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Xavier MB, Pires CAA, Gomes CMDC, Rodrigues GF, Xavier DP, de Brito JAGDSM, Corbett CEP. The expression of FOXP3 in lesions of several forms of leprosy in patients co-infected with HIV. PLoS Negl Trop Dis 2021; 15:e0009887. [PMID: 34748560 PMCID: PMC8601607 DOI: 10.1371/journal.pntd.0009887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/18/2021] [Accepted: 10/08/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Brazil remains endemic for infection by the human immunodeficiency virus (HIV) and leprosy, having a major impact on public health and the life quality of affected patients. Although the relevance of this co-infection is recognized, several aspects, such as the immune response, are not yet fully understood. The objective of this study was to investigate the expression of FOXP3+ Treg cells in leprosy skin lesions and to correlate their clinical forms, laboratory characteristics (CD4, CD8, and CV), and the immune reconstitution syndrome in HIV-leprosy co-infection. METHODOLOGY/PRINCIPAL FINDINGS An observational, cross-sectional, and analytical study was carried out comparing four groups of patients: those with concomitant diagnosis of leprosy and HIV infection without a leprosy reaction, those with leprosy and HIV co-infection patients with a reverse reaction (RR), those with leprosy without HIV and without reaction, and those with leprosywithout HIV and with RR. The patients were diagnosed at a dermatology outpatient clinic located in Belém, Pará, Brazil, from 2003 to 2017. In the sample studied, there was a positive correlation between FOXP3+ cell density and viral load, negative correlation with blood CD4+ (not statistically significant), significant positive correlation in CD8 count in patients with leprosy reaction, and positive relationship in patients with IRIS. The density of cells expressing FOXP3 was higher in the BL/LL forms in patients without HIV, although the difference was not statistically significant. However, the cell mean was higher in the TT/BT forms in patients co-infected with leprosy and HIV, showing contradictory results. CONCLUSIONS/SIGNIFICANCE These findings support that higher activity of the HIV may stimulate or result in a higher expression of FOXP3-Tregs and that they may be involved in active immunosuppression observed at the infection site at the tissue level. This supports the need to expand studies on FOXP3+ Treg cells in co-infected patients.
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Affiliation(s)
- Marília Brasil Xavier
- Research Laboratory in Tropical Dermatology and Endemic Diseases of the Nucleus of Tropical Medicine/Federal University of Pará (NMT/UFPA), Belém, Pará, Brazil
- Research Laboratory on Skin diseases of Sanitary Interest, Biological and Health Sciences Center, State University of Pará (UEPA), Belém, Pará, Brazil
| | - Carla Andréa Avelar Pires
- Research Laboratory in Tropical Dermatology and Endemic Diseases of the Nucleus of Tropical Medicine/Federal University of Pará (NMT/UFPA), Belém, Pará, Brazil
- Research Laboratory on Skin diseases of Sanitary Interest, Biological and Health Sciences Center, State University of Pará (UEPA), Belém, Pará, Brazil
| | - Cláudia Maria de Castro Gomes
- Laboratory of Pathology of Infectious Diseases, Department of Pathology, Medical School, São Paulo University, São Paulo, Brazil
| | - Gabriela Fernandes Rodrigues
- Laboratory of Pathology of Infectious Diseases, Department of Pathology, Medical School, São Paulo University, São Paulo, Brazil
| | - Débora Pinheiro Xavier
- Research Laboratory in Tropical Dermatology and Endemic Diseases of the Nucleus of Tropical Medicine/Federal University of Pará (NMT/UFPA), Belém, Pará, Brazil
| | | | - Carlos Eduardo Pereira Corbett
- Laboratory of Pathology of Infectious Diseases, Department of Pathology, Medical School, São Paulo University, São Paulo, Brazil
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Queiroz EA, Medeiros NI, Mattos RT, Pinto BF, Carvalho APM, Dutra WO, Félix-Lana FC, Correa-Oliveira R, Gomes JAS. CCL2 and IFN-γ serum levels as biomarkers for subclinical infection in household contacts of leprosy patients. Microb Pathog 2021; 150:104725. [PMID: 33400985 DOI: 10.1016/j.micpath.2020.104725] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/10/2020] [Accepted: 12/27/2020] [Indexed: 10/22/2022]
Abstract
