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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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2
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Katru SC, Balakrishnan AS, Munirathinam G, Hadadianpour A, Smith SA, Kalyanasundaram R. Identification and characterization of a novel nematode pan allergen (NPA) from Wuchereria bancrofti and their potential role in human filarial tropical pulmonary eosinophilia (TPE). PLoS Negl Trop Dis 2024; 18:e0011972. [PMID: 38354188 PMCID: PMC10898765 DOI: 10.1371/journal.pntd.0011972] [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: 12/06/2023] [Revised: 02/27/2024] [Accepted: 02/06/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Tropical pulmonary eosinophilia (TPE) is a chronic respiratory syndrome associated with Lymphatic Filariasis (LF), a tropical parasitic infection of the human, transmitted by mosquitoes. The larval form of LF (microfilariae) are trapped in the lungs of TPE subjects have a major role in initiating the TPE syndrome. To date, there are no reports on the potential allergen that is responsible for generating parasite-specific IgE in TPE. METHODOLOGY/PRINCIPAL FINDINGS In this project, we screened a cDNA expression library of the microfilarial stages of Wuchereria bancrofti with monoclonal IgE antibodies prepared from subjects with clinical filarial infections. Our studies identified a novel molecule that showed significant sequence similarity to an allergen. A blast analysis showed the presence of similar proteins in a number of nematodes parasites. Thus, we named this molecule as Nematode Pan Allergen (NPA). Subsequent functional analysis showed that NPA is a potent allergen that can cause release of histamine from mast cells, induce secretion of proinflammatory cytokines from alveolar macrophages and promote accumulation of eosinophils in the tissue, all of which occur in TPE lungs. CONCLUSIONS/SIGNIFICANCE Based on our results, we conclude that the NPA protein secreted by the microfilariae of W. bancrofti may play a significant role in the pathology of TPE syndrome in LF infected individuals. Further studies on this molecule can help design an approach to neutralize the NPA in an attempt to reduce the pathology associated with TPE in LF infected subjects.
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Affiliation(s)
- Samuel Christopher Katru
- Department of Biomedical Sciences, University of Illinois, College of Medicine Rockford, Rockford, IL, United States of America
| | - Anand Setty Balakrishnan
- Department of Biomedical Sciences, University of Illinois, College of Medicine Rockford, Rockford, IL, United States of America
| | - Gnanasekar Munirathinam
- Department of Biomedical Sciences, University of Illinois, College of Medicine Rockford, Rockford, IL, United States of America
| | - Azadeh Hadadianpour
- Vanderbilt University Medical Center, Department of Pathology, Microbiology and Immunology, A2210 Medical Center North, Nashville, Tennessee, United States of America
| | - Scott A. Smith
- Vanderbilt University Medical Center, Department of Pathology, Microbiology and Immunology, A2210 Medical Center North, Nashville, Tennessee, United States of America
| | - Ramaswamy Kalyanasundaram
- Department of Biomedical Sciences, University of Illinois, College of Medicine Rockford, Rockford, IL, United States of America
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Panjwani A, Salman MR, Nabar U. An interesting case of pulmonary infiltrates with eosinophilia: out of sight out of mind. Breathe (Sheff) 2023; 19:230097. [PMID: 38020341 PMCID: PMC10644105 DOI: 10.1183/20734735.0097-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/18/2023] [Indexed: 12/01/2023] Open
Abstract
Tropical pulmonary eosinophilia should be considered in patients presenting with respiratory symptoms and hypereosinophilia, even in areas not endemic for filariasis. This awareness may prevent morbidity associated with its late or wrong diagnosis. https://bit.ly/3t8hHVc.
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Affiliation(s)
- Amit Panjwani
- Department of Internal Medicine (Respiratory Unit), Government Hospitals-Salmaniya Medical Complex, Manama, Kingdom of Bahrain
- Department of Medicine, Royal College of Surgeons in Ireland, Medical University of Bahrain, Busaiteen, Kingdom of Bahrain
| | - Mohamed Redha Salman
- Department of Internal Medicine (Respiratory Unit), Government Hospitals-Salmaniya Medical Complex, Manama, Kingdom of Bahrain
| | - Umesh Nabar
- Department of Radiology, Government Hospitals-Salmaniya Medical Complex, Manama, Kingdom of Bahrain
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Hadadianpour A, Daniel J, Zhang J, Spiller BW, Makaraviciute A, DeWitt ÅM, Walden HS, Hamilton RG, Peebles RS, Nutman TB, Smith SA. Human IgE mAbs identify major antigens of parasitic worm infection. J Allergy Clin Immunol 2022; 150:1525-1533. [PMID: 35760390 PMCID: PMC9742163 DOI: 10.1016/j.jaci.2022.05.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/14/2022] [Accepted: 05/17/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Much of our understanding of the targets of IgE comes from studies of allergy, though little is known about the natural immunogenic targets seen after parasitic worm infections. OBJECTIVE We used human monoclonal antibodies (mAbs) for an unbiased and comprehensive characterization of the immunodominant antigens targeted by IgE in conditions like allergy or helminth infection that are associated with elevated levels of IgE. METHODS Using human hybridoma technology to immortalize IgE encoding B-cells from peripheral blood of subjects with filarial infections and elevated IgE, we generated naturally occurring human IgE mAbs. B-cell cultures were screened in an unbiased manner for IgE production without regard to specificity. Isolated IgE mAbs were then tested for binding to Brugia malayi somatic extracts using ImmunoCAP, immunoblot, and ELISA. Immunoprecipitation followed by mass spectrometry proteomics was used to identify helminth antigens that were then expressed in Escherichia coli for IgE binding characterization. RESULTS We isolated 56 discrete IgE mAbs from 7 individuals with filarial infections. From these mAbs, we were able to definitively identify 19 filarial antigens. All IgE mAbs targeted filarial excreted/secretory proteins, including a family of previously uncharacterized proteins. Interestingly, the transthyretin-related antigens acted as the dominant inducer of the filaria-specific IgE antibody response. These filaria-specific IgE mAbs were potent inducers of anaphylaxis when passively administered to human FcεRI-expressing mice. CONCLUSIONS We generated human hybridomas secreting naturally occurring helminth-specific IgE mAbs from filarial-infected subjects. This work provides much-needed insight into the ontogeny of helminth-induced immune response and IgE antibody response.
