CCR5 promotes the migration of pathological CD8+ T cells to the leishmanial lesions.

Cytolytic CD8+ T cells mediate immunopathology in cutaneous leishmaniasis without controlling parasites. Here, we identify factors involved in CD8+ T cell migration to the lesion that could be targeted to ameliorate disease severity. CCR5 was the most highly expressed chemokine receptor in patient lesions, and the high expression of CCL3 and CCL4, CCR5 ligands, was associated with delayed healing of lesions. To test the requirement for CCR5, Leishmania-infected Rag1-/- mice were reconstituted with CCR5-/- CD8+ T cells. We found that these mice developed smaller lesions accompanied by a reduction in CD8+ T cell numbers compared to controls. We confirmed these findings by showing that the inhibition of CCR5 with maraviroc, a selective inhibitor of CCR5, reduced lesion development without affecting the parasite burden. Together, these results reveal that CD8+ T cells migrate to leishmanial lesions in a CCR5-dependent manner and that blocking CCR5 prevents CD8+ T cell-mediated pathology.

Selective whole-genome amplification reveals population genetics of Leishmania braziliensis directly from patient skin biopsies.

In Brazil, Leishmania braziliensis is the main causative agent of the neglected tropical disease, cutaneous leishmaniasis (CL). CL presents on a spectrum of disease severity with a high rate of treatment failure. Yet the parasite factors that contribute to disease presentation and treatment outcome are not well understood, in part because successfully isolating and culturing parasites from patient lesions remains a major technical challenge. Here we describe the development of selective whole genome amplification (SWGA) for Leishmania and show that this method enables culture-independent analysis of parasite genomes obtained directly from primary patient skin samples, allowing us to circumvent artifacts associated with adaptation to culture. We show that SWGA can be applied to multiple Leishmania species residing in different host species, suggesting that this method is broadly useful in both experimental infection models and clinical studies. SWGA carried out directly on skin biopsies collected from patients in Corte de Pedra, Bahia, Brazil, showed extensive genomic diversity. Finally, as a proof-of-concept, we demonstrated that SWGA data can be integrated with published whole genome data from cultured parasite isolates to identify variants unique to specific geographic regions in Brazil where treatment failure rates are known to be high. SWGA provides a relatively simple method to generate Leishmania genomes directly from patient samples, unlocking the potential to link parasite genetics with host clinical phenotypes.

Effects of different interventions on bruxism: an overview of systematic reviews.

OBJECTIVE: This study aimed to evaluate, qualify, and summarize evidence presented in systematic reviews (SR) on treatments for bruxism. METHODS: The overview was conducted using the PICO strategy: children, adolescents, and adults with bruxism (P) were submitted to different treatments (I) compared to other treatments, placebo, or no treatment (C) in order to evaluate incidence, prevalence, and number of episodes of bruxism (O). The search was carried out in six databases and gray literature up to July 2023. Data were extracted, and the ROBS tool was used, followed by a descriptive synthesis of the results. RESULTS: A total of 31 SR were included. Sixteen showed a positive effect on episodes of bruxism (BE), while two had negative, one had neutral, and nine had inconclusive effects. Using the risk of bias in systematic reviews tool (ROBIS), risk of bias varied from low (n = 23) to high (n = 5) among the SR. Pharmacological treatment, oral rehabilitation, and other therapeutic approaches presented inconclusive or negative effects on BE, while oral appliances showed controversial effects. Biofeedback, physical therapy, laser therapy, and botulinum toxin showed positive effects on the reduction of BE. CONCLUSION: Biofeedback, physical therapy, laser therapy, and botulinum toxin showed positive effects on the reduction of BE; there is still a lack of studies to support the safe and long-term use of these therapies. REGISTRATION NUMBER: PROSPERO CRD42021273905.

Transcriptomic landscape of skin lesions in cutaneous leishmaniasis reveals a strong CD8+ T cell immunosenescence signature linked to immunopathology.

