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Yizengaw E, Nibret E, Yismaw G, Gashaw B, Tamiru D, Munshea A, Takele Y, Müller I, Chapman L, Weller R, Cotton JA, Kropf P. Cutaneous leishmaniasis in a newly established treatment centre in the Lay Gayint district, Northwest Ethiopia. SKIN HEALTH AND DISEASE 2023; 3:e229. [PMID: 37538321 PMCID: PMC10395643 DOI: 10.1002/ski2.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/02/2023] [Accepted: 03/02/2023] [Indexed: 08/05/2023]
Abstract
Background Cutaneous leishmaniasis (CL) is a neglected tropical disease that primarily affects the most vulnerable populations. In Ethiopia, where this study took place, CL is an important health problem, however, the incidence of CL is poorly monitored. Objectives This study took place in a recently established CL treatment centre, at Nefas Mewcha Hospital, Lay Gayint. This area was considered to be endemic for CL, however, no cases of CL from Lay Gayint had previously been officially reported to the Amhara Regional Health Bureau. Methods Following a CL awareness campaign, a retrospective data review was performed of patients presenting to this centre between July 2019 and March 2021. Basic demographic and clinical data were collected by a nurse and recorded in the logbook of the CL treatment centre. Results Two hundred and one patients presented for diagnosis and treatment. The age of the patients ranged from 2 to 75 years and 63.2% were males. Most patients were between 10- and 19-years-old. The majority (79.1%) of the patients presented with localised cutaneous leishmaniasis and 20.9% with mucocutaneous leishmaniasis. 98% of the patients tested positive for Leishmania parasites by microscopy. Conclusions This work underpinned how CL is a major public health problem in the Lay Gayint district. It also shows that raising awareness about CL in the community and providing diagnosis and treatment encouraged patients to travel to seek diagnosis and treatment.
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Affiliation(s)
- Endalew Yizengaw
- Department of Medical Laboratory ScienceCollege of Medicine and Health ScienceBahir Dar UniversityBahir DarEthiopia
- Institute of BiotechnologyBahir Dar UniversityBahir DarEthiopia
- Amhara Public Health InstituteBahir DarEthiopia
| | - Endalkachew Nibret
- Institute of BiotechnologyBahir Dar UniversityBahir DarEthiopia
- Department of BiologyCollege of ScienceBahir Dar UniversityBahir DarEthiopia
| | | | - Bizuayehu Gashaw
- Amhara Public Health InstituteBahir DarEthiopia
- Department of BiologyCollege of ScienceBahir Dar UniversityBahir DarEthiopia
| | | | - Abaineh Munshea
- Institute of BiotechnologyBahir Dar UniversityBahir DarEthiopia
- Department of BiologyCollege of ScienceBahir Dar UniversityBahir DarEthiopia
| | - Yegnasew Takele
- Department of Infectious DiseaseImperial College LondonLondonUK
| | - Ingrid Müller
- Department of Infectious DiseaseImperial College LondonLondonUK
| | - Lloyd Chapman
- Department of DermatologyUniversity of EdinburghEdinburghUK
| | - Richard Weller
- Department of Infectious Disease and EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUK
| | - James A. Cotton
- School of BiodiversityOne Health and Veterinary MedicineWellcome Centre for Integrative ParasitologyCollege of MedicalVeterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Pascale Kropf
- Department of Infectious DiseaseImperial College LondonLondonUK
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2
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Alzahrani MJ, Elfaki N, Abdalla YHA, Alkhadher MA, Ali MHM, Ahmed WAM. Cutaneous Leishmaniasis: Associated Risk Factors and Prevention in Hubuna, Najran, Saudi Arabia. Int J Gen Med 2023; 16:723-731. [PMID: 36872939 PMCID: PMC9984274 DOI: 10.2147/ijgm.s401618] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/16/2023] [Indexed: 03/02/2023] Open
Abstract
Background Many countries are currently affected by leishmaniasis, and cutaneous leishmaniasis is ranked among the ten most neglected diseases. The aim of this study was to determine the risk factors related to cutaneous leishmaniasis and preventive measures among people living in Hubuna, Najran, Saudi Arabia. Methods A community-based cross-sectional survey was conducted from January to October 2022. A convenience sampling technique was used, with 396 individuals invited to participate in the current study and 391 included. A self-administered questionnaire was utilized for collecting data. Descriptive analysis was used for risk factors and preventive measures, while χ2 tests were used for determining associations with risk factors. Results Among participants, 38.1% (n=149) reported having cutaneous leishmaniasis clinically diagnosed and under treatment. Age 0-10 years was found to be associated significantly with cutaneous leishmaniasis infection (AOR 3.08, 95% CI 1.6-6.4; P=0.002) compared to other groups. A significant association was noted too for those residing in/around planted areas versus those who were not (AOR 1.18, 95% CI 0.13-2.24; P<0.001). In terms of occupation, farming was significantly associated with cutaneous leishmaniasis (AOR 2.54, 95% CI 1.15-3.76; P=0.010). No significant associations were observed in regard to sex (AOR 1.4, 95% CI 0.7-1.6; P=0.11), education (P=0.072), or preventive measures used (P>0.05). Conclusion The cutaneous leishmaniasis endemicity level in Hubuna was high. Several socioeconomic and environmental factors contribute enormously to the spread of the disease in the area. Further investigation of risk factors of cutaneous leishmaniasis all over the country and setting up appropriate interventions to prevent its spread are recommended.
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Affiliation(s)
| | - Nahid Elfaki
- Community Health Nursing Department, College of Nursing, Najran University, Najran, Saudi Arabia
| | | | - Mugahed Ali Alkhadher
- Medical and Surgical Nursing Department, College of Nursing, Najran University, Najran, Saudi Arabia
| | - Maha Hamed Mohamed Ali
- Public Health Department, Faculty of Applied Medical Sciences, King Khalid University, Khamis Mushait, Saudi Arabia
| | - Waled A M Ahmed
- Nursing Department, Faculty of Applied Medical Sciences, Albaha University, Al-Baha, Saudi Arabia
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3
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Naz S, Aroosh A, Raza N, Islam A, Ozbel Y, Toz S, Ahmed H, Waseem S. Multiparametric approach to assess the disease severity and progression of cutaneous leishmaniasis infection. Acta Trop 2022; 235:106659. [PMID: 35988821 DOI: 10.1016/j.actatropica.2022.106659] [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: 04/02/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 01/08/2023]
Abstract
The pathophysiology of Cutaneous Leishmaniasis (CL), an infection caused by Leishmania tropica (L. tropica) and Leishmania major (L. major) is primarily determined by inflammation-mediated immune cells. The immune response mainly depends on cells and molecules related to T-cells that influence susceptibility and disease development. Understanding the immunological mechanisms that cause tissue injury or lesion healing is critical for developing appropriate treatment strategies. In the present study, T-cells profile and cell-free mitochondrial DNA (CF mt-DNA) were investigated in CL patients infected with L. tropica (n = 34) and L. major (n = 2) and compared with non-infected healthy controls (n = 20). There was a significant (p<0.0001) difference between CD4+ T-cells among L. tropica and L. major CL-infected groups as compared to control while no significant difference (p = 0.8597) was found in the percentages of CD8+ T-cells. When L. tropica and L. major CL-infected individuals were compared to controls, the levels of IL-4 and expression of CF mt-DNA were significantly higher (p<0.0001). Higher levels of CF mt-DNA were detected in CL patients, irrespective of the infective Leishmania species. We proposed that the levels of CF mt-DNA and IL-4 in CL-infected individuals can be used to determine the disease progression. A better understanding of these biomarkers and evaluation of the immune responses in CL patients might benefit the development of vaccines and immunotherapies.
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Affiliation(s)
- Shumaila Naz
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan.
| | - Aiman Aroosh
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Naeem Raza
- Department of Dermatology, Pak Emirates Military Hospital (MH), Rawalpindi, Pakistan
| | - Arshad Islam
- Department of Pathology, Government Lady Reading Hospital Medical Teaching Institution, Peshawar, Pakistan
| | - Yusuf Ozbel
- Department of Parasitology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Seray Toz
- Department of Parasitology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Haroon Ahmed
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
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4
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Haghdoust S, Noroozbeygi M, Hajimollahoseini M, Masooleh MM, Yeganeh F. A candidate vaccine composed of live nonpathogenic Iranian Lizard Leishmania mixed with Chitin microparticles protects mice against Leishmania major infection. Acta Trop 2022; 227:106298. [PMID: 34971566 DOI: 10.1016/j.actatropica.2021.106298] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 12/26/2021] [Accepted: 12/27/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND The protective effect of immunization using Iranian Lizard Leishmania (ILL) mixed with CpG oligodeoxynucleotides (CpG-ODN) was demonstrated in a previous study. Here, we report the effect of leishmanization using ILL mixed with chitin microparticles (CMPs) as an adjuvant against L. major infection in BALB/c mice. METHODS Briefly, 2 × 107 live ILL were mixed with 10 µg CMPs (<40 μm in size) (ILL+CMP) and were injected subcutaneously into the right footpad of BALB/c mice. Three control groups were included in the study and received ILL, chitin, and PBS respectively. Three weeks later, mice were challenged with 2 × 105 live L. majorEGFP promastigotes, which were inoculated into the left footpad. The infection course was monitored using footpad swelling measurement and in vivo imaging. Eleven weeks after the challenge, all mice were sacrificed and parasite burden was measured in the spleen and the draining lymph node using three different methods including real-time PCR, flow cytometry, and direct fluorescent microscopy. In addition, cytokines levels (IFN-γ and IL-10), and nitric oxide production were assayed in splenocytes. RESULTS Mice immunized with ILL+CMP had a smaller footpad diameter in comparison to control groups and notably, no lesion was developed at the inoculation site. Additionally, in vivo imaging study revealed that there was no detectable fluorescence in the ILL+CMP group footpad by the end of the tenth week. This finding was confirmed by three methods used for parasite burden assays. Moreover, higher IFN-γ level was observed in mice immunized with ILL+CMP in comparison with other groups. On the other hand, nitric oxide concentration was higher in the ILL control group. CONCLUSION ILL mixed with chitin microparticles is an effective vaccine against leishmaniasis in BALB/c mice. This vaccine is able to induce an adequate immune response to decrease the parasite burden and prevent lesion formation. Further studies are needed to evaluate long-lasting immunity, especially in experimental outbreed models.
