Citoquinas reguladoras de la respuesta al trasplante renal alogénico / Regulatory cytokines in the response to the allogeneic renal transplant

The outcome of the kidney allograft mainly depends on the immune response and on its complex regulation, where the cytokine network and other mediators play an important role. At present, kidney biopsy is the most useful tool for monitoring the transplant rejection and the diagnosis of the associated nephropathies, in spite of the invasiveness of the procedure. Thus, it is of great interest to find alternative tools for diagnosis. The evaluation of regulatory cytokines is a simple procedure of low cost that could be useful to increase the sensitivity of the detection of polymorphic differences, to predict the graft acceptance and for the early detection of rejection. Recent studies suggest that the high production of pro-inflammatory mediators, such as Th1 cytokines, could be detrimental, whereas the production of anti-inflammatory regulatory cytokines, such as interleukin (IL)-10 and tumor necrosis factor (TGF)-beta, could be beneficial for graft survival. In the early stages, the cellular cytotoxicity is activated by the Th1 response and the detection of cytotoxic molecules is associated to the acute rejection. Later, the balance between pro and anti-inflammatory mediators and the regulation of their levels could be more important. In this regard, TGF-beta is also fibrogenic and a high local production can contribute to kidney damage. On the other hand, the increased production of IL-10 in response to the allogeneic stimuli could be, in most cases, an important marker of long-term acceptance.

La aceptación o el rechazo del riñón alogénico dependen principalmente de la respuesta inmune y de su compleja regulación en la cual la red de citoquinas y otros mediadores juegan un importantepapel. Actualmente, la biopsia renal es, a pesar de lo invasor del procedimiento, la herramienta de mayor utilidadpara el control del rechazo al trasplante y el diagnóstico de las nefropatías asociadas. Por ello, es de graninterés encontrar métodos alternativos para el diagnóstico. La evaluación de citoquinas reguladoras de la respuestainmune es un procedimiento sencillo y de bajo costo que podría ser de utilidad para incrementar la sensibilidadde la detección de diferencias polimórficas, para pronosticar la aceptación del trasplante y para ladetección precoz del rechazo. Los estudios recientes sugieren que la producción exagerada de mediadores proinflamatorios, incluyendo a citoquinas Th1, sería desventajosa para la sobrevida del trasplante, mientras que la producción de citoquinas reguladoras anti-inflamatorias, como la interleuquina (IL)-10 y el factor de crecimiento tumoral (TGF)-β, sería beneficiosa. En las primeras etapas, la respuesta Th1 puede incrementar la actividad citotóxica y la detección de moléculas citotóxicas está asociada al rechazo agudo. Luego podría ser más importante considerar el balance entre la producción de mediadores pro- y anti-inflamatorios y la regulación desus niveles. Así, el TGF-β es también fibrogénico y su excesiva producción local puede contribuir al daño renal.Por otro lado, el incremento de la producción de IL-10 en respuesta al estímulo alogénico sería, en la mayoríade los casos, un marcador importante para pronosticar la aceptación prolongada.

Proinflammatory and anti-inflammatory cytokines in pregnant women chronically infected with Trypanosoma cruzi.

Mother-to-child transmission of intracellular parasites could be related to the production of immunoregulatory cytokines. The levels of gamma interferon (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha) and lnterleukin (IL)-10 were evaluated during pregnancy in sera of women chronically infected with Trypanosoma cruzi that delivered infected or non-infected children. The levels of IL-10 increased in both, women only pregnant and only infected, compared to non-infected non-pregnant women. However, in pregnant women chronically infected with T. cruzi, IL-10 did not increase significantly, neither in the mothers of infected nor in the mothers of non-infected children. The levels of the inflammatory cytokine TNF-alpha were not affected in normal pregnancy but increased in the infected mothers of non-infected children. The levels of IFN-gamma did not increase in the groups studied, indicating that the production of this pro-inflammatory cytokine was controlled, even when the levels of IL-10 did not increase, as in pregnant women chronically infected with T. cruzi.

