1
|
Adem E, Yizengaw E, Mulaw T, Nibret E, Müller I, Takele Y, Kropf P. Altered co-stimulatory and inhibitory receptors on monocyte subsets in patients with visceral leishmaniasis. PLoS Negl Trop Dis 2024; 18:e0012417. [PMID: 39159266 DOI: 10.1371/journal.pntd.0012417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 07/30/2024] [Indexed: 08/21/2024] Open
Abstract
Visceral leishmaniasis (VL) is a neglected tropical disease caused by parasites from the Leishmania (L.) donovani complex. VL is characterised by uncontrolled parasite replication in spleen, liver and bone marrow, and by an impaired immune response and high systemic levels of inflammation. Monocytes have been poorly characterised in VL patients. The aim of this study was to evaluate the expression levels of markers involved in the regulation of T cell responses on different subsets of monocytes from the blood of VL patients and healthy non-endemic controls (HNEC). Monocytes can broadly be divided into three subsets: classical, intermediate and non-classical monocytes. Our results show that the percentages of all three subsets stay similar at the time of VL diagnosis (ToD) and at the end of anti-leishmanial treatment (EoT). We first looked at co-stimulatory receptors: the expression levels of CD40 were significantly increased on classical and intermediate, but not non-classical monocytes, at ToD as compared to EoT and HNEC. CD80 expression levels were also increased on intermediate monocytes at ToD as compared to EoT and HNEC, and on classical monocytes only as compared to HNEC. The levels of CD86 were similar at EoT and ToD and in HNEC on classical and intermediate monocytes, but significantly higher at EoT on non-classical monocytes. We also looked at an inhibitory molecule, PD-L1. Our results show that the expression levels of PD-L1 is significantly higher on all three monocyte subsets at ToD as compared to HNEC, and to EoT on classical and intermediate monocytes. These results show that monocytes from the blood of VL patients upregulate both co-stimulatory and inhibitory receptors and that their expression levels are restored at EoT.
Collapse
Affiliation(s)
- Emebet Adem
- Leishmaniasis Research and Treatment Centre, University of Gondar, Gondar, Ethiopia
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Endalew Yizengaw
- Department of Medical Laboratory Science, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
- Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Tadele Mulaw
- Leishmaniasis Research and Treatment Centre, University of Gondar, Gondar, Ethiopia
| | - Endalkachew Nibret
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
- Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ingrid Müller
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Yegnasew Takele
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Pascale Kropf
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| |
Collapse
|
2
|
Takele Y, Mulaw T, Adem E, Womersley R, Kaforou M, Franssen SU, Levin M, Taylor GP, Müller I, Cotton JA, Kropf P. Recurrent visceral leishmaniasis relapses in HIV co-infected patients are characterized by less efficient immune responses and higher parasite load. iScience 2023; 26:105867. [PMID: 36685039 PMCID: PMC9845767 DOI: 10.1016/j.isci.2022.105867] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/13/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Visceral leishmaniasis (VL) and HIV co-infection (VL/HIV) has emerged as a significant public health problem in Ethiopia, with up to 30% of patients with VL co-infected with HIV. These patients suffer from recurrent VL relapses and increased mortality. Those with a previous history of VL relapses (recurrent VL/HIV) experience increased VL relapses as compared to patients with HIV presenting with their first episode of VL (primary VL/HIV). Our aim was to identify drivers that account for the higher rate of VL relapses in patients with recurrent VL/HIV (n = 28) as compared to primary VL/HIV (n = 21). Our results show that the relapse-free survival in patients with recurrent VL/HIV was shorter, that they had higher parasite load, lower weight gain, and lower recovery of all blood cell lineages. Their poorer prognosis was characterized by lower production of IFN-gamma, lower CD4+ T cell counts, and higher expression of programmed cell death protein 1 (PD1) on T cells.