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5
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Zayats R, Uzonna JE, Murooka TT. Visualizing the In Vivo Dynamics of Anti- Leishmania Immunity: Discoveries and Challenges. Front Immunol 2021; 12:671582. [PMID: 34093571 PMCID: PMC8172142 DOI: 10.3389/fimmu.2021.671582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/07/2021] [Indexed: 11/20/2022] Open
Abstract
Intravital microscopy, such as 2-photon microscopy, is now a mainstay in immunological research to visually characterize immune cell dynamics during homeostasis and pathogen infections. This approach has been especially beneficial in describing the complex process of host immune responses to parasitic infections in vivo, such as Leishmania. Human-parasite co-evolution has endowed parasites with multiple strategies to subvert host immunity in order to establish chronic infections and ensure human-to-human transmission. While much focus has been placed on viral and bacterial infections, intravital microscopy studies during parasitic infections have been comparatively sparse. In this review, we will discuss how in vivo microscopy has provided important insights into the generation of innate and adaptive immunity in various organs during parasitic infections, with a primary focus on Leishmania. We highlight how microscopy-based approaches may be key to providing mechanistic insights into Leishmania persistence in vivo and to devise strategies for better parasite control.
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Affiliation(s)
- Romaniya Zayats
- Rady Faculty of Health Sciences, Department of Immunology, University of Manitoba, Winnipeg, MB, Canada
| | - Jude E Uzonna
- Rady Faculty of Health Sciences, Department of Immunology, University of Manitoba, Winnipeg, MB, Canada.,Rady Faculty of Health Sciences, Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Thomas T Murooka
- Rady Faculty of Health Sciences, Department of Immunology, University of Manitoba, Winnipeg, MB, Canada.,Rady Faculty of Health Sciences, Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
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6
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Immunotherapy in treatment of leishmaniasis. Immunol Lett 2021; 233:80-86. [PMID: 33771555 DOI: 10.1016/j.imlet.2021.03.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/12/2021] [Accepted: 03/19/2021] [Indexed: 11/21/2022]
Abstract
Leishmaniasis caused by various species of protozoan transmitted by sand fly vectors occurs as a spectrum of clinical features including cutaneous, mucocutaneous and visceral forms. It is a geographically distributed parasitic disease and a major public health problem in the world. The clinical syndromes are highly variable depending on the parasite species, host genetics, vectors and environment. To date, there is no effective vaccine and traditional treatments are toxic, expensive with long administration duration and many adverse side effects and/or drug resistance. Instead of treatments based on chemotherapy, certain strategies aim to recover leishmaniasis and reduce the parasitic burden. Immunotherapy has focused on the induction of effective immune response to rapidly control the disease. Recent studies have indicated that a single dose of a suitable therapeutic vaccine induces a quick and lasting recovery in patients. Immunotherapy reduces the toxicity of drug and the emergence of resistance dramatically. It could be an effective addition to chemotherapy with a safe and potent drug compared with monotherapy, resulting in a prophylactic and therapeutic cure of leishmaniasis. This review has focused on treatment of leishmaniasis with particular emphasis on immunotherapy as an alternative to conventional drug treatment.
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7
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Barazandeh AF, Mou Z, Ikeogu N, Mejia EM, Edechi CA, Zhang WW, Alizadeh J, Hatch GM, Ghavami S, Matlashewski G, Marshall AJ, Uzonna JE. The Phosphoenolpyruvate Carboxykinase Is a Key Metabolic Enzyme and Critical Virulence Factor of Leishmania major. THE JOURNAL OF IMMUNOLOGY 2021; 206:1013-1026. [PMID: 33462138 DOI: 10.4049/jimmunol.2000517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/14/2020] [Indexed: 11/19/2022]
Abstract
There is currently no effective vaccine against leishmaniasis because of the lack of sufficient knowledge about the Ags that stimulate host-protective and long-lasting T cell-mediated immunity. We previously identified Leishmania phosphoenolpyruvate carboxykinase (PEPCK, a gluconeogenic enzyme) as an immunodominant Ag that is expressed by both the insect (promastigote) and mammalian (amastigote) stages of the parasite. In this study, we investigated the role of PEPCK in metabolism, virulence, and immunopathogenicity of Leishmania major We show that targeted loss of PEPCK results in impaired proliferation of L. major in axenic culture and bone marrow-derived macrophages. Furthermore, the deficiency of PEPCK results in highly attenuated pathology in vivo. BALB/c mice infected with PEPCK-deficient parasites failed to develop any cutaneous lesions despite harboring parasites at the cutaneous site of infection. This was associated with a dramatic reduction in the frequency of cytokine (IFN-γ, IL-4, and IL-10)-producing CD4+ T cells in spleens and lymph nodes draining the infection site. Cells from mice infected with PEPCK-deficient parasites also produced significantly low levels of these cytokines into the culture supernatant following in vitro restimulation with soluble Leishmania Ag. PEPCK-deficient parasites exhibited significantly greater extracellular acidification rate, increased proton leak, and decreased ATP-coupling efficiency and oxygen consumption rates in comparison with their wild-type and addback counterparts. Taken together, these results show that PEPCK is a critical metabolic enzyme for Leishmania, and its deletion results in altered metabolic activity and attenuation of virulence.
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Affiliation(s)
- Aida Feiz Barazandeh
- Department of Immunology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba R3T 0T5, Canada
| | - Zhirong Mou
- Department of Immunology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba R3T 0T5, Canada
| | - Nnamdi Ikeogu
- Department of Immunology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba R3T 0T5, Canada
| | - Edgard M Mejia
- Department of Immunology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba R3T 0T5, Canada
| | - Chidalu A Edechi
- Department of Pathology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada
| | - Wen-Wei Zhang
- Department of Microbiology and Immunology, McGill University, Montreal, Quebec H3A 0F4, Canada
| | - Javad Alizadeh
- Department of Human Anatomy and Cell Sciences, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada
| | - Grant M Hatch
- Department of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada.,Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada; and.,Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada
| | - Saeid Ghavami
- Department of Human Anatomy and Cell Sciences, University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada
| | - Greg Matlashewski
- Department of Microbiology and Immunology, McGill University, Montreal, Quebec H3A 0F4, Canada
| | - Aaron J Marshall
- Department of Immunology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba R3T 0T5, Canada
| | - Jude E Uzonna
- Department of Immunology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba R3T 0T5, Canada;
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8
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Irum S, Aftab M, Khan A, Naz S, Simsek S, Habib A, Afzal MS, Nadeem MA, Qasim M, Ahmed H. Cutaneous Leishmaniasis (CL): A Cross-Sectional Community Based Survey on Knowledge, Attitude and Practices in a Highly Endemic Area of Waziristan (KPK Province), Pakistan. Acta Trop 2021; 213:105746. [PMID: 33160955 DOI: 10.1016/j.actatropica.2020.105746] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/09/2020] [Accepted: 10/01/2020] [Indexed: 11/27/2022]
Abstract
Recent outbreaks of Cutaneous Leishmaniasis (CL) in Waziristan make the disease a public health concern in Khyber Pakhtunkhwa (KPK) province, Pakistan. The awareness and behavior of local community towards the disease is an important factor towards effective control and management of CL in endemic areas of Pakistan. A cross-sectional community based survey was piloted in new emerging district of North Waziristan Agency (KPK province), Pakistan from August 2019- February 2020. The study aimed to examine the Knowledge, Attitude and Practices (KAP) of the local community members regarding CL. The results revealed that majority of the participants were male. Only 48.2% participants have knowledge about CL and the respondents had a moderate knowledge of CL vector and the disease. Few of the respondents were aware that CL is caused by sand flies, their breeding place, biting time, transmission of CL and control measures. Skin infection and sand-flies were the main disease symptoms and disease vector were known to some of the respondents. Most of the respondents showed positive attitude towards disease seriousness and believed that the disease could be cured and can be treated through modern medicines. Admission to hospitals, cleanliness and use of bed nets were the treatment measures for the disease in suspected patients, whereas some believed that the use of bed nets could be helpful in preventing the leishmaniasis. Moderate knowledge of the CL and its transmission in the study area emphasize the need to initiate health education and awareness campaigns to reduce the disease risk and burden in this highly endemic area in near future.
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Affiliation(s)
- Shamaila Irum
- Department of Zoology, University of Gujrat, Gujrat, Pakistan
| | - Malik Aftab
- Department of Zoology, University of Gujrat, Gujrat, Pakistan
| | - Aisha Khan
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Shumaila Naz
- Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
| | - Sami Simsek
- Department of Parasitology, Faculty of Veterinary Medicine, Firat University, Elazig, Turkey
| | - Ayesha Habib
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Muhammad Sohail Afzal
- Department of Life Sciences, School of Science, University of Management & Technology (UMT), Lahore, Pakistan
| | - Muhammad Arif Nadeem
- Department of Life Sciences, School of Science, University of Management & Technology (UMT), Lahore, Pakistan
| | - Muhammad Qasim
- Department of Economics, Finance and Statistics, Jönköping International Business School, Jönköping University, Sweden
| | - Haroon Ahmed
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad, Pakistan.