The severity of lesions that develop in patients infected by Leishmania braziliensis is mainly associated with a highly cytotoxic and inflammatory cutaneous environment. Recently, we demonstrated that senescent T and NK cells play a role in the establishment and maintenance of this tissue inflammation. Here, we extended those findings using transcriptomic analyses that demonstrate a strong co-induction of senescence and pro-inflammatory gene signatures in cutaneous leishmaniasis (CL) lesions. The senescence-associated signature was characterized by marked expression of key genes such as ATM, Sestrin 2, p16, p21 and p38. The cell type identification from deconvolution of bulk sequencing data showed that the senescence signature was linked with CD8+ effector memory and TEMRA subsets and also senescent NK cells. A key observation was that the senescence markers in the skin lesions are age-independent of patients and were correlated with lesion size. Moreover, a striking expression of the senescence-associated secretory phenotype (SASP), pro-inflammatory cytokine and chemokines genes was found within lesions that were most strongly associated with the senescent CD8 TEMRA subset. Collectively, our results confirm that there is a senescence transcriptomic signature in CL lesions and supports the hypothesis that lesional senescent cells have a major role in mediating immunopathology of the disease.

Solar photon-Fenton process eliminates free plasmid DNA harboring antimicrobial resistance genes from wastewater.

This work aimed to assess the elimination and inactivation of resistance-conferring plasmids (RCPs) present in suspension in secondary wastewater by solar photo-Fenton as these are important vectors for the dissemination of antimicrobial resistance. Experiments were performed in synthetic secondary wastewater (SWW) and municipal wastewater treatment plant effluent (MWWTPE). Solar photo-Fenton (50 mg L-1 of H2O2 and 30 mg L-1 of Fe2+) was carried out for 60 min at neutral pH by applying the intermittent iron addition strategy. The removal of RCPs was assessed by Real-Time Polymerase Chain Reaction (qPCR). The transformation of competent non-resistant E. coli was used to evaluate the inactivation of target RCPs harboring antibiotic resistance genes (ARGs) to ampicillin (pSB1A2) or kanamycin (pSB1K3) after treatment and controls. Solar photo-Fenton completely removed RCPs initially present in both matrixes (SWW and MWWTPE), showing enhanced performance compared to the dark Fenton process. Both RCPs were inactivated after 30 min of solar photo-Fenton treatment, while 60 min were necessary to achieve the same effect for the dark Fenton reaction under similar conditions. These results indicate the potential of solar photo-Fenton to improve wastewater quality and reduce the spread of antimicrobial resistance in the environment by hampering the discharge of cell-free RCPs present in suspension in MWWTP onto environmental waters.

Perception Regarding Pediatric Dentist's Appearance and Factors Influencing the Child's Responses.

OBJECTIVE: To develop, validate, and apply an instrument for assessing the children's perception regarding pediatric dentist's appearance, based upon the influence of age, gender, previous dental experience, and anxiety. STUDY DESIGN: Images and a nine-item questionnaire were developed. The acceptability, convergent-construct validity, and reliability based on reproducibility and internal consistency were evaluated. The validated instrument was applied in a cross-sectional study, with children (n=120) aged 7-12 years asked to evaluate images of pediatric dentists wearing different dental attire (A:all-white (control); B:printed coat and cap, colorful face mask; C:printed coat, cap and face mask; and D:white coat and cap, printed face mask). Children's age, gender, and previous dental experiences were collected with the guardians. The Children's Fear Survey Schedule-Dental Subscale assessed children's anxiety. Descriptive and inferential statistics were carried out (p<0.05). RESULTS: The instrument showed excellent acceptability, construct validity with moderate and strong correlations (>0.40), satisfactory reproducibility (ICC >0.70), and internal consistency (Cronbach's alpha coefficient >0.70). Considering only the attire, the children's perceptions were more positive with the use of attire C and D (p<0.05). Intergroup analysis of all the variables did not identify a statistically significant difference (p>0.05). In the intragroup analysis, compared to attire A: younger children have higher perception scores to attire D; girls, children with previous experience and without anxiety favored attire C and D; and children without previous experience showed no difference in comparison to A but did between B and C (p<0.05). CONCLUSION: The C and D attires promoted a more positive perception of the appearance of a pediatric dentist when compared to A; however, age, gender, previous dental experience, and anxiety did not influence the perception scores.