Collapse
Affiliation(s)
- Yegnasew Takele
- Department of Infectious Disease, Imperial College London, London, UK
- Leishmaniasis Research and Treatment Centre, University of Gondar, Gondar, Ethiopia
| | - Tadele Mulaw
- Leishmaniasis Research and Treatment Centre, University of Gondar, Gondar, Ethiopia
| | - Emebet Adem
- Leishmaniasis Research and Treatment Centre, University of Gondar, Gondar, Ethiopia
| | - Rebecca Womersley
- Department of Infectious Disease, Imperial College London, London, UK
| | - Myrsini Kaforou
- Department of Infectious Disease, Imperial College London, London, UK
| | | | - Michael Levin
- Department of Infectious Disease, Imperial College London, London, UK
| | | | - Ingrid Müller
- Department of Infectious Disease, Imperial College London, London, UK
| | | | - Pascale Kropf
- Department of Infectious Disease, Imperial College London, London, UK
| |
Collapse
|
3
|
Magalhães LS, Melo EV, Damascena NP, Albuquerque ACB, Santos CNO, Rebouças MC, Bezerra MDO, Louzada da Silva R, de Oliveira FA, Santos PL, da Silva JS, Lipscomb MW, da Silva ÂM, de Jesus AR, de Almeida RP. Use of N-acetylcysteine as treatment adjuvant regulates immune response in visceral leishmaniasis: Pilot clinical trial and in vitro experiments. Front Cell Infect Microbiol 2022; 12:1045668. [PMID: 36506010 PMCID: PMC9730326 DOI: 10.3389/fcimb.2022.1045668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/03/2022] [Indexed: 11/25/2022] Open
Abstract
This investigation aimed to assess the effect of N-acetylcysteine (NAC) as an adjuvant treatment to alleviate visceral leishmaniasis (VL). The present work includes both blinded randomized clinical intervention and experimental in vitro studies. The clinical trial included 60 patients with VL randomly allocated into two groups: a test group (n = 30) treated with meglumine antimoniate plus NAC (SbV + NAC) and a control group (n = 30) treated with meglumine antimoniate only (SbV). The primary outcome was clinical cure (absence of fever, spleen and liver sizes reduction, and hematological improvement) in 180 days. The cure rate did not differ between the groups; both groups had similar results in all readout indices. The immunological parameters of the patients treated with SbV + NAC showed higher sCD40L in sera during treatment, and the levels of sCD40L were negatively correlated with Interleukin-10 (IL-10) serum levels. In addition, data estimation showed a negative correlation between the sCD40L levels and the spleen size in patients with VL. For the in vitro experiments, peripheral blood mononuclear cells (PBMCs) or PBMC-derived macrophages from healthy donors were exposed to soluble Leishmania antigen (SLA) or infected with stationary promastigotes of Leishmania infantum in the presence or absence of NAC. Results revealed that NAC treatment of SLA-stimulated PBMCs reduces the frequency of monocytes producing IL-10 and lowers the frequency of CD4+ and CD8+ T cells expressing (pro-)inflammatory cytokines. Together, these results suggest that NAC treatment may modulate the immune response in patients with VL, thus warranting additional investigations to support its case use as an adjuvant to antimony therapy for VL.
Collapse
Affiliation(s)
- Lucas Sousa Magalhães
- Laboratory of Immunology and Molecular Biology, University Hospital, Federal University of Sergipe, Aracaju, Brazil,Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil,Sector of Parasitology and Pathology, Biological and Health Sciences Institute, Federal University of Alagoas, Maceió, Brazil
| | - Enaldo Vieira Melo
- Department of Medicine, University Hospital-Empresa Brasileira de Serviços Hospitalares (EBSERH), Federal University of Sergipe, Aracaju, Brazil
| | - Nayra Prata Damascena
- Department of Medicine, University Hospital-Empresa Brasileira de Serviços Hospitalares (EBSERH), Federal University of Sergipe, Aracaju, Brazil
| | - Adriana Cardoso Batista Albuquerque
- Department of Medicine, University Hospital-Empresa Brasileira de Serviços Hospitalares (EBSERH), Federal University of Sergipe, Aracaju, Brazil
| | - Camilla Natália Oliveira Santos
- Laboratory of Immunology and Molecular Biology, University Hospital, Federal University of Sergipe, Aracaju, Brazil,Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil
| | - Mônica Cardozo Rebouças
- Laboratory of Immunology and Molecular Biology, University Hospital, Federal University of Sergipe, Aracaju, Brazil
| | - Mariana de Oliveira Bezerra
- Laboratory of Immunology and Molecular Biology, University Hospital, Federal University of Sergipe, Aracaju, Brazil,Department of Medicine, University Hospital-Empresa Brasileira de Serviços Hospitalares (EBSERH), Federal University of Sergipe, Aracaju, Brazil
| | - Ricardo Louzada da Silva
- Laboratory of Immunology and Molecular Biology, University Hospital, Federal University of Sergipe, Aracaju, Brazil,Department of Health Education, Federal University of Sergipe, Lagarto, Brazil
| | - Fabricia Alvisi de Oliveira
- Laboratory of Immunology and Molecular Biology, University Hospital, Federal University of Sergipe, Aracaju, Brazil
