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Sustained Attention in Mild Alzheimer’s Disease

Sustained Attention in Mild Alzheimer’s Disease

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05/10/2014

 
Research article
Suppression of adaptive immunity to heterologous antigensduring
Plasmodium
infection through hemozoin-induced failure of dendritic cell function
Owain R Millington*
§
, Caterina Di Lorenzo*, R Stephen Phillips
, PaulGarside*
§
and James M Brewer*
§
 Addresses: *Division of Immunology, Infection and Inflammation, University of Glasgow, Glasgow G11 6NT, UK.
Division of Infectionand Immunity, Joseph Black Building, University of Glasgow, Glasgow G12 8QQ, UK.
§
Current address: Centre for Biophotonics, University of Strathclyde, Glasgow G4 0NR, UK.Correspondence: Owain R Millington. Email: owain.millington@strath.ac.uk 
Abstract
Background:
Dendritic cells (DCs) are central to the initiation and regulation of theadaptive immune response during infection. Modulation of DC function may therefore allowevasion of the immune system by pathogens. Significant depression of the host’s systemicimmune response to both concurrent infections and heterologous vaccines has beenobserved during malaria infection, but the mechanisms underlying this immunehyporesponsiveness are controversial.
Results:
Here, we demonstrate that the blood stages of malaria infection induce a failure of DC function
in vitro
and
in vivo
, causing suboptimal activation of T cells involved inheterologous immune responses. This effect on T-cell activation can be transferred touninfected recipients by DCs isolated from infected mice. Significantly, T cells activated bythese DCs subsequently lack effector function, as demonstrated by a failure to migrate tolymphoid-organ follicles, resulting in an absence of B-cell responses to heterologous antigens.Fractionation studies show that hemozoin, rather than infected erythrocyte (red blood cell)membranes, reproduces the effect of intact infected red blood cells on DCs. Furthermore,hemozoin-containing DCs could be identified in T-cell areas of the spleen
in vivo
.
Conclusions:
Plasmodium
infectioninhibits the induction of adaptive immunity toheterologous antigens by modulating DC function, providing a potential explanation forepidemiological studies linking endemic malaria with secondary infections and reduced vaccineefficacy.
BioMed
 
Central
 Journalof Biology
Published: 12 April 2006
 Journal of Biology 
2006,
5:
5The electronic version of this article is the complete one and can befound online at http://jbiol.com/content/5/2/5Received: 2 September 2005Revised: 16 December 2005Accepted: 2 March 2006© 2006 Millington
et al.
; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Journal of Biology 
2006,
5:
5
 