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Affiliation(s)
- Azadeh Hadadianpour
- Departments of Medicine and Pathology, Nashville, Tenn; departments of Medicine Microbiology and Immunology, Nashville, Tenn
| | - Jacob Daniel
- Departments of Medicine and Pathology, Nashville, Tenn; departments of Medicine Microbiology and Immunology, Nashville, Tenn
| | - Jian Zhang
- Departments of Medicine and Pathology, Nashville, Tenn; departments of Medicine Microbiology and Immunology, Nashville, Tenn
| | - Benjamin W Spiller
- departments of Medicine Microbiology and Immunology, Nashville, Tenn; Pharmacology, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tenn
| | | | - Åsa M DeWitt
- Special Allergen Service, Thermo Fisher Scientific, Uppsala, Sweden
| | - Heather S Walden
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, Fla
| | - Robert G Hamilton
- Dermatology, Allergy and Clinical Immunology Laboratory, Johns Hopkins University School of Medicine, Baltimore, Md
| | - R Stokes Peebles
- Departments of Medicine and Pathology, Nashville, Tenn; departments of Medicine Microbiology and Immunology, Nashville, Tenn
| | - Thomas B Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Scott A Smith
- Departments of Medicine and Pathology, Nashville, Tenn; departments of Medicine Microbiology and Immunology, Nashville, Tenn.
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Ehrens A, Hoerauf A, Hübner MP. Eosinophils in filarial infections: Inducers of protection or pathology? Front Immunol 2022; 13:983812. [PMID: 36389745 PMCID: PMC9659639 DOI: 10.3389/fimmu.2022.983812] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/05/2022] [Indexed: 05/29/2024] Open
Abstract
Filariae are parasitic roundworms, which can cause debilitating diseases such as lymphatic filariasis and onchocerciasis. Lymphatic filariasis, also known as elephantiasis, and onchocerciasis, commonly referred to as river blindness, can lead to stigmatizing pathologies and present a socio-economic burden for affected people and their endemic countries. Filariae typically induce a type 2 immune response, which is characterized by cytokines, i.e., IL-4, IL-5 and IL-13 as well as type 2 immune cells including alternatively activated macrophages, innate lymphoid cells and Th2 cells. However, the hallmark characteristic of filarial infections is a profound eosinophilia. Eosinophils are innate immune cells and pivotal in controlling helminth infections in general and filarial infections in particular. By modulating the function of other leukocytes, eosinophils support and drive type 2 immune responses. Moreover, as primary effector cells, eosinophils can directly attack filariae through the release of granules containing toxic cationic proteins with or without extracellular DNA traps. At the same time, eosinophils can be a driving force for filarial pathology as observed during tropical pulmonary eosinophilia in lymphatic filariasis, in dermatitis in onchocerciasis patients as well as adverse events after treatment of onchocerciasis patients with diethylcarbamazine. This review summarizes the latest findings of the importance of eosinophil effector functions including the role of eosinophil-derived proteins in controlling filarial infections and their impact on filarial pathology analyzing both human and experimental animal studies.
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Affiliation(s)
- 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
| | - 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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Delcros Q, Groh M, Nasser M, Kahn JE, Cottin V. Steroid alternatives for managing eosinophilic lung diseases. Expert Opin Orphan Drugs 2021. [DOI: 10.1080/21678707.2021.2003777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Quentin Delcros
- National Reference Center for Hypereosinophilic Syndrome (Cereo)
- Department of Internal Medicine Hôpital Foch, Suresnes, France
| | - Matthieu Groh
- National Reference Center for Hypereosinophilic Syndrome (Cereo)
- Department of Internal Medicine Hôpital Foch, Suresnes, France
| | - Mouhamad Nasser
- Department of Respiratory Medicine, National Coordinating Reference Centre for Rare Pulmonary Diseases (Orphalung), Louis Pradel Hospital, Hospices Civils De Lyon, and Claude Bernard University Lyon 1, IVPC, Member of OrphaLung, RespiFIL and ERN-lung, France
| | - Jean-Emmanuel Kahn
- National Reference Center for Hypereosinophilic Syndrome (Cereo)
- Department of Internal Medicine, Hôpital Ambroise Paré, Université Paris Saclay, Assistance Publique Hôpitaux De Paris, Boulogne-Billancourt, France
| | - Vincent Cottin
- Department of Respiratory Medicine, National Coordinating Reference Centre for Rare Pulmonary Diseases (Orphalung), Louis Pradel Hospital, Hospices Civils De Lyon, and Claude Bernard University Lyon 1, IVPC, Member of OrphaLung, RespiFIL and ERN-lung, France
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Magalhães L, Nogueira DS, Gazzinelli-Guimarães PH, Oliveira FMS, Kraemer L, Gazzinelli-Guimarães AC, Vieira-Santos F, Fujiwara RT, Bueno LL. Immunological underpinnings of Ascaris infection, reinfection and co-infection and their associated co-morbidities. Parasitology 2021; 148:1-10. [PMID: 33843506 DOI: 10.1017/s0031182021000627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Human ascariasis is the most common and prevalent neglected tropical disease and is estimated that ~819 million people are infected around the globe, accounting for 0.861 million years of disability-adjusted life years in 2017. Even with the existence of highly effective drugs, the constant presence of infective parasite eggs in the environment contribute to a high reinfection rate after treatment. Due to its high prevalence and broad geographic distribution Ascaris infection is associated with a variety of co-morbidities and co-infections. Here, we provide data from both experimental models and humans studies that illustrate how complex is the interaction of Ascaris with the host immune system, especially, in the context of reinfections, co-infections and associated co-morbidities.
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Affiliation(s)
- Luisa Magalhães
- Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Denise S Nogueira
- Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Pedro H Gazzinelli-Guimarães
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Fabricio M S Oliveira
- Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Kraemer
- Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Flaviane Vieira-Santos
- Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo T Fujiwara
- Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lilian L Bueno
- Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Sharma P, Sharma A, Ganga L, Satoeya N, Jha R, Srivastava M. Acidic Calcium-Independent Phospholipase A2 Regulates Eosinophil-Mediated Pathology during Filarial Manifestation of Tropical Pulmonary Eosinophilia. THE JOURNAL OF IMMUNOLOGY 2021; 206:722-736. [PMID: 33441441 DOI: 10.4049/jimmunol.2000604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 11/17/2020] [Indexed: 12/24/2022]
Abstract
Eosinophils mediate pathological manifestations during tropical pulmonary eosinophilia (TPE), a potentially fatal complication of lymphatic filariasis, by mechanisms that are incompletely understood. Using two-dimensional gel electrophoresis, mass spectrometry, flow cytometry, and pharmacological and functional studies, we identified acidic calcium-independent phospholipase A2 (aiPLA2) as the master regulator of TPE pathogenesis. FACS-sorted lung eosinophils from TPE mice exhibited aiPLA2-dependent activation characterized by heavy calcium influx, F-actin polymerization, increased degranulation, and heightened reactive oxygen species generation. Interestingly, aiPLA2 also promoted alternative activation in lung macrophages and regulated the release of inflammatory intermediates from them. Treatment of TPE mice with MJ33, a nontoxic pharmacological inhibitor of aiPLA2, lowered eosinophil counts in the bronchoalveolar lavage fluid, reduced eosinophil peroxidase and β-hexosaminidase activity, increased airway width, improved lung endothelial barrier, and lowered the production of inflammatory lipid intermediates, which significantly improved the pathological condition of the lungs. Importantly, ex vivo reconstitution of arachidonic acid to eosinophils from MJ33-treated TPE mice increased eosinophil degranulation and inflammatory lipid intermediates underlining the pivotal role of aiPLA2 in arachidonic acid metabolism. Mechanistically, phosphorylation of JNK-1 regulated phospholipase activity of aiPLA2, whereas IgG cross-linking mediated pathological activation of eosinophils. Taken together, ours is the first study, to our knowledge, to report hitherto undocumented role of aiPLA2 in regulating TPE pathogenesis.
