Human serum resistant Trypanosoma brucei rhodesiense accumulates similar amounts of fluorescently-labelled trypanolytic human HDL3 particles as human serum sensitive T.b. brucei

Natural human immunity to trypanosomes

Complement-dependent destruction of invading micro-organisms is a crucial first-line defense against infection, yet both African and American trypanosomes are able to resist attack by complement. African trypanosomes resist non-specific complement attack by virtue of a thick glycoprotein surface coat, and the host range of certain African trypanosomes is believed to be defined by their susceptibility to a subclass of human high density lipoprotein (HDL) and/or a high molecular weight protein complex present in human serum. In the first part of this review, Stephen Tomlinson and Jayne Raper look at the properties and mechanisms of action of these trypanolytic factors on African trypanosomes, and discuss briefly the possible mechanisms whereby these human pathogens resist lysis by human serum. The mechanisms that enable the American trypanosome Trypanosoma cruzi to resist complement attack are reviewed in the second part of this article.

The trypanolytic factor-mechanism, impacts and applications

The Trypanosoma brucei subspecies T. brucei brucei is non-human infective due to susceptibility to lysis by trypanolytic factor (TLF) in human serum. Reviewed here are the advances which have revealed apolipoprotein L1 (ApoL1), found in high density lipoprotein, as the lysis-inducing component of TLF, the means of uptake via haptoglobin-related protein receptor and the mechanism of resistance in T. b. rhodesiense via its serum resistance-associated (SRA) protein. The first practical steps to application of these discoveries are now in progress; transgenic animals expressing either baboon or minimally truncated human ApoL1 show resistance to both T. b. brucei and T. b. rhodesiense. This has major implications for treatment and prevention of human and animal African trypanosomiasis.

In vitro generation of human high-density-lipoprotein-resistant Trypanosoma brucei brucei

The host range of African trypanosomes is influenced by innate protective molecules in the blood of primates. A subfraction of human high-density lipoprotein (HDL) containing apolipoprotein A-I, apolipoprotein L-I, and haptoglobin-related protein is toxic to Trypanosoma brucei brucei but not the human sleeping sickness parasite Trypanosoma brucei rhodesiense. It is thought that T. b. rhodesiense evolved from a T. b. brucei-like ancestor and expresses a defense protein that ablates the antitrypanosomal activity of human HDL. To directly investigate this possibility, we developed an in vitro selection to generate human HDL-resistant T. b. brucei. Here we show that conversion of T. b. brucei from human HDL sensitive to resistant correlates with changes in the expression of the variant surface glycoprotein (VSG) and abolished uptake of the cytotoxic human HDLs. Complete transcriptome analysis of the HDL-susceptible and -resistant trypanosomes confirmed that VSG switching had occurred but failed to reveal the expression of other genes specifically associated with human HDL resistance, including the serum resistance-associated gene (SRA) of T. b. rhodesiense. In addition, we found that while the original active expression site was still utilized, expression of three expression site-associated genes (ESAG) was altered in the HDL-resistant trypanosomes. These findings demonstrate that resistance to human HDLs can be acquired by T. b. brucei.

The trypanolytic factor of human serum

African trypanosomes (the prototype of which is Trypanosoma brucei brucei) are protozoan parasites that infect a wide range of mammals. Human blood, unlike the blood of other mammals, has efficient trypanolytic activity, and this needs to be counteracted by these parasites. Resistance to this activity has arisen in two subspecies of Trypanosoma brucei - Trypanosoma brucei rhodesiense and Trypanosoma brucei gambiense - allowing these parasites to infect humans, and this results in sleeping sickness in East Africa and West Africa, respectively. Study of the mechanism by which T. b. rhodesiense escapes lysis by human serum led to the identification of an ionic-pore-forming apolipoprotein - known as apolipoprotein L1 - that is associated with high-density-lipoprotein particles in human blood. In this Opinion article, we argue that apolipoprotein L1 is the factor that is responsible for the trypanolytic activity of human serum.

The trypanosome lytic factor of human serum and the molecular basis of sleeping sickness

Trypanosoma brucei brucei infects a wide range of mammals but is unable to infect humans because this subspecies is lysed by normal human serum (NHS). The trypanosome lytic factor is associated with High Density Lipoproteins (HDLs). Several HDL-associated components have been proposed as candidate lytic factors, and contradictory hypotheses concerning the mechanism of lysis have been suggested. Elucidation of the process by which Trypanosoma brucei rhodesiense resists lysis and causes human sleeping sickness has indicated that the HDL-bound apolipoprotein L-I (apoL-I) could be the long-sought after lytic component of NHS. This research also allowed the identification of a specific diagnostic DNA probe for T. b. rhodesiense, and may lead to the development of novel anti-trypanosome strategies for use in the field.

