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Lenz B, Ehrens A, Ajendra J, Risch F, Gal J, Neumann AL, Reichwald JJ, Strutz W, McSorley HJ, Martin C, Hoerauf A, Hübner MP. Repeated sensitization of mice with microfilariae of Litomosoides sigmodontis induces pulmonary eosinophilia in an IL-33-dependent manner. PLoS Pathog 2024; 20:e1012071. [PMID: 38457461 PMCID: PMC10954174 DOI: 10.1371/journal.ppat.1012071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 03/20/2024] [Accepted: 02/24/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Eosinophilia is a hallmark of helminth infections and eosinophils are essential in the protective immune responses against helminths. Nevertheless, the distinct role of eosinophils during parasitic filarial infection, allergy and autoimmune disease-driven pathology is still not sufficiently understood. In this study, we established a mouse model for microfilariae-induced eosinophilic lung disease (ELD), a manifestation caused by eosinophil hyper-responsiveness within the lung. METHODS Wild-type (WT) BALB/c mice were sensitized with dead microfilariae (MF) of the rodent filarial nematode Litomosoides sigmodontis three times at weekly intervals and subsequently challenged with viable MF to induce ELD. The resulting immune response was compared to non-sensitized WT mice as well as sensitized eosinophil-deficient dblGATA mice using flow cytometry, lung histology and ELISA. Additionally, the impact of IL-33 signaling on ELD development was investigated using the IL-33 antagonist HpARI2. RESULTS ELD-induced WT mice displayed an increased type 2 immune response in the lung with increased frequencies of eosinophils, alternatively activated macrophages and group 2 innate lymphoid cells, as well as higher peripheral blood IgE, IL-5 and IL-33 levels in comparison to mice challenged only with viable MF or PBS. ELD mice had an increased MF retention in lung tissue, which was in line with an enhanced MF clearance from peripheral blood. Using eosinophil-deficient dblGATA mice, we demonstrate that eosinophils are essentially involved in driving the type 2 immune response and retention of MF in the lung of ELD mice. Furthermore, we demonstrate that IL-33 drives eosinophil activation in vitro and inhibition of IL-33 signaling during ELD induction reduces pulmonary type 2 immune responses, eosinophil activation and alleviates lung lacunarity. In conclusion, we demonstrate that IL-33 signaling is essentially involved in MF-induced ELD development. SUMMARY Our study demonstrates that repeated sensitization of BALB/c mice with L. sigmodontis MF induces pulmonary eosinophilia in an IL-33-dependent manner. The newly established model recapitulates the characteristic features known to occur during eosinophilic lung diseases (ELD) such as human tropical pulmonary eosinophilia (TPE), which includes the retention of microfilariae in the lung tissue and induction of pulmonary eosinophilia and type 2 immune responses. Our study provides compelling evidence that IL-33 drives eosinophil activation during ELD and that blocking IL-33 signaling using HpARI2 reduces eosinophil activation, eosinophil accumulation in the lung tissue, suppresses type 2 immune responses and mitigates the development of structural damage to the lung. Consequently, IL-33 is a potential therapeutic target to reduce eosinophil-mediated pulmonary pathology.
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Affiliation(s)
- Benjamin Lenz
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Alexandra Ehrens
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
| | - Jesuthas Ajendra
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Frederic Risch
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Joséphine Gal
- Unité Molécules de Communication et Adaptation des Microorganismes (MCAM, UMR 7245), Equipe Parasites et Protistes Libres, Muséum National d’Histoire Naturelle, CNRS; CP52, Paris, France
| | - Anna-Lena Neumann
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Julia J. Reichwald
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Wiebke Strutz
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Henry J. McSorley
- Division of Cell Signaling and Immunology, School of Life Sciences, University of Dundee, Dundee, United Kingdom
| | - Coralie Martin
- Unité Molécules de Communication et Adaptation des Microorganismes (MCAM, UMR 7245), Equipe Parasites et Protistes Libres, Muséum National d’Histoire Naturelle, CNRS; CP52, Paris, France
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
| | - Marc P. Hübner
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
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Chetty A, Darby MG, Pillaye J, Taliep A, Cunningham AF, O’Shea MK, Katawa G, Layland LE, Ritter M, Horsnell WGC. Induction of Siglec-F hiCD101 hi eosinophils in the lungs following murine hookworm Nippostrongylus brasiliensis infection. Front Immunol 2023; 14:1170807. [PMID: 37251384 PMCID: PMC10213982 DOI: 10.3389/fimmu.2023.1170807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/12/2023] [Indexed: 05/31/2023] Open
Abstract
Helminth-induced eosinophils accumulate around the parasite at the site of infection, or in parasite-damaged tissues well after the helminth has left the site. The role of helminth-elicited eosinophils in mediating parasite control is complex. While they may contribute to direct parasite-killing and tissue repair, their involvement in long-term immunopathogenesis is a concern. In allergic Siglec-FhiCD101hi, eosinophils are associated with pathology. Research has not shown if equivalent subpopulations of eosinophils are a feature of helminth infection. In this study, we demonstrate that lung migration of rodent hookworm Nippostrongylus brasiliensis (Nb) results in a long-term expansion of distinct Siglec-FhiCD101hi eosinophil subpopulations. Nb-elevated eosinophil populations in the bone marrow and circulation did not present this phenotype. Siglec-FhiCD101hi lung eosinophils exhibited an activated morphology including nuclei hyper-segmentation and cytoplasm degranulation. Recruitment of ST2+ ILC2s and not CD4+ T cells to the lungs was associated with the expansion of Siglec-FhiCD101hi eosinophils. This data identifies a morphologically distinct and persistent subset of Siglec-FhiCD101hi lung eosinophils induced following Nb infection. These eosinophils may contribute to long-term pathology following helminth infection.
