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Covre LP, Fantecelle CH, Queiroz AM, Fardin JM, Miranda PH, Henson S, da Fonseca-Martins AM, de Matos Guedes HL, Mosser D, Falqueto A, Akbar A, Gomes DCO. NKG2C+CD57+ natural killer cells with senescent features are induced during cutaneous leishmaniasis and accumulate in patients with lesional healing impairment. Clin Exp Immunol 2024; 217:279-290. [PMID: 38700066 PMCID: PMC11310703 DOI: 10.1093/cei/uxae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/30/2024] [Accepted: 05/02/2024] [Indexed: 05/05/2024] Open
Abstract
Natural killer (NK) cells include different subsets with diverse effector capacities that are poorly understood in the context of parasitic diseases. Here, we investigated inhibitory and activating receptor expression on NK cells in patients with cutaneous leishmaniasis (CL) and explored their phenotypic and functional heterogeneity based on CD57 and NKG2C expression. The expression of CD57 identified NK cells that accumulated in CL patients and exhibited features of senescence. The CD57+ cells exhibited heightened levels of the activating receptor NKG2C and diminished expression of the inhibitory receptor NKG2A. RNA sequencing analyses based on NKG2C transcriptome have revealed two distinct profiles among CL patients associated with cytotoxic and functional genes. The CD57+NKG2C+ subset accumulated in the blood of patients and presented conspicuous features of senescence, including the expression of markers such as p16, yH2ax, and p38, as well as reduced proliferative capacity. In addition, they positively correlated with the number of days until lesion resolution. This study provides a broad understanding of the NK cell biology during Leishmania infection and reinforces the role of senescent cells in the adverse clinical outcomes of CL.
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Affiliation(s)
- Luciana Polaco Covre
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brazil
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Division of Medicine, University College London, London, UK
| | | | | | - Julia Miranda Fardin
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | - Sian Henson
- Translational Medicine and Therapeutics, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Herbert Leonel de Matos Guedes
- Instituto de Microbiologia Professor Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - David Mosser
- Department of Cell Biology and Molecular Genetics, University of Maryland, College Park, Maryland, USA
| | - Aloisio Falqueto
- Departamento de Medicina Social, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Arne Akbar
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Daniel Claudio Oliveira Gomes
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brazil
- Division of Medicine, University College London, London, UK
- Núcleo de Biotecnologia, Universidade Federal do Espírito Santo, Vitória, Brazil
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Carvalho AM, Costa RS, Lago A, Bacellar O, Beiting DP, Scott P, Carvalho LP, Carvalho EM. In Situ versus Systemic Immune Response in the Pathogenesis of Cutaneous Leishmaniasis. Pathogens 2024; 13:199. [PMID: 38535542 PMCID: PMC10975199 DOI: 10.3390/pathogens13030199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 04/01/2024] Open
Abstract
The role of the immune response in the pathogenesis of cutaneous leishmaniasis (CL) due to Leishmania (Viannia) braziliensis is predominantly carried out via blood cells. Here, we evaluate whether cytokine production by peripheral blood mononuclear cells (PBMCs) reflects what has been documented at the lesion site. The participants included 22 CL patients diagnosed with a positive PCR. PBMCs were stimulated for 72 h with a soluble leishmania antigen (SLA). Biopsies obtained from the edge of the ulcers were incubated for the same period. Cytokines in supernatants were assessed via ELISA. TNF, IL-1β, IL-6, IL-17, and granzyme B (GzmB) were higher in the supernatants of biopsies than in PBMCs, but IFN-γ was higher in the supernatants of PBMCs than in biopsies. There was a positive correlation between IFN-γ and TNF in PBMCs, and an inverse correlation between TNF and IL-10 in the cells from the lesion site. A strong correlation between IL-1β, IL-17, and GzmB was observed in the biopsies, and a positive correlation was detected between these cytokines and the lesion size. Our results indicate that the immune response in L. braziliensis lesions is different from that observed in peripheral blood, and our data suggest that in addition to IL-1β and GzmB, IL-17 participates in the pathology of CL.
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Affiliation(s)
- Augusto M. Carvalho
- Gonçalo Moniz Institute (IGM), Fiocruz, Salvador 40296-710, BA, Brazil; (A.M.C.); (R.S.C.); (L.P.C.)
- Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador 40110-160, BA, Brazil; (A.L.); (O.B.)
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Ministério da Ciência e Tecnologia e Inovação (MCTI), CNPq, Salvador 40110-160, BA, Brazil
| | - Rúbia S. Costa
- Gonçalo Moniz Institute (IGM), Fiocruz, Salvador 40296-710, BA, Brazil; (A.M.C.); (R.S.C.); (L.P.C.)
- Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador 40110-160, BA, Brazil; (A.L.); (O.B.)
| | - Alexsandro Lago
- Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador 40110-160, BA, Brazil; (A.L.); (O.B.)
| | - Olívia Bacellar
- Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador 40110-160, BA, Brazil; (A.L.); (O.B.)
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Ministério da Ciência e Tecnologia e Inovação (MCTI), CNPq, Salvador 40110-160, BA, Brazil
| | - Daniel P. Beiting
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-4539, USA; (D.P.B.); (P.S.)
| | - Phillip Scott
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-4539, USA; (D.P.B.); (P.S.)
| | - Lucas P. Carvalho
- Gonçalo Moniz Institute (IGM), Fiocruz, Salvador 40296-710, BA, Brazil; (A.M.C.); (R.S.C.); (L.P.C.)
- Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador 40110-160, BA, Brazil; (A.L.); (O.B.)
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Ministério da Ciência e Tecnologia e Inovação (MCTI), CNPq, Salvador 40110-160, BA, Brazil
| | - Edgar M. Carvalho
- Gonçalo Moniz Institute (IGM), Fiocruz, Salvador 40296-710, BA, Brazil; (A.M.C.); (R.S.C.); (L.P.C.)
- Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador 40110-160, BA, Brazil; (A.L.); (O.B.)
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Ministério da Ciência e Tecnologia e Inovação (MCTI), CNPq, Salvador 40110-160, BA, Brazil
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3
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Cavalcante MKDA, de Freitas e Silva R, Pereira VRA, Brelaz-de-Castro MCA. Opinion Article: NK Cells in Cutaneous Leishmaniasis: Protection or Damage? Front Immunol 2022; 13:933490. [PMID: 35844579 PMCID: PMC9283678 DOI: 10.3389/fimmu.2022.933490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 06/01/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Marton Kaique de Andrade Cavalcante
- Department of Immunology, Aggeu Magalhães Institute - Oswaldo Cruz Foundation, Recife, Brazil
- Parasitology Laboratory, Federal University of Pernambuco, Vitoria de Santo Antão, Brazil
| | - Rafael de Freitas e Silva
- Department of Immunology, Aggeu Magalhães Institute - Oswaldo Cruz Foundation, Recife, Brazil
- Department of Natural Sciences, University of Pernambuco, Garanhuns, Brazil
| | | | - Maria Carolina Accioly Brelaz-de-Castro
- Department of Immunology, Aggeu Magalhães Institute - Oswaldo Cruz Foundation, Recife, Brazil
- Parasitology Laboratory, Federal University of Pernambuco, Vitoria de Santo Antão, Brazil
- *Correspondence: Maria Carolina Accioly Brelaz-de-Castro,
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Gonzalez K, Calzada JE, Tomokane TY, Pacheco CMS, Flores GVA, Castro Gomes CM, Pereira Corbett CE, Saldaña A, Laurenti MD. In situ study of cellular immune response in human cutaneous lesions caused by Leishmania (Viannia) panamensis in Panama. Parasite Immunol 2020; 43:e12801. [PMID: 33068443 DOI: 10.1111/pim.12801] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 12/19/2022]
Abstract
AIMS Leishmaniasis is considered a disease with multiple clinical/immunopathological characteristics, depending on the immunity of the host and the species of the parasite. In Panama, the most prevalent species that causes localized cutaneous leishmaniasis (LCL) is Leishmania (Viannia) panamensis, and its immune response is poorly studied. Therefore, we evaluated by immunohistochemistry, the in situ immune response during this infection. METHODS AND RESULTS Biopsies from Panamanian patients with LCL were collected and processed by histological techniques. Infection by L. (V.) panamensis was demonstrated by isolation in culture and molecular characterization by Hsp70-RFLP. The in situ immune response was assessed by immunohistochemistry. The immune response was characterized by predominance of T cells, mainly CD8 cells that showed positive correlation with IFN-γ and Granzyme B. CD4 cells presented positive correlation with both IFN-γ and IL-13, pointed by mixed cellular immune response. Regulatory response was characterized by FoxP3 cells, which showed positive correlation to IL-10 but not with TGF-β. CONCLUSIONS L. (V.) panamensis infection triggers a mixed cellular immune response, characterized by the presence of pro-inflammatory, anti-inflammatory and regulatory elements in the skin lesion of Panamanian patients. These data contribute to a better understanding of the immunopathogenesis of Leishmania Viannia infection in Panama.