| | - Priscila Lima Santos
- Laboratory of Immunology and Molecular Biology, University Hospital, Federal University of Sergipe, Aracaju, Brazil,Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil,Department of Health Education, Federal University of Sergipe, Lagarto, Brazil
| | - João Santana da Silva
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Ângela Maria da Silva
- Laboratory of Immunology and Molecular Biology, University Hospital, Federal University of Sergipe, Aracaju, Brazil,Department of Medicine, University Hospital-Empresa Brasileira de Serviços Hospitalares (EBSERH), Federal University of Sergipe, Aracaju, Brazil
| | - Amélia Ribeiro de Jesus
- Laboratory of Immunology and Molecular Biology, University Hospital, Federal University of Sergipe, Aracaju, Brazil,Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil,Department of Medicine, University Hospital-Empresa Brasileira de Serviços Hospitalares (EBSERH), Federal University of Sergipe, Aracaju, Brazil,Immunology Institute of Investigation (iii), National Institute of Science and Technology (INCT), Brazilian Research and Technology Council (CNPq), São Paulo, Brazil
| | - Roque Pacheco de Almeida
- Laboratory of Immunology and Molecular Biology, University Hospital, Federal University of Sergipe, Aracaju, Brazil,Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil,Department of Medicine, University Hospital-Empresa Brasileira de Serviços Hospitalares (EBSERH), Federal University of Sergipe, Aracaju, Brazil,Immunology Institute of Investigation (iii), National Institute of Science and Technology (INCT), Brazilian Research and Technology Council (CNPq), São Paulo, Brazil,*Correspondence: Roque Pacheco de Almeida,
| |
Collapse
|
4
|
Ibarra-Meneses AV, Corbeil A, Wagner V, Onwuchekwa C, Fernandez-Prada C. Identification of asymptomatic Leishmania infections: a scoping review. Parasit Vectors 2022; 15:5. [PMID: 34983616 PMCID: PMC8727076 DOI: 10.1186/s13071-021-05129-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/11/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Asymptomatic Leishmania infection may play an important role in the transmission of the parasite in endemic areas. At present there is no consensus on the definition of asymptomatic Leishmania infection, nor is there a safe and accessible gold standard test for its identification. METHODS This paper presents a scoping review to summarize definitions of asymptomatic Leishmania infection found in the literature, as well as to detail the approach (molecular, serological, cellular, and/or parasitological tests) used by researchers to identify this asymptomatic population. A scoping review of published and gray literature related to asymptomatic Leishmania infection was conducted; retrieved citations were screened based on predefined eligibility criteria, and relevant data items were extracted from eligible articles. The analysis is descriptive and is presented using tables, figures, and thematic narrative synthesis. RESULTS We conducted a screening of 3008 articles, of which 175 were selected for the full review. Of these articles, we selected 106 that met the inclusion criteria. These articles were published between 1991 and 2021, and in the last 5 years, up to 38 articles were reported. Most of the studies were conducted in Brazil (26%), Spain (14%), India (12%), Bangladesh (10%), and Ethiopia (7%). Of the studies, 84.9% were conducted in the immunocompetent population, while 15.1% were conducted in the immunosuppressed population (HIV, immunosuppressive drugs, and organ transplantation population). We report 14 different techniques and 10 strategies employed by researchers to define asymptomatic Leishmania infection in an endemic area. CONCLUSIONS The definition of asymptomatic Leishmania infection is not unified across the literature, but often includes the following criteria: residence (or extended stay) in a Leishmania-endemic area, no reported signs/symptoms compatible with leishmaniasis, and positive on a combination of serological, molecular, cellular, and/or parasitological tests. Caution is recommended when comparing results of different studies on the subject of asymptomatic infections, as the reported prevalence cannot be confidently compared between areas due to the wide variety of tests employed by research groups. More research on the importance of asymptomatic immunosuppressed and immunocompetent Leishmania-positive populations in leishmaniasis epidemiology is required.
Collapse
Affiliation(s)
- Ana Victoria Ibarra-Meneses
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, Canada
| | - Audrey Corbeil
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, Canada
| | - Victoria Wagner
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, Canada
| | - Chukwuemeka Onwuchekwa
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Christopher Fernandez-Prada
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada. .,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, Canada.