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9
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Vacas A, Fernández-Rubio C, Larrea E, Peña-Guerrero J, Nguewa PA. LmjF.22.0810 from Leishmania major Modulates the Th2-Type Immune Response and Is Involved in Leishmaniasis Outcome. Biomedicines 2020; 8:biomedicines8110452. [PMID: 33114674 PMCID: PMC7692454 DOI: 10.3390/biomedicines8110452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 11/16/2022] Open
Abstract
A novel serine/threonine protein kinase, LmjF.22.0810, was recently described in Leishmania major. After generating an L. major cell line overexpressing LmjF.22.0810 (named LmJ3OE), the ability of this novel protein to modulate the Th2-type immune response was analyzed. Our results suggest that the protein kinase LmjF.22.0810 might be involved in leishmaniasis outcomes. Indeed, our study outlined the LmJ3OE parasites infectivity in vitro and in vivo. Transgenic parasites displayed lower phagocytosis rates in vitro, and their promastigote forms exhibited lower expression levels of virulence factors compared to their counterparts in control parasites. In addition, LmJ3OE parasites developed significantly smaller footpad swelling in susceptible BALB/c mice. Hematoxylin-eosin staining allowed the observation of a lower inflammatory infiltrate in the footpad from LmJ3OE-infected mice compared to animals inoculated with control parasites. Gene expression of Th2-associated cytokines and effectors revealed a dramatically lower induction in interleukin (IL)-4, IL-10, and arginase 1 (ARG1) mRNA levels at the beginning of the swelling; no expression change was found in Th1-associated cytokines except for IL-12. Accordingly, such results were validated by immunohistochemistry studies, illustrating a weaker expression of ARG1 and a similar induction for inducible NO synthase (iNOS) in footpads from LmJ3OE-infected mice compared to control L. major infected animals. Furthermore, the parasite burden was lower in footpads from LmJ3OE-infected mice. Our analysis indicated that such significant smaller footpad swellings might be due to an impairment of the Th2 immune response that subsequently benefits Th1 prevalence. Altogether, these studies depict LmjF.22.0810 as a potential modulator of host immune responses to Leishmania. Finally, this promising target might be involved in the modulation of infection outcome.
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Affiliation(s)
- Andrés Vacas
- Department of Microbiology and Parasitology, ISTUN Institute of Tropical Health, IdiSNA (Navarra Institute for Health Research), University of Navarra, E-31008 Pamplona, Navarra, Spain; (A.V.); (C.F.-R.); (J.P.-G.)
| | - Celia Fernández-Rubio
- Department of Microbiology and Parasitology, ISTUN Institute of Tropical Health, IdiSNA (Navarra Institute for Health Research), University of Navarra, E-31008 Pamplona, Navarra, Spain; (A.V.); (C.F.-R.); (J.P.-G.)
| | - Esther Larrea
- ISTUN Institute of Tropical Health, Navarra Institute for Health Research (IdiSNA), University of Navarra, E-31008 Pamplona, Navarra, Spain;
| | - José Peña-Guerrero
- Department of Microbiology and Parasitology, ISTUN Institute of Tropical Health, IdiSNA (Navarra Institute for Health Research), University of Navarra, E-31008 Pamplona, Navarra, Spain; (A.V.); (C.F.-R.); (J.P.-G.)
| | - Paul A. Nguewa
- Department of Microbiology and Parasitology, ISTUN Institute of Tropical Health, IdiSNA (Navarra Institute for Health Research), University of Navarra, E-31008 Pamplona, Navarra, Spain; (A.V.); (C.F.-R.); (J.P.-G.)
- Correspondence: ; Tel.: +34-948-425-600 (ext. 6434)
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10
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Oliaee RT, Sharifi I, Bamorovat M, Keyhani A, Babaei Z, Salarkia E, Tavakoly R, Khosravi A, Mostafavi M, Sharifi F, Mousavi SM. The potential role of nicotinamide on Leishmania tropica: An assessment of inhibitory effect, cytokines gene expression and arginase profiling. Int Immunopharmacol 2020; 86:106704. [PMID: 32590317 DOI: 10.1016/j.intimp.2020.106704] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/30/2020] [Accepted: 06/11/2020] [Indexed: 11/26/2022]
Abstract
Leishmaniasis represents a major health concern worldwide which has no effective treatment modality. Nicotinamide (NAm) has been used for a wide range of applications from anticancer to antimicrobial usage. This study aimed to assess the effect of NAm combination on Leishmania tropica Inhibition, as well as on cytokines gene expression and arginase (ARG) activity in L. tropica-infected macrophages in an in vitro model. The leishmanicidal effects of NAm and Glucantime (meglumine antimoniate, MA) alone and in combination (NAm/MA) were evaluated using a colorimetric assay and macrophage model. Additionally, immunomodulatory effects and enzymatic activity were assessed by analyzing Th1 and Th2 cytokines gene expression and ARG level, respectively, in infected macrophages treated with NAm and MA, alone and in combination. Findings indicated that the NAm/MA combination demonstrated greater inhibitory effects on L. tropica promastigotes and amastigotes compared with each drug individually. Docking results proved the affinity of NAm to IFN-γ, which can affirm the increased levels of IFN-γ, IL-12p40 and TNF-α as well as reductions in IL-10 secretion with a dose-response effect, especially in the combination group. The NAm/MA combination also showed a significant reduction in the level of ARG activity at all concentrations used compared to each drug individually. These findings indicate higher effectiveness of NAm plus MA in reducing parasite growth, promoting immune response and inhibiting ARG level. This combination should be considered as a potential therapeutic regimen for treatment of volunteer patients with anthroponotic cutaneous leishmaniasis (ACL) in future control programs.
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Affiliation(s)
- Razieh Tavakoli Oliaee
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran; Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Mehdi Bamorovat
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Alireza Keyhani
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Babaei
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ehsan Salarkia
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Rahele Tavakoly
- Student Research Committee, School of Health, Kerman University of Medical Sciences, Kerman, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Khosravi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahshid Mostafavi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Sharifi
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | - Seyed Mohammad Mousavi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
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11
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Solana JC, Ramírez L, Cook ECL, Hernández-García E, Sacristán S, Martín ME, Manuel González V, Reguera RM, Balaña-Fouce R, Fresno M, Requena JM, Iborra S, Soto M. Subcutaneous Immunization of Leishmania HSP70-II Null Mutant Line Reduces the Severity of the Experimental Visceral Leishmaniasis in BALB/c Mice. Vaccines (Basel) 2020; 8:vaccines8010141. [PMID: 32210040 PMCID: PMC7157689 DOI: 10.3390/vaccines8010141] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 03/20/2020] [Accepted: 03/21/2020] [Indexed: 02/05/2023] Open
Abstract
Leishmania infantum parasites cause a severe form of visceral leishmaniasis in human and viscerocutaneous leishmaniasis in dogs. Recently, we reported that immunization with an attenuated L. infantum cell line, lacking the hsp70-II gene, protects against the development of murine cutaneous leishmaniasis. In this work, we analyzed the vaccine potential of this cell line towards the long-term protection against murine visceral leishmaniasis. This model shows an organ-dependent evolution of the disease. The infection can resolve in the liver but chronically affect spleen and bone marrow. Twelve weeks after subcutaneous administration of attenuated L. infantum, Bagg Albino (BALB/c) mice were challenged with infective L. infantum parasites expressing the luciferase-encoding gene. Combining in vivo bioimaging techniques with limiting dilution experiments, we report that, in the initial phase of the disease, vaccinated animals presented lower parasite loads than unvaccinated animals. A reduction of the severity of liver damage was also detected. Protection was associated with the induction of rapid parasite-specific IFN-γ production by CD4+ and CD8+ T cells. However, the vaccine was unable to control the chronic phase of the disease, since we did not find differences in the parasite burdens nor in the immune response at that time point.
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Affiliation(s)
- José Carlos Solana
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular, Nicolás Cabrera 1, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- WHO Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, 28220 Madrid, Spain
| | - Laura Ramírez
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular, Nicolás Cabrera 1, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Emma C. L. Cook
- Department of Immunology, Ophthalmology and ENT. Complutense University School of Medicine and 12 de Octubre Health Research Institute (imas12), 28040 Madrid, Spain
| | - Elena Hernández-García
- Department of Immunology, Ophthalmology and ENT. Complutense University School of Medicine and 12 de Octubre Health Research Institute (imas12), 28040 Madrid, Spain
| | - Silvia Sacristán
- Departamento de Bioquímica-Investigación, Hospital Ramón y Cajal (IRYCIS), 28034 Madrid, Spain
| | - M. Elena Martín
- Departamento de Bioquímica-Investigación, Hospital Ramón y Cajal (IRYCIS), 28034 Madrid, Spain
| | - Víctor Manuel González
- Departamento de Bioquímica-Investigación, Hospital Ramón y Cajal (IRYCIS), 28034 Madrid, Spain
| | - Rosa María Reguera
- Departamento de Ciencias Biomédicas, Universidad de León, Campus de Vegazana s/n, 24071 León, Spain
| | - Rafael Balaña-Fouce
- Departamento de Ciencias Biomédicas, Universidad de León, Campus de Vegazana s/n, 24071 León, Spain
| | - Manuel Fresno
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular, Nicolás Cabrera 1, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - José María Requena
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular, Nicolás Cabrera 1, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Salvador Iborra
- Department of Immunology, Ophthalmology and ENT. Complutense University School of Medicine and 12 de Octubre Health Research Institute (imas12), 28040 Madrid, Spain
- Correspondence: (S.I.); (M.S.); Tel.: +34-91-394-7220 (S.I.); +34-91-196-4647 (M.S.)
| | - Manuel Soto
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular, Nicolás Cabrera 1, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Correspondence: (S.I.); (M.S.); Tel.: +34-91-394-7220 (S.I.); +34-91-196-4647 (M.S.)
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12
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Yadav PK, Chandrakar P, Sharma P, Vishwakarma P, Parmar N, Srivastava M, Kar S. Reciprocal changes in CD11c +CD11b + and CD11c +CD8α + dendritic cell subsets determine protective or permissive immune response in murine experimental VL. Vaccine 2020; 38:355-365. [PMID: 31648908 DOI: 10.1016/j.vaccine.2019.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/20/2019] [Accepted: 10/01/2019] [Indexed: 01/02/2023]
Abstract
CD11c+CD8α+ and CD11c+CD11b+ dendritic cells are two major subsets of murine splenic CD11c+ DCs which play a crucial role in T cell priming and shaping Th1/Th2 responses, but their role in the context of experimental visceral leishmaniasis (VL) is poorly understood. Herein, we showed that L. donovani infection in Balb/c mice preferentially decreased the population abundance of CD11c+CD11b+ DCs and increased relative abundance of splenic CD11c+CD8α +DCs. During infection, splenic CD11c+CD11b+ DCs induced Th1 differentiation whereas CD11c+CD8α+ DCs promoted Th2 differentiation. Additionally, treatment of infected mice with miltefosine as experimental control exhibited host defense allowing the restoration of CD11c+CD11b+ population and decrease in CD11c+CD8α+ subset. Furthermore, reciprocal regulation of immune accessory surface molecules, Sema4A and OX40L critically determined Th1/Th2 response induced by these DC subsets during VL. L. donovani infection significantly induced OX40L expression and slightly downregulated SEMA 4A expression in CD11c+CD8α+ DCs whereas miltefosine treatment significantly downregulated OX40L expression along with pronounced upregulation of SEMA 4A expression in CD11c+CD11b+ DCs. SiRNA mediated knockdown of SEMA 4A markedly reduced CD11c+CD11b+ driven IFN-γ, TNF-α and IL-12 synthesis in miltefosine treated mice whereas functional blocking of OX40L decreased CD11c+CD8α+ induced IL-10, IL-4 and TGF-β synthesis in L. donovani infected group. Vaccination of Balb/c mice with antigen-pulsed + CpG-ODN-activated DC subsets revealed that only antigen-pulsed CD11c+CD11b+ DCs eliminated parasite load in visceral organ and restored protective Th1 cytokine response. Collectively, our results suggest that differential regulation of splenic CD11c+ subsets by L. donovani is essential for disease progression and specific subtypes may be exploited as prophylactic measures against visceral leishmaniasis.