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Affiliation(s)
- Pankaj Sharma
- Molecular Parasitology and Immunology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow 226031, India; and
| | - Aditi Sharma
- Molecular Parasitology and Immunology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow 226031, India; and.,Academy of Scientific and Innovative Research, Ghaziabad 201002, India
| | - Laxmi Ganga
- Molecular Parasitology and Immunology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow 226031, India; and
| | - Neha Satoeya
- Molecular Parasitology and Immunology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow 226031, India; and
| | - Ruchi Jha
- Molecular Parasitology and Immunology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow 226031, India; and
| | - Mrigank Srivastava
- Molecular Parasitology and Immunology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, Lucknow 226031, India; and .,Academy of Scientific and Innovative Research, Ghaziabad 201002, India
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9
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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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10
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Weatherhead JE, Gazzinelli-Guimaraes P, Knight JM, Fujiwara R, Hotez PJ, Bottazzi ME, Corry DB. Host Immunity and Inflammation to Pulmonary Helminth Infections. Front Immunol 2020; 11:594520. [PMID: 33193446 PMCID: PMC7606285 DOI: 10.3389/fimmu.2020.594520] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/30/2020] [Indexed: 01/04/2023] Open
Abstract
Helminths, including nematodes, cestodes and trematodes, are complex parasitic organisms that infect at least one billion people globally living in extreme poverty. Helminthic infections are associated with severe morbidity particularly in young children who often harbor the highest burden of disease. While each helminth species completes a distinct life cycle within the host, several helminths incite significant lung disease. This impact on the lungs occurs either directly from larval migration and host immune activation or indirectly from a systemic inflammatory immune response. The impact of helminths on the pulmonary immune response involves a sophisticated orchestration and activation of the host innate and adaptive immune cells. The consequences of activating pulmonary host immune responses are variable with several helminthic infections leading to severe, pulmonary compromise while others providing immune tolerance and protection against the development of pulmonary diseases. Further delineation of the convoluted interface between helminth infection and the pulmonary host immune responses is critical to the development of novel therapeutics that are critically needed to prevent the significant global morbidity caused by these parasites.
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Affiliation(s)
- Jill E. Weatherhead
- Department of Medicine, Infectious Diseases, Baylor College of Medicine, Houston, TX, United States
- Department of Pediatrics, Pediatric Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | | | - John M. Knight
- Department of Medicine, Pathology and Immunology, and the Biology of Inflammation Center, Baylor College of Medicine, Houston, TX, United States
| | - Ricardo Fujiwara
- Departamento de Parasitologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Peter J. Hotez
- Department of Pediatrics, Pediatric Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
- Texas Children’s Center for Vaccine Development, Houston, TX, United States
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
- Department of Biology, Baylor University, Waco, TX, United States
- Hagler Institute for Advanced Study at Texas A&M University, College State, TX, United States
| | - Maria Elena Bottazzi
- Department of Pediatrics, Pediatric Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
- Texas Children’s Center for Vaccine Development, Houston, TX, United States
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
| | - David B. Corry
- Department of Medicine, Pathology and Immunology, and the Biology of Inflammation Center, Baylor College of Medicine, Houston, TX, United States
- Department of Medicine, Immunology, Allergy, Rheumatology, Baylor College of Medicine, Houston, TX, United States
- Michael E. DeBakey VA Center for Translational Research in Inflammatory Diseases, Houston, TX, United States
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11
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Simmons RP, Dudzinski DM, Shepard JAO, Hurtado RM, Coffey KC. Case 16-2019: A 53-Year-Old Man with Cough and Eosinophilia. N Engl J Med 2019; 380:2052-2059. [PMID: 31116923 DOI: 10.1056/nejmcpc1900595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Rachel P Simmons
- From the Department of Medicine, Boston Medical Center (R.P.S.), the Department of Medicine, Boston University School of Medicine (R.P.S.), the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Harvard Medical School - all in Boston
| | - David M Dudzinski
- From the Department of Medicine, Boston Medical Center (R.P.S.), the Department of Medicine, Boston University School of Medicine (R.P.S.), the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Harvard Medical School - all in Boston
| | - Jo-Anne O Shepard
- From the Department of Medicine, Boston Medical Center (R.P.S.), the Department of Medicine, Boston University School of Medicine (R.P.S.), the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Harvard Medical School - all in Boston
| | - Rocio M Hurtado
- From the Department of Medicine, Boston Medical Center (R.P.S.), the Department of Medicine, Boston University School of Medicine (R.P.S.), the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Harvard Medical School - all in Boston
| | - K C Coffey
- From the Department of Medicine, Boston Medical Center (R.P.S.), the Department of Medicine, Boston University School of Medicine (R.P.S.), the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Massachusetts General Hospital, and the Departments of Medicine (D.M.D., R.M.H.), Radiology (J.-A.O.S.), and Pathology (K.C.C.), Harvard Medical School - all in Boston
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Gupta N, Ray A, Ghosh S, Malla S, Vyas S. First things first: Importance of eosinophil count in diagnosing occult parasites. Drug Discov Ther 2018; 12:55-57. [PMID: 29553083 DOI: 10.5582/ddt.2018.01005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Tropical pulmonary eosinophilia (TPE) is a rare allergic manifestation to the filarial nematode. A 38-year old male and a 15-year old female presented with cough and breathlessness. Their complete blood count showed eosinophilia. This finding was overshadowed by the radiological findings suggestive of tuberculosis. The diagnosis of TPE was confirmed by filarial antigen detection test and both the patients were successfully treated with diethylcarbamazine. TPE presents with cough and breathlessness and can be often confused with tuberculosis, especially in endemic settings. An important clue in differentiating the two entities is the presence of eosinophilia in the former.
