Low dosages of interleukin 1 protect mice against lethal cerebral malaria.

In cerebral malaria, pathological changes can be found in the brain of infected people and in the brain of Plasmodium berghei-infected mice. The pathogenesis of cerebral malaria in mice is believed to be due to an immunopathological reaction giving rise to an excessive production of cytokines such as interferon gamma (IFN-gamma) and tumor necrosis factor (TNF). We find that low doses of interleukin 1 (IL-1) protect mice against cerebral malaria; IL-1 also inhibits parasitemia. The IL-1 effect on parasitemia was not observed in nude mice and was at least partly reversed in mice treated with IL-1 in combination with antibody to IFN-gamma, indicating the involvement of T cells. Mice protected against development of cerebral malaria by IL-1 treatment developed the syndrome when TNF was given as observed in control infected mice or infected mice treated with inactivated IL-1.

The influence of the route of administration and liposome composition on the potential of liposomes to protect tissue against local toxicity of two antitumor drugs.

The present paper reports on the influence of the route of administration and liposome stability on the protective effect of liposome encapsulation of two model antitumor agents, mitoxantrone and doxorubicin. The results demonstrate that liposome encapsulation can protect surrounding tissue from the cytotoxic effects of the drugs after subcutaneous (s.c.) and intramuscular (i.m.) administration. The route of administration is an important factor influencing tissue damage. Liposomal mitoxantrone caused much less tissue irritation after im injection than after s.c. injection. Liposome stability is also an important factor. Liposomes composed of 'fluid-state' phospholipids only delayed the damaging effects of doxorubicin when injected sc. Liposomes with a more rigid nature were much more effective in preventing local tissue damage over a longer period of time when administered sc. Results suggest that slow release of liposome-associated drugs may eventually cause severe local tissue damage. The incorporation of the hydrophilic lipid derivative distearoylphosphatidylethanolamine-poly(ethyleneglycol) (PEG-PE) had no apparent effect on the protective effect of liposomes after sc administration.

Immunospecific targeting of immunoliposomes, F(ab')2 and IgG to red blood cells in vivo.

In this report a model to study the fate of target cells in the blood circulation after injection of appropriate immunoliposomes is discussed. The effect of intravenous administration of antimouse RBC immunoliposomes, F(ab')2 or IgG on the fate of intravenously injected 51Cr-labelled mouse RBC (Cr-mRBC) in the mouse and, particularly, in the rat was studied. The immunoliposome was of the Fab'-MPBPE-REV type (Fab'-fragments covalently linked to reverse phase evaporation vesicles by maleimido-4-(p-phenylbutyrate)phosphatidylethanolamine). In the rat model a high blood level (80%) of the injected dose of target cells, Cr-mRBC, was maintained for several hours. The elimination by Fab'-liposomes, F(ab')2 or IgG of Cr-mRBC, and subsequent uptake into liver and spleen was dose dependent. Administration of Fab'-liposomes or F(ab')2 resulted in a preferential uptake into the spleen (above a certain dose also, but much lower, uptake into the liver was observed), while after IgG administration 51Cr-label was mainly recovered in the liver. At equal protein doses (+/- 130 micrograms) Fab'-liposomes induced a faster elimination of the Cr-mRBC and a higher uptake into the spleen than F(ab')2. The potential advantage of the use of drug-loaded immunoliposomes to eliminate target cells from the blood stream and to induce a certain pharmacological effect in the target cells, in comparison with the free antibody administration of F(ab')2 or IgG is discussed.

Therapeutic effect of chloroquine(CQ)-containing immunoliposomes in rats infected with Plasmodium berghei parasitized mouse red blood cells: comparison with combinations of antibodies and CQ or liposomal CQ.

The potential therapeutic application of chloroquine-containing immunoliposomes (Fab'-lipCQ) in a Plasmodium berghei malaria model was studied. Extending a previously described in vivo model (Peeters et al. (1988) Biochim. Biophys. Acta 943, 137-147) it was demonstrated that injection of antimouse red blood cell (anti-mRBC) Fab'-lipCQ was significantly more effective than liposome-encapsulated chloroquine (lipCQ) or free chloroquine in delaying or preventing a patent infection after intravenous injection of parasitized mouse red blood cells (p-mRBC) in rats. The results could be improved by injecting synchronized infected cells instead of non-synchronous p-mRBC in order to minimize the presence of free parasites which could easily infect rat RBC. It was further demonstrated that sequential injection of anti-mRBC IgG and lipCQ or chloroquine resulted in complete inactivation of the injected parasitized cells while Fab'-lipCQ administration resulted in a maximum score of 50% at an equal chloroquine, protein and phospholipid dose. In this report the potential of the concept of drug targeting for the effective treatment of a disease, which manifests in blood cells, was demonstrated.

