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de Souza-Silva TG, Gollob KJ, Dutra WO. T-cell receptor variable region usage in Chagas disease: A systematic review of experimental and human studies. PLoS Negl Trop Dis 2022; 16:e0010546. [PMID: 36107855 PMCID: PMC9477334 DOI: 10.1371/journal.pntd.0010546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
T cells recognize their ligand, the peptide major histocompatibility complex (MHC), via the T-cell receptor (TCR), which is composed of covalently linked α and β or γ and δ chains. This recognition is critical for T-cell ontogeny and controls the selection, activation, and function of T lymphocytes. Specific TCR αβ variable regions have been associated with immunopathogenesis of Chagas disease. Here, we present a systematic review that compiles experimental in vivo and human data regarding the preferential expression of variable alpha (Vα) and variable beta (Vβ) chain regions in Trypanosoma cruzi infection. The original studies indexed in PubMed/Medline, Scopus, and Web of Science databases were screened according to the PRISMA strategy. The analysis showed that expression of TCR Vα subfamilies were evaluated in one human study, and, unlike TCR Vβ, TCR Vα presented a more restricted usage. Despite the great variability in the usage of TCR Vβ regions in human Chagas disease, a down-regulation of TCR Vβ5 expression by T cells from patients in the acute phase of the disease was shown. Opposingly, this TCR region was found overly expressed in CD4+ T cells from chronic Chagas patients. It was also demonstrated that murine Vβ9+ T cells derived from nonlymphoid organs of T. cruzi-infected animals had a modulatory profile, while splenic Vβ9+ T cells produced inflammatory cytokines, indicating that although they display the same TCR Vβ region usage, these cells are functionally distinct. Despite the limitations of few papers and year of publication of the studies, compiling the data derived from them reveals that further investigation of TCR usage will point to their potential role in protective or pathogenic responses, as biomarkers of disease progression, and in the search for dominant peptides potentially useful for the development of vaccines or therapies. Chagas disease is a neglected tropical disease, caused by infection with Trypanosoma cruzi. Differential expression of certain T-cell receptor (TCR) variable regions has been associated with the immunopathogenesis of Chagas disease. Here, we present a systematic review that compiled experimental in vivo and human data regarding the preferential expression of TCR alpha and beta chain variable regions in Chagas disease. The original studies indexed in the PubMed/Medline, Scopus, and Web of Science databases were screened according to the PRISMA strategy. Despite the great variability in the use of TCR Vβ in T. cruzi infection, the outcomes indicate that there is a down-regulation of TCR Vβ5 expression in T cells from patients in the acute phase of Chagas disease. However, this region is preferentially expressed by CD4+ T cells from chronic Chagas patients. Additionally, it has been demonstrated that murine Vβ9+ T cells derived from nonlymphoid organs displayed a modulatory profile, while splenic Vβ9+ T cells produced inflammatory cytokines, indicating that although they express the same TCR Vβ region, these cells are functionally distinct. Information on TCR expression, specificity and function have critical impact on vaccine design.
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Affiliation(s)
- Thaiany Goulart de Souza-Silva
- Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Kenneth J. Gollob
- Hospital Israelita Albert Einstein, São Paulo, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, Belo Horizonte, Minas Gerais, Brazil
| | - Walderez O. Dutra
- Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
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Zhang F, Li Y, Shi Y, Wang L, Zhou Q, Huang X. A novel evaluation of the effect of lanthanum exposure on plant populations. CHEMOSPHERE 2018; 202:377-386. [PMID: 29574391 DOI: 10.1016/j.chemosphere.2018.03.086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 02/25/2018] [Accepted: 03/12/2018] [Indexed: 06/08/2023]
Abstract
The accumulation of rare earth elements (REEs) in the environment has recently become a new environmental problem. There have been many studies about the effects of REEs on plant at the individual, organ, cellular and genetic levels. Plants exist in populations under natural conditions, but little is known about the effects of REEs on plant populations. In this study, the effects of lanthanum (III) [La(III)] on the root module growth of soybean (Glycine max L) populations at different densities were investigated by simulating La(III) pollution. Results showed that at La(III) concentrations of 0.40 and 1.20 mM, both the root module growth parameters and leaf photosynthesis parameters were decreased, with 1.20 mM of La(III) causing a more significant decrease. In addition, the above parameters in low-density soybean populations decreased more significantly than those in high-density soybean populations. The above results show that the inhibitory effects of 0.40 and 1.20 mM of La(III) on the growth of root modules are closely related to the inhibition of photosynthesis in soybean population. Moreover, the inhibitory effect of La(III) on the growth of root modules of soybean population is enhanced as the La(III) concentration increases, while is weakened as plant population density increases. This study would provide a reference for the further research on the ecotoxicology of REEs, and show a new perspective and basis for the objective assessment of the environmental risks of REEs. ONE SENTENCE SUMMARY La(III) pollution affects the root module growth and photosynthesis in soybean populations, and the effects vary depending on soybean population densities.