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Affiliation(s)
- Alisha Chetty
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, Department of Pathology, Division of Immunology, University of Cape Town, Cape Town, South Africa
| | - Matthew G. Darby
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, Department of Pathology, Division of Immunology, University of Cape Town, Cape Town, South Africa
| | - Jamie Pillaye
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - A'ishah Taliep
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, Department of Pathology, Division of Immunology, University of Cape Town, Cape Town, South Africa
| | - Adam F. Cunningham
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Matthew K. O’Shea
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Gnatoulma Katawa
- Unité de Recherche en Immunologie et Immunomodulation (UR2IM)/Laboratoire de Microbiologie et de Contrôle de Qualité des Denrées Alimentaires (LAMICODA), Ecole Supérieure des Techniques Biologiques et Alimentaires, Universite de Lomé, Lomé, Togo
| | - Laura E. Layland
- German Centre for Infection Research (DZIF), Neglected Tropical Disease, Partner site Bonn-Cologne, Bonn, Germany
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany
| | - Manuel Ritter
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany
| | - William G. C. Horsnell
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, Department of Pathology, Division of Immunology, University of Cape Town, Cape Town, South Africa
- Laboratory of Molecular and Experimental Immunology and Neuro-genetics, Centre National de la Recherche Scientifique (CNRS)-University of Orleans and Le Studium Institute for Advanced Studies, Orléans, France
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, United Kingdom
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3
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Hilvering B, Koenderman L. Quality over quantity; eosinophil activation status will deepen the insight into eosinophilic diseases. Respir Med 2023; 207:107094. [PMID: 36572067 DOI: 10.1016/j.rmed.2022.107094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/01/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
Eosinophil associated diseases have gained much attention recently because of the introduction of specific eosinophil targeted therapies. These diseases range from acute parasitic infections to chronic inflammatory diseases such as eosinophilic asthma. In eosinophilic asthma an increased eosinophil cell count in peripheral blood is the gold standard for determination of the pheno-/endotype and severity of disease. Despite a broad consensus there is concern on validity of this simple measurement, because the eosinophil compartment is far from homogenous. Multiple tissues harbour non-activated cells under homeostatic conditions and other tissues, normally devoid of eosinophils, become infested with these cells under inflammatory conditions. It will, therefore, be clear that eosinophils become differentially (pre)-activated at different tissue sites in homeostatic and inflammatory conditions. This complexity should be investigated in detail as it is 1) far from clear what the long-term side effects are that are caused by application of eosinophil targeted therapies in a "one size fits all" concept and 2) real-world data of eosinophil targeted therapies in asthma shows a broad variety in the treatment response. This review will focus on complex mechanisms of eosinophil activation in vivo to create a better view on the dynamics of the eosinophil compartment in health and disease both to prevent collateral damage caused by aberrant activation of eosinophils ánd to improve effectiveness of eosinophil targeted treatments.
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Affiliation(s)
- B Hilvering
- Dept. Pulmonary Medicine, Amsterdam University Medical Center, the Netherlands.
| | - L Koenderman
- Dept. Respiratory Medicine and Center for Translational Immunology, University Medical Center Utrecht, the Netherlands
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Eosinophils and helminth infection: protective or pathogenic? Semin Immunopathol 2021; 43:363-381. [PMID: 34165616 DOI: 10.1007/s00281-021-00870-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 05/14/2021] [Indexed: 02/07/2023]
Abstract
Since the earliest descriptions of this enigmatic cell, eosinophils have been implicated in both protective and pathogenic immune responses to helminth infection. Nevertheless, despite substantial data from in vitro studies, human infections, and animal models, their precise role in helminth infection remains incompletely understood. This is due to a number of factors, including the heterogeneity of the many parasites included in the designation "helminth," the complexity and redundancy in the host immune response to helminths, and the pleiotropic functions of eosinophils themselves. This review examines the consequences of helminth-associated eosinophilia in the context of protective immunity, pathogenesis, and immunoregulation.
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Reddy AK, Chakrabarty M, Liu Y, Cohen SH, Maniar AH. Case Report: Clonorchis sinensis Infection Associated with Eosinophilic Pneumonia: A Case Report and Review of the Literature. Am J Trop Med Hyg 2021; 104:2065-2068. [PMID: 33939634 DOI: 10.4269/ajtmh.20-0632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 01/10/2021] [Indexed: 11/07/2022] Open
Abstract
Clonorchis sinensis, a trematode prevalent in East Asia, causes hepatobiliary infection. Exposure typically occurs through ingestion of raw or undercooked fish containing the encysted larval form of the parasite. Extrahepatobiliary disease has not commonly been described. In this case report, we describe an unusual case of C. sinensis infection associated with eosinophilic pneumonia. A middle-aged man from China presented with subacute cough and was found to have a bilateral diffuse eosinophilic pneumonia with associated peripheral eosinophilia. Stool microscopy revealed C. sinensis eggs, and the patient improved after treatment with prednisone and praziquantel. Pulmonary clonorchiasis should be considered in patients with eosinophilic pneumonia from areas highly endemic for this pathogen.
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Affiliation(s)
- Archana K Reddy
- 1Division of Infectious Diseases, Department of Internal Medicine, University of California-Davis Health, Sacramento, California
| | - Melony Chakrabarty
- 1Division of Infectious Diseases, Department of Internal Medicine, University of California-Davis Health, Sacramento, California
| | - Ying Liu
- 2Department of Pathology and Laboratory Medicine, University of California-Davis Health, Sacramento, California
| | - Stuart H Cohen
- 1Division of Infectious Diseases, Department of Internal Medicine, University of California-Davis Health, Sacramento, California
| | - Archana H Maniar
- 1Division of Infectious Diseases, Department of Internal Medicine, University of California-Davis Health, Sacramento, California
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Williams TL, Rada B, Tandon E, Gestal MC. "NETs and EETs, a Whole Web of Mess". Microorganisms 2020; 8:E1925. [PMID: 33291570 PMCID: PMC7761834 DOI: 10.3390/microorganisms8121925] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 12/13/2022] Open
Abstract
Neutrophils and eosinophils are granulocytes that have very distinct functions. Neutrophils are first responders to external threats, and they use different mechanisms to control pathogens. Phagocytosis, reactive oxygen species, and neutrophil extracellular traps (NETs) are some of the mechanisms that neutrophils utilize to fight pathogens. Although there is some controversy as to whether NETs are in fact beneficial or detrimental to the host, it mainly depends on the biological context. NETs can contribute to disease pathogenesis in certain types of diseases, while they are also undeniably critical components of the innate immune response. On the contrary, the role of eosinophils during host immune responses remains to be better elucidated. Eosinophils play an important role during helminthic infections and allergic responses. Eosinophils can function as effector cells in viral respiratory infections, gut bacterial infections, and as modulators of immune responses by driving the balance between Th1 and Th2 responses. In particular, eosinophils have biological activities that appear to be quite similar to those of neutrophils. Both possess bactericidal activity, can activate proinflammatory responses, can modulate adaptive immune responses, can form extracellular traps, and can be beneficial or detrimental to the host according to the underlying pathology. In this review we compare these two cell types with a focus on highlighting their numerous similarities related to extracellular traps.
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Affiliation(s)
- Tyler L. Williams
- Department of Microbiology and Immunology, Louisiana State University (LSU), Health Science Center, Shreveport, LA 71103, USA; (T.L.W.); (E.T.)
| | - Balázs Rada
- Department of Infectious Diseases, University of Georgia, Athens, GA 30302, USA;
| | - Eshaan Tandon
- Department of Microbiology and Immunology, Louisiana State University (LSU), Health Science Center, Shreveport, LA 71103, USA; (T.L.W.); (E.T.)
| | - Monica C. Gestal
- Department of Microbiology and Immunology, Louisiana State University (LSU), Health Science Center, Shreveport, LA 71103, USA; (T.L.W.); (E.T.)