Induction of Plasmodium falciparum sporozoite-neutralizing antibodies upon vaccination with recombinant Pfs16 vaccinia virus and/or recombinant Pfs16 protein produced in yeast.

Pfs16 is a sexual stage/sporozoite-specific antigen of Plasmodium falciparum and is a potential candidate for a sporozoite-neutralizing vaccine. To obtain more information on the function of Pfs16 and to investigate its role during transmission and hepatocyte invasion, immunization experiments were performed with both a Pfs16-specific recombinant vaccinia virus and virus-like particles produced in yeast composed of the hepatitis B surface antigen (HBsAg) and antigen Pfs16 fused to HBsAg. Upon transformation of yeast cells, harbouring a genomic copy of the HBsAg gene, with a plasmid carrying the fusion gene Pfs16-HBsAg (Pfs16-S) virus-like hybrid particles composed of HBsAg and Pfs16-S were formed of a size similar to those present in human sera after infection with the hepatitis B virus. Cells infected with recombinant Pfs16 vaccinia virus synthesized a polypeptide of approx. 16 kDa that reacted with a Pfs16-specific polyclonal antibody. Animals vaccinated with the yeast hybrid particles and/or recombinant vaccinia virus both produced Pfs16-specific antibodies. These antibodies showed no transmission-blocking activity, but they efficiently diminished or abolished in vitro invasion of sporozoites into human hepatoma cells (HepG2-A16) and primary human hepatocytes.

Immunospecific targeting of liposomes to erythrocytes.

Immunoliposomes were made by covalently linking Fab' fragments (from rabbit antimouse erythrocyte IgG) to reverse-phase evaporation vesicles (REV) via maleimido-4-(p-phenylbutyrate) phosphatidylethanolamine (MPB-PE) as anchor molecule. These immunoliposomes were characterized in terms of size, charge, stability and antigen binding capacity. The effect of the liposomal Fab' density on the interaction with the target cell was studied. Two isolation methods were tested to separate free Fab' from liposomally bound Fab'. The necessity of deactivation of remaining reactive sites with dithiothreitol preincubation to increase the specificity of immunoliposome target cell interactions was demonstrated.

Relationship of the CD22 immunotoxin dose and the tumour establishment in a SCID mice model.

Immunotoxins (ITs) may be very potent to erradicate tumour growth in vivo. We investigated the influence of the IT-dose, in relation to the establishment of the tumour, on the anti-tumour activity of CD22-recombinant (rec) ricin A for a disseminated tumour (Ramos) in SCID mice. Furthermore, the enhancement of the IT cytotoxicity in vivo by chloroquine was assessed. CD22-rec ricin A appeared to be highly effective. Paralysis of the hind legs was significantly delayed by a very low IT-dose of 2 microg administered intravenously (i.v.) 7 days after i.v. inoculation of the tumour cells. Even a dose of 30 microg administered 21 days after inoculation of the target cells significantly delayed the onset of paralysis up to 8 days compared with the median paralysis time (MPT) of the control group. The efficacy of treatment was obviously influenced by the establishment of the tumour, the tumour load and localisation. The anti-tumour activity of 10 and 30 microg IT diminished when the IT was administered after increasing the time lag following inoculation of tumour cells. Delaying IT administration resulted in growth of solid tumours. This implies that cells migrate to sanctuaries protected from the IT indicating that the anti-tumour activity was influenced by the accessibility of the IT to the target cells. The in vivo anti-tumour activity of CD22-rec ricin A could not be enhanced by simultaneously administered chloroquine, despite the continuous infusion with an intraperitoneally (i.p.) implanted mini-osmotic pump. Ex vivo experiments revealed that the maximally tolerated serum concentration (3.9 microM) was too low to be effective. In conclusion, CD22-rec ricin A is highly effective for in vivo treatment of B-cell malignancies, in particular if treatment is started when the tumour load is low and before migration takes place to poorly accessible sanctuaries.