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Affiliation(s)
- Nitin Gupta
- Departments of Medicine and Microbiology, All India Institute of Medical Sciences
| | - Animesh Ray
- Department of Medicine, All India Institute of Medical Sciences
| | - Sudeshna Ghosh
- Department of Medicine, All India Institute of Medical Sciences
| | - Sundeep Malla
- Department of Radiology, All India Institute of Medical Sciences
| | - Surabhi Vyas
- Department of Radiology, All India Institute of Medical Sciences
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Abstract
OBJECTIVE The purpose of this article is to review the clinical and imaging findings associated with eosinophilic lung diseases. CONCLUSION The spectrum of eosinophilic lung diseases comprises a diverse group of pulmonary disorders that have an association with tissue or peripheral eosinophilia. These diseases have varied clinical presentations and may be associated with several other abnormalities. Characteristic imaging findings are often detected with chest radiography, and CT best shows parenchymal abnormalities. The integration of clinical, radiologic, and pathologic findings facilitates diagnosis and directs appropriate treatment.
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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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16
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Abstract
In determining the etiology of eosinophilia, it is necessary to consider the type of patient, including previous travel and exposure history, comorbidities, and symptoms. In this review, we discuss the approach to the patient with eosinophilia from an infectious diseases perspective based on symptom complexes.
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Affiliation(s)
- Elise M O'Connell
- Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 4 Center Drive, Building 4, Room B105, Bethesda, MD 20892, USA.
| | - Thomas B Nutman
- Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 4 Center Drive, Building 4, Room B105, Bethesda, MD 20892, USA
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17
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Rana AK, Kushwaha S, Singh PK, Misra-Bhattacharya S. Immunological evaluation of an rsmD-like rRNA methyltransferase from Wolbachia endosymbiont of Brugia malayi. Comp Immunol Microbiol Infect Dis 2016; 44:41-7. [PMID: 26851594 DOI: 10.1016/j.cimid.2015.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 10/15/2015] [Accepted: 12/02/2015] [Indexed: 11/27/2022]
Abstract
Wolbachia is a wonderful anti-filarial target with many of its enzymes and surface proteins (WSPs) representing potential drug targets and vaccine candidates. Here we report on the immunologic response of a drug target, rsmD-like rRNA methyltransferase from Wolbachia endosymbiont of Brugia malayi. The recombinant protein generated both humoral and cell-mediated response in BALB/c mice but compromised its immunity. The humoral response was transient and endured barely for six months in mice with or without B. Malayi challenge. In splenocytes of mice, the key humoral immunity mediating cytokine IL4 was lowered (IL4↓) while IFNγ, the major cytokine mediating cellular immunity was decreased along with upregulation of IL10 cytokine (IFNγ↓, IL10↑). The finding here indicates that the enzyme has low immunogenicity and triggers lowering of cytokine level in BALB/c mice. Interestingly the overall immune profile can be summed up with equivalent response generated by WSP or whole Wolbachia.
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Affiliation(s)
- Ajay Kumar Rana
- Division of Parasitology, CSIR - Central Drug Research Institute, Lucknow, India
| | - Susheela Kushwaha
- Division of Parasitology, CSIR - Central Drug Research Institute, Lucknow, India
| | - Prashant Kumar Singh
- Division of Parasitology, CSIR - Central Drug Research Institute, Lucknow, India
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18
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Mehta AC, Jain P, Gildea TR. Parasitic Diseases of the Lung. DISEASES OF THE CENTRAL AIRWAYS 2016. [PMCID: PMC7122070 DOI: 10.1007/978-3-319-29830-6_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Parasitic infection is a major healthcare problem that affects millions of the world’s population. Immigration and global warming have changed the natural distribution of parasitic diseases far removed from endemic areas. The respiratory system can be affected by a broad spectrum of helminthic and protozoal parasitic diseases. The diagnosis of parasitic infection of the respiratory system may be delayed due to myriad clinical and radiographic presentations of parasitic diseases which make the diagnosis of these entities challenging. Pulmonologists need to be familiar with the epidemiology, clinical presentation, pathophysiology, and bronchoscopic findings of parasitic lung diseases, in order to provide proper management in a timely fashion. This review provides a comprehensive view of both helminthic and protozoal parasitic diseases that affect the respiratory system, especially the central airways.
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Affiliation(s)
- Atul C. Mehta
- Family Endowed Chair in Lung Transplanta, Lerner College of Medicine Buoncore, Clevland, Ohio USA
| | - Prasoon Jain
- Louis A Johnson VA Medical Center, Fairmont, West Virginia USA
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19
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Craig JM, Scott AL. Helminths in the lungs. Parasite Immunol 2014; 36:463-74. [PMID: 25201409 DOI: 10.1111/pim.12102] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 01/21/2014] [Indexed: 12/21/2022]
Abstract
Parasitic helminths infect well over one billion people and typically cause chronic and recurrent infections that exert a considerable toll on human health and productivity. A significant number of important intestinal- and tissue-dwelling helminth parasites have evolved a scripted migration through select organ systems. Of specific interest here are the helminth parasites that interact with respiratory tissues and the pulmonary immune system. This review will consider the nature of the interactions between helminth parasites and the lung environment, as well as the consequences of these interactions on the evolution of parasitism and host immunity.
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Affiliation(s)
- J M Craig
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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20
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Cheepsattayakorn A, Cheepsattayakorn R. Parasitic pneumonia and lung involvement. BIOMED RESEARCH INTERNATIONAL 2014; 2014:874021. [PMID: 24995332 PMCID: PMC4068046 DOI: 10.1155/2014/874021] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 05/15/2014] [Accepted: 05/20/2014] [Indexed: 11/17/2022]
Abstract
Parasitic infestations demonstrated a decline in the past decade as a result of better hygiene practices and improved socioeconomic conditions. Nevertheless, global immigration, increased numbers of the immunocompromised people, international traveling, global warming, and rapid urbanization of the cities have increased the susceptibility of the world population to parasitic diseases. A number of new human parasites, such as Plasmodium knowlesi, in addition to many potential parasites, have urged the interest of scientific community. A broad spectrum of protozoal parasites frequently affects the respiratory system, particularly the lungs. The diagnosis of parasitic diseases of airway is challenging due to their wide varieties of clinical and roentgenographic presentations. So detailed interrogations of travel history to endemic areas are critical for clinicians or pulmonologists to manage this entity. The migrating adult worms can cause mechanical airway obstruction, while the larvae can cause airway inflammation. This paper provides a comprehensive review of both protozoal and helminthic infestations that affect the airway system, particularly the lungs, including clinical and roentgenographic presentations, diagnostic tests, and therapeutic approaches.