[Inflammatory response to acute Trypanosoma cruzi infection]. / La respuesta inflamatoria en la infección aguda con Trypanosoma cruzi.

The acute stage of Trypanosoma cruzi infections related to high parasitemia is characterized by the presence of inflammatory infiltrates in several tissues, including the heart and squeletal muscle, as well as by an increased production of inflammatory mediators, such as gamma-interferon (IFN-gamma), tumor necrosis factor (TNF), interleukin-1 (IL-1) and oxygen and nitrogen reactive intermediates. The activation of phagocytic cells seems to be closely related to both the inflammatory process and host resistance to the infection. Herein, the inflammatory mediators produced in vivo and their relationship with the tissue damage and TH1 immune response are reviewed.

[Superantigens: a particular interaction between microorganisms and the immune system]. / Superantígenos: una particular interacción entre microorganismos y el sistema inmune.

The discovery of the superantigens (SAgs) offered new insights on the interaction between microorganisms and the host immune system. Associated to Major Histocompatibility Complex (MHC) class II molecules, SAgs bind to the variable domain of the beta chain (V beta) of the TCR alpha beta engaged in the family specificity of lymphocytes. Therefore, these molecules are able to activate a high number of T lymphocytes as well as surface MHC class II bearing cells, leading to an overriding release of cytokines and inflammatory mediators, which have been related to their toxic effects. Endogenous SAgs are encoded by murine tumor proviruses (Mtv) which are integrated in the genome of mice. Bacteria and viruses produce exogenous SAgs and those related to food poisoning have been widely studied. The presence of parasite SAgs is still unclear and further studies are required to establish their existence and effects on the corresponding infections.

Trypanosoma cruzi: T-cell-dependent mechanisms of resistance during chronic infection.

Effector mechanisms of resistance exerted by T cells from BALB/c mice chronically infected with Trypanosoma cruzi, Tulahuén strain, were studied. Spleen cells from chronically infected mice (Chro-SC) prestimulated with heat-killed trypomastigotes (HKT) and/or IL-2 destroyed PHA-labeled p-815 mastocytoma cells, HKT-pulsed macrophages, and normal peritoneal macrophages. However, HKT-stimulated Chro-SC did not affect the infectivity of free bloodstream forms of the parasite. Upon HKT stimulation, Chro-SC or their culture supernatant activated peritoneal macrophages for the destruction of intracellular amastigotes. The effect was abolished after Thy 1.2+ cell depletion. The addition of Cyclosporin A (CyA), which blocks T-cell activation, during HKT-stimulation of Chro-SC, diminished their ability to activate the trypanocidal activity of macrophages. CyA also inhibited the production of both macrophage-activating factors and interferon-gamma by HKT-stimulated Chro-SC. CyA administration to recipients of nylon-wool nonadherent spleen cells from chronically infected mice inhibited their adoptively acquired resistance against T. cruzi, suggesting that the conferred resistance depended on the effect of specifically activated cells. When administered during the chronic stage of the infection, CyA abrogated the antigen-specific delayed type hypersensitivity response but increased the levels of anti-T. cruzi IgG antibodies. Neither parasitemia, tissular parasitism in myocardium or skeletal muscle, nor mortality were detected after CyA treatment, suggesting the presence of a CyA nonsensitive mechanism(s) in the control of T. cruzi during the chronic phase of the infection.