Background
Malaria is the major parasitic disease of humans throughout the tropics and subtropics, mainly affecting children under 5 years of age and causing 500 million clinical cases and upto 2.7 million deaths each year [1]. In addition to infection-induced mortality, malaria is also associated with public-health problems resulting from impairment of immuneresponses. Although this immunosuppression may haveevolved as a mechanism by which the parasite can prevent immune-mediated clearance [2-8], it leaves malaria-infectedindividuals or experimental animals more susceptible tosecondary infections, such as non-typhoidal
Salmonella
[9],herpes zoster virus [10], hepatitis B virus [11], Moloney leukemia virus [12] and nematode infection [13], as well asEpstein-Barr virus reactivation [14-17]. Because the efficacy of heterologous vaccines can also be suppressed in malaria-infected patients [18-21], children showing clinical signs of malaria are rarely immunized until after anti-malarialchemoprophylaxis, which can improve the response to vac-cination [22]. In a recent study of a new conjugate vaccineagainst pneumococci, efficacy was reduced during themalaria transmission season [23], demonstrating the possi-ble impact of malaria infection on large-scale vaccineregimes. Certain vaccines, however, seem to induce protec-tive responses irrespective of malaria status and theimmunosuppressive effect of malaria infection might thusnot extend to all antigens [20]; studies
in vivo
are required toinvestigate this controversy further. Several animal studieshave described suppression of immune function by 
Plas-modium
parasites
in vitro
and
in vivo
[24-34], but the mecha-nisms involved remain unclear.Dendritic cells (DCs) have a crucial role in the activation of  T cells and consequently in the induction of adaptiveimmune responses and immunity [35,36]. There is evidencethat many pathogens have evolved mechanisms that subvert DC function, thereby modulating the host’s immuneresponse to their advantage [37,38]. Recent studies haverevealed that DCs are important in malaria infection, partic-ularly during the early events of induction of the protectiveimmune response to infection [39,40]. It has been reportedthat red blood cells (RBCs) infected with schizont-stage
Plasmodiumfalciparum
activate plasmacytoid DCs asdetected by increased expression of the antigen CD86 andthe cytokine interferon-
(IFN-
)
in vitro
[41]. In contrast,the asexual erythrocytic stages of 
P.falciparum
 were shown toimpair the ability of human DCs to undergo maturation
invitro
[42]. Indeed, peripheral blood DCs of 
P.falciparum-
infected children showed reduced levels of the major histo-compatibility complex (MHC) molecule HLA-DR compared with uninfected controls [43], suggesting a reduced activ-ation state. Thus, the ability of malaria parasites to inhibit maturation of DCs could be involved not only in parasite-specific immunosuppression but also in the suppression of responses to heterologous antigens such as vaccines andunrelated pathogens [2,19,20]. As human malaria parasitesare host-specific, however, observations on the effect of human malaria on DCs are largely limited to studies
in vitro
.Here, we describe the mechanism underlying this suppres-sion of immunity 
in vitro
and
in vivo
. DC activation isdynamically altered by parasitized erythrocytes (pRBCs),partly because of deposition of the malarial pigment hemo-zoin (HZ) within these cells. Following presentation of het-erologous antigen by pRBC-exposed DCs, there is lessexpansion of CD4
+
‘helper’ T cells that are essential for theinduction of adaptive immunity. Subsequently, migrationof T cells to lymphoid follicles is abrogated, leading todefective B-cell expansion and differentiation and a failureof the antibody response. These studies explain why immu-nity to malaria is slow to develop and why protectionagainst secondary infections is reduced in
Plasmodium-
infected individuals.
Results
Suppression of heterologous immune responsesduring malaria infection
 We first examined the response to a heterologous antigenduring 
Plasmodiumchabaudi
(AS strain) infection(Figure 1a)to determine whether this murine model reflected the clini-cal immunosuppression observed with
P.falciparum
infec-tion [18-21]. Mice were immunized with the model antigenovalbumin (OVA) and lipopolysaccharide (LPS) to act asadjuvant at various times after infection, and OVA-specific serum immunoglobulin G (IgG) was measured 21 days later.
5.2
 Journal of Biology 
2006,Volume 5, Article 5Millington
et al.
http://jbiol.com/content/5/2/5
 Journal of Biology 
2006,
5:
5
Figure 1
(see figure on the following page)
Suppression of immunity by
P.chabaudi
infection.
(a)
BALB/c mice were infected with 10
6
P.chabaudi
(AS strain) parasites by intra-peritonealinjection and the proportion of peripheral blood cells parasitized (parasitemia) was monitored by Giemsa’s stain of peripheral blood smears.
(b)
Uninfected (squares) or
P.chabaudi
-infected (circles) BALB/c mice were immunized with OVA/LPS at the indicated times after infection. Threeweeks after immunization, sera were analyzed for OVA-specific IgG. Data represent the mean of three mice per group ±1 standard deviation (s.d.)and are representative of two similar experiments (*
p
0.05,
#
p
0.005 uninfected versus
P.chabaudi-
infected).
(c)
Spleen cells from uninfected(open bars) or
P.chabaudi
-infected (filled bars) BALB/c mice immunized with OVA/LPS 10 days post-infection were re-stimulated
in vitro
as indicatedand supernatants assayed for levels of IFN-
(left) and IL-5 (right) after 48 h.
 
http://jbiol.com/content/5/2/5
 Journal of Biology 
2006,Volume 5, Article 5Millington
et al.
5.3
 Journal of Biology 
2006,
5:
5
Figure 1
(see legend on the previous page)
   P  r  o  p  o  r   t   i  o  n  o   f   R   B   C  s  p  a  r  a  s   i   t   i  z  e   d
Days post-infection00.20.40.60.81
   O  p   t   i  c  a   l   d  e  n  s   i   t  y   (   6   3   0  n  m   )
00.20.40.60.811.2
   O  p   t   i  c  a   l   d  e  n  s   i   t  y   (   6   3   0  n  m   )
00.20.40.60.81
   O  p   t   i  c  a   l   d  e  n  s   i   t  y   (   6   3   0  n  m   )
Dilution factor00.20.40.60.81
   O  p   t   i  c  a   l   d  e  n  s   i   t  y   (   6   3   0  n  m   )
Dilution factor00.20.40.60.811.2
   O  p   t   i  c  a   l   d  e  n  s   i   t  y   (   6   3   0  n  m   )
Dilution factor
   U  n  s   t   i  m  u   l  a   t  e   d   O   V   A  -  s   t   i  m  u   l  a   t  e   d   C  o  n   A  -  s   t   i  m  u   l  a   t  e   d
010203040
   C  y   t  o   k   i  n  e  p  r  o   d  u  c   t   i  o  n   (  n  g   /  m   l   )   U  n  s   t   i  m  u   l  a   t  e   d   O   V   A  -  s   t   i  m  u   l  a   t  e   d   C  o  n   A  -  s   t   i  m  u   l  a   t  e   d
050100150200250
   C  y   t  o   k   i  n  e  p  r  o   d  u  c   t   i  o  n   (  p  g   /  m   l   )
6 hours 4 days 12 days21 daysIFN-
γ 
IL-528 days
****
####
*****
00 10 20 30 40 501020304050
   5   0   1   5   0   4   5   0   1 ,   3   5   0   4 ,   0   5   0   1   2 ,   1   5   0   3   6 ,   4   5   0   1   0   9 ,   3   5   0   5   0   1   5   0   4   5   0   1 ,   3   5   0   4 ,   0   5   0   1   2 ,   1   5   0   3   6 ,   4   5   0   1   0   9 ,   3   5   0   5   0   1   5   0   4   5   0   1 ,   3   5   0   4 ,   0   5   0   1   2 ,   1   5   0   3   6 ,   4   5   0   1   0   9 ,   3   5   0
(a)(b)(c)

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