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Affiliation(s)
- Attapon Cheepsattayakorn
- 10th Zonal Tuberculosis and Chest Disease Center, Chiang Mai, Thailand
- 10th Office of Disease Prevention and Control, Department of Disease Control, Ministry of Public Health, Chiang Mai 50100, Thailand
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22
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Bhalla D, Dumas M, Preux PM. Neurological manifestations of filarial infections. HANDBOOK OF CLINICAL NEUROLOGY 2013; 114:235-42. [PMID: 23829914 DOI: 10.1016/b978-0-444-53490-3.00018-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Filarial infections cause a huge public health burden wherever they are endemic. These filaria may locate anywhere in the human body. Their manifestations and pathogenic mechanisms, except the most common ones, are rarely investigated systematically. Their neurological manifestations, however, are being increasingly recognized particularly with onchocerciasis or Loa loa infections, Wuchereria bancrofti, or Mansonella perstans. The risk of developing these manifestations may also increase in cases that harbor multiple filariasis or coinfections, for instance as with Plasmodium. The microfilaria of Onchocerca and Loa loa are seen in cerebrospinal fluid. The pathogenesis of neurological manifestations of these infections is complex; however, pathogenic reactions may be caused by mechanical disruption, e.g., degeneration often followed by granulomas, causing fibrosis or mass effects on other tissues, vascular lesions, e.g., vascular block of cerebral vessels, or disordered inflammatory responses resulting in meningitis, encephalitis or localized inflammatory responses. The chances of having neurological manifestations may also depend upon the frequency and"heaviness"of infection over a lifetime. Hence, this type of infection should no longer be considered a disease of the commonly affected areas but one that may produce systemic effects or other manifestations, and these should be considered in populations where they are endemic.
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Affiliation(s)
- Devender Bhalla
- INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France; University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France; Centre Hospitalier Universitaire, Limoges, France
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23
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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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PATHOLOGIE INFECTIEUSE. IMAGERIE THORACIQUE 2013. [PMCID: PMC7156015 DOI: 10.1016/b978-2-294-71321-7.50016-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Immunopathogenesis of lymphatic filarial disease. Semin Immunopathol 2012; 34:847-61. [PMID: 23053393 DOI: 10.1007/s00281-012-0346-4] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 09/13/2012] [Indexed: 01/06/2023]
Abstract
Although two thirds of the 120 million people infected with lymph-dwelling filarial parasites have subclinical infections, ~40 million have lymphedema and/or other pathologic manifestations including hydroceles (and other forms of urogenital disease), episodic adenolymphangitis, tropical pulmonary eosinophilia, lymphedema, and (in its most severe form) elephantiasis. Adult filarial worms reside in the lymphatics and lymph nodes and induce changes that result in dilatation of lymphatics and thickening of the lymphatic vessel walls. Progressive lymphatic damage and pathology results from the summation of the effect of tissue alterations induced by both living and nonliving adult parasites, the host inflammatory response to the parasites and their secreted antigens, the host inflammatory response to the endosymbiont Wolbachia, and those seen as a consequence of secondary bacterial or fungal infections. Inflammatory damage induced by filarial parasites appears to be multifactorial, with endogenous parasite products, Wolbachia, and host immunity all playing important roles. This review will initially examine the prototypical immune responses engendered by the parasite and delineate the regulatory mechanisms elicited to prevent immune-mediated pathology. This will be followed by a discussion of the proposed mechanisms underlying pathogenesis, with the central theme being that pathogenesis is a two-step process-the first initiated by the parasite and host innate immune system and the second propagated mainly by the host's adaptive immune system and by other factors (including secondary infections).
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26
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Abstract
High-grade eosinophilia can be a diagnostic dilemma, as the etiologies are extensive and varied. Hypereosinophilic syndromes (HES) are a group of heterogeneous disorders, many of which remain poorly defined. By definition, HES must be distinguished from other disorders with persistently elevated eosinophilia with a defined cause. Although marked eosinophilia worldwide is most commonly caused by helminth (worm) infections, non-infectious causes must be considered, and include drug reactions, malignancies, and immunologic, inflammatory and allergic diseases.
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Affiliation(s)
- Rojelio Mejia
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-0425, USA
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27
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Tropical pulmonary eosinophilia misdiagnosed as miliary tuberculosis: A case report and literature review. Parasitol Int 2012; 61:381-4. [DOI: 10.1016/j.parint.2011.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 11/26/2011] [Accepted: 11/29/2011] [Indexed: 11/20/2022]
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Modulation of specific and allergy-related immune responses by helminths. J Biomed Biotechnol 2011; 2011:821578. [PMID: 22219659 PMCID: PMC3248237 DOI: 10.1155/2011/821578] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 09/09/2011] [Indexed: 01/10/2023] Open
Abstract
Helminths are master regulators of host immune responses utilising complex mechanisms to dampen host protective Th2-type responses and favour long-term persistence. Such evasion mechanisms ensure mutual survival of both the parasite and the host. In this paper, we present recent findings on the cells that are targeted by helminths and the molecules and mechanisms that are induced during infection. We discuss the impact of these factors on the host response as well as their effect in preventing the development of aberrant allergic inflammation. We also examine recent findings on helminth-derived molecules that can be used as tools to pinpoint the underlying mechanisms of immune regulation or to determine new anti-inflammatory therapeutics.
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29
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Mondal SK. Incidental detection of filaria in fine-needle aspirates: a cytologic study of 14 clinically unsuspected cases at different sites. Diagn Cytopathol 2010; 40:292-6. [PMID: 22431316 DOI: 10.1002/dc.21557] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Accepted: 08/30/2010] [Indexed: 11/11/2022]
Abstract
Filariasis is a major health problem in tropical countries like India. Detection of microfilariae or adult worm or egg in FNAC is very unusual despite the high incidence of this parasite in endemic zone. The aim of this study was to document the value of fine-needle aspiration cytology (FNAC) in diagnosis of filaria at all possible sites presenting as mass or swelling. Fourteen patients (nine males and five females) in the age range of 14-61 years were subjected to FNAC. FNA from swellings was done using 22-gauge needles fitted with 10 or 20 ml disposable plastic syringes. The slides were stained with May-Grunwald-Giemsa stain, Haematoxylin and Eosin (H&E) stain, and Papanicolaou (Pap) stain. In total, 14 cases of filariasis were detected, which included subcutaneous swellings (six cases), epididymis/spermatic cord nodules (four cases), breast lumps (two cases), lymph nodes (one case), and thyroid swelling (one case). Larvae (microfilariae), eggs, and adult worms were detected in cytological smears. Microfilaria was present in all 14 cases whereas adult worm was found in three cases only. In four cases, eggs were seen in the smears. None of the patients was microfilariaemic and significant eosinophilia (>10%) was seen seen in two patients. Filarisis should be considered as one of the differential diagnosis of swelling in endemic area. Identification of the parasite, Wuchereria bancrofti, in FNA smears and accurate diagnosis of filaria is important to employ proper treatment. Early diagnosis and treatment prevents the more severe manifestation of the disease, lymphatic filariasis.