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7
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Fercoq F, Remion E, Vallarino-Lhermitte N, Alonso J, Raveendran L, Nixon C, Le Quesne J, Carlin LM, Martin C. Microfilaria-dependent thoracic pathology associated with eosinophilic and fibrotic polyps in filaria-infected rodents. Parasit Vectors 2020; 13:551. [PMID: 33160409 PMCID: PMC7648300 DOI: 10.1186/s13071-020-04428-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 10/24/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pulmonary manifestations are regularly reported in both human and animal filariasis. In human filariasis, the main known lung manifestations are the tropical pulmonary eosinophilia syndrome. Its duration and severity are correlated with the presence of microfilariae. Litomosoides sigmodontis is a filarial parasite residing in the pleural cavity of rodents. This model is widely used to understand the immune mechanisms that are established during infection and for the screening of therapeutic molecules. Some pulmonary manifestations during the patent phase of infection with L. sigmodontis have been described in different rodent hosts more or less permissive to infection. METHODS Here, the permissive Mongolian gerbil (Meriones unguiculatus) was infected with L. sigmodontis. Prevalence and density of microfilariae and adult parasites were evaluated. Lungs were analyzed for pathological signatures using immunohistochemistry and 3D imaging techniques (two-photon and light sheet microscopy). RESULTS Microfilaremia in gerbils was correlated with parasite load, as amicrofilaremic individuals had fewer parasites in their pleural cavities. Fibrotic polypoid structures were observed on both pleurae of infected gerbils. Polyps were of variable size and developed from the visceral mesothelium over the entire pleura. The larger polyps were vascularized and strongly infiltrated by immune cells such as eosinophils, macrophages or lymphocytes. The formation of these structures was induced by the presence of adult filariae since small and rare polyps were observed before patency, but they were exacerbated by the presence of gravid females and microfilariae. CONCLUSIONS Altogether, these data emphasize the role of host-specific factors in the pathogenesis of filarial infections.
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Affiliation(s)
- Frédéric Fercoq
- Unité Molécules de Communication et Adaptation des Microorganismes (MCAM UMR 7245), Muséum national d'Histoire naturelle, CNRS, P52, 61 rue Buffon, 75005, Paris, France
- CRUK Beatson Institute, Garscube Estate, Switchback Road, Bearsden, Glasgow, G61 1BD, UK
| | - Estelle Remion
- Unité Molécules de Communication et Adaptation des Microorganismes (MCAM UMR 7245), Muséum national d'Histoire naturelle, CNRS, P52, 61 rue Buffon, 75005, Paris, France
| | - Nathaly Vallarino-Lhermitte
- Unité Molécules de Communication et Adaptation des Microorganismes (MCAM UMR 7245), Muséum national d'Histoire naturelle, CNRS, P52, 61 rue Buffon, 75005, Paris, France
| | - Joy Alonso
- Unité Molécules de Communication et Adaptation des Microorganismes (MCAM UMR 7245), Muséum national d'Histoire naturelle, CNRS, P52, 61 rue Buffon, 75005, Paris, France
| | - Lisy Raveendran
- Unité Molécules de Communication et Adaptation des Microorganismes (MCAM UMR 7245), Muséum national d'Histoire naturelle, CNRS, P52, 61 rue Buffon, 75005, Paris, France
| | - Colin Nixon
- CRUK Beatson Institute, Garscube Estate, Switchback Road, Bearsden, Glasgow, G61 1BD, UK
| | - John Le Quesne
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Leo M Carlin
- CRUK Beatson Institute, Garscube Estate, Switchback Road, Bearsden, Glasgow, G61 1BD, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, G61 1GH, UK
| | - Coralie Martin
- Unité Molécules de Communication et Adaptation des Microorganismes (MCAM UMR 7245), Muséum national d'Histoire naturelle, CNRS, P52, 61 rue Buffon, 75005, Paris, France.
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Chen X, Ji N, Qin N, Tang SA, Wang R, Qiu Y, Duan H, Kong D, Jin M. 1,6-O,O-Diacetylbritannilactone Inhibits Eotaxin-1 and ALOX15 Expression Through Inactivation of STAT6 in A549 Cells. Inflammation 2017; 40:1967-1974. [DOI: 10.1007/s10753-017-0637-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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9
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Gazzinelli-Guimarães PH, Bonne-Année S, Fujiwara RT, Santiago HC, Nutman TB. Allergic Sensitization Underlies Hyperreactive Antigen-Specific CD4+ T Cell Responses in Coincident Filarial Infection. THE JOURNAL OF IMMUNOLOGY 2016; 197:2772-9. [PMID: 27566825 DOI: 10.4049/jimmunol.1600829] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/04/2016] [Indexed: 12/11/2022]
Abstract
Among the various hypotheses put forward to explain the modulatory influence of helminth infection on allergic effector responses in humans, the IL-10-induced suppression of Th2-associated responses has been the leading candidate. To explore this helminth/allergy interaction more fully, parasite- and allergen-specific CD4(+) T cell responses in 12 subjects with filarial infections, and coincident allergic sensitization (filarial [Fil](+)allergy [A](+)) were compared with the responses to three appropriate control groups (Fil(-)A(-) [n = 13], Fil(-)A(+) [n = 12], Fil(+)A(-) [n = 11]). The most important findings revealed that Fil(+)A(+) had marked (p < 0.0001 for all cytokines) increases in parasite Ag-driven Th2 (IL-4, IL-5, IL-13), Th9 (IL-9), and the regulatory (IL-10) cytokines when compared with Fil(+)A(-) Moreover, using multiparameter flow cytometry, filarial parasite Ag induced a marked increase in not only the frequency of CD4(+) T cells producing IL-4, IL-5, IL-2, and TNF-α in Fil(+)A(+) when compared with Fil(+)A(-) patients, but also in the frequencies of polyfunctional Th2-like (CD4(+)IL-4(+)IL-5(+) and CD4(+)IL-2(+)IL-4(+)IL-5(+)TNF-α(+)) cells. The Th2-associated responses seen in the Fil(+)A(+) group were correlated with serum IgE levels (p < 0.01, r = 0.5165 for IL-4; p < 0.001, r = 0.5544 for IL-5; and p < 0.001, r = 0.4901 for IL-13) and levels of circulating eosinophils (p < 0.0116, r = 0.5656) and their degranulation/activation products (major basic protein [p < 0.001, r = 0.7353] and eosinophil-derived neurotoxin [p < 0.01, r = 0.7059]). CD4(+) responses to allergen were not different (to a large extent) among the groups. Taken together, our data suggest that allergic sensitization coincident with filarial infection drives parasite Ag-specific T cell hyperresponsiveness, which is characterized largely by an augmented Th2-dominated immune response.