Morphological characteristics of intracerebral arterioles in clinical (Plasmodium falciparum) and experimental (Plasmodium berghei) cerebral malaria.

Spastic constriction of intracerebral arterioles was identified in clinical (P. falciparum) and experimental (P. berghei) cerebral malaria. Morphological criteria were used to characterize pathologically spastic constriction of arterioles. The significance of spastic constriction of intracerebral arterioles for microcirculatory disturbance in relation to development of cerebral malaria is discussed.

Selective damage of hippocampal neurons in murine cerebral malaria prevented by pentoxifylline.

The effect of pentoxifylline, a phosphodiesterase inhibitor, was investigated on the development of cerebral malaria in Plasmodium berghei K 173 infected C57/B16 mice. No significant differences occurred in the course of parasitemia and survival time after infection between control mice and pentoxifylline treated mice. Moreover, no differences were observed between the groups with respect to the occurrence of cerebral malaria. The only striking difference was that pentoxifylline treatment selectively prevented neuronal cell damage in the sector CA1 of the hippocampus. These findings are in contrast to previous studies, where pentoxifylline prevented cerebral malaria in P. berghei ANKA infected CBA/Ca mice, another widely used model of cerebral malaria. Obvious differences exist between these models.

A cytochemical study of cerebrovascular lesions in mice infected with Plasmodium berghei.

Mice with a Plasmodium berghei infection exhibit morphological and cytochemical changes in the blood-brain barrier. Changes in activity and localization of alkaline phosphatase and adenosine triphosphatase, enzymes with important functions in the maintenance of the blood-brain barrier, were observed. Changes in activity and localization of those enzymes in and near the endothelial cells of the microvasculature, concomitant with an increase in pinocytotic activity, and formation of irregular cytoplasmic extensions in these cells, as well as loosening of the basal lamina are indicative of a functional deterioration of the blood-brain barrier in the course of infection.

Cortisol and Plasmodium falciparum infection in pregnant women in Kenya.

Women living under holoendemic conditions of malaria in Kenya exhibited an increased prevalence of clinical malaria during pregnancy. In addition parasite rate and density were higher in primigravidae compared to multigravidae. Higher serum cortisol concentrations were found in women with patent malaria during pregnancy and the levels were higher before, during and after the malaria episode. A causal relation between serum cortisol levels and suppression of malaria immunity during pregnancy is discussed.

Role of macrophages in the pathogenesis of endomyocardial fibrosis in murine malaria.

C57B1/Rij mice developed progressive endocardial oedema and extensive endocardial thrombosis with a predilection for the right half of the heart in the course of a lethal Plasmodium berghei infection. Chemotherapy of an ongoing infection resulted in fibrosis of affected areas. Despite a close correlation between development of lesions and parasitaemia, parasitized erythrocytes were not usually present in the affected areas. Macrophages might play, however, an important role in the pathogenesis of the lesions. Early changes included sticking of macrophages to the endocardial endothelium, migration to subendothelial areas associated with leakage, and oedema. Subsequently, subendothelial infiltrates of lymphocytes, neutrophilic granulocytes, macrophages and fibroblasts were found. Moreover, endothelial lesions, sometimes associated with cell migration, were found to be plugged by microthrombi. Mural thrombi grew out eventually until death of the host or until chemotherapy cleared the infection.

Attenuation of malaria infection, paralysis and lesions in the central nervous system by low protein diets in rats.

Young Wistar rats developed a fulminant infection when inoculated with the rodent malaria parasite Plasmodium berghei. Rats that died during the infection exhibited a progressive paralysis of the extremities, a rapidly decreasing body temperature and minute haemorrhages in the brain. Increasing the level of protein in the diet from 4 to 8 and 16% was accompanied by an increase in morbidity and mortality from 15 to 40 and 90% respectively on day 6 of the infection. Increasing the level of dietary protein also increased the reticulocyte count of the peripheral blood in infected and non-infected rats. The attenuation of the cerebral syndrome in rats fed a diet low in protein may be related to changes in erythropoiesis or to changes in immune reactivity.

Pharmacokinetic and pharmacodynamic aspects of artelinic acid in rodents.