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Affiliation(s)
- Kadir Gonzalez
- Departamento de Parasitología Molecular, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panamá.,Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - José Eduardo Calzada
- Departamento de Parasitología Molecular, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panamá.,Facultad de Medicina Veterinaria, Universidad de Panamá, Panamá, Panamá
| | - Thaise Yumie Tomokane
- Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Carmen Maria Sandoval Pacheco
- Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Gabriela Venicia Araujo Flores
- Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Cláudia Maria Castro Gomes
- Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Carlos Eduardo Pereira Corbett
- Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Azael Saldaña
- Departamento de Parasitología Molecular, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panamá.,Centro de Investigación y Diagnóstico de Enfermedades Parasitarias, Facultad de Medicina, Universidad de Panamá, Panamá, Panamá
| | - Marcia Dalastra Laurenti
- Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
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5
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Contribution of Leishmania braziliensis antigen-specific CD4+ T, CD8+ T, NK and CD3+CD56+NKT cells in the immunopathogenesis of cutaneous leishmaniasis patients: Cytotoxic, activation and exhaustion profiles. PLoS One 2020; 15:e0229400. [PMID: 32203546 PMCID: PMC7089553 DOI: 10.1371/journal.pone.0229400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 02/05/2020] [Indexed: 11/19/2022] Open
Abstract
The pathogenesis of cutaneous leishmaniasis (CL) caused by Leishmania (Viannia) braziliensis is dictated mainly by the immune-mediated-tissue inflammation developed. The understanding of the immunological mechanisms that generate tissue damage or resolution of lesions is the key to the development of effective vaccine protocols and proper therapeutic schemes. It is clear that the specific immune response mediated by T cells is responsible for the beneficial outcome of the disease, however, the roles of CD4+ T, CD8+ T, NK and NKT cell subpopulations in immunopathogenesis of CL need to be elucidated. Peripheral blood cells from patients before, during and after the antimonial therapy, as well as healthy individuals (HI) were cultured with (LbAgS) or without (NS) L. braziliensis antigens (LbAg). Afterwards, the frequencies of LbAg-specific-cytotoxic CD8+ T, CD4+ T, NK and CD3+CD56+ NKT cells, as well as their activation and exhaustion profiles, were defined by flow cytometry. We observed higher frequencies of CD8+ T, NK and CD3+CD56+ NKT cells and lower frequencies of CD4+ T lymphocytes in LbAgS cell cultures from patients before treatment. The specific response to LbAg resulted in an expansion of cytotoxic-activated CD4+ T, CD8+ T, and NK cells, before and during treatment, indicating specificity in the response by these cells against L. braziliensis. Furthermore, comparing the differences of frequencies of cytotoxic-activated CD4+T, CD8+T, and NK cells, among before and during treatment patients and HI groups, we conclude that these cell populations are in charge of immune response elicited by antimonial therapy. Interestingly, we also observed that NK cells were induced by LbAg to an exhaustion profile during all clinical stages of the disease. The increased antigen-specific activation and cytotoxic activity are in line with the strong inflammatory response described in this disease, a likely cause of tissue damage. These findings reinforce the involvement of these distinct cytotoxic-activated cell populations in the immunopathogenesis of CL, showing a character of specificity in this immune response.
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6
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Covre LP, Devine OP, Garcia de Moura R, Vukmanovic-Stejic M, Dietze R, Ribeiro-Rodrigues R, Guedes HLDM, Lubiana Zanotti R, Falqueto A, Akbar AN, Gomes DCO. Compartmentalized cytotoxic immune response leads to distinct pathogenic roles of natural killer and senescent CD8 + T cells in human cutaneous leishmaniasis. Immunology 2020; 159:429-440. [PMID: 31925782 DOI: 10.1111/imm.13173] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 12/12/2019] [Accepted: 12/18/2019] [Indexed: 12/29/2022] Open
Abstract
Cytotoxic activity mediated by CD8+ T cells is the main signature of the immunopathogenesis of cutaneous leishmaniasis (CL). Here, we performed a broad evaluation of natural killer (NK) cell phenotypic and functional features during cutaneous leishmaniasis. We demonstrate for the first time that CL patients present the accumulation of circulating NK cells with multiple features of replicative senescence including low proliferative capacity and shorter telomeres, elevated expression of CD57, KLRG1 but diminished CD27 stimulatory receptor expression. Moreover, they exhibited higher cytotoxic and inflammatory potential than age-matched controls. The accumulation of circulating senescent NK cells (CD56dim CD57bright ) correlated positively with skin lesion size in the same patients, suggesting that they, like circulating senescent CD8+ T cells, may contribute to the immunopathology of CL. However, this senescent population had lower cutaneous lymphocyte antigen expression and so had diminished skin-homing potential compared with total or senescent CD8+ T cells. This was confirmed in CL skin lesions where we found a predominance of CD8+ T cells (both senescent and non-senescent) that correlated with the severity of the disease. Although there was also a correlation between the proportions of senescent NK cells (CD56+ CD57+ ) in the skin and lesion size, this was less evident. Collectively our results demonstrate first-hand that senescent cytotoxic cells may mediate skin pathology during human cutaneous leishmaniasis. However, as senescent cytotoxic CD8+ T cells predominate in the skin lesions, they may have a greater role than NK cells in mediating the non-specific skin damage in CL.
