

Specific and nonspecific mediation of protective immunity to Toxoplasma gondii

We studied the specificity of protection conferred by Toxoplasma gondii immune lymphocytes and their supernatants on infected hamster kidney cells, using Besnoitia jellisoni immune lymphocytes as a nonspecific control. The intracellular growth of the organisms was measured by [3H]uracil incorporation, and inhibition of multiplication was used as a measurement of immunity. Although the immune lymphocytes restricted principally the multiplication of homologous organisms, partial protection, expressed against the heterologous organism, was found. This was true for either parasite with intact lymphocytes or their supernatants. Exposure of immune lymphocytes to antigen for 18 to 24 h and treatment of kidney cells with supernatant fluids for 18 to 24 h were required for maximal protection. The specific protective mediator in supernatants of immune lymphocytes was characterized by dialysis as having a molecular weight between 3,000 and 12,000 and was found in the 3,000 to 5,000 peak after Sephadex G-50 chromatography. Nonspecific protective activity was greater than 12,000 by dialysis; it chromatographed in the excluded peak, measuring over 43,000, and was destroyed by exposure to pH 2. In vitro production of lymphokines from toxoplasma immune lymphocytes was first detected 7 to 10 days after vaccination of hamsters. At about the same time, hamsters began to resist challenge infection with the pathogenic RH strain of T. gondii and were able to prevent its multiplication in lungs, liver, spleen, and the subcutaneous infection site. The expression of tissue immunity and the production of toxoplasma-immune lymphokines appear to be time-related events.

Experimental infection of pregnant sheep with Toxoplasma gondii: pathological and immunological observations on the placenta and foetus

The pathogenesis of Toxoplasma gondii infection in pregnant sheep was investigated. In one experiment, sheep were infected at 40, 60 and 90 days gestation and examined 30 days later, while in a second experiment, pregnant sheep were infected at either 60 or 90 days gestation and examined 10, 15 and 20 days later. By 10 days post infection (dpi), the parasite had invaded the gravid uterus and caused focal damage in the caruncular septa and, by 15 days, the degenerative changes had spread to the crypt wall and trophoblast. At this time, toxoplasma were isolated from all challenged foetuses. Foetuses did not produce any significant immune response until 20 dpi when increased numbers of IgM positive cells were found in lymphoid tissues. However, at 30 dpi, the numbers were normal while numbers of IgG positive cells and circulating IgG were increased. It was concluded that, while the foetal immune system need not be fully mature to respond to T. gondii infection, its ability to mount a response is limited at 70 days gestation but becomes increasingly competent after this. Furthermore, while it is able to respond more comprehensively with increasing maturity, maturation itself appears to be accelerated by the stimulus of infection.

Specific mediation of cellular immunity to Toxoplasma gondii in somatic cells of mice

Lymphocytes from mice immunized against Toxoplasma gondii protected T. gondii-infected macrophage and kidney cell cultures. After contact with antigens, supernatants of such immune lymphocytes, also contained a factor protective for T. gondii-infected macrophages and kidney cells. Supernatants were protective only when the lymphocytes and kidneys cells were isogeneic. Protection was specific in that supernatants from only T. gondii-immune, but not Besnoitia jellisoni-immune, lymphocytes provided protection against toxoplasmosis. Sixteen to 24 h were required for an appreciable amount of protective factor to be secreted; a similar absorption time was necessary for kidney cells to be protected. Peritoneal lymphocyte lysates, prepared as transfer factor, contained protective substances with a potency similar to that of lymphocyte supernatants, which were also strain restricted in their effect.