Evidence for a Trypanosoma brucei lipoprotein scavenger receptor

African trypanosomes are lipid auxotrophs that live in the bloodstream of their human and animal hosts. Trypanosomes require lipoproteins in addition to other serum components in order to multiply under axenic culture conditions. Delipidation of the lipoproteins abrogates their capacity to support trypanosome growth. Both major classes of serum lipoproteins, LDL and HDL, are primary sources of lipids, delivering cholesterol esters, cholesterol, and phospholipids to trypanosomes. We show evidence for the existence of a trypanosome lipoprotein scavenger receptor, which facilitates the endocytosis of both native and modified lipoproteins, including HDL and LDL. This lipoprotein scavenger receptor also exhibits selective lipid uptake, whereby the uptake of the lipid components of the lipoprotein exceeds that of the protein components. Trypanosome lytic factor (TLF1), an unusual HDL found in human serum that protects from infection by lysing Trypanosoma brucei brucei, is also bound and endocytosed by this lipoprotein scavenger receptor. HDL and LDL compete for the binding and uptake of TLF1 and thereby attenuate the trypanosome lysis mediated by TLF1. We also show that a mammalian scavenger receptor facilitates lipid uptake from TLF1 in a manner similar to the trypanosome scavenger receptor. Based on these results we propose that HDL, LDL, and TLF1 are all bound and taken up by a lipoprotein scavenger receptor, which may constitute the parasite's major pathway mediating the uptake of essential lipids.

Natural immunity to human African trypanosomiasis: trypanosome lytic factors and the blood incubation infectivity test

This review focuses on the epidemiology of human African trypanosomiasis: why it occurs in humans, the current methods of surveillance, and the drugs available to treat it. Emphasis is placed on the identification of human-infective trypanosomes by the blood incubation infectivity test. This test distinguishes between trypanosomes that are non-infective for humans and those that are potentially infective. Currently the test requires incubation of parasites with human serum before injection into mice; any surviving parasites are considered human-infective. The factors in serum that kill all non-human-infective parasites are known as trypanosome lytic factors. The paper details the biochemistry of these factors and recommends standardization of the test based on current knowledge. This test can be used to screen animals with trypanosomiasis, in order to evaluate their role during endemic and epidemic human African trypanosomiasis.

An investigation into the mechanism of trypanosome lysis by human serum factors

African trypanosomes are the causative agents of sleeping sickness in humans and of Nagana in cattle. The infectivity of African trypanosome species for humans appears to be defined by their susceptibility to two lytic factors in human serum; trypanosome lytic factor (TLF)1, a subclass of human high density lipoprotein (HDL) and TLF2, a high molecular weight protein complex. Available evidence indicates that following receptor mediated uptake, TLF is targeted to the lysosome where the low pH triggers a TLF-dependant peroxidase activity resulting in the formation of reactive oxygen radicals with consequent lipid peroxidation and destruction of the lysosomal membrane. Nearly all previous work on the mechanism of parasite lysis has been performed using TLF1. In this study, we directly test the hypothesis that TLF1 and TLF2 kill Trypanosoma brucei by a mechanism involving oxidative stress. We found no evidence for lipid peroxidation in trypanosomes exposed to high concentrations of trypanolytic HDL (impure TLF1), although lipid peroxidation was detected in parasites exposed to low concentrations of low molecular weight peroxides. Neither HDL, TLF1 nor TLF2 generated detectable levels of intracellular reactive oxygen intermediates. Various antioxidants also had no effect on TLF1 or TLF2-mediated lysis, although the antioxidants catalase and superoxide dismutase were effective at inhibiting peroxide generation and parasite lysis in control systems. Various metal chelating agents and protease inhibitors were also tested without effect. These data provide strong evidence against a peroxidative mechanism being involved in TLF-mediated lysis.

The lysis of Trypanosoma brucei brucei by human serum

The natural immunity of humans to the cattle pathogen Trypanosoma brucei brucei, but not to the morphologically indistinguishable human pathogens T. brucei gambiense and T. brucei rhodesiense, is due to the selective killing of the parasite by normal human serum. The factor in human serum that mediates lysis of T. brucei brucei has long been attributed to a minor subclass of high density lipoprotein (HDL). Evidence indicates that the trypanolytic activity of isolated human HDL is due to peroxidase activity of an associated haptoglobin-related protein-hemoglobin complex. However, recent data suggest that the trypanolytic activity of HDL may be completely inhibited in whole human serum, and that trypanolytic activity of norman human serum is due to a second, less well-defined factor of high molecular weight. Current research aimed at understanding the mechanisms of cytotoxicity and the affected metabolic pathways may open new approaches for the development of specific drugs and vaccines against trypanosomiasis.