Leprosy, also known as Hansen's disease, is a long-term infection by the bacteria Mycobacterium leprae, and actually still persists as a serious public health problem. The clinical parameters are used for diagnosis, however, some studies have indicated the selection of a set of biomarkers of subclinical infection, both serological and cellular, that allow the early diagnosis. Some cytokines and chemokines have been differentially expressed in index cases (paucibacillary and multibacillary patients) and household contacts (HHC), and may present a potential biomarker of M. leprae subclinical infection. Thus, the aim of this study was to analyze the variations in the profile of cytokines and chemokines, longitudinally, between index cases and their household contacts with a view to identifying possible biomarkers with differential expression, which may guide the early subclinical infection in household contacts. A longitudinal study was carried out between 2014 and 2015. The serum levels of the cytokines and chemokines were measured in all patient samples by CBA (Cytometric Bead Array). We observed a reduction of IL-4 and IL-17 expression of HHC group in the second evaluation (T1), as also a reduction of IL-17 in MB. We observed increased expression of IL-2 in PB patients as well. HHC, PB and MB showed a similar reduction profile of the chemokines CXCL8, CXCL9 and CXCL10 from T0 to T1. Interestingly, only serological levels of CCL2 are increased after a follow-up of HHC group, and this group, but not PB and MB patients, showed a significant association and a negative correlation between CCL2 and IFN-γ. The present study showed for the first time a similarity in the immunological scenario between HHC, PB and MB patients. In addition, this work highlights CCL2 chemokine in association with IFN-γ as possible biomarkers of subclinical infection of HHC, as also a parameter of early infection monitoring.
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Affiliation(s)
- Edson A Queiroz
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Nayara I Medeiros
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rafael T Mattos
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Bruna F Pinto
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Paula M Carvalho
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Walderez O Dutra
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Rodrigo Correa-Oliveira
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Imunologia Celular e Molecular, Instituto René Rachou, Fundação Oswaldo Cruz - FIOCRUZ, Belo Horizonte, MG, Brazil
| | - Juliana A S Gomes
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Mendes ALG, Joaquim HDM, Zamae MIS, Assis RM, Peixoto JRDM, de Araújo MMG, Guedes ACM, Oliveira EJ, Magalhães VP, Pascoal-Xavier MA. Expression of NLRP3 inflammasome in leprosy indicates immune evasion of Mycobacterium leprae. Mem Inst Oswaldo Cruz 2020; 115:e190324. [PMID: 32130367 PMCID: PMC7046136 DOI: 10.1590/0074-02760190324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 01/22/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Leprosy is an infectious-contagious disease caused by Mycobacterium
leprae that remain endemic in 105 countries. This neglected
disease has a wide range of clinical and histopathological manifestations
that are related to the host inflammatory and immune responses. More
recently, the inflammasome has assumed a relevant role in the inflammatory
response against microbiological agents. However, the involvement of
inflammasome in leprosy remains poorly understood. OBJECTIVES The aim is to associate biomarkers of inflammasome with the different
immunopathological forms of leprosy. METHODS We performed an observational, cross-sectional, and comparative study of the
immunophenotypic expression of inflammasome-associated proteins in
immunopathological forms of leprosy of 99 skin lesion samples by
immunohistochemistry. The intensity and percentage of NLRP3, Caspase-1,
Caspases-4/5, interleukin-1β and interleukin-18 immunoreactivities in the
inflammatory infiltrate of skin biopsies were evaluated. FINDINGS Strong expression of NLRP3 and inflammatory Caspases-4/5 were observed in
lepromatous leprosy (lepromatous pole). In addition, were observed low
expression of caspase-1, interleukin-1β, and interleukin-18 in tuberculoid
and lepromatous leprosy. The interpolar or borderline form showed
immunophenotype predominantly similar to the lepromatous pole. MAIN CONCLUSIONS Our results demonstrate that the NLRP3 inflammasome is inactive in leprosy,
suggesting immune evasion of M. leprae.