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Affiliation(s)
- Luciana Polaco Covre
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Espírito Santo, Brazil
| | | | - Renan Garcia de Moura
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Espírito Santo, Brazil
| | | | - Reynaldo Dietze
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Espírito Santo, Brazil.,Global Health & Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | | | - Herbert Leonel de Matos Guedes
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Aloisio Falqueto
- Departamento de Medicina Social, Universidade Federal do Espírito Santo, Espírito Santo, Brazil
| | - Arne N Akbar
- Division of Infection and Immunity, University College London, London, UK
| | - Daniel Claudio Oliveira Gomes
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Espírito Santo, Brazil.,Núcleo de Biotecnologia, Universidade Federal do Espírito Santo, Espírito Santo, Brazil
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7
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Rodrigues-Alves ML, Melo-Júnior OAO, Coelho-Dos-Reis JG, Pascoal-Xavier MA, Alves-Costa H, Reis CA, Dutra WO, Silva RE, Senna MCR, Faria AC, Medeiros NI, Gomes JAS, Silveira-Lemos D, Martins-Filho OA, Teixeira-Carvalho A, Costa-Silva MF, Giunchetti RC, Peruhype-Magalhães V. Fcγ-RI, Fcγ-RII and IL-10 as predictive biomarkers for post-therapeutic cicatrization time in monocytes from cutaneous leishmaniasis patients. Parasite Immunol 2018; 40:e12565. [PMID: 29908029 DOI: 10.1111/pim.12565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 06/08/2018] [Indexed: 12/25/2022]
Abstract
Cutaneous leishmaniasis (CL) treatment is based on therapy with Glucantime® , yet, there are few laboratory methods to monitor its success. In this study, ex vivo and in vitro evaluations of peripheral blood monocytes were performed in a longitudinal study to characterize the impact of Glucantime® on overall phenotypic/functional features of these cells from CL patients to identify predictive biomarkers for post-therapeutic monitoring by flow cytometry. The ex vivo evaluation from CL patients demonstrated a modulatory profile before treatment, with a decrease in TLR-2, FcγRII, HLA-DR, CD86, IFN-γR, TNF, IL-12, NO, and an increase in FcγRIII and IL-10R. Conversely, treatment changes some of these biomarker expressions by decreasing FcγRIII and IL-10R and increasing IFN-γR, IL-12 and NO. Moreover, an in vitro analysis of these patients showed a reduced phagocytic capacity of Leishmania braziliensis and higher levels of IL-10 and TGF-β modulating functional profile. Regardless of the compromised L. braziliensis phagocytic capacity, treatment re-established the production of IL-12, IL-10, TGF-β and NO at the basal level. Notably, monocytes from patients with early cicatrization showed enhanced FcγRI and FcγRII expressions and reduced IL-10, which was further corroborated by a baseline fold change analysis. Finally, the logistic regression model emphasized the performance of FcγRI, FcγRII and IL-10 as robust predictive biomarkers for post-therapeutic cicatrization during cutaneous leishmaniasis.
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Affiliation(s)
- M L Rodrigues-Alves
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Grupo Integrado de Pesquisa em Biomarcadores, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil
| | - O A O Melo-Júnior
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - J G Coelho-Dos-Reis
- Grupo Integrado de Pesquisa em Biomarcadores, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil
| | - M A Pascoal-Xavier
- Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil.,Departamento de Anatomia Patológica e Medicina Legal, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - H Alves-Costa
- Grupo Integrado de Pesquisa em Biomarcadores, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil
| | - C A Reis
- Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil
| | - W O Dutra
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - R E Silva
- Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil
| | - M C R Senna
- Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil
| | - A C Faria
- Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil
| | - N I Medeiros
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - J A S Gomes
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - D Silveira-Lemos
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - O A Martins-Filho
- Grupo Integrado de Pesquisa em Biomarcadores, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil
| | - A Teixeira-Carvalho
- Grupo Integrado de Pesquisa em Biomarcadores, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil
| | - M F Costa-Silva
- Grupo Integrado de Pesquisa em Biomarcadores, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil
| | - R C Giunchetti
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - V Peruhype-Magalhães
- Grupo Integrado de Pesquisa em Biomarcadores, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil
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8
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Kumari S, Shivam P, Hansa J, Jamal F, Singh MK, Bimal S, Narayan S, Pandey K, Das VNR, Das P, Singh SK. CD8 dim but not CD8 bright cells positive to CD56 dominantly express KIR and are cytotoxic during visceral leishmaniasis. Hum Immunol 2018; 79:616-620. [PMID: 29842895 DOI: 10.1016/j.humimm.2018.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/16/2018] [Accepted: 05/22/2018] [Indexed: 10/16/2022]