The efficacy of artelinic acid and artemisinin, orally administered at 10 and 50 mg kg-1 day-1, was compared in Plasmodium berghei infected mice. Subsequently, the pharmacokinetics of artelinic acid after intravenous, intramuscular, oral and rectal administration of a 20 mg kg-1 aqueous solution to rabbits were studied in a four-way randomized cross-over experiment. After intravenous administration, artelinic acid concentrations in blood plasma were high (C0: 76 +/- 15 mg L-1), and the drug was rapidly eliminated from the central compartment, showing linear elimination kinetics with an elimination half-life of 15 +/- 3 min. A large inter-subject variation appeared in the absorption rate and the extent of absorption (2-92%) over the 120 min interval after intramuscular administration. Also, a large inter-subject variation in individual rectal bioavailability (17-100%) was shown, which was dependent on the site of absorption in the rectum. The estimated oral bioavailability was low (4.6 +/- 1.7%), probably due to a high first-pass effect and possible decomposition in the acidic gastric environment.

The parenteral controlled release of liposome encapsulated chloroquine in mice.

Free (0.6 mg), and liposome encapsulated chloroquine (0.6, 3 mg), were injected intraperitoneally, intramuscularly and subcutaneously in mice. Intraperitoneal administration of liposome-encapsulated chloroquine resulted in high and long lasting concentrations of chloroquine in the blood compared with intraperitoneal administration of free chloroquine. After administration of the liposome-encapsulated chloroquine the concentrations in the spleen were also higher, indicating that chloroquine liposomes reached the blood compartment intact after intraperitoneal administration. After intramuscular and subcutaneous administration the chloroquine liposomes acted as a local depot, giving a slower release from the subcutaneous fat layer than from the muscle depot. After the 0.6 mg dose a burst effect was found at about 7 h in most of the animals; this was not found after the 3 mg dose. This finding and the slower release after the 3 mg dose than after the 0.6 mg dose could be explained by the formation of aggregates after the injection.

Evaluation of the standard membrane feeding assay (SMFA) for the determination of malaria transmission-reducing activity using empirical data.

Host responses to the transmittable stages of the malaria parasite may reduce transmission effectively. Transmission-reducing activity (TRA) of human serum can be determined as a percentage, using the Standard Membrane Feeding Assay (SMFA). This laboratory assay was evaluated using the results of 121 experiments with malaria-endemic sera among which many repeated measurements were obtained. The assay consists of the feeding of Anopheles stephensi mosquitoes with cultured Plasmodium falciparum gametocytes, mixed with human red blood cells, and control and experimental sera. The TRA of individual sera was determined by the comparison of oocyst densities between these sera. Bootstrap data on oocyst densities in individual mosquitoes in control feeds were used to construct confidence limits for TRA percentages of serum feeds. Low (<20%) and high TRA (>90%) values for individual sera were usually reproduced in a second experiment, whereas this was more difficult for values between 20% and 90%. The observed variability of TRA values is explained in part by the variability in oocyst density per mosquito. Oocyst densities in control feeds varied more between experiments than within experiments and showed a slight decline over the 3 years of experiments. Reproducibility of TRA of field sera was low (20%) between experiments, but much higher (61 %) within experiments. A minimum of 35 oocysts per mosquito in control feeds gave optimal reproducibility (44%) between experiments. We recommend that (1) sera are compared within an experiment, or (2) assays are only analysed where controls have at least 35 oocysts per mosquito. The SMFA is under the recommended conditions appropriate for the study of factors that may influence TRA, e.g. transmission blocking vaccines.

Chronic, patent Plasmodium berghei malaria in splenectomized mice.

It was shown that splenectomized mice could develop a certain resistance to Plasmodium berghei but usually no real immunity, since the infection became chronic, often with high parasitemias. A patent infection lasting at least 2 weeks was necessary for the development of this degree of protection. Prolonged suppression to subpatent levels (sulfonamide treatment), rather than radical cure (chloroquine), after 2 weeks of patency yielded a higher proportion of mice resistant to superinfection. An increasing proportion of B10LP, but not C57BL/Rij or BALB/c, mice cleared their chronic infection spontaneously in time. Chronic patent infections were accompanied by anemia, elevated serum glutamate oxaloacetate transaminase levels, indicating liver pathology, and decreased immune reactivity, but the magnitude to these pathological changes was limited compared with changes in primary, lethal infections in intact controls. Parasitemia and pathology did not always develop synchronously.