Trypanosoma cruzi: inducción de alteraciones del sistema nervioso periférico en diferentes cepas de ratones / Trypanosoma cruzi: induction of changes in the peripheral nervous system in different strains of mice

Este estudio fue diseñado buscando un método sencillo que permitiera evaluar el compromiso denervatorio o muscular primario en la infección experimental con T. cruzi. Para ello se empleó la exploración electromiográfica convencional de los músculos isquiotibiales de una de las patas en diferentes cepas de ratones infectados con 3 cepas de T. cruzi. Se estudiaron las siguientes asociaciones entre parásitos y huéspedes: Tulahuén (Tul) y C3H/HeN, C57Bl, Balb/c ó Swiss; CA-I y C3H/HeN, Rockland, NIH; RA y C3H/HeN, Rockland. Los ratones se infectaron con tripomastigotes sanguíneos de t. cruzi administrados por vía intraperitoneal. En el electromiograma fueron estudiadas la amplitud, duración y número de fases de los potenciales de undad motora aislados. Se observó que la cepa Tul inducía alteraciones de tipo denervatório en ratones C3H/HeN y C57BI y que igual acontecía con la cepa RA en ratones C3H/HeN. Modificaciones sugestivas de daño muscular primario se vieron en la asociación parásito CA-I y huéspede C3H/HeN y entre CA-I y HIH. La metodología empleada demostró ser de utilidad práctica para la rápida detección del tipo de compromiso de la unidad motora en las infecciones murinas experimentales con T. cruzi

Increased production of reactive oxygen species by cells from mice acutely infected with Trypanosoma cruzi.

Release of reactive oxygen species (ROS) by cells from BALB/c mice was studied during the acute stage of the infection with 50 bloodstream forms of Trypanosoma cruzi, Tulahuén strain. Production of ROS by spleen and peritoneal cells was evaluated by chemiluminescence using luminol as enhancer (CL-Lum). Three to four weeks after infection, CL-Lum response after the addition of opsonized zymosan to spleen and peritoneal cells from infected mice was 13 and 98 times, respectively, above the levels obtained with cells from noninfected mice. The kinetics of this hyperactivity was similar to that of the parasitemia. Both reached maximal values on the third to fourth weeks and decreased at 7 weeks postinfection. During this hyperactivation stage, spleen and peritoneal cells from infected mice showed a "spontaneous" CL-Lum response (without any stimulus added in vitro) absent in noninfected mice. Both, "spontaneous" and zymosan stimulated CL-Lum responses were inhibited by 100 microM azide and by 0.8 microM superoxide dismutase, suggesting the involvement of hemoproteins and superoxide anion in the measured responses. Moreover, spleen cells from acutely infected mice displayed a hyperactivity in the CL-Lum response when recombinant interferon-gamma was added in vitro. Supernatants of spleen cells from both normal or infected mice, stimulated in vitro with concanavalin A, contained similar levels of interferon and were equally able to stimulate the trypanocidal activity of normal macrophages. These results suggest that mediators of activation of phagocytic cells can be produced during acute T. cruzi infection. In addition, phagocytic cells from acutely infected mice were activated in vivo and were hyperactive to the in vitro stimulation.

[Molecular and immunologic bases for the development of a vaccine against Chagas disease]. / Bases moleculares e inmunológicas para el desarrollo de una vacuna contra la enfermedad de Chagas.

Subcellular fractions of T. cruzi epimastigotes (Epi) were studied for their capability to induce protective or aggressive effects in animals. The flagellar fraction (F) showed the best immunoprotective properties without tissular aggression. Monoclonal antibodies were raised against F. Two of them, FCH-F8-1 and 4, were able to neutralize the infectivity of bloodstream forms, to mediate lysis by complement of cell culture derived[trypomastigotes (Tripo) and to recognize the surface of Tripo and Epi. FCH-F8-1 reacted with a 85 kDa protein from Tripo (assayed by immunoprecipitation) and with peptides of 43 kDa on Epi and Tripo (tested by immunoblotting). FCH-F8-4 recognized several proteins ranging from 50 to 150 kDa on Epi and two molecules of 15 and 48 kDa on Tripo. Mice immunized with antigens purified by affinity chromatography by using FCH-F8-4 were protected against the infection. Several recombinant clones were detected on a cDNA lambda gt11 expression library constructed from T. cruzi Epi (Tulahuén strain): three with FCH-F8-4 and two with FCH-F8-1. One clone recognized by each monoclonal antibody was studied gamma (FCH-F8-1) 1 and gamma (FCH-F8-4) 1. Both inserts were of 150 base pairs each; they detected a 3.5 and 5.0 kilobases Epi mRNA, respectively. Both inserts were sequenced, and the amino acid sequences were inferred. gamma (FCH-F8-4) 1 codified for a 19 aa peptide, PAFLGCSSRFSGSFSGVEP, and gamma (FCH-F8-1) 1 for a 29 aa peptide EFLERGRISCORHSYTSYTSCSDEHNVTPFC. The whole 19 aa peptide was synthesized. This peptide (SP4) inhibited the ELISA reactivity against the parasite of chronically infected and F immunized mouse sera.(ABSTRACT TRUNCATED AT 250 WORDS)