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Affiliation(s)
- Pedro H Gazzinelli-Guimarães
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; Department of Parasitology, Biological Sciences Institute, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil; and
| | - Sandra Bonne-Année
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Ricardo T Fujiwara
- Department of Parasitology, Biological Sciences Institute, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil; and
| | - Helton C Santiago
- Department of Immunology and Biochemistry, Biological Sciences Institute, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Thomas B Nutman
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892;
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Mishra PK, Li Q, Munoz LE, Mares CA, Morris EG, Teale JM, Cardona AE. Reduced Leukocyte Infiltration in Absence of Eosinophils Correlates with Decreased Tissue Damage and Disease Susceptibility in ΔdblGATA Mice during Murine Neurocysticercosis. PLoS Negl Trop Dis 2016; 10:e0004787. [PMID: 27332553 PMCID: PMC4917226 DOI: 10.1371/journal.pntd.0004787] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 05/28/2016] [Indexed: 02/01/2023] Open
Abstract
Neurocysticercosis (NCC) is one of the most common helminth parasitic diseases of the central nervous system (CNS) and the leading cause of acquired epilepsy worldwide. NCC is caused by the presence of the metacestode larvae of the tapeworm Taenia solium within brain tissues. NCC patients exhibit a long asymptomatic phase followed by a phase of symptoms including increased intra-cranial pressure and seizures. While the asymptomatic phase is attributed to the immunosuppressive capabilities of viable T. solium parasites, release of antigens by dying organisms induce strong immune responses and associated symptoms. Previous studies in T. solium-infected pigs have shown that the inflammatory response consists of various leukocyte populations including eosinophils, macrophages, and T cells among others. Because the role of eosinophils within the brain has not been investigated during NCC, we examined parasite burden, disease susceptibility and the composition of the inflammatory reaction in the brains of infected wild type (WT) and eosinophil-deficient mice (ΔdblGATA) using a murine model of NCC in which mice were infected intracranially with Mesocestoides corti, a cestode parasite related to T. solium. In WT mice, we observed a time-dependent induction of eosinophil recruitment in infected mice, contrasting with an overall reduced leukocyte infiltration in ΔdblGATA brains. Although, ΔdblGATA mice exhibited an increased parasite burden, reduced tissue damage and less disease susceptibility was observed when compared to infected WT mice. Cellular infiltrates in infected ΔdblGATA mice were comprised of more mast cells, and αβ T cells, which correlated with an abundant CD8+ T cell response and reduced CD4+ Th1 and Th2 responses. Thus, our data suggest that enhanced inflammatory response in WT mice appears detrimental and associates with increased disease susceptibility, despite the reduced parasite burden in the CNS. Overall reduced leukocyte infiltration due to absence of eosinophils correlates with attenuated tissue damage and longer survival of ΔdblGATA mice. Therefore, our study suggests that approaches to clear NCC will require strategies to tightly control the host immune response while eradicating the parasite with minimal damage to brain tissue. Eosinophils are known to mediate a protective response against several parasitic infections. This is largely accomplished by eosinophil degranulation (direct killing) and modulating effective adaptive immune responses. Consequently, eosinophils can also contribute to host pathology via a bystander effect. However, the outcome of infection varies depending upon the parasite species. In the case of neurocysticercosis (NCC), the role of eosinophils in disease progression has not been investigated despite the known eosinophilic response in patients. NCC is one of the most common parasitic diseases of the brain which is caused by the metacestode (larva) of the tapeworm Taenia solium. To determine the role of eosinophils in NCC disease outcome, we used a murine model of NCC in which wildtype (WT) or eosinophil deficient mice (ΔdblGATA) were infected intracranially with Mesocestoides corti, a cestode parasite related to T. solium. Our data show that murine NCC is characterized by a robust eosinophil response that correlates with lower parasite burden in the brain. Comparison of T cell response reveals a mixed Th1/Th2 in the WT brain, and ΔdblGATA mice showed a significant decrease in both population but in particular in the Th2 response. In addition, the strong eosinophil reaction observed in WT brains correlates with exacerbated pathology and increased morbidity. Thus, our study suggest that eosinophils act as a double-edged sword playing a role in controlling the infection but worsening the disease outcome by contributing to host pathology.
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Affiliation(s)
- Pramod K. Mishra
- Department of Biology, South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, Texas, United States of America
- * E-mail: (PKM); (AEC)
| | - Qun Li
- Department of Biology, South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Luis E. Munoz
- Department of Biology, South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Chris A. Mares
- Department of Biology, South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Elizabeth G. Morris
- Department of Biology, South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Judy M. Teale
- Department of Biology, South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Astrid E. Cardona
- Department of Biology, South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, Texas, United States of America
- * E-mail: (PKM); (AEC)
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11
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Pham TH, Damera G, Newbold P, Ranade K. Reductions in eosinophil biomarkers by benralizumab in patients with asthma. Respir Med 2016; 111:21-9. [PMID: 26775606 DOI: 10.1016/j.rmed.2016.01.003] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 12/01/2015] [Accepted: 01/06/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND Eosinophilic inflammation is frequently associated with increased asthma severity. Benralizumab is a humanized, afucosylated, anti-interleukin-5Rα monoclonal antibody that selectively depletes eosinophils and basophils through enhanced antibody-dependent cell-mediated cytotoxicity. OBJECTIVE To study effects of benralizumab on eosinophil counts and activity following administration to asthma patients. METHODS Sera were collected from asthma patients enrolled in two clinical studies. Placebo or benralizumab was subcutaneously administered to patients in Phase I (100 or 200 mg, multiple doses; N = 14; NCT00659659) and Phase IIa (25, 100, or 200 mg every 4 weeks; N = 24; NCT00783289) studies. Sera were also collected from healthy volunteers (N = 20) for comparison. Blood eosinophils, IL-5, eosinophil-derived neurotoxin (EDN), eosinophil cationic protein (ECP), eotaxin/chemokine (C-C motif) 11 (CCL11), eotaxin-2/CCL24, tumor necrosis factor (TNF), and interferon-γ (IFN-γ) were measured at baseline and post-treatment. RESULTS Increased EDN concentrations were observed in sera of patients from both studies relative to healthy volunteers (p < 0.05). At baseline, sera EDN concentrations correlated with blood eosinophil counts (rs = 0.5; p < 0.05). Benralizumab reduced blood eosinophil numbers and sera EDN and ECP relative to baseline (p < 0.05). No changes in TNF or IFN-γ were observed, while serum IL-5, eotaxin/CCL11, and eotaxin-2/CCL24 increased after benralizumab administration vs. placebo (p < 0.05). CONCLUSIONS In two independent studies, serum IL-5, EDN, and ECP were modulated following benralizumab. Eosinophil depletion after benralizumab also resulted in significant reductions in EDN and ECP concentrations, suggesting that cytotoxic granule proteins were not released after eosinophil reduction.