Effect of phorbol myristate acetate, a tumor-promoting agent, on the growth of Mycobacterium lepraemurium in the mouse footpad

Phorbol myristate acetate (PMA), a potent inflammatory agent with tumor-promoting activity, was examined for its effect on the growth of Mycobacterium lepraemurium (MLM) in the left hind footpad of mice. When the animals were infected with 10(4) MLM and received multiple injections of 3 micrograms of PMA in the infection site weekly during the first 2 months and biweekly thereafter, the growth of the bacilli was markedly enhanced. PMA injection in the infection site resulted in severe footpad swelling accompanied by inflammatory signs such as redness, edema, induration, and sometimes ulcer. Acetic acid, as potent an inflammatory and hyperplastic agent as PMA but without any appreciable tumor-promoting action, did not stimulate MLM growth when it was injected biweekly in the site of infection with MLM at a dose of 30 mumol per injection. When mice were infected with 10(8) MLM, proper elimination of bacilli from the infection site was observed during the first 3 months. In this case, multiple injections of PMA in the infection site resulted in the enhancement of the elimination of MLM by host defense mechanisms, although PMA caused as severe inflammation as that observed when MLM infection was produced with a small inoculum (10(4) MLM). In both cases, dexamethasone was synergistic with, but indomethacin and L-l-tosylamide-2-phenyl-ethylchloromethyl ketone were antagonistic to, the effect of PMA.

Cell-mediated killing of protozoa

Cell-mediated immunity represents an important host defence mechanism against protozoal infections. The effector cells directly involved are neutrophils, macrophages and, ultimately, activated macrophages. Within this simple scheme there are, however, considerable variations in activity. Effector cells from different animal species, and even from different strains of the same species, may be more or less effective in controlling a certain protozoal infection. Different protozoa differ in their susceptibility to cell-mediated killing according to genus, species, strain and morphological form. The most susceptible morphological form is that which occurs in the insect vector, and which has not yet adapted to protect itself from the vertebrate host. Epimastigotes of Trypanosoma and promastigotes of Leishmania are readily killed by phagocytic cells, while the corresponding trypomastigote and amastigote forms are considerably more resistant. Protozoa which live in macrophages, such as amastigotes of Leishmania, endozoites (tachyzoites) of Toxoplasma and amastigotes of reticulotropic strains of T. cruzi, have developed a remarkable resistance to the microbicidal activity of the host cell. Conversely, amastigotes of myotropic strains of T. cruzi, which live in muscle cells, have not developed this resistance to cell-mediated killing by macrophages. Readily accessible protozoa, such as T. brucei trypomastigotes and Plasmodium merozoites in the bloodstream, while they lack the marked resistance developed by reticulotropic protozoa, have a partial protection since they are attacked by phagocytic cells only when specific antibody is present. Granulocyte-mediated killing can be largely attributed to neutrophils. Eosinophils appear to play only a minor role and compete ineffectually when neutrophils are also present. The only group of protozoal species which may be significantly controlled by eosinophils are the stercorarian species of Trypanosoma. In vitro experiments show that antibody-coated trypomastigotes of T. cruzi can be killed by eosinophils, although there is little evidence that this occurs in vivo. Interestingly, this is the only species that has been reported to be susceptible to the major basic protein of eosinophils, a toxic component of the lysosomal granules which is very active against helminths. Neutrophils are not very active against endozoites of Toxoplasma gondii, Trypanosoma, trypomastigotes of salivarian Trypanosoma, free merozoites of Plasmodium, and promastigotes and amastigotes of Leishmania.(ABSTRACT TRUNCATED AT 400 WORDS)

Effect of hydrocortisone on macrophage response to lymphokine

To define the suppressive effects of corticosteroids on mononuclear phagocyte antiprotozoal activity, normal resident peritoneal macrophages were exposed to hydrocortisone (HC) before, during, and after in vitro activation with cell-free supernatants (lymphokines). The presence of pharmacological concentrations of HC before or during lymphokine activation prevented normal macrophages from acquiring the capacity to either respond oxidatively to Toxoplasma gondii ingestion or to inhibit intracellular toxoplasma replication. HC had no effect, however, on the cells fully stimulated by lymphokine or on macrophages previously activated in vivo. These findings indicate that although HC does not impair the ability of activated macrophages to control intracellular protozoan infection, it does compromise the antimicrobial activity of the cell-mediated immune system by rendering normal macrophages unresponsive to lymphokine.