Local and systemic production of proinflammatory chemokines in the pathogenesis of HAM/TSP.

BACKGROUND: HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) is related with high proviral load, high proinflammatory cytokine levels, and passage of infected cell from the blood to the central nervous system. We aimed to evaluate the participation of chemokines and adhesion molecules in HAM/TSP pathogenesis. METHODS: CXCL9, CXCL10, sICAM-1, and sVCAM-1 were determined by ELISA in serum and cerebrospinal fluid (CSF) of HTLV-1 infected individuals. The frequency and median fluorescence intensity (MFI) of lymphocytes and monocytes expressing ligands of adhesion molecules (CD11a and CD49d) and a chemokine receptor (CXCR3) were analyzed by flow cytometry. RESULTS: The levels of CXCL9 and CXCL10 in serum of definite HAM/TSP were higher than in serum of probable HAM/TSP and HTLV-1 carriers. Considering the production of chemokines by patients with definite HAM/TSP, CXCL9 levels were higher in serum than in CSF, and CXCL10 production was higher in CSF than in serum. Levels of adhesion molecules in serum and CSF of HTLV-1 infected individuals did not differ. The MFI of CD11a on CD4+, CD8+ and CD14+ cells was lower in definite HAM/TSP than in HTLV-1 carriers and did not differ from probable HAM/TSP and healthy subjects (HS). The frequency of lymphocytes expressing CXCR3 was lower in definite HAM/TSP than in cells of probable HAM/TSP and did not differ from carrier and HS. CONCLUSION: These data point to the participation of proinflammatory chemokines, especially CXCL10, in the pathogenesis of definite HAM/TSP.

Frequency of crown and root dilaceration of permanent incisors after dental trauma to their predecessor teeth.

BACKGROUND/AIMS: Dental trauma to the predecessor teeth can cause crown and root dilacerations to the successor teeth, which can interfere with the normal development of permanent teeth. The aims of this study were to verify the types of trauma more frequent to the predecessor teeth that cause dilaceration to their successor teeth, to determine the frequency of crown and root dilacerations in permanent incisors, taking into account the child's age at the time of trauma, and to describe the types of treatment performed. MATERIALS AND METHODS: Details of 815 anterior primary teeth with dental injury were obtained from 483 dental records of children aged 0-9 years at the time of trauma. RESULTS: Of 815 traumatized primary teeth, 161 successor teeth were clinically and radiographically reviewed until complete eruption and had some type of sequel. Avulsion and intrusive luxation were the most frequent types of trauma to the predecessor teeth that caused dilaceration to their successor teeth. Enamel discoloration (30.4%), hypoplasia (23.6%), root (14.3%) and crown (9.9%) dilacerations were the most common sequelae observed in the successor teeth. Root and crown dilacerations were more frequent in children aged more than and up to 3 years, respectively. Tooth extraction and orthodontic treatment were the most common treatments. CONCLUSIONS: Dentists must be aware of the relationship between the child's age at the time of trauma to the predecessor tooth and the type of sequel to the successor tooth in order to diagnose, monitor, and treat the sequel properly.

Multistage ozone and biological treatment system for real wastewater containing antibiotics.

In this study, a multistage treatment system was proposed to treat real pharmaceutical wastewater containing the antibiotic amoxicillin. Ozonation (O3), and ozonation combined with aerobic biodegradation, were performed. The real pharmaceutical wastewater presented a high concentration of organic matter (TOC: 803 mg C·L-1 and COD: 2775 mg O2·L-1), significant amoxicillin content (50 mg L-1) and acute ecotoxicity (Aliivibrio fischeri aTU: 48.22). Ozonation proved to be effective for amoxicillin degradation (up to 99%) and the results also indicated the removal of the original colour of the wastewater, with average consumption of 1 g of ozone. However, the ozonation system alone could not achieve complete mineralization. Therefore, a combination of ozonation and biodegradation in a multistage system was proposed in order to improve cost and treatment efficiency. The multistage treatment system presented promising results, achieving degradation of more than 99% of the amoxicillin, more than 98% of the original chemical oxygen demand (COD), and 90% of initial toxicity, with the consumption of approximately 500 mg of ozone. This indicates that this system could prevent dangerous and biorecalcitrant antibiotics from entering water resources.