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Affiliation(s)
- Fan Zhang
- State Key Laboratory of Food Science and Technology, Jiangsu Key Laboratory of Anaerobic Biotechnology, School of Environment and Civil Engineering, Jiangnan University, Wuxi, 214122, China
| | - Yihang Li
- State Key Laboratory of Food Science and Technology, Jiangsu Key Laboratory of Anaerobic Biotechnology, School of Environment and Civil Engineering, Jiangnan University, Wuxi, 214122, China
| | - Yu Shi
- State Key Laboratory of Food Science and Technology, Jiangsu Key Laboratory of Anaerobic Biotechnology, School of Environment and Civil Engineering, Jiangnan University, Wuxi, 214122, China
| | - Lihong Wang
- State Key Laboratory of Food Science and Technology, Jiangsu Key Laboratory of Anaerobic Biotechnology, School of Environment and Civil Engineering, Jiangnan University, Wuxi, 214122, China
| | - Qing Zhou
- State Key Laboratory of Food Science and Technology, Jiangsu Key Laboratory of Anaerobic Biotechnology, School of Environment and Civil Engineering, Jiangnan University, Wuxi, 214122, China; Jiangsu Cooperative Innovation Center of Water Treatment Technology and Materials, Suzhou University of Science and Technology, Suzhou, 215009, China.
| | - Xiaohua Huang
- Jiangsu Collaborative Innovation Center of Biomedical Functional Materials, Jiangsu Key Laboratory of Biomedical Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing, 210046, China.
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3
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Menezes CAS, Sullivan AK, Falta MT, Mack DG, Freed BM, Rocha MOC, Gollob KJ, Fontenot AP, Dutra WO. Highly conserved CDR3 region in circulating CD4(+)Vβ5(+) T cells may be associated with cytotoxic activity in Chagas disease. Clin Exp Immunol 2012; 169:109-18. [PMID: 22774985 PMCID: PMC3406370 DOI: 10.1111/j.1365-2249.2012.04608.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2012] [Indexed: 12/17/2022] Open
Abstract
Human infection with Trypanosoma cruzi leads to Chagas disease, which presents as several different clinical conditions ranging from an asymptomatic form to a severe dilated cardiomyopathy. Several studies have demonstrated that T cells play a critical role in the development of cardiac pathology, as well as in immunoregulation during chronic disease. However, the mechanisms that drive protective or pathogenic T cell response are not known. We have shown that CD4(+) T cells from chagasic patients preferentially express T cell receptor (TCR) β-chain variable region (Vβ) 5. The aim of this work was to determine whether T cells expressing this particular Vβ region displayed variable or restricted CDR3 sequences, as an indicator of the nature of the stimulus leading to the activation of these T cells in vivo. Additionally, we aimed to evaluate phenotypic characteristics of these cells that might be associated with pathology. CDR3 junctional region sequencing of Vβ5·1 expressing CD4(+) T cells revealed the occurrence of a highly homologous CDR3 region with conserved TCR Jβ region usage among patients with cardiac, but not indeterminate, Chagas disease. Moreover, correlation analysis indicated that the frequency of CD4(+)Vβ5·1(+) cells is associated with granzyme A expression, suggesting that these cells might display cytotoxic function. Together these results provide new insight into T cell recognition of antigens involved in Chagas disease and suggest that these cells may be implicated in the pathogenesis of chagasic cardiomyopathy.