Abstract
This study reports a structural and functional heterogeneity of CD8+CD56+NKT cells, which usually decrease quantitatively during visceral leishmaniasis. Based on fluorescence intensity of CD8 receptors on CD56+NKT cells, two populations of CD8+CD56+NKT cells have been identified. These cells were recognized as CD8dimCD56+NKT and CD8brightCD56+NKT cells. We further analyzed the functional nature of CD8dim and CD8bright positive CD56+NKT cells. In comparison to CD8brightCD56+NKT cells, a significantly higher percentage of CD8dimCD56+NKT cells expressed KIR during VL. The percentage of CD8dimCD56+NKT cells expressing KIR was found 4 fold higher in VL as compared to healthy subjects. But, the difference was insignificant in case of CD8brightCD56+NKT cells. CD8+CD56+NKT cells release granzyme B to kill the infected cells. A categorical difference was also observed in the function of CD8dimCD56+NKT and CD8brightCD56+NKT cells during visceral leishmaniasis. The percentage of granzyme B expressing CD8dimCD56+NKT cells was 2.83 fold higher in VL compared to healthy subjects. But, there was no significant difference in granzyme B expressing CD8brightCD56+NKT cells in samples from healthy and VL subjects. However, within VL subject, the percentage of granzyme B expressing CD8dimCD56+NKT cells was 5.7 fold higher in comparison to CD8brightCD56+NKT cells. This study concludes that CD8dimCD56+NKT cells are more cytotoxic than CD8brightCD56+NKT cells during VL.
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Affiliation(s)
- Sarita Kumari
- Indian Council of Medical Research-Rajendra Memorial Research Institute of Medical Sciences (ICMR-RMRIMS), Agamkuan, Patna 800007, India
| | - Pushkar Shivam
- Indian Council of Medical Research-Rajendra Memorial Research Institute of Medical Sciences (ICMR-RMRIMS), Agamkuan, Patna 800007, India
| | - Jagadish Hansa
- Indian Council of Medical Research-Rajendra Memorial Research Institute of Medical Sciences (ICMR-RMRIMS), Agamkuan, Patna 800007, India
| | - Fauzia Jamal
- Indian Council of Medical Research-Rajendra Memorial Research Institute of Medical Sciences (ICMR-RMRIMS), Agamkuan, Patna 800007, India
| | - Manish Kumar Singh
- Indian Council of Medical Research-Rajendra Memorial Research Institute of Medical Sciences (ICMR-RMRIMS), Agamkuan, Patna 800007, India
| | - Sanjiva Bimal
- Indian Council of Medical Research-Rajendra Memorial Research Institute of Medical Sciences (ICMR-RMRIMS), Agamkuan, Patna 800007, India
| | - Shyam Narayan
- Indian Council of Medical Research-Rajendra Memorial Research Institute of Medical Sciences (ICMR-RMRIMS), Agamkuan, Patna 800007, India
| | - Krishna Pandey
- Indian Council of Medical Research-Rajendra Memorial Research Institute of Medical Sciences (ICMR-RMRIMS), Agamkuan, Patna 800007, India
| | - Vidya Nand Ravi Das
- Indian Council of Medical Research-Rajendra Memorial Research Institute of Medical Sciences (ICMR-RMRIMS), Agamkuan, Patna 800007, India
| | - Pradeep Das
- Indian Council of Medical Research-Rajendra Memorial Research Institute of Medical Sciences (ICMR-RMRIMS), Agamkuan, Patna 800007, India
| | - Shubhankar K Singh
- Indian Council of Medical Research-Rajendra Memorial Research Institute of Medical Sciences (ICMR-RMRIMS), Agamkuan, Patna 800007, India.
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9
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Leishmania donovani mediated higher expression of CCL4 induces differential accumulation of CD4 +CD56 +NKT and CD8 +CD56 +NKT cells at infection site. Cytokine 2018; 110:306-315. [PMID: 29807685 DOI: 10.1016/j.cyto.2018.03.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/15/2018] [Accepted: 03/17/2018] [Indexed: 01/20/2023]
Abstract
Sterile cure from visceralized Leishmania donovani (L. donovani) needs Th1 cell support along with the assistance from innate immune cells, NK cells and NKT cells. NKT cells play as a connecting link between innate and adaptive immune cell and support T helper cell function. Earlier, a categorical function of CD56 positive CD4+ or CD8+ NKT cells was reported in visceral leishmaniasis (VL). It was observed in in vitro that CD4+CD56+NKT cells, but not CD8+CD56+NKT cells, were accumulated at the L. donovani infection site. Therefore, in vitro experiments have been carried out to decipher the mechanism behind preferential accumulation of CD4+CD56+NKT cells at infection site. In this study, 1.89 fold higher expression of CCL4/MIP-1β was noticed in infected macrophages. The higher expression of CCL4 was correlated with preferential accumulation of CCR5+CD4+CD56+NKT cells and apoptosis of CD8+CD56+NKT cells at in vitro infection site. The CD4+CD56+NKT cells were also observed expressing TGF-β dominantly. Interaction of CCL4 chemotaxis was interrupted by blocking, which led to drift back the TGF-β producing CD4+CD56+NKT cells and promoted CD8+CD56+NKT cells recruitment in in vitro infection site. CCR5 blockade also reduced CD25 and FoxP3 positive CD4+CD56+NKT cells in in vitro infection site. Therefore, it was concluded that Leishmania promotes strategic expression of CCL4, which alternately attracts CCR5+ cells, mostly expressing regulatory cytokines, at infection site. This reduces the CD8+CD56+NKT cells at infection site through Smad4 mediated TGF-β expression and activation of caspases. Data indicates that L. donovani induces higher expression of CCL4 in host cell to attract CCR5+ cells under its strategic plan to downregulate host immune response.