| |
Collapse
|
5
|
Ferreira GR, Santos-Oliveira JR, Silva-Freitas ML, Honda M, Costa DL, Da-Cruz AM, Costa CHN. Biomarkers of disease severity in patients with visceral leishmaniasis co-infected with HIV. Cytokine 2021; 149:155747. [PMID: 34715475 DOI: 10.1016/j.cyto.2021.155747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 10/06/2021] [Accepted: 10/09/2021] [Indexed: 12/30/2022]
Abstract
Visceral leishmaniasis (VL) is caused by the protozoan Leishmania spp, transmitted by sand fly bites. VL is one of the deadliest tropical infection diseases, yet the coinfection with HIV virus drastically increases relapses, treatment failure and mortality. The concomitant action of these two pathogens leads to high cellular activation independently of the progression to AIDS. In addition, microbial translocation and bacterial infections are thought to contribute worsening the clinical picture. Identifying biomarkers associated with disease severity is of interest for clinical management of patients with VL-HIV/AIDS. Thus, we analyzed in the sera several markers including interleukins (IL-1β, IL-6, IL-8, and IL-17), interferon-γ (IFN- γ), tumor necrosis factor (TNF), lipopolysaccharide (LPS), soluble CD14 (sCD14), macrophage migration inhibitory factor (MIF) and intestinal fatty acid-binding protein (IFABP). These markers were compared with disease severity in 24 patients with VL/HIV presenting different clinical outcomes. Disease severity was defined by the probability of death calculated using a score set system derived by the Kala-Cal® software. Probability of death ranged from 3.7% to 97.9%, with median of 28.8%. Five patients died (20%). At the univariate analysis, disease severity was correlated with TNF, IFN-γ and sCD14. LPS was positively correlated with sCD14 specifically in patients with low CD4+ count (CD4+ T-cell <200 cells/mL). Most importantly, the multivariate analysis including LPS, CD4+count and sCD14 showed that sCD14 was the only independent predictor for disease severity and death. Altogether, our results indicated that sCD14 is a powerful marker of pathogenicity and death for patients with VL-HIV/AIDS.
Collapse
Affiliation(s)
- Gabriel Reis Ferreira
- Department of Microbiology-Infectious Disease and Immunology, Faculty of Medicine, University Laval, Quebec, Canada; Leishmaniasis Research Laboratory at Natan Portella Tropical Diseases Institute, Teresina, Brazil.
| | | | | | | | - Dorcas Lamounier Costa
- Leishmaniasis Research Laboratory at Natan Portella Tropical Diseases Institute, Teresina, Brazil; Centro de Inteligência em Agravos Tropicais Emergentes e Negligenciados, Teresina, Brazil; Universidade Federal do Piauí, Teresina, Brazil
| | | | - Carlos Henrique Nery Costa
- Leishmaniasis Research Laboratory at Natan Portella Tropical Diseases Institute, Teresina, Brazil; Centro de Inteligência em Agravos Tropicais Emergentes e Negligenciados, Teresina, Brazil; Universidade Federal do Piauí, Teresina, Brazil
| |
Collapse
|
6
|
Marimuthu S, Selvam R, Kaninathan A, D'Souza P. Effect of dietary supplementation of phytogenic feed additive on performance traits, serum neopterin, and cutaneous basophil hypersensitivity response in heat-induced stress model of broiler chickens. J Adv Vet Anim Res 2020; 7:141-147. [PMID: 32219120 PMCID: PMC7096127 DOI: 10.5455/javar.2020.g403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 12/14/2019] [Accepted: 12/16/2019] [Indexed: 11/03/2022] Open
Abstract
Objective The trial was aimed at assessing the effect of phytogenic feed additive (PFA), a natural adaptogen, on growth performance, serum neopterin level, and cutaneous basophil hypersensitivity (CBH) response in heat-induced stress model of broilers. Materials and Methods One-day-old Ross 308 chicks (N = 360) were randomly distributed among normal control (NOR), heat-stress control (HSC), and PFA treatment (HSC plus PFA at 200 gm/ton of feed) group. HSC and PFA groups were subjected to heat stress (HS) (32°C-36°C) from 9:00 a.m. to 5:00 p.m. for 35 days. The impact of HS on growth performance, serum neopterin level, and CBH response was assessed. Results High ambient temperature worsened the performance traits [bodyweight (p < 0.05) and feed conversion ratio] and significantly lowered the serum neopterin level and CBH response in the HSC group when compared to the NOR group. However, supplementation of PFA at 200 gm/ton of feed to birds mitigated the detrimental effects of HS. Conclusion PFA at 200 gm/ton demonstrated the immunomodulatory effect through the restoration of serum neopterin level, CBH response, and growth performance traits in heat-stressed broiler chickens. Thus, PFA can be used as a natural adaptogen to increase the stress resistance and mitigate the negative consequences of various stressors in broiler chickens.
Collapse
Affiliation(s)
- Saravanakumar Marimuthu
- Animal Health Science Department, Natural Remedies Pvt. Ltd., # 5B, Veera Sandra Industrial Area, Electronic City Phase-II, Bengaluru 560100, India
| | - Ramasamy Selvam
- Techno commercial Marketing, Natural Remedies Pvt. Ltd., # 5B, Veera Sandra Industrial Area, Electronic City Phase-II, Bengaluru 560100, India
| | - Arigesavan Kaninathan
- Animal Health Science Department, Natural Remedies Pvt. Ltd., # 5B, Veera Sandra Industrial Area, Electronic City Phase-II, Bengaluru 560100, India
| | - Prashanth D'Souza
- Animal Health Science Department, Natural Remedies Pvt. Ltd., # 5B, Veera Sandra Industrial Area, Electronic City Phase-II, Bengaluru 560100, India
| |
Collapse
|