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MESH Headings
- Amino Acid Sequence
- Base Sequence
- CD4-Positive T-Lymphocytes/immunology
- CD4-Positive T-Lymphocytes/metabolism
- Chagas Disease/genetics
- Chagas Disease/immunology
- Chagas Disease/metabolism
- Complementarity Determining Regions/chemistry
- Complementarity Determining Regions/immunology
- Cytotoxicity, Immunologic
- Gene Expression Regulation/immunology
- Histocompatibility Antigens Class II/genetics
- Histocompatibility Antigens Class II/immunology
- Histocompatibility Testing
- Humans
- Immunophenotyping
- Leukocytes, Mononuclear/immunology
- Leukocytes, Mononuclear/metabolism
- Molecular Sequence Data
- Receptors, Antigen, T-Cell, alpha-beta/genetics
- Receptors, Antigen, T-Cell, alpha-beta/immunology
- Receptors, Antigen, T-Cell, alpha-beta/metabolism
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Affiliation(s)
- C A S Menezes
- Department of Biological Sciences, Exact and Biological Sciences Institute, Federal University of Ouro Preto, Minas Gerais, Brazil
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Vogt J, Alba Soto CD, Mincz MP, Mirkin GA. Impaired Trypanosoma cruzi-specific IFN-gamma secretion by T cells bearing the BV9 T-cell receptor is associated with local IL-10 production in non-lymphoid tissues of chronically infected mice. Microbes Infect 2008; 10:781-90. [PMID: 18534889 DOI: 10.1016/j.micinf.2008.04.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2007] [Revised: 03/28/2008] [Accepted: 04/16/2008] [Indexed: 01/25/2023]
Abstract
The role of non-lymphoid tissue T cells expressing the BV9 family T-cell receptor (TCRBV9) was studied in mice chronically infected with the Trypanosoma cruzi. Heart and skeletal muscles had higher frequencies and ratios of CD8+ TCRBV9+ to CD4+ TCRBV9+ T cells than lymph nodes. Also, homing experiments of CFSE-labeled T cells showed preferential homing of TCRBV9+ T cells to heart tissue. In vitro proliferation assays showed higher [3H]thymidine uptake by non-lymphoid tissue TCRBV9+ T cells than lymph node TCRBV9+ T cells co-cultured with antigen-presenting cells (APC), in response to T. cruzi amastigote antigens (TcAg). Lymph node TCRBV9+ T cells secreted IFN-gamma and IL-10, but not IL-4, upon stimulation with TcAg in the presence of APC. Moreover, non-lymphoid tissue-derived TCRBV9+ T cells showed impairment of IFN-gamma, no IL-4 production, and higher levels of IL-10 secretion under the same conditions. Our results show that T. cruzi-specific IFN-gamma- and IL-10-producing TCR BV9+ T cells develop in the mouse lymph nodes during chronic infection with T. cruzi. Upon homing to non-lymphoid parasitized tissues, IFN-gamma secretion might subside due to the overt secretion of IL-10, of which TCRBV9+ T cells represent a significant source.
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Affiliation(s)
- Javier Vogt
- Departamento de Microbiología, Parasitología e Inmunología. Facultad de Medicina, Universidad de Buenos Aires. Paraguay 2155, Buenos Aires, Argentina
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Tekiel V, Oliveira GC, Correa-Oliveira R, Sánchez D, González-Cappa SM. Chagas' disease: TCRBV9 over-representation and sequence oligoclonality in the fine specificity of T lymphocytes in target tissues of damage. Acta Trop 2005; 94:15-24. [PMID: 15777704 DOI: 10.1016/j.actatropica.2005.01.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2004] [Revised: 01/26/2005] [Accepted: 01/27/2005] [Indexed: 10/25/2022]
Abstract
Using the same mouse strain and two Trypanosoma cruzi sub-populations (CA-I and RA) it is possible to induce pathology in different target tissues: skeletal muscle (CA-I) or sciatic nerve and spinal cord (RA). On the other hand, T cells are directly involved in tissue injury in a strain-dependent way, resembling the abnormalities of chronic Chagas' disease. In the present work, we examined the TCRBV repertoire and the CDR3 sequence polymorphism of T cells infiltrating spinal cord, sciatic nerve and skeletal muscle in chronically infected mice. The TCRBV9 segment was systematically over-represented in the target tissues for each T. cruzi strain: sciatic nerve and spinal cord in RA and skeletal muscle in CA-I-infected mice. The analysis of CDR3 sequence polymorphism in the same tissues showed a high proportion of identical TCRBV9 clones in RA-infected mice: 66.6% of the TCRBV9 clones found in sciatic nerve and spinal cord expressed one out of four major CDR3 rearrangements. Sequence identity was shared among clones from sciatic nerve and spinal cord, tissues that are also damaged by passive transfer of CD8 + TL. Those observations are consistent with an antigen driven T-cell expansion sequestered at the inflammation site and demonstrate -- for the first time -- the presence of an oligoclonal repertoire in the antigen recognition site of over-represented T cells in nervous system tissues in chronic Chagas' disease.