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10
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Unbalanced inflammatory reaction could increase tissue destruction and worsen skin infectious diseases - a comparative study of leishmaniasis and sporotrichosis. Sci Rep 2018; 8:2898. [PMID: 29440688 PMCID: PMC5811542 DOI: 10.1038/s41598-018-21277-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 01/29/2018] [Indexed: 01/09/2023] Open
Abstract
The clinical presentations of skin diseases produced by different pathogens, as American tegumentary leishmaniasis (ATL) and sporotrichosis can be similar and possibly influenced by the skin immune system (SIS). The aim of the study was to understand the underlying mechanisms of skin inflammation produced by different pathogens. We used immunohistochemistry to analyze 96 patients: a- localized cutaneous leishmaniasis (LCL-ATL); b- sporotrichoid cutaneous leishmaniasis (SCL-ATL); c-lymphocutaneous (LC-SP); d- fixed (F-SP) sporotrichosis. LCL-ATL and SCL-ATL had a significantly higher percentage of CD8, FasL and NOS2 than sporotrichosis. In contrast, LC-SP had a substantially higher percentage of CD4, BCl2 and neutrophils than ATL lesions. These results indicated some differences in the profile of the in situ immune response suggesting that SIS is a complex, adaptable system capable of different responses to intracellular or extracellular pathogens. However, regardless of the etiological agents, the inflammatory reaction and clinical manifestations can be similar. SCL-ATL and LC-SP presented similarities in both clinical presentation and in situ inflammatory profile (CD3, CD22, neutrophils, macrophages). The clinical presentation of ATL and sporotrichosis could be explained by a combination of factors both of the host SIS and the etiological agent. The unbalanced host parasite relationship could result in atypical manifestations of skin disease.
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11
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Lima JB, Araújo-Santos T, Lázaro-Souza M, Carneiro AB, Ibraim IC, Jesus-Santos FH, Luz NF, Pontes SDM, Entringer PF, Descoteaux A, Bozza PT, Soares RP, Borges VM. Leishmania infantum lipophosphoglycan induced-Prostaglandin E 2 production in association with PPAR-γ expression via activation of Toll like receptors-1 and 2. Sci Rep 2017; 7:14321. [PMID: 29084985 PMCID: PMC5662570 DOI: 10.1038/s41598-017-14229-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 10/05/2017] [Indexed: 01/16/2023] Open
Abstract
Lipophosphoglycan (LPG) is a key virulence factor expressed on the surfaces of Leishmania promastigotes. Although LPG is known to activate macrophages, the underlying mechanisms resulting in the production of prostaglandin E2 (PGE2) via signaling pathways remain unknown. Here, the inflammatory response arising from stimulation by Leishmania infantum LPG and/or its lipid and glycan motifs was evaluated with regard to PGE2 induction. Intact LPG, but not its glycan and lipid moieties, induced a range of proinflammatory responses, including PGE2 and nitric oxide (NO) release, increased lipid droplet formation, and iNOS and COX2 expression. LPG also induced ERK-1/2 and JNK phosphorylation in macrophages, in addition to the release of PGE2, MCP-1, IL-6, TNF-α and IL-12p70, but not IL-10. Pharmacological inhibition of ERK1/2 and PKC affected PGE2 and cytokine production. Moreover, treatment with rosiglitazone, an agonist of peroxisome proliferator-activated receptor gamma (PPAR-γ), also modulated the release of PGE2 and other proinflammatory mediators. Finally, we determined that LPG-induced PPAR-γ signaling occurred via TLR1/2. Taken together, these results reinforce the role played by L. infantum-derived LPG in the proinflammatory response seen in Leishmania infection.