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Affiliation(s)
- Santosh Kumar Mondal
- Department of Pathology, Medical College, West Bengal Health University, West Bengal, Kolkata, India.
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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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31
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Eosinophilia in returning travellers and migrants from the tropics: UK recommendations for investigation and initial management. J Infect 2010; 60:1-20. [DOI: 10.1016/j.jinf.2009.11.003] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Revised: 11/11/2009] [Accepted: 11/13/2009] [Indexed: 11/18/2022]
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Gupta K, Saikia UN, Bhatia P, Garg M, Wanchu A. Disseminated microfilaremia associated with lung cyst and empyema: an autopsy report. THE KOREAN JOURNAL OF PARASITOLOGY 2009; 47:49-52. [PMID: 19290091 DOI: 10.3347/kjp.2009.47.1.49] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Revised: 01/15/2009] [Accepted: 01/22/2009] [Indexed: 11/23/2022]
Abstract
Clinical manifestations of extralymphatic disease caused by filariasis are varied and range from symptoms due to tropical pulmonary eosinophilia to hematuria, proteinuria, splenomegaly, and rarely arthritis. Disseminated microfilaremia in association with loculated lung cyst and empyema is of rare occurrence and to the best of our knowledge has not been documented in the literature so far. We report here a case of disseminated microfilaremia due to Wuchereria bancrofti infection accompanied by a lung cyst and empyema in a 21-year-old Indian man.
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Affiliation(s)
- Kirti Gupta
- Department of Histopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
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33
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Abstract
Pneumonia is a leading killer of children in developing countries and results in significant morbidity worldwide. This article reviews the management of pneumonia and its complications from the perspective of both developed and resource-poor settings. In addition, evidence-based management of other respiratory infections, including tuberculosis, is discussed. Finally, the management of common complications of pneumonia is reviewed.
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Affiliation(s)
- Sarath C Ranganathan
- Department of Respiratory Medicine, Royal Children's Hospital Melbourne, Parkville, Melbourne, VIC 3052, Australia.
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34
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Marsland BJ, Kurrer M, Reissmann R, Harris NL, Kopf M. Nippostrongylus brasiliensis infection leads to the development of emphysema associated with the induction of alternatively activated macrophages. Eur J Immunol 2008; 38:479-88. [PMID: 18203142 DOI: 10.1002/eji.200737827] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is the 5(th) most prevalent disease worldwide leading to severe morbidity and mortality in developed countries. The disease is strongly associated with smoking, and can be characterized by progressive and irreversible deterioration in lung function and destruction of the lung parenchyma. We show here that infection with the hookworm Nippostrongylus brasiliensis results in deterioration in lung function, destruction of alveoli and long-term airways hyperresponsiveness, consistent with COPD and emphysema. N. brasiliensis infection leads to chronic low level hemorrhaging in the lung and the presence of hemosiderin-laden macrophages in the absence of an overt inflammatory infiltrate. Microarray analysis of gene expression in diseased lungs and quantitative RT-PCR analysis of purified macrophages revealed a state of prolonged tissue injury and the presence of alternatively activated macrophages producing MMP-12. Taken together, these data show that lung tissue damage caused by hookworm infection can result in the development of COPD and emphysema.
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Affiliation(s)
- Benjamin J Marsland
- Molecular Biomedicine, Swiss Federal Institute of Technology, Zurich-Schlieren, Switzerland
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Mitre E, Chien D, Nutman TB. CD4(+) (and not CD25+) T cells are the predominant interleukin-10-producing cells in the circulation of filaria-infected patients. J Infect Dis 2008; 197:94-101. [PMID: 18171291 DOI: 10.1086/524301] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Interleukin (IL)-10 plays an important role in down-regulating the immune response to filarial parasites. The goal of this study was to characterize the predominant cellular source of IL-10 in human filarial infections. METHODS Multicolor flow cytometry was used to determine the frequencies of IL-10 production from various lymphocyte populations in the circulation of 23 patients with filarial infections and 8 uninfected control subjects. RESULTS The frequencies of cells spontaneously producing IL-10 was significantly greater in filaria-infected patients than in uninfected control subjects (geometric mean, 93 vs. 18 IL-10-producing cells/100,000 peripheral blood mononuclear cells; P = .03). Most IL-10-producing cells in filaria-infected patients were T cells, with CD4(+) and CD8(+) cells accounting for 48% and 27%, respectively, of all IL-10-producing cells; CD19(+) B cells, CD14(+) monocytes, and CD56(+) NK cells accounted for 10%, 8%, and 7%, respectively. Surprisingly, only 12% of the IL-10-producing CD3(+)CD4(+) cells were CD25(+). Seventy-seven percent of IL-10-producing CD4(+) T cells stained negatively for both IL-4 and interferon (IFN)-gamma, 22% were positive for IL-4, and <1% were positive for IFN-gamma. CONCLUSIONS These experiments demonstrate that the most frequent producers of IL-10 in human filarial infections are CD4(+) T cells, many of which are skewed toward a type 2 phenotype and most of which are not CD25(+).
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Affiliation(s)
- Edward Mitre
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
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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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Yong MK, Marshall CL, Eisen DP. Tropical pulmonary eosinophilia: a rare cause of cough in immigrants to Australia. Med J Aust 2007; 187:416-8. [PMID: 17908009 DOI: 10.5694/j.1326-5377.2007.tb01316.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Accepted: 06/21/2007] [Indexed: 11/17/2022]
Affiliation(s)
- Michelle K Yong
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, VIC, Australia.
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Abstract
Hypereosinophilic syndromes (HES) are a group of heterogeneous disorders many of which remain ill-defined. By definition, the HES must be distinguished from other disorders with persistently elevated eosinophilia with a defined cause. Although marked eosinophilia worldwide is most commonly caused by helminth (worm) infections, the diagnostic approach must include noninfectious (nonparasitic) causes of marked eosinophilia as well.
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Affiliation(s)
- Thomas B Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Building 4, Room B1-03, 4 Center Drive, Bethesda, MD 20892-0425, USA.