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MESH Headings
- Amino Acid Sequence
- Animals
- Chagas Disease/immunology
- Chagas Disease/parasitology
- Clone Cells
- Complementarity Determining Regions/genetics
- Complementarity Determining Regions/immunology
- Male
- Mice
- Mice, Inbred BALB C
- Mice, Inbred C3H
- Molecular Sequence Data
- Muscle, Skeletal/immunology
- Muscle, Skeletal/parasitology
- Neuromuscular Diseases/immunology
- Neuromuscular Diseases/parasitology
- Polymorphism, Genetic
- Receptors, Antigen, T-Cell, alpha-beta/genetics
- Receptors, Antigen, T-Cell, alpha-beta/immunology
- Reverse Transcriptase Polymerase Chain Reaction
- Sciatic Nerve/immunology
- Sciatic Nerve/parasitology
- Spinal Cord/immunology
- Spinal Cord/parasitology
- T-Lymphocytes/immunology
- T-Lymphocytes/parasitology
- Trypanosoma cruzi/genetics
- Trypanosoma cruzi/immunology
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Affiliation(s)
- Valeria Tekiel
- Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
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Paiva CN, Pyrrho AS, Lannes-Vieira J, Vacchio M, Soares MBP, Gattass CR. Trypanosoma cruzi sensitizes mice to fulminant SEB-induced shock: overrelease of inflammatory cytokines and independence of Chagas' disease or TCR Vbeta-usage. Shock 2003; 19:163-8. [PMID: 12578126 DOI: 10.1097/00024382-200302000-00013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Trypanosoma cruzi-infected mice display increased susceptibility to shock induced by injection of lipopolysaccharide (LPS), anti-CD3, or resulting from interleukin (IL)-10-defective response to the parasite itself, but the basis of such susceptibility remains unknown. Herein, we tested the susceptibility of mice inoculated with virulent and avirulent T. cruzi to staphylococcal enterotoxins (SE), potent inducers of inflammatory cytokine secretion. Mice infected with T. cruzi CL-strain or inoculated with the avirulent clone CL-14, a clone that does not induce disease or polyclonal lymphocyte activation, succumb suddenly to low doses of staphylococcal enterotoxin B (SEB), but not to staphylococcal enterotoxin A (SEA). High plasma levels of TNF, IFN-gamma, and liver transaminases alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were found in these mice, indicating lethal toxic shock. Sensitization to shock required inoculation of live avirulent trypomastigotes and a time interval before challenge with SEB. We found no prior skewing of T cell receptor (TCR) Vbeta-repertoire in CL-14-inoculated mice that could be responsible for sensitization. Splenocytes from CL-14-inoculated mice proliferated more under anti-Vbeta8 than anti-TCRbeta stimulation when compared with normal mice, but were suppressed to SEB stimulation. Both SEB and anti-Vbeta8 antibodies stimulated splenocytes from T. cruzi-inoculated mice to secrete higher levels of inflammatory cytokines than normal controls. Taken together, our results show that T. cruzi inoculation can sensitize mice to lethal SEB-induced shock even in the absence of tissue damage, polyclonal lymphocyte activation, or previously increased levels of inflammatory cytokines, and they suggest that altered reactivity of Vbeta8 lymphocytes may be involved in the phenomenon.