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Affiliation(s)
- Jonilson Berlink Lima
- Gonçalo Moniz Institut, Oswaldo Cruz Foundation (FIOCRUZ-BA), 40296-710, Salvador, BA, Brazil.,Center of Biological Sciences and Health, Federal University of Western Bahia (UFOB), 47808-021, Barreiras, BA, Brazil
| | - Théo Araújo-Santos
- Gonçalo Moniz Institut, Oswaldo Cruz Foundation (FIOCRUZ-BA), 40296-710, Salvador, BA, Brazil.,Center of Biological Sciences and Health, Federal University of Western Bahia (UFOB), 47808-021, Barreiras, BA, Brazil
| | - Milena Lázaro-Souza
- Gonçalo Moniz Institut, Oswaldo Cruz Foundation (FIOCRUZ-BA), 40296-710, Salvador, BA, Brazil.,Federal University of Bahia (UFBA), 40110-170, Salvador, BA, Brazil
| | - Alan Brito Carneiro
- Laboratory of Immunopharmacology, Oswaldo Cruz Institut, FIOCRUZ-RJ, 21040-900, Rio de Janeiro, RJ, Brazil
| | - Izabela Coimbra Ibraim
- René Rachou Institut, Oswaldo Cruz Foundation (FIOCRUZ-MG), 30190-002, Belo Horizonte, MG, Brazil
| | - Flávio Henrique Jesus-Santos
- Gonçalo Moniz Institut, Oswaldo Cruz Foundation (FIOCRUZ-BA), 40296-710, Salvador, BA, Brazil.,Federal University of Bahia (UFBA), 40110-170, Salvador, BA, Brazil
| | - Nívea Farias Luz
- Gonçalo Moniz Institut, Oswaldo Cruz Foundation (FIOCRUZ-BA), 40296-710, Salvador, BA, Brazil
| | - Sara de Moura Pontes
- Gonçalo Moniz Institut, Oswaldo Cruz Foundation (FIOCRUZ-BA), 40296-710, Salvador, BA, Brazil.,Federal University of Bahia (UFBA), 40110-170, Salvador, BA, Brazil
| | - Petter Franco Entringer
- Federal University of Rio de Janeiro (UFRJ), NUPEM, Campus Macaé, 27933-378, Macaé, RJ, Brazil
| | - Albert Descoteaux
- Institut National de la Recherche Scientifique, Institut Armand-Frappier, H7V 1B7, Laval, Canada
| | - Patrícia Torres Bozza
- Laboratory of Immunopharmacology, Oswaldo Cruz Institut, FIOCRUZ-RJ, 21040-900, Rio de Janeiro, RJ, Brazil
| | - Rodrigo Pedro Soares
- René Rachou Institut, Oswaldo Cruz Foundation (FIOCRUZ-MG), 30190-002, Belo Horizonte, MG, Brazil.
| | - Valéria Matos Borges
- Gonçalo Moniz Institut, Oswaldo Cruz Foundation (FIOCRUZ-BA), 40296-710, Salvador, BA, Brazil. .,Federal University of Bahia (UFBA), 40110-170, Salvador, BA, Brazil.
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12
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Ferraz R, Cunha CF, Pimentel MIF, Lyra MR, Pereira-Da-Silva T, Schubach AO, Da-Cruz AM, Bertho AL. CD3 +CD4 negCD8 neg (double negative) T lymphocytes and NKT cells as the main cytotoxic-related-CD107a + cells in lesions of cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis. Parasit Vectors 2017; 10:219. [PMID: 28468680 PMCID: PMC5415843 DOI: 10.1186/s13071-017-2152-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 04/21/2017] [Indexed: 02/03/2023] Open
Abstract
Background Cutaneous leishmaniasis (CL) is caused by Leishmania (Viannia) braziliensis, which infects dermal macrophages and dendritic cells, causing an intense immune-mediated-tissue inflammation and a skin ulcer with elevated borders that can heal spontaneously or after antimonial therapy. The resolution of lesions depends on an adaptive immune response, and cytotoxic cells seem to have a fundamental role in this process. The aim of this study is to better understand the role of cytotoxicity mediated mechanisms that occur during the immune response in the CL lesion milieu, considering distinct cytotoxic-related CD107a+ cells, such as CD8+, CD4+, CD4neg CD8neg (double-negative, DN) and CD4+CD8+ (double-positive, DP) T lymphocytes, as well as NK and NKT cells. Methods Lesion derived cells were assessed for T cell subpopulations and NK cells, as well as CD107a expression by flow cytometry. In addition, cytometric bead array (CBA) was used to quantify cytokines and granzyme B concentrations in supernatants from macerated lesions. Results Flow cytometry analyses revealed that NKT cells are the major CD107a-expressing cell population committed to cytotoxicity in CL lesion, although we also observed high frequencies of CD4+ and DN T cells expressing CD107a. Analysing the pool of CD107a+-cell populations, we found a higher distribution of DN T cells (44%), followed by approximately 25% of NKT cells. Interestingly, NK and CD8+ T cells represented only 3 and 4% of the total-CD107a+-cell pool, respectively. Conclusions The cytotoxicity activity that occurs in the lesion milieu of CL patients seems to be dominated by DN T and NKT cells. These findings suggest the need for a reevaluation of the role of classical-cytotoxic NK and CD8+ T cells in the pathogenesis of CL, implicating an important role for other T cell subpopulations.