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Affiliation(s)
- Ana Luisa Gomes Mendes
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil
| | - Heloísa Di Matteo Joaquim
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil
| | - Mara Inês Stefanini Zamae
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil
| | - Ramon Meira Assis
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil
| | - Jéssica Renata de Moura Peixoto
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil
| | - Margarida Maria Gomes de Araújo
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil
| | - Antônio Carlos Martins Guedes
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte, MG, Brasil
| | - Edward José Oliveira
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Belo Horizonte, MG, Brasil
| | | | - Marcelo Antônio Pascoal-Xavier
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Belo Horizonte, MG, Brasil
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Organization of the Skin Immune System and Compartmentalized Immune Responses in Infectious Diseases. Clin Microbiol Rev 2019; 32:32/4/e00034-18. [PMID: 31366611 DOI: 10.1128/cmr.00034-18] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The skin is an organ harboring several types of immune cells that participate in innate and adaptive immune responses. The immune system of the skin comprises both skin cells and professional immune cells that together constitute what is designated skin-associated lymphoid tissue (SALT). In this review, I extensively discuss the organization of SALT and the mechanisms involved in its responses to infectious diseases of the skin and mucosa. The nature of these SALT responses, and the cellular mediators involved, often determines the clinical course of such infections. I list and describe the components of innate immunity, such as the roles of the keratinocyte barrier and of inflammatory and natural killer cells. I also examine the mechanisms involved in adaptive immune responses, with emphasis on new cytokine profiles, and the role of cell death phenomena in host-pathogen interactions and control of the immune responses to infectious agents. Finally, I highlight the importance of studying SALT in order to better understand host-pathogen relationships involving the skin and detail future directions in the immunological investigation of this organ, especially in light of recent findings regarding the skin immune system.
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Silva LM, de Sousa JR, Hirai KE, Dias LB, Furlaneto IP, Carneiro FRO, de Souza Aarão TL, Sotto MN, Quaresma JAS. The inflammasome in leprosy skin lesions: an immunohistochemical evaluation. Infect Drug Resist 2018; 11:2231-2240. [PMID: 30519061 PMCID: PMC6237140 DOI: 10.2147/idr.s172806] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objective Leprosy is a chronic infectious disease presenting with a spectrum of clinical manifestations that correspond to the type of immune response that develops in the host. Factors that may be involved in this process include inflammasomes, cytosolic proteins responsible for the activation of caspase 1, IL-1β and IL-18 secretion, and induction of a type of death called pyroptosis. Patients and methods We evaluated the expression of inflammasome markers (nucleotide-binding oligomerization domain-like receptor containing pyrin domain 1 [NLRP1], nucleotide-binding oligomerization domain-like receptor containing pyrin domain 3 [NLRP3], caspase 1, IL-1β, and IL-18) by immunohistochemistry in 43 samples of skin lesions of leprosy patients from the groups indeterminate (I) leprosy (13 patients), tuberculoid (TT) leprosy (15 patients), and lepromatous leprosy (LL; 15 patients). Results The evaluated markers were most upregulated in LL lesions, followed by lesions of TT leprosy and I leprosy. Differences were statistically significant between the I leprosy and LL leprosy forms and between the I leprosy and TT leprosy forms. Positive and significant correlations were found between IL-18 and caspase 1 in LL (r=0.7516, P=0.0012) and TT leprosy (r=0.7366, P=0.0017). In I leprosy, correlations were detected between caspase 1 and IL-1β (r=0.6412, P=0.0182), NLRP1 and IL-18 (r=0.5585, P=0.473), NLRP3 and IL-18 (r=0.6873, P=0.0094), and NLRP1 and NLRP3 (r=0.8040, P=0.0009). Conclusion The expression of inflammasome markers in LL lesions indicates the ineffectiveness of this protein complex in controlling the infection. Caspase 1 may be involved in the pyroptotic cell death in the lepromatous form of the disease. Inflammasomes may act together in the initial phase of I leprosy; this phenomenon may influence the clinical outcome of the disease.