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Affiliation(s)
- Tuyet-Hang Pham
- Translational Sciences, MedImmune LLC, Gaithersburg, MD, USA.
| | - Gautam Damera
- Translational Sciences, MedImmune LLC, Gaithersburg, MD, USA.
| | - Paul Newbold
- Translational Sciences, MedImmune LLC, Gaithersburg, MD, USA.
| | - Koustubh Ranade
- Translational Sciences, MedImmune LLC, Gaithersburg, MD, USA.
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12
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Abstract
An effective host defense mechanism involves inflammation to eliminate pathogens from the site of infection, followed by the resolution of inflammation and the restoration of tissue homeostasis. Lipoxins are endogenous anti-inflammatory, pro-resolving molecules that play a vital role in reducing excessive tissue injury and chronic inflammation. In this review, the mechanisms of action of lipoxins at the site of inflammation and their interaction with other cellular signaling molecules and transcription factors are discussed. Emphasis has also been placed on immune modulatory role(s) of lipoxins. Lipoxins regulate components of both the innate and adaptive immune systems including neutrophils, macrophages, T-, and B-cells. Lipoxins also modulate levels of various transcription factors such as nuclear factor κB, activator protein-1, nerve growth factor-regulated factor 1A binding protein 1, and peroxisome proliferator activated receptor γ and control the expression of many inflammatory genes. Since lipoxins and aspirin-triggered lipoxins have clinical relevance, we discuss their important role in clinical research to treat a wide range of diseases like inflammatory disorders, renal fibrosis, cerebral ischemia, and cancer. A brief overview of lipoxins in viral malignancies and viral pathogenesis especially the unexplored role of lipoxins in Kaposi’s sarcoma-associated herpes virus biology is also presented.
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Affiliation(s)
- Jayashree A Chandrasekharan
- HM Bligh Cancer Research Laboratories, Department of Microbiology and Immunology, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Neelam Sharma-Walia
- HM Bligh Cancer Research Laboratories, Department of Microbiology and Immunology, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
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13
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Synephrine inhibits eotaxin-1 expression via the STAT6 signaling pathway. Molecules 2014; 19:11883-95. [PMID: 25111027 PMCID: PMC6271232 DOI: 10.3390/molecules190811883] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 07/30/2014] [Accepted: 07/30/2014] [Indexed: 11/17/2022] Open
Abstract
Citrus contain various flavonoids and alkaloids that have multiple biological activities. It is known that the immature Citrus contains larger amounts of bioactive components, than do the mature plants. Although Citrus flavonoids are well known for their biological activities, Citrus alkaloids have not previously been assessed. In this study, we identified synephrine alkaloids as an active compound from immature Citrus unshiu, and investigated the effect of synephrine on eotaxin-1 expression. Eotaxin-1 is a potent chemoattractant for eosinophils, and a critical mediator, during the development of eosinophilic inflammation. We found that synephrine significantly inhibited IL-4-induced eotaxin-1 expression. This synephrine effect was mediated through the inhibition of STAT6 phosphorylation in JAK/STAT signaling. We also found that eosinophil recruitment induced by eotaxin-1 overexpression was inhibited by synephrine. Taken together, these findings indicate that inhibiting IL-4-induced eotaxin-1 expression by synephrine occurs primarily through the suppression of eosinophil recruitment, which is mediated by inhibiting STAT6 phosphorylation.
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14
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Cadman ET, Thysse KA, Bearder S, Cheung AYN, Johnston AC, Lee JJ, Lawrence RA. Eosinophils are important for protection, immunoregulation and pathology during infection with nematode microfilariae. PLoS Pathog 2014; 10:e1003988. [PMID: 24626328 PMCID: PMC3953434 DOI: 10.1371/journal.ppat.1003988] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 01/27/2014] [Indexed: 01/21/2023] Open
Abstract
Eosinophil responses typify both allergic and parasitic helminth disease. In helminthic disease, the role of eosinophils can be both protective in immune responses and destructive in pathological responses. To investigate whether eosinophils are involved in both protection and pathology during filarial nematode infection, we explored the role of eosinophils and their granule proteins, eosinophil peroxidase (EPO) and major basic protein-1 (MBP-1), during infection with Brugia malayi microfilariae. Using eosinophil-deficient mice (PHIL), we further clarify the role of eosinophils in clearance of microfilariae during primary, but not challenge infection in vivo. Deletion of EPO or MBP-1 alone was insufficient to abrogate parasite clearance suggesting that either these molecules are redundant or eosinophils act indirectly in parasite clearance via augmentation of other protective responses. Absence of eosinophils increased mast cell recruitment, but not other cell types, into the broncho-alveolar lavage fluid during challenge infection. In addition absence of eosinophils or EPO alone, augmented parasite-induced IgE responses, as measured by ELISA, demonstrating that eosinophils are involved in regulation of IgE. Whole body plethysmography indicated that nematode-induced changes in airway physiology were reduced in challenge infection in the absence of eosinophils and also during primary infection in the absence of EPO alone. However lack of eosinophils or MBP-1 actually increased goblet cell mucus production. We did not find any major differences in cytokine responses in the absence of eosinophils, EPO or MBP-1. These results reveal that eosinophils actively participate in regulation of IgE and goblet cell mucus production via granule secretion during nematode-induced pathology and highlight their importance both as effector cells, as damage-inducing cells and as supervisory cells that shape both innate and adaptive immunity. Eosinophil recruitment is a classic characteristic of both allergic and parasitic helminth diseases. Elucidation of the role of eosinophils in these diseases is of pivotal importance for understanding the mechanisms of protection and the development of pathology. In the last few years, the part played by eosinophils in helminth-defence has been dissected using in vivo models and their importance in protection has been shown to be highly specific to the host-parasite combination. This study dissects the role of eosinophils during infection with the human lymphatic filarial parasite, Brugia malayi, which causes the major neglected tropical disease, lymphatic filariasis. In particular, we study the role of the eosinophil as a double–edged sword in generating both protection and pathology. We definitively confirm the importance of eosinophils in protection against B. malayi microfilariae and show that protection is not mediated by release of the eosinophil granule proteins, major basic protein or eosinophil peroxidase alone. Overall, we reveal that during an infection with B. malayi microfilariae, eosinophils are critical for primary protective responses. However, eosinophils contribute to nematode-induced lung dysfunction, while additionally, eosinophil granules are important negative regulators of parasite-induced lung inflammatory and some adaptive immune responses.