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Affiliation(s)
- Raquel Ferraz
- Laboratory of Immunoparasitology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil.,Flow Cytometry Sorting Core Facility, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Clarissa F Cunha
- Laboratory of Immunoparasitology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Maria Inês F Pimentel
- Laboratory of Surveillance for Leishmaniasis, Evandro Chagas National Institute of Infectology, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Marcelo R Lyra
- Laboratory of Surveillance for Leishmaniasis, Evandro Chagas National Institute of Infectology, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Tatiana Pereira-Da-Silva
- Laboratory of AIDS and Molecular Immunology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Armando O Schubach
- Laboratory of Surveillance for Leishmaniasis, Evandro Chagas National Institute of Infectology, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Alda Maria Da-Cruz
- Laboratory of Interdisciplinary Medical Research, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Alvaro Luiz Bertho
- Laboratory of Immunoparasitology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil. .,Flow Cytometry Sorting Core Facility, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, RJ, Brazil.
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13
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Immunopathological characterization of human cutaneous leishmaniasis lesions caused by Leishmania (Viannia) spp. in Amazonian Brazil. Parasitol Res 2017; 116:1423-1431. [PMID: 28224222 DOI: 10.1007/s00436-017-5403-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 02/03/2017] [Indexed: 10/20/2022]
Abstract
American cutaneous leishmaniasis (ACL) is a chronic infectious disease caused by different protozoan species of Leishmania, and it is endemic in both tropical and subtropical countries. Using immunohistochemistry, we investigate the density of CD68+, lysozyme+, CD1a+, factor XIIIa+, CD4+, CD8+, CD56+, interferon (IFN)-γ+, and inducible NO synthase (iNOS+) cells. These cells were analyzed from 22 biopsy samples obtained from the lesions of ACL patients, whose infection was caused by Leishmania (Viannia) spp. Histopathological analysis showed dense mononuclear inflammatory infiltration in the dermis, which was composed of lymphocytes, macrophages, plasma cells, and discrete tissue parasitism. Granulomatous reactions were also present in the majority of cases. The density of the activated macrophages was higher than that of inactivated macrophages in the lesions. The density of Langerhans cells (CD1a+) was lower than that of dermal dendrocytes (factor XIIIa+). The density of CD8+ T lymphocytes was higher than that of CD4+ T lymphocytes. The cellular density of these immunological markers in relation to the species of Leishmania demonstrated that L. (Viannia) sp. lesions had higher IFN-γ expression than that Leishmania (Viania) braziliensis lesions. The evaluation of these markers, according to disease progression, did not reveal any significant differences. L. (Viannia) sp. infection leads to a favorable immune response in the host, as predominantly represented by lysozyme+, factor XIIIa+, CD8+ T cells, and the expression of (IFN)-γ+ at the lesion site.
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14
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Borghi SM, Fattori V, Conchon-Costa I, Pinge-Filho P, Pavanelli WR, Verri WA. Leishmania infection: painful or painless? Parasitol Res 2016; 116:465-475. [PMID: 27933392 DOI: 10.1007/s00436-016-5340-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 11/28/2016] [Indexed: 11/25/2022]
Abstract
The complex life cycle and immunopathological features underpinning the interaction of Leishmania parasites and their mammalian hosts poses frequent poorly explored and inconclusively resolved questions. The altered nociceptive signals over the course of leishmaniasis remain an intriguing issue for nociceptive and parasitology researchers. Experimental investigations have utilized behavioral, morphological, and neuro-immune approaches in the study of experimental cutaneous leishmaniasis (CL). The data generated indicates new venues for the study of the pathological characteristics of nociceptive processing in this parasitic disease. Leishmania-induced pain may be easily observed in mice and rats. However, nociceptive data is more complex in human investigations, including the occurrence of painless lesions in mucocutaneous and cutaneous leishmaniasis. Data from recent decades indicate that humans can also be affected by pain-related symptoms, often distinct from the region of body infection. The molecular and cellular mechanisms underlying such variable nociceptive states in humans during the course of leishmaniasis are an active area of research. The present article reviews nociception in leishmaniasis, including in experimental models of CL and clinical reports.
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Affiliation(s)
- Sergio M Borghi
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Victor Fattori
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Ivete Conchon-Costa
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Phileno Pinge-Filho
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Wander R Pavanelli
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Waldiceu A Verri
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil.
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