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Affiliation(s)
- Luciana Mota Silva
- Center of Biological and Health Science, State University of Para, Belem, Brazil,
| | - Jorge Rodrigues de Sousa
- Tropical Medicine Center, Federal Do Para University, Belem, Brazil, .,Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil,
| | - Kelly Emi Hirai
- Center of Biological and Health Science, State University of Para, Belem, Brazil,
| | - Leônidas Braga Dias
- Center of Biological and Health Science, State University of Para, Belem, Brazil,
| | | | | | | | - Mirian Nacagami Sotto
- School of Medicine, Sao Paulo University, Sao Paulo, Brazil.,Tropical Medicine Institute, Sao Paulo University, Sao Paulo, Brazil,
| | - Juarez Antonio Simões Quaresma
- Center of Biological and Health Science, State University of Para, Belem, Brazil, .,Tropical Medicine Center, Federal Do Para University, Belem, Brazil, .,Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil, .,Tropical Medicine Institute, Sao Paulo University, Sao Paulo, Brazil,
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Shah JA, Berrington WR, Vary JC, Wells RD, Peterson GJ, Kunwar CB, Khadge S, Hagge DA, Hawn TR. Genetic Variation in Toll-Interacting Protein Is Associated With Leprosy Susceptibility and Cutaneous Expression of Interleukin 1 Receptor Antagonist. J Infect Dis 2015; 213:1189-97. [PMID: 26610735 DOI: 10.1093/infdis/jiv570] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 11/19/2015] [Indexed: 01/03/2023] Open
Abstract
Leprosy is a chronic disease characterized by skin and peripheral nerve pathology and immune responses that fail to control Mycobacterium leprae. Toll-interacting protein (TOLLIP) regulates Toll-like receptor (TLR) and interleukin 1 receptor (IL-1R) signaling against mycobacteria. We analyzed messenger RNA (mRNA) expression of candidate immune genes in skin biopsy specimens from 85 individuals with leprosy. TOLLIP mRNA was highly and specifically correlated with IL-1R antagonist (IL-1Ra). In a case-control gene-association study with 477 cases and 1021 controls in Nepal, TOLLIP single-nucleotide polymorphism rs3793964 TT genotype was associated with increased susceptibility to leprosy (recessive, P = 1.4 × 10(-3)) and with increased skin expression of TOLLIP and IL-1Ra. Stimulation of TOLLIP-deficient monocytes with M. leprae produced significantly less IL-1Ra (P < .001), compared with control. These data suggest that M. leprae upregulates IL-1Ra by a TOLLIP-dependent mechanism. Inhibition of TOLLIP may decrease an individual's susceptibility to leprosy and offer a novel therapeutic target for IL-1-dependent diseases.
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Affiliation(s)
- Javeed A Shah
- University of Washington School of Medicine, Seattle, Washington
| | | | - James C Vary
- University of Washington School of Medicine, Seattle, Washington Puget Sound VA Health Care System, Seattle, Washington
| | - Richard D Wells
- University of Washington School of Medicine, Seattle, Washington
| | | | - Chhatra B Kunwar
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Saraswoti Khadge
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Deanna A Hagge
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Thomas R Hawn
- University of Washington School of Medicine, Seattle, Washington
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