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Affiliation(s)
- Emma T. Cadman
- The Royal Veterinary College, Department of Comparative Biomedical Sciences, London, United Kingdom
| | - Katherine A. Thysse
- The Royal Veterinary College, Department of Comparative Biomedical Sciences, London, United Kingdom
| | - Siobhan Bearder
- The Royal Veterinary College, Department of Comparative Biomedical Sciences, London, United Kingdom
| | - Anita Y. N. Cheung
- The Royal Veterinary College, Department of Comparative Biomedical Sciences, London, United Kingdom
| | - Ashleigh C. Johnston
- The Royal Veterinary College, Department of Comparative Biomedical Sciences, London, United Kingdom
| | - James J. Lee
- Division of Pulmonary Medicine, Department of Biochemistry and Molecular Biology, Mayo Clinic Arizona, Scottsdale, Arizona, United States of America
| | - Rachel A. Lawrence
- The Royal Veterinary College, Department of Comparative Biomedical Sciences, London, United Kingdom
- * E-mail:
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15
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Abstract
Two of the major filarial infections, lymphatic filariasis (LF) and onchocerciasis, affect 150 million people, while 1 billion living in endemic areas are at risk of infection. Public health programs to control these infections have successfully existed for years and have evolved from activities driven by the WHO into global programs with public-private partnerships. Currently, these programs use yearly mass application of drugs that mainly kill the larval stages (the microfilariae), with the aim of preventing uptake by the transmitting insect vectors and thus, to block transmission and reduce the infections to such levels that in 15-30 years from now, they will no longer pose a public health problem. While the programs have been very successful in general, there are drawbacks such as coverage being too low within the population, reappearance of infection by migration of infected people into controlled areas, targeting of a stage (the microfilaria) that does not induce pathology in LF and thus lowers compliance, and the potential development of drug resistance, first indications of which have been clearly observed in onchocerciasis. In addition, even without drawbacks, program scopes are not the eradication of filarial infections, which is, however, an ultimate goal of control activities. There is therefore an unequivocal call for the development of higher efficient, complementary chemotherapeutical approaches that lead to a long-lasting reduction of the pathology-inducing worm stages; that is, microfilariae in onchocerciasis and adult worms in LF, or to a macrofilaricidal effect. The recent discovery that depletion of Wolbachia endosymbionts by tetracycline antibiotics leads to long-lasting sterility of adult female worms in onchocerciasis and a macrofilaricidal effect in LF fulfils these requirements. Successful regimens have already been published and agreed upon for use by expert panels. While these regimens are still too long for mass application, the antiwolbachial chemotherapy can currently be applied in the form of a suitable doxycycline regimen for 6 weeks for the treatment of individuals, and exploited in the future for the development of new drugs suitable for mass application. In addition, first data suggest that Wolbachia may also be major mediators of lymphangiogenesis and that their depletion is associated with reduction of lymph vessel-specific vascular endothelial growth factors and reduced lymph vessel size.
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Affiliation(s)
- Achim Hoerauf
- Institute of Medical Microbiology, Immunology and Parasitology, University Clinic Bonn, 53105 Bonn, Germany.
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16
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Mullerpattan JB, Udwadia ZF, Udwadia FE. Tropical pulmonary eosinophilia--a review. Indian J Med Res 2013; 138:295-302. [PMID: 24135173 PMCID: PMC3818591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Indexed: 11/12/2022] Open
Abstract
Tropical pulmonary eosinophilia (TPE) is a syndrome of wheezing, fever and eosiniphilia seen predominantly in the Indian subcontinent and other tropical areas. Its etiological link with Wuchereria bancrofti and Brugia malayi has been well established. The pathogenesis is due to an exaggerated immune response to the filarial antigens which includes type I, type III and type IV reactions with eosinophils playing a pivotal role. Peripheral blood eosinophilia is usually striking with levels over 3000/μl being common. High serum levels of IgE and filarial-specific IgE and IgG are also found. The pathology may vary from an acute eosinophilic alveolitis to histiocytic infiltration depending on the stage of the disease. While earlier studies had suggested that the disease runs a benign course, more recent work has shown that untreated TPE could result in a fair degree of respiratory morbidity. Pulmonary function tests may show a mixed restrictive and obstructive abnormality with a reduction in diffusion capacity. The bronchoalveolar lavage (BAL) eosinophil count has a negative correlation with the diffusion capacity. Treatment consists of diethylcarbamazine (DEC) for at least three weeks. Despite treatment with DEC, about 20 per cent of patients may relapse. Steroids have shown to have a beneficial effect but the exact dose and duration is yet to be confirmed by randomized controlled trials. A specific and easily available marker is required for TPE in order to distinguish it from other parasitic and non-parasitic causes of pulmonary eosinophilia.
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Affiliation(s)
- Jai B. Mullerpattan
- Department of Respiratory Medicine, P.D. Hinduja National Hospital & MRC, Mumbai, India
| | - Zarir F. Udwadia
- Department of Respiratory Medicine, P.D. Hinduja National Hospital & MRC, Mumbai, India
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17
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Roh KB, Jung E, Park D, Lee J. Fumaric acid attenuates the eotaxin-1 expression in TNF-α-stimulated fibroblasts by suppressing p38 MAPK-dependent NF-κB signaling. Food Chem Toxicol 2013; 58:423-31. [PMID: 23707484 DOI: 10.1016/j.fct.2013.05.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 05/13/2013] [Accepted: 05/14/2013] [Indexed: 10/26/2022]
Abstract
Eotaxin-1 is a potent chemoattractant for eosinophils and a critical mediator during the development of eosinophilic inflammation. Fumaric acid is an intermediate product of the citric acid cycle, which is source of intracellular energy. Although fumaric acid ameliorates psoriasis and multiple sclerosis, its involvement in eotaxin-1-mediated effects has not been assessed. In this study, we investigated the effects of fumaric acid on eotaxin-1 expression in a mouse fibroblast cell line. We found that fumaric acid significantly inhibited tumor necrosis factor-α (TNF-α-induced eotaxin-1 expression. This fumaric acid effect was mediated through the inhibition of p38 mitogen-activated protein kinase (MAPK)-dependent nuclear factor (NF)-κB signaling. We also found that fumaric acid operates downstream of MEKK3 during TNF-α-induced NF-κB signaling, which upregulated eotaxin-1 expression. In addition, fumaric acid attenuated expression of CC-chemokine receptor 3 (CCR3), an eotaxin-1 receptor, and adhesion molecules that play important roles in eosinophil binding to induce allergic inflammation. Taken together, these findings indicate that inhibiting TNF-α-induced eotaxin-1 expression by fumaric acid occurs primarily through suppression of NF-κB signaling, which is mediated by inhibiting p38 MAPK and suggest that fumaric acid may be used as a complementary treatment option for eotaxin-1-mediated diseases.