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Affiliation(s)
- Pawan Kumar Yadav
- Division of Parasitology, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Anusandhan Bhawan, New Delhi, India
| | - Pragya Chandrakar
- Division of Parasitology, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Anusandhan Bhawan, New Delhi, India
| | - Pankaj Sharma
- Division of Parasitology, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| | - Preeti Vishwakarma
- Division of Parasitology, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Anusandhan Bhawan, New Delhi, India
| | - Naveen Parmar
- Division of Parasitology, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Anusandhan Bhawan, New Delhi, India
| | - Mrigank Srivastava
- Division of Parasitology, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Anusandhan Bhawan, New Delhi, India
| | - Susanta Kar
- Division of Parasitology, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Anusandhan Bhawan, New Delhi, India.
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13
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Gbedande K, Carpio VH, Stephens R. Using two phases of the CD4 T cell response to blood-stage murine malaria to understand regulation of systemic immunity and placental pathology in Plasmodium falciparum infection. Immunol Rev 2020; 293:88-114. [PMID: 31903675 PMCID: PMC7540220 DOI: 10.1111/imr.12835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 12/08/2019] [Accepted: 12/09/2019] [Indexed: 02/06/2023]
Abstract
Plasmodium falciparum infection and malaria remain a risk for millions of children and pregnant women. Here, we seek to integrate knowledge of mouse and human T helper cell (Th) responses to blood-stage Plasmodium infection to understand their contribution to protection and pathology. Although there is no complete Th subset differentiation, the adaptive response occurs in two phases in non-lethal rodent Plasmodium infection, coordinated by Th cells. In short, cellular immune responses limit the peak of parasitemia during the first phase; in the second phase, humoral immunity from T cell-dependent germinal centers is critical for complete clearance of rapidly changing parasite. A strong IFN-γ response kills parasite, but an excess of TNF compared with regulatory cytokines (IL-10, TGF-β) can cause immunopathology. This common pathway for pathology is associated with anemia, cerebral malaria, and placental malaria. These two phases can be used to both understand how the host responds to rapidly growing parasite and how it attempts to control immunopathology and variation. This dual nature of T cell immunity to Plasmodium is discussed, with particular reference to the protective nature of the continuous generation of effector T cells, and the unique contribution of effector memory T cells.
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Affiliation(s)
- Komi Gbedande
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Victor H Carpio
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas
| | - Robin Stephens
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas
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14
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Dutra WO, Barbosa DF, de Souza PEA, Morgan D, Poetker S, Guimarães LH, Bacelar O, Gollob KJ, Carvalho EM. A Th2-Type Response Is Associated With Exuberant Lesions in Pregnant Women Infected With Leishmania braziliensis. J Infect Dis 2019; 219:480-488. [PMID: 30165577 DOI: 10.1093/infdis/jiy510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 08/23/2018] [Indexed: 11/14/2022] Open
Abstract
Background Cutaneous leishmaniasis (CL) is characterized by an exaggerated inflammatory response. During pregnancy there is a decreased inflammatory response, and we have shown that pregnant women with CL develop exuberant lesions. Methods Cytokine production by peripheral blood mononuclear cells and the frequency of cells expressing cytokines in lesions from pregnant and nonpregnant women with CL were evaluated. Results We observed that CL lesions from pregnant women displayed a more intense cellular infiltrate, associated with an increase in neutrophils and CD4+ cells. While no difference was observed regarding the number of interferon-gamma (IFN-γ)+ cells in lesions from pregnant compared to nonpregnant women with CL, interleukin-10 (IL-10) and IL-4 expression were approximately 3-times higher in lesions in pregnant women. Main sources of IL-4 and IL-10 were CD4+ and CD68+ cells, respectively. Expression of IL-4, but not IFN-γ or IL-10, was positively correlated with the intensity of inflammatory infiltrate in lesions from pregnant women. Conclusions These results provide evidence of an IL-4-mediated pathology in Leishmania braziliensis-infected pregnant women. These differences in lesion pathogenesis in pregnant and nonpregnant women may open possibilities for new therapies for CL treatment during pregnancy, which are currently lacking.
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Affiliation(s)
- Walderez O Dutra
- Laboratory of Cell-Cell Interactions, Department of Morphology, Biological Sciences Institute, Universidade Federal de Minas Gerais, Belo Horizonte
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, Salvador, Bahia, Brazil
| | - Daniela Faria Barbosa
- Laboratory of Cell-Cell Interactions, Department of Morphology, Biological Sciences Institute, Universidade Federal de Minas Gerais, Belo Horizonte
- Centro Universitário de Formiga, Minas Gerais
| | | | - Daniel Morgan
- Division of International Medicine and Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, NewYork
| | - Shelene Poetker
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, NewYork
| | - Luiz Henrique Guimarães
- Immunology Service, Hospital Universitário Prof. Edgar Santos, Universidade Federal da Bahia, Salvador
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, Salvador, Bahia, Brazil
| | - Olívia Bacelar
- Immunology Service, Hospital Universitário Prof. Edgar Santos, Universidade Federal da Bahia, Salvador
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, Salvador, Bahia, Brazil
| | - Kenneth J Gollob
- A.C. Camargo Cancer Center, São Paulo, Universidade Federal da Bahia, Salvador
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, Salvador, Bahia, Brazil
| | - Edgar M Carvalho
- Immunology Service, Hospital Universitário Prof. Edgar Santos, Universidade Federal da Bahia, Salvador
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, Salvador, Bahia, Brazil
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15
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Coutinho De Oliveira B, Duthie MS, Alves Pereira VR. Vaccines for leishmaniasis and the implications of their development for American tegumentary leishmaniasis. Hum Vaccin Immunother 2019; 16:919-930. [PMID: 31634036 DOI: 10.1080/21645515.2019.1678998] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The leishmaniases are a collection of vector-borne parasitic diseases caused by a number of different Leishmania species that are distributed worldwide. Clinical and laboratory research have together revealed several important immune components that control Leishmania infection and indicate the potential of immunization to prevent leishmaniasis. In this review we introduce previous and ongoing experimental research efforts to develop vaccines against Leishmania species. First, second and third generation vaccine strategies that have been proposed to counter cutaneous and visceral leishmaniasis (CL and VL, respectively) are summarized. One of the major bottlenecks in development is the transition from results in animal model studies to humans, and we highlight that although American tegumentary leishmaniasis (ATL; New World CL) can progress to destructive and disfiguring mucosal lesions, most research has been conducted using mouse models and Old World Leishmania species. We conclude that assessment of vaccine candidates in ATL settings therefore appears merited.
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Affiliation(s)
- Beatriz Coutinho De Oliveira
- Pós-Graduação em Inovação Terapêutica, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.,Departamento de Imunologia, Instituto Aggeu Magalhães, Recife, Brazil
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16
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Loiseau R, Nabet C, Simon S, Ginouves M, Brousse P, Blanchet D, Demar M, Couppie P, Blaizot R. American cutaneous leishmaniasis in French Guiana: an epidemiological update and study of environmental risk factors. Int J Dermatol 2019; 58:1323-1328. [PMID: 31524286 PMCID: PMC6900021 DOI: 10.1111/ijd.14625] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 05/29/2019] [Accepted: 08/08/2019] [Indexed: 01/26/2023]
Abstract
Background American cutaneous leishmaniasis (ACL) is endemic in French Guiana. Its epidemiology is evolving, notably because of immigration, anthropization of natural areas, and new microbiological methods. Our first objective was to update epidemiological data. Our second objective was to look for risk factors of ACL. Methods This multicentric study was conducted from October 2017 to June 2018 in French Guiana. Patients with suspicion of mucocutaneous leishmaniasis were included in case of positive smear, culture, or PCR‐RFLP on skin biopsy. Results One hundred and twenty‐three patients met the inclusion criteria. Among those patients, 59.3% were Brazilian, mostly gold miners. Most of them (58%) were between 16 and 40 years old, and 69% were male. A large proportion of patients lived in traditional wooden houses (51%). Patients living in coastal towns were usually infected during trips to the primary forest (60%) and had a shorter time to diagnosis than workers of the hinterland. Among environmental risk factors, the presence of a water spring (40%) and dogs around houses (40%) were frequently reported. Leishmania guyanensis represented 80% of cases, followed by Leishmania braziliensis (6%), Leishmania naiffi (2%), and Leishmania amazonensis (1%). Conclusions Gold mining and trips to the primary forest represent high‐risk situations for ACL in French Guiana, where the population of infected patients is dominated by Brazilian immigrants. Possible environmental risk factors such as the presence of dogs, water sources, and traditional wooden houses require further investigation.