Phagocytosis and killing of salmonella typhimurium by peritoneal exudate cells

Normal peritoneal cells from conventional, germfree, or nu/nu mice readily killed opsonized salmonellae, an observation that suggests that this activity in the normal peritoneal cavity may not be dependent on either environmental antigenic stimulation or T-cell mediation. In contrast, peritoneal cells elicited 4 days after injection with thioglycolate medium failed to kill opsonized salmonellae but appeared to be highly phagocytic. Peritoneal cells from thioglycolate-treated mice could be induced to kill opsonized salmonellae by giving the mice a primary footpad injection and a secondary intraperitoneal injection of Corynebacterium parvum. This activation by C. parvum appeared to be thymus dependent, since it did not occur in nu/nu mice.

The antinflammatory effects of glucocorticosteroids. A brief review of the literature

The effects of glucocorticosteroids on immune and inflammatory responses are reviewed. The steroids seem to change the number or function of cell receptors for regulating agents, so that in areas of inflammation: (a) blood vessels dilate less, (b) lymphocytes proliferate less, (c) all leukocytes infiltrate less, (d) macrophages become less activated (digesting and secreting less), and (e) fibroblasts produce less collagen and ground substance. In addition, the corticosteroids seem to alter the response of cells to various signals from their receptors by affecting the prostaglandin system, cyclic nucleotides, and perhaps other internal mediators.

Mediation of immunity to intracellular infection (Toxoplasma and Besnoitia) within somatic cells

Antigen-treated lymphocytes from immune hamsters specifically protected not only macrophages, but also cultured fibroblasts and kidney cells infected with Toxoplasma gondii or Besnoitia jellisoni. Macrophages were not necessary for the protection of fibroblasts and kidney cells. A mediator that inhibited the intracellular proliferation of these microbes was obtained from immune lymphocytes in contact with specific antigen. Again, macrophages were not necessary for the elaboration of this mediator or its activity in kidney cells or fibroblasts. The mediator was microbe and host specific, had a molecular weight between 4,000 and 5,000, was resistant to heating at 56 degrees C for 30 min, and was sensitive to chymotrypsin, but resistant to ribonuclease and deoxyribonuclease. A single injection of Besnoitia mediator afforded better protection to hamsters infected with Besnoitia than did antibody. Whereas antibody lysed extracellular organisms, the microbe-specific mediators conferred immunity not only on macrophages, but also on other cells of the body, apparently the first such demonstration.

Immune competence in a patient with Hodgkin's disease and relapsing toxoplasmosis

A 40 year old woman with Hodgkin's disease twice developed signs of encephalitis while being treated with prednisone and cyclophosphamide for 10 months. Since on both occasions her Toxoplasma dye test titer was 1 : 8000 or higher, she was treated on suspicion of toxoplasmosis with sulfadizine and pyrimethamine. Her tumor therapy was changed to bleomycin with lower doses of prednisone for 12 months. After death from central pontine myelinolysis, Toxoplasma and cytomegalovirus could be isolated, but no lesions attributable to these infectious agents were present. Maintenance of the patient's immune competence suggested an inquiry into the effects of the chemotherapeutic agents and of tumor infiltration for their respective interference with immunity. Using hamsters with chronic latent toxoplasmosis, it was found that both cortisone and cyclophosphamide caused recrudescence of chronic inapparent infection, that vinblastine and bleomycin interfered only slightly with the development of immunity, whereas in infiltrating lymphoma permitted immunity to develop normally. It is concluded that greater attention should be directed to the immunosuppressive effects of tumor treatment. By choice of an effective tumor therapy which is least immunosuppressive, and if necessary under cover of antimicrobial therapy, a patient with Hodgkin's disease can be aided in developing immunities which he may subsequently be able to maintain.