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Affiliation(s)
- Cláudia N Paiva
- Laboratório de Imunoparasitologia, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, RJ, Brasil 21949-900
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Fernández-Mestre MT, Jaraquemada D, Bruno RE, Caro J, Layrisse Z. Analysis of the T-cell receptor beta-chain variable-region (Vbeta) repertoire in chronic human Chagas' disease. TISSUE ANTIGENS 2002; 60:10-5. [PMID: 12366778 DOI: 10.1034/j.1399-0039.2002.600102.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Previous studies have shown that infection with the protozoan Trypanosoma cruzi (Chagas' disease) is associated with genetic components [human leukocyte antigen (HLA) genes and T-cell receptor (TCR) genes]. We studied the TCR Vbeta repertoire of peripheral blood lymphocytes of 23 unrelated serologically positive subjects using reverse transcriptase-polymerase chain reaction (RT-PCR). The patients, previously tested for HLA genotypes, were clinically classified as asymptomatic, arrhythmic and cardiopathic patients. Statistical analysis showed the significant increment of the Vbeta7 family in chagasics with arrhythmia compared with asymptomatic and cardiopathic patients, indicating that the frequency of this family is variable in different clinical forms of the disease and possibly that these T cells might be a marker of the progression of Chagas' disease. Based on the calculation of a Delta score the order of variability in the TCR repertoire was: patients with heart failure > asymptomatic > arrhythmic patients. The major histocompatibility complex (MHC) of the individual may influence the use of particular V genes in T-cell response to foreign antigens. We found a significant increase of the Vbeta7 family in arrhythmic patients who were DRB1*01 DQB1*0501 DPB1*0401, a marker associated with susceptibility to cardiac damage in Chagas' disease. If confirmed by further studies in a larger cohort, a possible association between the TCR Vbeta repertoire and the MHC haplotype of chagasic patients could be postulated.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Alleles
- Arrhythmias, Cardiac/genetics
- Arrhythmias, Cardiac/metabolism
- Chagas Disease/genetics
- Chagas Disease/metabolism
- Chronic Disease
- Gene Frequency/genetics
- Genotype
- HLA Antigens/genetics
- Heart Failure/genetics
- Heart Failure/metabolism
- Humans
- Leukocytes, Mononuclear/metabolism
- Middle Aged
- Receptors, Antigen, T-Cell, alpha-beta/genetics
- Receptors, Antigen, T-Cell, alpha-beta/metabolism
- Statistics as Topic
- Venezuela
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Affiliation(s)
- M T Fernández-Mestre
- Laboratorio de Fisiopatología, Centro de Medicina Experimental, Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela
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Sunnemark D, Harris RA, Frostegård J, Orn A. Induction of early atherosclerosis in CBA/J mice by combination of Trypanosoma cruzi infection and a high cholesterol diet. Atherosclerosis 2000; 153:273-82. [PMID: 11164416 DOI: 10.1016/s0021-9150(00)00406-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In addition to established factors such as hyperlipidemia, smoking and hypertension, inflammation and infection have recently been implicated as major risk factors for atherosclerotic disease. Proatherogenic effects induced by infection may be related to both systemic inflammation and to direct effects on the vascular wall. We report here that a high fat diet combined with a protozoal infection with known tropism to the heart induced early atherosclerosis and intimal inflammatory infiltrates (CD4+, CD8+ cells and macrophages) in aortas of all (n = 7) CBA/J mice investigated. These mice are normally quite resistant to atherosclerotic development and in the control group (n = 7) receiving only a fatty diet, only one mouse presented a lesion. This lesion was completely devoid of infiltrating CD8+ cells. Parasite-infected mice receiving a normal diet exhibited vasculitis, but no signs of atherosclerosis and control mice receiving normal diet, as expected, exhibited neither signs of vasculitis nor atherosclerosis. Secretion of IL-6, TNF-alpha, and IFN-gamma were demonstrated in all atherosclerotic lesions and IL-6 appeared to be the dominant cytokine, both in the lesions themselves as well as in the intimal-medial junction. There were no traces of parasites present in the artery wall, indicating that atherosclerosis was induced via an indirect route. We conclude that a high fat diet in conjunction with infection and systemic (or localized) inflammation may have a strong proatherogenic effect. Finally, we suggest that CBA/J mice infected with T. cruzi parasites and given a fatty diet could serve as a useful experimental model in the continued analysis of factors contributing to the induction of atherosclerosis.
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Affiliation(s)
- D Sunnemark
- Microbiology and Tumorbiology Center MTC, Karolinska Institutet, Stockholm, Sweden.
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Sunnemark D, Frostegård J, Orn A, Harris RA. Cellular and cytokine characterization of vascular inflammation in CBA/J mice chronically infected with Trypanosoma cruzi. Scand J Immunol 1998; 48:480-4. [PMID: 9822255 DOI: 10.1046/j.1365-3083.1998.00410.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Continuing our characterization of the immunopathological events occurring during experimental murine Chagas' disease, an immunohistological examination was conducted of the aortas of chronically infected CBA/J mice. Compared with non-infected mice of identical age, Trypanosoma cruzi-infected mice exhibited a marked vasculitis, with significant infiltration of inflammatory cells into the adventitial layer, including CD4+, CD8+ T cells and macrophages. Production of interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-alpha) was evident in the inflammatory infiltrate in the endothelial and smooth muscle layers. Vasculitis was most apparent in proximity to the heart, but extended along the aorta. Such an inflammation could lead to an alteration of the endothelium, altering the protective properties of this layer and further contributing to the focal pathology characteristic of this stage of infection.
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Affiliation(s)
- D Sunnemark
- Microbiology and Tumorbiology Center MTC, Karolinska Institute, Stockholm, Sweden
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