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Affiliation(s)
- Rémi Loiseau
- Département de Médecine Générale, Université des Antilles, Pointe-à-Pitre, Guadeloupe, France
| | - Cecile Nabet
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France.,Centre National de Référence des Leishmanioses, Laboratoire Associé, Hôpital Andrée Rosemon, Cayenne, French Guiana, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Stephane Simon
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France
| | - Marine Ginouves
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France
| | - Paul Brousse
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France
| | - Denis Blanchet
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France.,Centre National de Référence des Leishmanioses, Laboratoire Associé, Hôpital Andrée Rosemon, Cayenne, French Guiana, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Magalie Demar
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France.,Centre National de Référence des Leishmanioses, Laboratoire Associé, Hôpital Andrée Rosemon, Cayenne, French Guiana, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Pierre Couppie
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France.,Centre National de Référence des Leishmanioses, Laboratoire Associé, Hôpital Andrée Rosemon, Cayenne, French Guiana, France.,Service de Dermatologie, Hôpital Andrée Rosemon, Cayenne, French Guiana, France
| | - Romain Blaizot
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France.,Centre National de Référence des Leishmanioses, Laboratoire Associé, Hôpital Andrée Rosemon, Cayenne, French Guiana, France.,Service de Dermatologie, Hôpital Andrée Rosemon, Cayenne, French Guiana, France
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17
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Sazhnev V, DeKrey GK. The growth and infectivity of Leishmania major is not altered by in vitro exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin. BMC Res Notes 2018; 11:642. [PMID: 30180875 PMCID: PMC6122646 DOI: 10.1186/s13104-018-3759-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 08/31/2018] [Indexed: 12/04/2022] Open
Abstract
Objective The numbers of Leishmania major parasites in foot lesions of C57Bl/6, BALB/c or SCID mice can be significantly reduced by pre-exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). One potential mechanism to explain this enhanced resistance to infection is that TCDD is directly toxic to L. major. This potential mechanism was addressed by exposing L. major promastigotes and amastigotes to TCDD in vitro and examining their subsequent proliferation and infectivity. Results We found no significant change in the rate of in vitro L. major proliferation (promastigotes or amastigotes) after TCDD exposure at concentrations up to 100 nM. Moreover, in vitro TCDD exposure did not significantly alter the ability of L. major to infect mice, trigger lesion formation, or survive in those lesions.
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Affiliation(s)
- Vera Sazhnev
- School of Biological Sciences, College of Natural and Health Sciences, University of Northern Colorado, 501 20th Street, Greeley, CO, 80639, USA
| | - Gregory K DeKrey
- School of Biological Sciences, College of Natural and Health Sciences, University of Northern Colorado, 501 20th Street, Greeley, CO, 80639, USA.
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18
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Bhurani V, Mohankrishnan A, Morrot A, Dalai SK. Developing effective vaccines: Cues from natural infection. Int Rev Immunol 2018; 37:249-265. [PMID: 29927676 DOI: 10.1080/08830185.2018.1471479] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The ultimate goal of any vaccine is to generate a heterogeneous and stable pool of memory lymphocytes. Vaccine are designed with the hope to generate antigen specific long-lived T cell responses, as it may be the case in natural infection; however, inducing such response by sub-unit vaccine has been a challenge. Although significant progress has been made, there is lot of scope for designing novel vaccine strategies by taking cues from the natural infection. This review focuses upon the roadblocks and the possible ways to overcome them leading to developing effective vaccines. Here we propose that mimicking the natural course of infection as well as the inclusion of non-target antigens in vaccine formulations might generate heterogeneous pool of memory T cells to ensure long-lived protection.
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Affiliation(s)
- Vishakha Bhurani
- a Institute of Science , Nirma University , Ahmedabad , Gujarat , India
| | | | - Alexandre Morrot
- b Faculdade de Medicina , Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil.,c Instituto Oswaldo Cruz , Fiocruz , Rio de Janeiro , Brazil
| | - Sarat Kumar Dalai
- a Institute of Science , Nirma University , Ahmedabad , Gujarat , India
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19
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Immune Response and Protective Efficacy of a Heterologous DNA-Protein Immunization with Leishmania Superoxide Dismutase B1. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2145386. [PMID: 29359145 PMCID: PMC5735611 DOI: 10.1155/2017/2145386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 10/19/2017] [Indexed: 11/18/2022]
Abstract
Growing evidence shows that antioxidant proteins of Leishmania could be used as vaccine candidates. In this study, we report the efficacy of Leishmania donovani iron superoxide dismutase B1 (LdFeSODB1) as a vaccine antigen in BALB/c mice in a DNA-protein prime-boost immunization regimen in the presence or absence of murine granulocyte macrophage colony stimulating factor (mGMCSF) DNA adjuvant. The expression study confirmed that LdFeSODB1 is expressed in mammalian cells and mGMCSF fusion mediates the secretion of the recombinant protein. Heterologous immunization with LdFeSODB1 induced a strong antibody- and cell-mediated immune response in mice. Immunization triggered a mixed Th1/Th2 response as evidenced by the ratio of IgG2a to IgG1. Antigen-stimulated spleen cells from the immunized mice produced high level IFN-γ. Multiparametric flow cytometry data showed that immunization with LdFeSODB1 induced significantly higher expression of TNF-α or IL-2 by antigen-stimulated T cells. Eight weeks after L. major infection, immunization with the antigen shifted the immune response to a more Th1 type than the controls as demonstrated by IgG2a/IgG1 ratio. Moreover, IFN-γ production by antigen-stimulated spleen cells from immunized mice remained high. The footpad swelling experiment showed that immunization with LdFeSODB1 resulted in partial protection of mice from a high dose L. major infection.
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20
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Caffeic acid combined with autoclaved Leishmania major boosted the protection of infected BALB/c mice by enhancing IgG2 production, IFN-γ/TGF-β and iNO synthase/arginase1 ratios, and the death of infected phagocytes. Inflammopharmacology 2017; 26:621-634. [DOI: 10.1007/s10787-017-0399-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 09/12/2017] [Indexed: 12/19/2022]
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21
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Solana JC, Ramírez L, Corvo L, de Oliveira CI, Barral-Netto M, Requena JM, Iborra S, Soto M. Vaccination with a Leishmania infantum HSP70-II null mutant confers long-term protective immunity against Leishmania major infection in two mice models. PLoS Negl Trop Dis 2017; 11:e0005644. [PMID: 28558043 PMCID: PMC5466331 DOI: 10.1371/journal.pntd.0005644] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 06/09/2017] [Accepted: 05/16/2017] [Indexed: 12/24/2022] Open
Abstract
Background The immunization with genetically attenuated Leishmania cell lines has been associated to the induction of memory and effector T cell responses against Leishmania able to control subsequent challenges. A Leishmania infantum null mutant for the HSP70-II genes has been described, possessing a non-virulent phenotype. Methodology/Principal findings The L. infantum attenuated parasites (LiΔHSP70-II) were inoculated in BALB/c (intravenously and subcutaneously) and C57BL/6 (subcutaneously) mice. An asymptomatic infection was generated and parasites diminished progressively to become undetectable in most of the analyzed organs. However, inoculation resulted in the long-term induction of parasite specific IFN-γ responses able to control the disease caused by a challenge of L. major infective promastigotes. BALB/c susceptible mice showed very low lesion development and a drastic decrease in parasite burdens in the lymph nodes draining the site of infection and internal organs. C57BL/6 mice did not show clinical manifestation of disease, correlated to the rapid migration of Leishmania specific IFN-γ producing T cells to the site of infection. Conclusion/Significance Inoculation of the LiΔHSP70-II attenuated line activates mammalian immune system for inducing moderate pro-inflammatory responses. These responses are able to confer long-term protection in mice against the infection of L. major virulent parasites. Despite numerous efforts made, a vaccine against leishmaniasis for humans is not available. Attempts based on parasite fractions or selected antigens failed to confer long lasting protection. On the other side, leishmanization, which consists in the inoculation of live virulent parasites in hidden parts of the body, is effective against cutaneous leishmaniasis in humans but objectionable in terms of biosafety. Some efforts have been made to design live vaccines to make leishmanization safer. A promising strategy is the development of genetically attenuated parasites, able to confer immunity without undesirable side effects. Here, we have employed an attenuated L. infantum line (LiΔHSP70-II) as a vaccine against heterologous challenge with L. major in two experimental models. Infection with LiΔHSP70-II parasites does not cause pathology and induces long-term protection based on the induction of IFN-γ producing T cells that are recruited rapidly and specifically to the site of challenge with the virulent parasites. These results support the idea of using attenuated parasites for vaccination.
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Affiliation(s)
- José Carlos Solana
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular. Nicolás Cabrera 1, Universidad Autónoma de Madrid, Madrid, Spain
| | - Laura Ramírez
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular. Nicolás Cabrera 1, Universidad Autónoma de Madrid, Madrid, Spain
| | - Laura Corvo
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular. Nicolás Cabrera 1, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Manoel Barral-Netto
- Centro de Pesquisas Gonçalo Moniz (Fundação Oswaldo Cruz-FIOCRUZ). Salvador, Bahia, Brazil
| | - José María Requena
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular. Nicolás Cabrera 1, Universidad Autónoma de Madrid, Madrid, Spain
| | - Salvador Iborra
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular. Nicolás Cabrera 1, Universidad Autónoma de Madrid, Madrid, Spain
- * E-mail: (SI); (MS)
| | - Manuel Soto
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular. Nicolás Cabrera 1, Universidad Autónoma de Madrid, Madrid, Spain
- * E-mail: (SI); (MS)
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Olszański R, Siermontowski P, Juszczak D, Dąbrowiecki Z, Pedrycz A. A Case of Cutaneous Leishmaniasis Treated with Hyperbaric Oxygen Therapy. POLISH HYPERBARIC RESEARCH 2017. [DOI: 10.1515/phr-2016-0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Cutaneous leishmaniasis in Poland is an imported disease mainly occurring in tourists who travelled to tropical countries. Cutaneous symptoms occur as late as between ten and twenty days following the return from the tropics. Lesions connected with cutaneous leishmaniasis were most commonly diagnosed by Polish doctors as furuncle, ecthyma or ulceration and ineffectively treated for several weeks with antibiotics.
The paper presents the case of leishmaniasis in a 30-year-old male with an ulceration of the left shank, ineffectively treated with antibiotics over a period of four months. The ulceration was healed completely only after leishmaniasis was diagnosed and following the application of a treatment based on antimony derivatives, followed by hyperbaric oxygenation performed in a hyperbaric chamber.