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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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Okada F, Ono A, Ando Y, Yotsumoto S, Yotsumoto S, Tanoue S, Matsumoto S, Wakisaka M, Mori H. Pulmonary Computed Tomography Findings of Visceral Larva Migrans Caused by Ascaris suum. J Comput Assist Tomogr 2007; 31:402-8. [PMID: 17538287 DOI: 10.1097/01.rct.0000243444.18363.69] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To retrospectively evaluate the computed tomography (CT) findings of pulmonary involvement in patients with visceral larva migrans caused by Ascaris suum. METHODS Institutional review board approval was obtained, and informed consent was waived. Chest CT scans obtained between January 1994 and November 2005 in 32 patients infected with A. suum were retrospectively evaluated by 3 chest radiologists. In 4 patients who underwent surgical or transbronchial biopsy, comparisons of the CT images with the actual specimens were performed. RESULTS On CT scans, abnormal findings were seen in 28 patients. The most common abnormality consisted of nodules (n = 19) in which the majority had a halo of ground-glass attenuation (n = 17), followed by ground-glass attenuation (n = 18), and interlobular septal thickening (n = 14). These abnormalities were predominantly seen in the peripheral lung (n = 25). Of the 7 patients who underwent follow-up CT scans, nodules (n = 6) and ground-glass attenuation (n = 5) had migrated in 4 patients. Pathologically, these findings corresponded to marked eosinophilic infiltration into the interstitium. CONCLUSIONS These CT findings are considered to be suggestive of thoracic involvement in patients with visceral larva migrans caused by A. suum.
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Affiliation(s)
- Fumito Okada
- Department of Diagnostic and Interventional Radiology, Oita University Faculty of Medicine, Oita, Japan.
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Abstract
Lymphatic filariasis (LF) is a disease not just treatable or controllable; it is a disease that can be eliminated. Indeed, LF is currently the target of a major global initiative to do just that; a few visionaries of the past 50 years did hypothesize that LF elimination was feasible. However, for most of the scientific and global health communities, the elimination of such a broadly disseminated, mosquito-borne disease has seemed highly unlikely. During the past decade, however, both the treatment strategies and the control strategies for LF have undergone profound paradigm shifts-all because of a rapid increase in knowledge and understanding of LF that derived directly from a series of remarkable achievements by the scientific and medical research communities. As a result, a public health dimension with a focus on affected populations, now supplements the earlier, predominantly patient-oriented clinical approach to LF. The early uncertainties, then the essential steps leading to this change in outlook are outlined below, followed by descriptions of the new strategy for LF elimination, the Global Programme created to attain this goal and the successes achieved to date.
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Affiliation(s)
- Eric A Ottesen
- Lymphatic Filariasis Support Centre, The Task Force for Child Survival and Development, 750 Commerce Drive Decatur, GA 30030, USA
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Gyapong JO, Kumaraswami V, Biswas G, Ottesen EA. Treatment strategies underpinning the global programme to eliminate lymphatic filariasis. Expert Opin Pharmacother 2005; 6:179-200. [PMID: 15757416 DOI: 10.1517/14656566.6.2.179] [Citation(s) in RCA: 147] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Lymphatic filariasis (LF) is a disease targeted for elimination. The global strategy is a once-yearly, single-dose, two-drug regimen utilised by communities at risk for LF, with the goal of reaching 80% population coverage yearly, for at least 5 years, in order to interrupt transmission of LF. Where onchocerciasis is co-endemic, the regimen is ivermectin 200 - 400 microg/kg plus albendazole 400mg; elsewhere, the regimen should be diethylcarbamazine 6 mg/kg plus albendazole 400mg. This paper reviews in detail the evidence for the efficacy and safety of these two-drug regimens underpinning the global strategy and makes recommendations for future developments in chemotherapy for LF, focusing on unresolved issues. These include optimal frequency, duration and end point of treatment, tools for monitoring successful therapy and means for detecting the potential development of resistance to any of the three antifilarial drugs on which the Global Programme to Eliminate LF depends.
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Affiliation(s)
- John O Gyapong
- Health Research Unit, Ghana Health Service, PO Box GP-184, Accra, Ghana.
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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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Mitre E, Taylor RT, Kubofcik J, Nutman TB. Parasite antigen-driven basophils are a major source of IL-4 in human filarial infections. THE JOURNAL OF IMMUNOLOGY 2004; 172:2439-45. [PMID: 14764715 DOI: 10.4049/jimmunol.172.4.2439] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Basophil contribution to the IL-4 pool in filarial infections was assessed using PBMC from 20 patients with active filarial infections and from 9 uninfected subjects. Patient basophils released histamine in response to Brugia malayi Ag (BmAg). They also released IL-4 within 2 h after exposure to BmAg, as assessed by intracellular cytokine flow cytometry. This IL-4 induction was Ag specific, as IL-4 was not detected in BmAg-exposed basophils obtained from uninfected subjects. Although there were, on average, 64 times more CD4(+) T cells than basophils in the peripheral circulation of filaria-infected patients, the absolute numbers of basophils and CD4(+) T cells producing IL-4 per 100000 PBMC were equivalent (geometric mean: 16 IL-4-producing basophils/100000 PBMC vs 22 IL-4-producing CD4(+) T cells/100000 PBMC). Basophils also released IL-4 in response to both low and high concentrations of BmAg, whereas CD4(+) T cells released IL-4 only after incubation with a high concentration of BmAg, raising the possibility that basophils, due to their lower threshold for activation, may actually release IL-4 more frequently than CD4(+) T cells in vivo. Furthermore, IL-4 production in vitro by Ag-stimulated purified basophils or CD4(+) T cells provided evidence that basophils release greater quantities of IL-4 per cell than CD4(+) T cells in response to BmAg. These results suggest that, when Ag-specific IgE is present in a filaria-infected individual, basophils function to amplify the ongoing Th2 response by releasing IL-4 in greater amounts and possibly more frequently than CD4(+) T cells in response to filarial Ag.
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Affiliation(s)
- Edward Mitre
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
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Ravi V, Kubofcik J, Bandopathyaya S, Geetha M, Narayanan RB, Nutman TB, Kaliraj P. Wuchereria bancrofti: cloning and characterization of heat shock protein 70 from the human lymphatic filarial parasite. Exp Parasitol 2004; 106:1-10. [PMID: 15013783 DOI: 10.1016/j.exppara.2004.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2002] [Revised: 10/08/2003] [Accepted: 01/05/2004] [Indexed: 01/20/2023]
Abstract
Heat shock protein 70 (HSP70) was identified as an immunodominant antigen by screening a Wuchereria bancrofti (Wb) microfilarial cDNA library with pooled Wb-infected sera, with 28% of the immunopositive clones coding for Wb-HSP70. The deduced amino acid sequence showed greater than 97 and 85% identity with HSP70 from filarial nematodes and humans, respectively. Recombinant HSP70 (74 kDa) and a recombinant protein from the C-terminal portion (43 kDa) also reacted with pooled Wb-infected sera, suggesting that the C-terminal region of HSP70 contains at least one antibody epitope. Brugia malayi L3 larvae showed increasing levels of HSP70 with increasing temperatures. Further, a polyclonal mouse anti-Wb-HSP70 antibody had reactivity to the HSP70 of cattle filarial parasite Settaria digitata and to human HSP70 derived from a Hep-2 cell line. Immune reactivity to Wb-HSP70 was strong, with uninfected non-endemic normal sera showing significantly greater reactions than sera from filaria-infected individuals. Both immunodominant self-HSP70 and HSP70 from other microbial infections may be primary targets for developing autoantibodies naturally.