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Affiliation(s)
- Kyung-Baeg Roh
- Biospectrum Life Science Institute, Sangdaewon-Dong, Seongnam City, 442-13 Gyeonggi Do, Republic of Korea
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18
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Abstract
This review starts with discussions of several infectious causes of eosinophilic pneumonia, which are almost exclusively parasitic in nature. Pulmonary infections due specifically to Ascaris, hookworms, Strongyloides, Paragonimus, filariasis, and Toxocara are considered in detail. The discussion then moves to noninfectious causes of eosinophilic pulmonary infiltration, including allergic sensitization to Aspergillus, acute and chronic eosinophilic pneumonias, Churg-Strauss syndrome, hypereosinophilic syndromes, and pulmonary eosinophilia due to exposure to specific medications or toxins.
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19
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Vijayan VK, Kilani T. Emerging and established parasitic lung infestations. Infect Dis Clin North Am 2010; 24:579-602. [PMID: 20674793 DOI: 10.1016/j.idc.2010.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Many lung infestations from established and newly emerging parasites have been reported as a result of the emergence of HIV/AIDS, the increasing use of immunosuppressive drugs, increasing organ transplantations, the increase in global travel, and climate change. A renewed interest in parasitic lung infections has been observed recently because many protozoal and helminthic parasites cause clinically significant lung diseases. The diseases caused by these parasites may mimic common and complicated lung diseases ranging from asymptomatic disease to acute respiratory distress syndrome requiring critical care management. The availability of new molecular diagnostic methods and antiparasitic drugs enables early diagnosis and prompt treatment to avoid the morbidity and mortality associated with these infestations. Good hygiene practices, improvement in socioeconomic conditions, vector control measures, and consumption of hygienically prepared and properly cooked food are essential to reduce the occurrence of parasitic infestations.
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Affiliation(s)
- Vannan Kandi Vijayan
- Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi 110007, India.
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20
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Abstract
Parasitic infections previously seen only in developing tropical settings can be currently diagnosed worldwide due to travel and population migration. Some parasites may directly or indirectly affect various anatomical structures of the heart, with infections manifested as myocarditis, pericarditis, pancarditis, or pulmonary hypertension. Thus, it has become quite relevant for clinicians in developed settings to consider parasitic infections in the differential diagnosis of myocardial and pericardial disease anywhere around the globe. Chagas' disease is by far the most important parasitic infection of the heart and one that it is currently considered a global parasitic infection due to the growing migration of populations from areas where these infections are highly endemic to settings where they are not endemic. Current advances in the treatment of African trypanosomiasis offer hope to prevent not only the neurological complications but also the frequently identified cardiac manifestations of this life-threatening parasitic infection. The lack of effective vaccines, optimal chemoprophylaxis, or evidence-based pharmacological therapies to control many of the parasitic diseases of the heart, in particular Chagas' disease, makes this disease one of the most important public health challenges of our time.
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21
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Cadman ET, Lawrence RA. Granulocytes: effector cells or immunomodulators in the immune response to helminth infection? Parasite Immunol 2010; 32:1-19. [PMID: 20042003 DOI: 10.1111/j.1365-3024.2009.01147.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Granulocytes are effector cells in defence against helminth infections. We review the current evidence for the role of granulocytes in protective immunity against different helminth infections and note that for each parasite species the role of granulocytes as effector cells can vary. Emerging evidence also points to granulocytes as immunomodulatory cells able to produce many cytokines, chemokines and modulatory factors which can bias the immune response in a particular direction. Thus, the role of granulocytes in an immunomodulatory context is discussed including the most recent data that points to an important role for basophils under this guise.
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Affiliation(s)
- E T Cadman
- Royal Veterinary College, Royal College Street, London NW1 0TU, UK
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22
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Abstract
PURPOSE OF REVIEW Tropical pulmonary eosinophilia is predominantly seen in the tropical and subtropical regions of the world. It is being increasingly reported from other parts of world, however, due to increases in global travel and migration. This review focuses attention on recent developments. RECENT FINDINGS Tropical pulmonary eosinophilia is an occult form of human filariasis. The gamma-glutaryl transpeptidase found in the infective L3 stage larvae of Brugia malayi has been found to have similarities with the gamma-glutaryl transpeptidase present on the surface of human pulmonary epithelium. It has, therefore, been proposed that filarial gamma-glutaryl transpeptidase may play an important role in the pathogenesis of tropical eosinophilia. Airway hyperresponsiveness, manifesting as asthma-like syndrome, has been reported in tropical pulmonary eosinophilia and it has been suggested that interleukin-4 induces and interferon-gamma suppresses filarial-induced airway hyperresponsiveness. The intense eosinophilic alveolitis seen in acute tropical pulmonary eosinophilia is suppressed by 3 weeks of treatment with diethylcarbamazine citrate. A mild eosinophilic alveolitis along with radiological, physiological and hematological abnormalities, though with reduced intensity, persists in some patients however. SUMMARY A chronic mild interstitial lung disease has been found to persist in tropical pulmonary eosinophilia despite treatment.
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23
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Franco-Paredes C, Rouphael N, Méndez J, Folch E, Rodríguez-Morales AJ, Santos JI, Hurst JW. Cardiac manifestations of parasitic infections part 3: pericardial and miscellaneous cardiopulmonary manifestations. Clin Cardiol 2007; 30:277-80. [PMID: 17551959 PMCID: PMC6653132 DOI: 10.1002/clc.20092] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This is part three of a three-part series discussing parasites of the heart. In this section, we present an overview on parasitic diseases involving predominantly the pericardium and other miscellaneous cardiopulmonary manifestations such as some pulmonary hypertension syndromes and endomyocardial fibrosis.
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Affiliation(s)
- Carlos Franco-Paredes
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30303, USA.