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Affiliation(s)
- Romuald Olszański
- Maritime & Hyperbaric Medicine Department, Military Institute of Medicine, Gdynia, Poland
| | - Piotr Siermontowski
- Maritime & Hyperbaric Medicine Department, Military Institute of Medicine, Gdynia, Poland
| | | | - Zbigniew Dąbrowiecki
- Maritime & Hyperbaric Medicine Department, Military Institute of Medicine, Gdynia, Poland
| | - Agnieszka Pedrycz
- Department of Histology and Embryology, Medical University in Lublin, Poland
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Wound healing in cutaneous leishmaniasis: A double edged sword of IL-10 and TGF-β. Comp Immunol Microbiol Infect Dis 2017; 51:15-26. [PMID: 28504090 DOI: 10.1016/j.cimid.2017.02.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 01/16/2017] [Accepted: 02/08/2017] [Indexed: 01/05/2023]
Abstract
Immune responses have a crucial role during the wound healing process in cutaneous leishmaniasis (CL). However, there are several paradoxes in immunity against CL. On the one hand, regulatory cytokines interleukin (IL)-10 and transforming growth factor beta (TGF-β) increase susceptibility to CL through suppression of several proinflammatory cytokines that require for defense against CL. On the other hand, these cytokines play a pivotal role in the acceleration of wound healing process. This review discusses about the dual role of IL-10 and TGF-β during the wound healing process and immunity against CL to offer a new insight about wound healing in CL.
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Maspi N, Ghaffarifar F, Sharifi Z, Dalimi A, Dayer MS. Immunogenicity and efficacy of a bivalent DNA vaccine containing LeIF and TSA genes against murine cutaneous leishmaniasis. APMIS 2017; 125:249-258. [DOI: 10.1111/apm.12651] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 11/15/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Nahid Maspi
- Department of Medical Parasitology; Faculty of Medical Sciences; Tarbiat Modares University; Tehran Iran
| | - Fatemeh Ghaffarifar
- Department of Medical Parasitology; Faculty of Medical Sciences; Tarbiat Modares University; Tehran Iran
| | - Zohreh Sharifi
- Blood Transfusion Research Center; High Institute for Research and Education in Transfusion Medicine; Tehran Iran
| | - Abdolhossein Dalimi
- Department of Medical Parasitology; Faculty of Medical Sciences; Tarbiat Modares University; Tehran Iran
| | - Mohammad Saaid Dayer
- Department of Medical Parasitology; Faculty of Medical Sciences; Tarbiat Modares University; Tehran Iran
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Chronic Plasmodium chabaudi Infection Generates CD4 Memory T Cells with Increased T Cell Receptor Sensitivity but Poor Secondary Expansion and Increased Apoptosis. Infect Immun 2017; 85:IAI.00744-16. [PMID: 28031266 DOI: 10.1128/iai.00744-16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 12/20/2016] [Indexed: 01/13/2023] Open
Abstract
Exposure to blood-stage malaria infection is often persistent, leading to generation of CD4 effector and effector memory T cells that contribute to protection. We showed previously that chronic exposure to blood-stage Plasmodium chabaudi offers the best protection from parasitemia and pathology in reinfection cases, correlating with an increase in Th1 cells. Although much is known about the features of resting or exhausted memory T cells (Tmem), little is known about the functional capacities of chronically stimulated but protective T cells. To determine the functional capacity of CD4 T cells generated by chronic infection upon reexposure to parasite, we compared their responses to known features of classical Tmem. The numbers of cytokine-producing T cells increased following infection in the polyclonal populations, suggesting an increase in pathogen-specific T cells. Malaria antigen-specific B5 T cell receptor (TCR) transgenic (Tg) T cells from chronic infection proliferated on reinfection and were highly sensitive to TCR stimulation without costimulation, as shown for Tmem in acute stimulations. However, B5 Tmem did not accumulate more than naive B5 T cells in vivo or in vitro and became apoptotic. Failure to accumulate was partly the result of chronic stimulation, since eliminating persistent parasites before reinfection slightly increased the accumulation of B5 Tg T cells upon reinfection. The levels of specific gamma interferon-positive, interleukin-10-positive T cells, which protect animals from pathology, increased after malaria infection. These data demonstrate that although chronic infection generates a protective T cell population with increased TCR sensitivity and cytokine production, they do not reexpand upon reexposure due to increased apoptosis.
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Okwor I, Uzonna JE. Pathways leading to interleukin-12 production and protective immunity in cutaneous leishmaniasis. Cell Immunol 2016; 309:32-36. [PMID: 27394077 DOI: 10.1016/j.cellimm.2016.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 01/16/2023]
Abstract
Leishmaniasis affects millions of people worldwide and continues to pose public health problem. There is extensive evidence supporting the critical role for IL-12 in initiating and maintaining protective immune response to Leishmania infection. Although gene deletion studies show that CD40-CD40L interaction is an important pathway for IL-12 production by antigen-presenting cells and subsequent development of protective immunity in cutaneous leishmaniasis, several studies have uncovered other pathways that could also lead to IL-12 production and immunity in the absence of intact CD40-CD40L signaling. Here, we review the literature on the role of IL-12 in the induction and maintenance of protective T cell-mediated immunity in cutaneous leishmaniasis and the different pathways leading to IL-12 production by antigen-presenting cells following Leishmania major infection.
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Affiliation(s)
- Ifeoma Okwor
- Department of Immunology, Rady Faculty of Health Sciences, College of Medicine, University of Manitoba, Winnipeg R3E 0T5, Canada.
| | - Jude E Uzonna
- Department of Immunology, Rady Faculty of Health Sciences, College of Medicine, University of Manitoba, Winnipeg R3E 0T5, Canada
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Akram A, Khan HAA, Qadir A, Sabir AM. A Cross-Sectional Survey of Knowledge, Attitude and Practices Related to Cutaneous Leishmaniasis and Sand Flies in Punjab, Pakistan. PLoS One 2015; 10:e0130929. [PMID: 26090870 PMCID: PMC4474799 DOI: 10.1371/journal.pone.0130929] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 05/27/2015] [Indexed: 11/26/2022] Open
Abstract
Background Recent outbreaks of cutaneous leishmaniasis make the disease a public health concern in Punjab, Pakistan. The knowledge of how the population perceives the disease and its vector is essential in order to design an effective management strategy, but such studies are rare in Pakistan. Methodology/Principal Findings The present study was based on a cross-sectional self-administered survey comprising 250 household samples collected from five localities including Bhawalpur, Multan, Jhang, Faisalabad and Lahore. The results revealed that the respondents had a poor knowledge of the vector and disease. Few of the respondents were aware about the identification of sand flies, their breeding place, biting time, transmission of leishmaniasis and control measures. Skin infection and sandflies as the main disease symptom and vector of the disease, respectively, were known to some of the respondents. Some believed that summer was the main peak incidence of the disease and it could be transmitted from man to man via contact. However, most of the respondents believed that the disease could be cured. Admission to hospitals, cleanliness and use of bed nets were the treatment measures for the disease in suspected patients, whereas some thought that the use of bed nets could be helpful in preventing leishmaniasis infection. Conclusions/Significance Poor knowledge of the disease and its vector in the study population emphasize the need to initiate health education and awareness campaigns to minimize the risks of cutaneous leishmaniasis outbreaks in the future.
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Affiliation(s)
- Ayesha Akram
- College of Earth and Environmental Science, University of the Punjab, Lahore, Pakistan
| | - Hafiz Azhar Ali Khan
- Institute of Agricultural Sciences, University of the Punjab, Lahore, Pakistan
- * E-mail:
| | - Abdul Qadir
- College of Earth and Environmental Science, University of the Punjab, Lahore, Pakistan
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Bennis I, De Brouwere V, Ameur B, El Idrissi Laamrani A, Chichaoui S, Hamid S, Boelaert M. Control of cutaneous leishmaniasis caused by Leishmania major in south-eastern Morocco. Trop Med Int Health 2015; 20:1297-305. [PMID: 25975767 DOI: 10.1111/tmi.12543] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The incidence of cutaneous leishmaniasis (CL) caused by Leishmania major has increased in Morocco over the last decade, prompting the Ministry of Health to take intersectoral response measures including vector and reservoir control. The aim of this article was to describe the CL outbreak response measures taken in the province of Errachidia, where the reservoir of L. major, a sand rat (Meriones shawi), was targeted using strychnine-poisoned wheat baits from 2010 to 2012. METHOD We analysed routine surveillance data and other information using the data of the CL control programme. RESULTS We present data on the evolution and the extension of CL in this province as well as the epidemiological profile of the disease. Between 2004 and 2013, 7099 cases of CL were recorded in Errachidia Province, gradually affecting all districts. Our results demonstrate that more women were affected than men and that all age groups were represented. CONCLUSION Errachidia Province was the epicentre of the recent CL outbreak in Morocco. A notable decline in incidence rates was observed after 2011. The outbreak control measures may have contributed to this decline, as well as climatic trends or progressing herd immunity.
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Affiliation(s)
- Issam Bennis
- National School of Public Health, Rabat, Morocco.,Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Btissam Ameur
- Directorate of Epidemiology and Diseases Control, Ministry of Health, Rabat, Morocco
| | | | | | - Sahibi Hamid
- Department of Parasitology, Agronomic and Veterinary Institute Hassan II, Rabat, Morocco
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Khadem F, Uzonna JE. Immunity to visceral leishmaniasis: implications for immunotherapy. Future Microbiol 2015; 9:901-15. [PMID: 25156379 DOI: 10.2217/fmb.14.43] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Visceral leishmaniasis, caused by Leishmania donovani, L. infantum (syn. Leishmania chagasi), is a globally widespread disease with a burden of about 400,000 new infections reported annually. It is the most dangerous form of human leishmaniasis in terms of mortality and morbidity and is spreading to several nonendemic areas because of migration, global traveling and military conflicts. The emergence of Leishmania-HIV co-infection and increased prevalence of drug-resistant strains have worsened the impact of the disease. The traditional low-cost drugs are often toxic with several adverse effects, highlighting the need for development of new therapeutic and prophylactic strategies. Therefore, a detailed understanding of mechanisms of protective immunity is extremely important in order to develop new therapeutics in the form of vaccines or immunotherapies. This review gives an overview of visceral leishmaniasis, with particular emphasis on the innate and adaptive immune responses, vaccine and vaccination strategies and their potentials for immunotherapy against the disease.