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Affiliation(s)
- V Ravi
- Centre for Biotechnology, Anna University, Chennai, India
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Lobos E, Nutman TB, Hothersall JS, Moncada S. Elevated immunoglobulin E against recombinant Brugia malayi gamma-glutamyl transpeptidase in patients with bancroftian filariasis: association with tropical pulmonary eosinophilia or putative immunity. Infect Immun 2003; 71:747-53. [PMID: 12540554 PMCID: PMC145369 DOI: 10.1128/iai.71.2.747-753.2003] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A major allergen of the lymphatic filarial nematode Brugia malayi, a homologue of gamma-glutamyl transpeptidase (gamma-GT), is involved in the pathology of tropical pulmonary eosinophilia (TPE) through its potent allergenicity and the induction of antibodies against the host pulmonary epithelium. To investigate the immunoglobulin G (IgG) subclass and IgE responses to recombinant B. malayi gamma-GT, we analyzed the results obtained from 51 patients with differing clinical manifestations of bancroftian filariasis. gamma-GT-specific IgG1, rather than IgG4, was the predominant IgG subclass, particularly in patients with TPE (geomean, 6,321 ng/ml; range, 78 to 354,867 ng/ml) and was 75 times higher than in patients with elephantiasis (CP) (P < 0.003) and 185 times higher than in endemic normal individuals (ENL) (P < 0.010). IgG2 responses were low and IgG3 was almost absent, with no significant differences among the groups. gamma-GT-specific IgG4 responses were significantly elevated in those with subclinical microfilaremia (MF) compared to the CP and ENL groups and correlated with the presence of circulating filarial antigen (CAg). More significantly, gamma-GT-specific IgE antibody levels were strikingly elevated in patients with TPE (geomean, 681 ng/ml; range, 61 to 23,841 ng/ml) and in the ENL group (geomean, 106 ng/ml; range, 13 to 1,405 ng/ml) whereas the gamma-GT-specific IgE level was 44 and 61 times lower in those with MF and CP, respectively (P < 0.001). Elevated gamma-GT-specific IgE/IgG4 ratios were demonstrated in patients with TPE (ratio, 45) and ENL (ratio, 107). Because expression of gamma-GT in Brugia infective third-stage larvae (L3) was demonstrated by immunoblot analysis, the elevated gamma-GT-specific IgE antibodies appear to be associated not only with pulmonary pathology but also with possible resistance to infection in lymphatic filariasis.
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Affiliation(s)
- Edgar Lobos
- The Wolfson Institute for Biomedical Research, University College London, United Kingdom.
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Falcone FH, Loke P, Zang X, MacDonald AS, Maizels RM, Allen JE. A Brugia malayi homolog of macrophage migration inhibitory factor reveals an important link between macrophages and eosinophil recruitment during nematode infection. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2001; 167:5348-54. [PMID: 11673551 DOI: 10.4049/jimmunol.167.9.5348] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Infections with the helminth parasite Brugia malayi share many key features with Th2-mediated allergic diseases, including recruitment of eosinophils. We have investigated the dynamics of inflammatory cell recruitment under type 2 cytokine conditions in mice infected with B. malayi. Among the cells recruited to the site of infection is a novel population of "alternatively activated" macrophages that ablate cell proliferation and enhance Th2 differentiation. By profiling gene expression in this macrophage population, we found a dramatic up-regulation of a recently described eosinophil chemotactic factor, eosinophil chemotactic factor-L/Ym1, representing over 9% of clones randomly selected from a cDNA library. Because B. malayi is known to secrete homologs (Bm macrophage migration inhibitory factor (MIF)-1 and -2) of the human cytokine MIF, we chose to investigate the role this cytokine mimic may play in the development of the novel macrophage phenotype observed during infection. Strikingly, administration of soluble recombinant Bm-MIF-1 was able to reproduce the effects of live parasites, leading both to the up-regulation of Ym1 by macrophages and a marked recruitment of eosinophils in vivo. Because activity of Bm-MIF-1 is dependent upon an amino-terminal proline, this residue was mutated to glycine; the resultant recombinant (Bm-MIF-1G) was unable to induce Ym1 transcription in macrophages or to mediate the recruitment of eosinophils. These data suggest that macrophages may provide a crucial link between helminth parasites, their active cytokine mimics, and the recruitment of eosinophils in infection.
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Affiliation(s)
- F H Falcone
- Institute of Cell, Animal and Population Biology, University of Edinburgh, Edinburgh, United Kingdom
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Affiliation(s)
- C M Lloyd
- Leukocyte Biology Section, Biomedical Sciences Division, Imperial College of Science, Technology, and Medicine, London SW7 2AZ, United Kingdom
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Nutman TB, Kumaraswami V. Regulation of the immune response in lymphatic filariasis: perspectives on acute and chronic infection with Wuchereria bancrofti in South India. Parasite Immunol 2001; 23:389-99. [PMID: 11472558 DOI: 10.1046/j.1365-3024.2001.00399.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Delineating the immune responses in lymphatic filariasis has been complicated not only by the rapidly expanding knowledge of new immunological mediators and effortors, but also by new methodologies (in particular, circulating filarial antigen detection) for defining and categorizing filarial-infected individuals. By using assays for circulating antigen in the sera collected as part of the many immunological studies performed on individuals in a Wuchereria bancrofti-endemic region of South India, we have attempted to explore the influence of patency on the antigen-driven proliferative and cytokine responses seen in peripheral blood mononuclear cells of individuals with varying clinical manifestations of lymphatic filarial infection. Moreover, we have provided perspectives on the differences between acute and chronic infection with W. bancrofti and suggested mechanisms that may underly the modulation of the immune response as patency occurs.
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Affiliation(s)
- T B Nutman
- Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-0425, USA
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GUPTA AK, BHADORIA CBS. TROPICAL PULMONARY EOSINOPHILIA: NOCTURNAL SYMPTOMS. Med J Armed Forces India 2001; 57:182-3. [DOI: 10.1016/s0377-1237(01)80159-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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