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24
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Abstract
PURPOSE OF REVIEW Parasitic pneumonia is being increasingly reported from many parts of the world due to globalization and travel across the continents. This review outlines the recent developments in the diagnosis and management of parasitic pneumonias. RECENT FINDINGS A polymerase chain reaction that can differentiate pathogenic Entamoeba histolytica from nonpathogenic species has been reported. It has been observed that pulmonary infection with Leishmania donovani can occur in immunodeficient and lung transplant patients. Acute respiratory distress syndrome, seen in severe falciparum malaria, has also been observed in vivax malaria. A study has demonstrated the return of chloroquine-sensitive falciparum malaria several years after chloroquine treatment was discontinued. Pulmonary hypertension has been reported in Schistosoma hematobium, S. mansoni and S. japonicum infections. Strongyloides hyperinfection and disseminated disease are frequently reported in immunocompromised individuals. Parenteral ivermectin is found to be useful in the treatment of disseminated strongyloidiasis. A chronic mild interstitial lung disease has been found to persist in tropical pulmonary eosinophilia despite treatment. Studies are in progress to develop vaccines against amoebiasis, malaria and hookworm infections. SUMMARY Parasitic pneumonia can sometimes be life threatening. If proper diagnosis is made early, the pneumonia can be treated successfully with currently available drugs.
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25
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Abstract
Eosinophils are traditionally thought to form part of the innate immune response against parasitic helminths acting through the release of cytotoxic granule proteins. However, they are also a central feature in asthma. From their development in the bone marrow to their recruitment to the lung via chemokines and cytokines, they form an important component of the inflammatory milieu observed in the asthmatic lung following allergen challenge. A wealth of studies has been performed in both patients with asthma and in mouse models of allergic pulmonary inflammation to delineate the role of eosinophils in the allergic response. Although the long-standing association between eosinophils and the induction of airway hyper-responsiveness remains controversial, recent studies have shown that eosinophils may also promote airway remodelling. In addition, emerging evidence suggests that the eosinophil may also serve to modulate the immune response. Here we review the highly co-ordinated nature of eosinophil development and trafficking and the evolution of the eosinophil as a multi-factoral leukocyte with diverse functions in asthma.
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Affiliation(s)
- S. G. Trivedi
- Leukocyte Biology Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, SW7 2AZ UK
| | - C. M. Lloyd
- Leukocyte Biology Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, SW7 2AZ UK
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26
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Abstract
PURPOSE OF REVIEW The human pulmonary system can be affected by a variety of parasites. This review focuses on the most common parasitic infestations involving the lung, except for protozoon disease. RECENT FINDINGS In many parasitic lung conditions, the clinical manifestations and the imaging findings are non-specific and can make diagnosis challenging. Hydatid disease and paragonimiasis involve the lung directly. Chronic schistosomiasis can lead to pulmonary hypertension. Strongyloides stercoralis infestation is capable of transforming into a fulminant fatal disease. In many types of nematode infestations, the pulmonary phase can cause acute eosinophilic pneumonia. Chest radiographs of patients with paragonimiasis and dirofilariasis can cause diagnostic confusion. Cases of tropical pulmonary eosinophilia typically present with refractory bronchial asthma. Most of these diseases are initially diagnosed by detecting eggs or larvae in stool, sputum, pleural fluid or tissue, and are confirmed by serologic testing. Cystic hydatid disease generally requires surgical treatment, whereas almost all other parasitic lung conditions can be treated medically. SUMMARY Although most parasites that affect the lung are endemic to tropical and subtropical regions, immigration and travel practices have resulted in transfer of these diseases to other areas. It is important for physicians to know the epidemiologic characteristics, clinical presentations, and treatments of choice for these conditions.
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Affiliation(s)
- Akin Kuzucu
- Department of Thoracic Surgery, Faculty of Medicine, Inonu University, Malatya, Turkey.
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27
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Park EY, Shim JY, Yoo MH, Kim DS, Shim JW, Jung HL, Park MS. Relationship of serum IL-13 and eotaxin level with airway hyperresponsiveness in children with asthma. KOREAN JOURNAL OF PEDIATRICS 2006. [DOI: 10.3345/kjp.2006.49.8.889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Eun Young Park
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myung Hwan Yoo
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Deok Soo Kim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Won Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Lim Jung
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Moon Soo Park
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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28
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Falcone FH, Loukas A, Quinnell RJ, Pritchard DI. The innate allergenicity of helminth parasites. Clin Rev Allergy Immunol 2005; 26:61-72. [PMID: 14755076 DOI: 10.1385/criai:26:1:61] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Helminth parasites are well known to induce an immune response in their hosts characterised by elevated IgE, peripheral blood or local tissue eosinophilia, and in some cases, intestinal mastocytosis. This immunological response has a strong T-helper 2 (Th2) cytokine bias and is reminiscent of the immunological constellation found in allergic diseases. However, the molecular forces driving the Th2 response to helminth parasites are still not understood. By using the human hookworm parasite Necator americanus as an example, the authors of the current article propose that in the course of its life cycle, this parasite becomes innately allergenic through the secretion of a molecular array designed to promote tissue migration and homing, feeding and survival against immunological attack. This complex array comprises proteases, lectins and other classes of molecules. Subsequent immunological and physiological events seemingly protect the host from both the allergic sequelae of exposure to environmental allergens and, moreover, from the parasite itself.
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Affiliation(s)
- Franco H Falcone
- Immune Modulation Research Group, Boots Science Building, School of Pharmacy, University of Nottingham, Nottingham, UK.
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29
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Boggild AK, Keystone JS, Kain KC. Tropical pulmonary eosinophilia: a case series in a setting of nonendemicity. Clin Infect Dis 2004; 39:1123-8. [PMID: 15486834 DOI: 10.1086/423964] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2004] [Accepted: 05/20/2004] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Tropical pulmonary eosinophilia (TPE) is a rare but serious manifestation of infection with the lymphatic filarial parasites Wuchereria bancrofti and Brugia malayi. Although endemicity is limited to the tropical and subtropical regions of Africa, South America, and Asia, immigration and travel practices have led to the diagnosis of TPE in areas of nonendemicity. METHODS We herein present a case series of all patients with TPE who presented to the Toronto General Hospital during 1990-2003. RESULTS Seventeen individuals presented with TPE during the study period, and all were of South Asian ancestry. All 17 received an incorrect diagnosis at presentation (median number of consultations before diagnosis, 2), the most frequent of which was asthma (76%). Eosinophil count, serum immunoglobulin E levels, and anti-filarial antibody titers were elevated in all patients. Ten of 14 patients had an abnormal chest radiograph finding, and 11 of 12 patients had abnormal results of pulmonary function tests. CONCLUSIONS TPE is an important diagnostic consideration in patients with eosinophilia, respiratory symptoms, and history of exposure to this disease. In the untreated individual, TPE can lead to chronic and progressive respiratory compromise and death. Prompt recognition and treatment with diethylcarbamazine is therefore key to minimizing morbidity and mortality.
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Affiliation(s)
- Andrea K Boggild
- Faculty of Medicine, McLaughlin Center for Molecular Medicine, University of Toronto, Toronto, Ontario, Canada
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