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Affiliation(s)
- Forough Khadem
- Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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30
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Immunomodulatory effects of chitin microparticles on Leishmania major-infected BALB/c mice. Parasitol Int 2014; 64:219-21. [PMID: 25543078 DOI: 10.1016/j.parint.2014.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 11/24/2014] [Accepted: 12/19/2014] [Indexed: 11/20/2022]
Abstract
Chitin and its some derivatives are known to be non-allergic and non-toxic substances. It has been shown that chitin microparticles have immunomodulatory activities. In the present study, we investigated the in vivo immunomodulatory activities of chitin microparticles (CMPs) on Leishmania major-infected BALB/c mice. BALB/c mice were infected with L. major promastigotes at their base of the tail. CMPs (100μg/100μl) were injected into the site of infection from 3days before to 2 or 8 weeks after infection at two-day intervals. Cytokine concentrations (TNF-α, IFN-γ, IL-5 and IL-10) were measured using ELISA assays. Compared to the untreated group, production of TNF-α was significantly elevated in the CMPs-treated group. Moreover, the IFN-γ/IL-5 ratio was significantly elevated in CMPs-treated infected mice (P=0.023). Notably, the concentration of IL-10 was higher in CMPs-treated mice. These results showed that CMPs have in vivo immunomodulatory effects via the production of IFN-γ and IL-10. We also measured the onset and size of lesions in both treated and untreated mice. The average times taken for the onset of the lesion formation were 35 and 29days for CMPs-treated and untreated mice (P=0.023), respectively. The mean size of the lesions was smaller in CMPs-treated group. Our study serves as a basis for future investigations on the application of CMPs as a prophylactic (vaccine adjuvant) and/or therapeutic modality against leishmaniasis.
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Bayih AG, Daifalla NS, Gedamu L. DNA-protein immunization using Leishmania peroxidoxin-1 induces a strong CD4+ T cell response and partially protects mice from cutaneous leishmaniasis: role of fusion murine granulocyte-macrophage colony-stimulating factor DNA adjuvant. PLoS Negl Trop Dis 2014; 8:e3391. [PMID: 25500571 PMCID: PMC4263403 DOI: 10.1371/journal.pntd.0003391] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 10/31/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To date, no universally effective and safe vaccine has been developed for general human use. Leishmania donovani Peroxidoxin-1 (LdPxn-1) is a member of the antioxidant family of proteins and is predominantly expressed in the amastigote stage of the parasite. The aim of this study was to evaluate the immunogenicity and protective efficacy of LdPxn-1 in BALB/c mice in heterologous DNA-Protein immunization regimen in the presence of fusion murine granulocyte-macrophage colony-stimulating factor (mGMCSF) DNA adjuvant. METHODOLOGY AND PRINCIPAL FINDINGS A fusion DNA of LdPxn1 and mGMCSF was cloned into a modified pcDNA vector. To confirm the expression in mammalian system, Chinese hamster ovary cells were transfected with the plasmid vector containing LdPxn1 gene. BALB/c mice were immunized twice with pcDNA-mGMCSF-LdPxn-1 or pcDNA-LdPxn1 DNA and boosted once with recombinant LdPxn-1 protein. Three weeks after the last immunization, mice were infected with Leishmania major promastigotes. The result showed that immunization with pcDNA-mGMCSF-LdPxn1 elicited a mixed Th-1/Th-2 immune response with significantly higher production of IFN-γ than controls. Intracellular cytokine staining of antigen-stimulated spleen cells showed that immunization with this antigen elicited significantly higher proportion of CD4+ T cells that express IFN-γ, TNF-α, or IL-2. The antigen also induced significantly higher proportion of multipotent CD4+ cells that simultaneously express the three Th-1 cytokines. Moreover, a significant reduction in the footpad swelling was seen in mice immunized with pcDNA-mGMCSF-LdPxn1 antigen. Expression study in CHO cells demonstrated that pcDNA-mGMCSF-LdPxn-1 was expressed in mammalian system. CONCLUSION The result demonstrates that immunization of BALB/c mice with a plasmid expressing LdPxn1 in the presence of mGMCSF adjuvant elicits a strong specific immune response with high level induction of multipotent CD4+ cells that mediate protection of the mice from Leishmania major infection. To our knowledge, this is the first study showing the vaccine potential of Leishmania peroxidoxin -1.
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Affiliation(s)
- Abebe Genetu Bayih
- Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
| | - Nada S. Daifalla
- Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Lashitew Gedamu
- Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada
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Freitas-Silva R, Brelaz-de-Castro MCA, Rezende AM, Pereira VR. Targeting Dendritic Cells as a Good Alternative to Combat Leishmania spp. Front Immunol 2014; 5:604. [PMID: 25505469 PMCID: PMC4245024 DOI: 10.3389/fimmu.2014.00604] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 11/10/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rafael Freitas-Silva
- Department of Natural Sciences, University of Pernambuco , Garanhuns , Brazil ; Department of Immunology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation , Recife , Brazil
| | | | - Antônio Mauro Rezende
- Department of Microbiology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation , Recife , Brazil
| | - Valéria Rêgo Pereira
- Department of Immunology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation , Recife , Brazil
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Okwor IB, Jia P, Mou Z, Onyilagha C, Uzonna JE. CD8+ T cells are preferentially activated during primary low dose leishmania major infection but are completely dispensable during secondary anti-Leishmania immunity. PLoS Negl Trop Dis 2014; 8:e3300. [PMID: 25412267 PMCID: PMC4238992 DOI: 10.1371/journal.pntd.0003300] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 09/27/2014] [Indexed: 11/19/2022] Open
Abstract
We previously showed that CD8+ T cells are required for optimal primary immunity to low dose Leishmania major infection. However, it is not known whether immunity induced by low dose infection is durable and whether CD8+ T cells contribute to secondary immunity following recovery from low dose infection. Here, we compared primary and secondary immunity to low and high dose L. major infections and assessed the influence of infectious dose on the quality and magnitude of secondary anti-Leishmania immunity. In addition, we investigated the contribution of CD8+ T cells in secondary anti-Leishmania immunity following recovery from low and high dose infections. We found that the early immune response to low and high dose infections were strikingly different: while low dose infection preferentially induced proliferation and effector cytokine production by CD8+ T cells, high dose infection predominantly induced proliferation and cytokine production by CD4+ T cells. This differential activation of CD4+ and CD8+ T cells by high and low dose infections respectively, was imprinted during in vitro and in vivo recall responses in healed mice. Both low and high dose-infected mice displayed strong infection-induced immunity and were protected against secondary L. major challenge. While depletion of CD4+ cells in mice that healed low and high dose infections abolished resistance to secondary challenge, depletion of CD8+ cells had no effect. Collectively, our results show that although CD8+ T cells are preferentially activated and may contribute to optimal primary anti-Leishmania immunity following low dose infection, they are completely dispensable during secondary immunity. It is known that CD8+ T cells are important for primary immunity to low dose L. major infection, but whether low dose-induced immunity is long lasting and whether CD8+ T cells are also important for memory immune response to low dose L. major is unknown. We studied whether infectious dose affects primary anti-Leishmania immunity and the contribution of CD8+ T cells in immunity following recovery from low and high dose infections. We found that low and high dose infections preferentially induced proliferation and cytokine production by CD8+ and CD4+ T cells, respectively, during early and late stages of infections. Also, both low and high dose-infected mice were solidly protected against secondary L. major challenge. Depletion of CD4+ cells in mice that healed low and high dose infections abolished resistance to secondary challenge, but depletion of CD8+ cells had no effect. Together, our results show that although CD8+ T cells are selectively activated and contribute to optimal primary immunity after low dose infection, they are not required for secondary immunity. This research further enhances our understanding of the immunobiology of cutaneous leishmaniasis.
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Affiliation(s)
- Ifeoma B. Okwor
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ping Jia
- Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Zhirong Mou
- Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Jude E. Uzonna
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada
- * E-mail:
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Seyed N, Taheri T, Vauchy C, Dosset M, Godet Y, Eslamifar A, Sharifi I, Adotevi O, Borg C, Rohrlich PS, Rafati S. Immunogenicity evaluation of a rationally designed polytope construct encoding HLA-A*0201 restricted epitopes derived from Leishmania major related proteins in HLA-A2/DR1 transgenic mice: steps toward polytope vaccine. PLoS One 2014; 9:e108848. [PMID: 25310094 PMCID: PMC4195657 DOI: 10.1371/journal.pone.0108848] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 08/22/2014] [Indexed: 11/18/2022] Open
Abstract
Background There are several reports demonstrating the role of CD8 T cells against Leishmania species. Therefore peptide vaccine might represent an effective approach to control the infection. We developed a rational polytope-DNA construct encoding immunogenic HLA-A2 restricted peptides and validated the processing and presentation of encoded epitopes in a preclinical mouse model humanized for the MHC-class-I and II. Methods and Findings HLA-A*0201 restricted epitopes from LPG-3, LmSTI-1, CPB and CPC along with H-2Kd restricted peptides, were lined-up together as a polytope string in a DNA construct. Polytope string was rationally designed by harnessing advantages of ubiquitin, spacers and HLA-DR restricted Th1 epitope. Endotoxin free pcDNA plasmid expressing the polytope was inoculated into humanized HLA-DRB1*0101/HLA-A*0201 transgenic mice intramuscularly 4 days after Cardiotoxin priming followed by 2 boosters at one week interval. Mice were sacrificed 10 days after the last booster, and splenocytes were subjected to ex-vivo and in-vitro evaluation of specific IFN-γ production and in-vitro cytotoxicity against individual peptides by ELISpot and standard chromium-51(51Cr) release assay respectively. 4 H-2Kd and 5 HLA-A*0201 restricted peptides were able to induce specific CD8 T cell responses in BALB/C and HLA-A2/DR1 mice respectively. IFN-γ and cytolytic activity together discriminated LPG-3-P1 as dominant, LmSTI-1-P3 and LmSTI-1-P6 as subdominant with both cytolytic activity and IFN-γ production, LmSTI-1-P4 and LPG-3-P5 as subdominant with only IFN-γ production potential. Conclusions Here we described a new DNA-polytope construct for Leishmania vaccination encompassing immunogenic HLA-A2 restricted peptides. Immunogenicity evaluation in HLA-transgenic model confirmed CD8 T cell induction with expected affinities and avidities showing almost efficient processing and presentation of the peptides in relevant preclinical model. Further evaluation will determine the efficacy of this polytope construct protecting against infectious challenge of Leishmania. Fortunately HLA transgenic mice are promising preclinical models helping to speed up immunogenicity analysis in a human related mouse model.