The neuromuscular pathology of experimental Chagas' disease.

In this work, we describe skeletal muscle, neuromuscular junction, nerve and spinal cord lesions in the mouse model system of Chagas' disease. Myositis was a common finding and Trypanosoma cruzi amastigote nests were frequently found in the muscle fibers. Angular atrophy, targetoid fibers, groups of atrophic fibers, fibrosis, myofiber necrosis and phagocytosis of cellular debris were also observed. The neuromuscular junction studies showed degeneration of intramuscular nerve fibers, swelling and distortion of nerve endings and multiple ramifications on the same muscle fiber. Collateral, terminal and ultraterminal axonal sprouts were also present. Inflammatory neuropathy was seen in all of the infected mice. Demyelination, axonal degeneration, remyelination and axonal regeneration were observed in the transverse sections. There was an average reduction of 29% in the total number of myelin fibers. The teasing of single myelin fibers showed segmental and paranodal demyelination and remyelination more frequently than axonal degeneration and regeneration. The lumbar spinal cords presented inflammatory cell infiltration associated with tissue destruction. Amastigote nests were found in 3 out of the 8 infected mice studied. There was a mean loss of 21% of the large cytoneurons of the anterior horn of the lumbar spinal cord.

Oxygen-derived radicals from Trypanosoma cruzi-stimulated human neutrophils.

This study provides biochemical and electron spin resonance spectroscopic evidence that contract of human polymorphonuclear leukocytes with antibody-coated Trypanosoma cruzi triggers the respiratory burst. Oxygen consumption, superoxide anion and hydrogen peroxide release were stimulated under conditions of polymorphonuclear leukocyte-mediated killing. This stimulation did not occur under non-killing conditions when antibody was omitted. A common mechanism of cytotoxicity of human polymorphonuclear leukocytes against different T. cruzi forms is suggested by the triggering of the respiratory burst by antibody-coated epimastigotes and trypomastigotes.

Trypanosoma cruzi: sequence of phagocytosis and cytotoxicity by human polymorphonuclear leucocytes.

We have studied the relationship between phagocytosis and cytotoxicity of human polymorphonuclear leucocytes (PMN) to sensitized Trypanosoma cruzi. Assays were done simultaneously using [3H]-uridine labelled epimastigotes as target cells. Phagocytosis was evaluated by the uptake and cytotoxicity by the release of parasite associated [3H]-uridine. Both reactions reached maximum levels at the same effector- to target-cell ratio and antibody concentration. Uptake of epimastigotes by PMN was highest at 30 min and intracellular disruption and release of parasite debris took place later. In conditions that precluded repeated uptake of sensitized radiolabelled T. cruzi, the release profile of [3H]-uridine from PMN that contained intracellular parasites was similar to that of the standard cytotoxic assay. However, as the ingestion phase was separated from the release step, no lag in the onset of the reaction was observed. Although we cannot rule out extracellular killing, the results of this study demonstrate that the bulk of damaged T. cruzi epimastigotes had been previously internalized by the PMN.