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Affiliation(s)
- Negar Seyed
- Molecular Immunology and Vaccine Research Lab, Pasteur Institute of Iran, Tehran, Iran
| | - Tahereh Taheri
- Molecular Immunology and Vaccine Research Lab, Pasteur Institute of Iran, Tehran, Iran
| | - Charline Vauchy
- INSERM U1098, Unité Mixte de Recherche, Besançon, France
- Etablissement Français du Sang de Bourgogne Franche-Comté, Besançon, France
- Université de Franche-Comté, Besançon, France
| | - Magalie Dosset
- INSERM U1098, Unité Mixte de Recherche, Besançon, France
- Etablissement Français du Sang de Bourgogne Franche-Comté, Besançon, France
- Université de Franche-Comté, Besançon, France
| | - Yann Godet
- INSERM U1098, Unité Mixte de Recherche, Besançon, France
- Etablissement Français du Sang de Bourgogne Franche-Comté, Besançon, France
- Université de Franche-Comté, Besançon, France
| | - Ali Eslamifar
- Department of Electron Microscopy and Clinical Research, Pasteur Institute of Iran, Tehran, Iran
| | - Iraj Sharifi
- School of Medicine, Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Olivier Adotevi
- INSERM U1098, Unité Mixte de Recherche, Besançon, France
- Etablissement Français du Sang de Bourgogne Franche-Comté, Besançon, France
- Université de Franche-Comté, Besançon, France
- CHRU de Besançon, Service d′Oncologie, Besançon, France
| | - Christophe Borg
- INSERM U1098, Unité Mixte de Recherche, Besançon, France
- Etablissement Français du Sang de Bourgogne Franche-Comté, Besançon, France
- Université de Franche-Comté, Besançon, France
- CHRU de Besançon, Service d′Oncologie, Besançon, France
| | - Pierre Simon Rohrlich
- INSERM U1098, Unité Mixte de Recherche, Besançon, France
- Etablissement Français du Sang de Bourgogne Franche-Comté, Besançon, France
- Université de Franche-Comté, Besançon, France
- CHRU de Besançon, Service de pédiatrie, Besançon, France
| | - Sima Rafati
- Molecular Immunology and Vaccine Research Lab, Pasteur Institute of Iran, Tehran, Iran
- * E-mail:
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Ashok D, Acha-Orbea H. Timing is everything: dendritic cell subsets in murine Leishmania infection. Trends Parasitol 2014; 30:499-507. [DOI: 10.1016/j.pt.2014.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 08/07/2014] [Accepted: 08/08/2014] [Indexed: 02/02/2023]
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Saljoughian N, Taheri T, Rafati S. Live vaccination tactics: possible approaches for controlling visceral leishmaniasis. Front Immunol 2014; 5:134. [PMID: 24744757 PMCID: PMC3978289 DOI: 10.3389/fimmu.2014.00134] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 03/17/2014] [Indexed: 01/15/2023] Open
Abstract
Vaccination with durable immunity is the main goal and fundamental to control leishmaniasis. To stimulate the immune response, small numbers of parasites are necessary to be presented in the mammalian host. Similar to natural course of infection, strategy using live vaccine is more attractive when compared to other approaches. Live vaccines present the whole spectrum of antigens to the host immune system in the absence of any adjuvant. Leishmanization was the first effort for live vaccination and currently used in a few countries against cutaneous leishmaniasis, in spite of their obstacle and safety. Then, live attenuated vaccines developed with similar promotion of creating long-term immunity in the host with lower side effect. Different examples of attenuated strains are generated through long-term in vitro culturing, culturing under drug pressure, temperature sensitivity, and chemical mutagenesis, but none is safe enough and their revision to virulent form is possible. Attenuation through genetic manipulation and disruption of virulence factors or essential enzymes for intracellular survival are among other approaches that are intensively under study. Other designs to develop live vaccines for visceral form of leishmaniasis are utilization of live avirulent microorganisms such as Lactococcus lactis, Salmonella enterica, and Leishmania tarentolae called as vectored vaccine. Apparently, these vaccines are intrinsically safer and can harbor the candidate antigens in their genome through different genetic manipulation and create more potential to control Leishmania parasite as an intracellular pathogen.
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Affiliation(s)
- Noushin Saljoughian
- Molecular Immunology and Vaccine Research Laboratory, Pasteur Institute of Iran, Tehran, Iran
| | - Tahareh Taheri
- Molecular Immunology and Vaccine Research Laboratory, Pasteur Institute of Iran, Tehran, Iran
| | - Sima Rafati
- Molecular Immunology and Vaccine Research Laboratory, Pasteur Institute of Iran, Tehran, Iran
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Ali KS, Rees RC, Terrell-Nield C, Ali SA. Virulence loss and amastigote transformation failure determine host cell responses to Leishmania mexicana. Parasite Immunol 2014; 35:441-56. [PMID: 23869911 DOI: 10.1111/pim.12056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 07/15/2013] [Indexed: 12/26/2022]
Abstract
The effect of alterations in virulence and transformation by long-term in vitro culture of Leishmania mexicana promastigotes on infectivity and immune responses was investigated. Fresh parasite cultures harvested from Balb/c mice were passaged 20 times in vitro. Infectivity was decreased and was completely avirulent after 20 passages. The qPCR results showed a down-regulation of GP63, LPG2, CPC, CPB2, CPB2.8, CHT1, LACK and LDCEN3 genes after passage seven concomitant with a reduced and absence of infectivity by passages seven and 20, respectively. Parasites at passages one and 20 are referred to as virulent and avirulent, respectively. The growth of avirulent and virulent parasite was affected by conditioned media derived from macrophages or monocytes infected with parasites for 2 h. Giemsa staining showed the failure of avirulent but not virulent parasites to transform to the amastigote stage in infected host cells with both virulent and avirulent modulating the expression of CCL-22, Tgad51, Cox2, IL-1, IL-10, TGF-β, TNF-α, Rab7, Rab9 and A2 genes; virulent but not avirulent L. mexicana significantly up-regulated Th2-associated cytokines, but down-regulated Rab7 and Rab9 gene expression. In conclusion, a model for L. mexicana is reported, which is of potential value in studying host-parasite interaction.
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Affiliation(s)
- K S Ali
- Interdisciplinary Biomedical Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
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Rafati S, Modabber F. Cutaneous Leishmaniasis in Middle East and North Africa. NEGLECTED TROPICAL DISEASES 2014. [DOI: 10.1007/978-3-7091-1613-5_5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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2,3,7,8-tetrachlorodibenzo-p-dioxin slows the progression of experimental cutaneous Leishmaniasis in susceptible BALB/c and SCID mice. PLoS One 2013; 8:e76259. [PMID: 24098456 PMCID: PMC3788076 DOI: 10.1371/journal.pone.0076259] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 08/22/2013] [Indexed: 12/01/2022] Open
Abstract
In a model of experimental cutaneous leishmaniasis, pre-exposure of Leishmania major-resistant mice to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), an aryl hydrocarbon receptor agonist, causes suppression of the protective anti-parasite T helper 1 response while paradoxically also reducing parasite burdens in those animals. In this study, we examined if TCDD exposure could also reduce parasite burdens in L. major-susceptible BALB/c mice. In the highest dose group (160 µg/Kg), TCDD treatment caused a significant reduction of parasite burdens by 10-fold after three weeks while also causing a significant lymphoid atrophy indicating suppression of the non-protective T helper 2 response. A dose-dependent delay of foot lesion progression was also observed such that lesion size in the highest dose group was less than half that of controls after 35 days of infection. Importantly, although TCDD exposure initially reduced disease severity and prolonged the course of disease by as much as three fold in some animals, this effect was transitory and TCDD did not induce resistance to L. major infection. Because TCDD exposure reduced L. major burdens in both resistant and susceptible mice, we hypothesized that TCDD reduces L. major burdens in mice by a mechanism that does not involve adaptive immunity. To test this, severe combined immunodeficient (SCID) mice were used. In mice infected with a moderate number of L. major (10,000), TCDD treatment caused a time- and dose-dependent decrease of parasite burdens by nearly 100-fold after six weeks in the highest dose group (200 µg/Kg). A significant and dose-dependent delay of foot lesion progression was also observed in these animals. These results indicate that TCDD exposure can reduce the severity of leishmanial disease in mice independent of adaptive immunity.
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Daftarian PM, Stone GW, Kovalski L, Kumar M, Vosoughi A, Urbieta M, Blackwelder P, Dikici E, Serafini P, Duffort S, Boodoo R, Rodríguez-Cortés A, Lemmon V, Deo S, Alberola J, Perez VL, Daunert S, Ager AL. A targeted and adjuvanted nanocarrier lowers the effective dose of liposomal amphotericin B and enhances adaptive immunity in murine cutaneous leishmaniasis. J Infect Dis 2013; 208:1914-22. [PMID: 23901083 DOI: 10.1093/infdis/jit378] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Amphotericin B (AmB), the most effective drug against leishmaniasis, has serious toxicity. As Leishmania species are obligate intracellular parasites of antigen presenting cells (APC), an immunopotentiating APC-specific AmB nanocarrier would be ideally suited to reduce the drug dosage and regimen requirements in leishmaniasis treatment. Here, we report a nanocarrier that results in effective treatment shortening of cutaneous leishmaniasis in a mouse model, while also enhancing L. major specific T-cell immune responses in the infected host. METHODS We used a Pan-DR-binding epitope (PADRE)-derivatized-dendrimer (PDD), complexed with liposomal amphotericin B (LAmB) in an L. major mouse model and analyzed the therapeutic efficacy of low-dose PDD/LAmB vs full dose LAmB. RESULTS PDD was shown to escort LAmB to APCs in vivo, enhanced the drug efficacy by 83% and drug APC targeting by 10-fold and significantly reduced parasite burden and toxicity. Fortuitously, the PDD immunopotentiating effect significantly enhanced parasite-specific T-cell responses in immunocompetent infected mice. CONCLUSIONS PDD reduced the effective dose and toxicity of LAmB and resulted in elicitation of strong parasite specific T-cell responses. A reduced effective therapeutic dose was achieved by selective LAmB delivery to APC, bypassing bystander cells, reducing toxicity and inducing antiparasite immunity.
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