Degradation of ethylenethiourea pesticide metabolite from water by photocatalytic processes.

In this study, photocatalytic (photo-Fenton and H2O2/UV) and dark Fenton processes were used to remove ethylenethiourea (ETU) from water. The experiments were conducted in a photo-reactor with an 80 W mercury vapor lamp. The mineralization of ETU was determined by total organic carbon analysis, and ETU degradation was qualitatively monitored by the reduction of UV absorbance at 232 nm. A higher mineralization efficiency was obtained by using the photo-peroxidation process (UV/H2O2). Approximately 77% of ETU was mineralized within 120 min of the reaction using [H2O2]0 = 400 mg L(-1). The photo-Fenton process mineralized 70% of the ETU with [H2O2]0 = 800 mg L(-1) and [Fe(2+)] = 400 mg L(-1), and there is evidence that hydrogen peroxide was the limiting reagent in the reaction because it was rapidly consumed. Moreover, increasing the concentration of H2O2 from 800 mg L(-1) to 1200 mg L(-1) did not enhance the degradation of ETU. Kinetics studies revealed that the pseudo-second-order model best fit the experimental conditions. The k values for the UV/H2O2 and photo-Fenton processes were determined to be 6.2 × 10(-4) mg L(-1) min(-1) and 7.7 × 10(-4) mg L(-1) min(-1), respectively. The mineralization of ETU in the absence of hydrogen peroxide has led to the conclusion that ETU transformation products are susceptible to photolysis by UV light. These are promising results for further research. The processes that were investigated can be used to remove pesticide metabolites from drinking water sources and wastewater in developing countries.

Monitoring network optimization and impact of fish farming upon water quality in the Três Marias Hydroelectric Reservoir, Brazil.

Hydroelectric power is the main source of electrical energy in Brazil. Electrical energy providers have the duty to monitor water quality in reservoirs to preserve water quality and support best management practices that enable multiple water uses, including fish production. In this context, the objectives of this study were (i) to perform a historical evaluation of water quality in Três Marias Reservoir, (ii) to present an optimization of the water quality monitoring network, and (iii) to evaluate the evolution and impact of fish farming upon surface water quality by using secondary data measured in situ and remote sensing. A systematic approach was applied to analyze historical water quality data. Principal component analysis (PCA) and cluster analysis (CA) were applied to identify the most important parameters and monitoring points. Images obtained from Sentinel 2 were treated by contrast to quantify simple and weighted densities of fish farming activities in the region while regression analysis was performed to verify correlations between these densities and water quality parameters. Results showed that the pH and total suspended solids were the most important parameters for characterizing water quality, especially near tributaries, and that monitoring points could be grouped into three clusters (upstream, central, and downstream regions) with distinct water quality conditions. The PCA indicated that there is no redundance among parameters nor monitoring stations and that areas near tributaries must be prioritized for monitoring as these are important sources of suspended solids. Remote sensing images showed that the area occupied by fish farms has increased in the reservoir from 2016 to 2022 and the methodology used for this purpose in this study may be applied to other bodies of water. Chlorophyll-a showed a direct relationship with the density of fish farms indicating a possible influence of nutrient input to the reservoir by this activity. These results provide valuable information to support decision-making related to water management in the reservoir.

Occurrence and potential ecological risks of PFAS in Pampulha Lake, Brazil, a UNESCO world heritage site.

Per- and polyfluoroalkyl substances (PFAS) comprise >4000 synthetic substances used in industrial applications and consumer products. PFAS used daily in households and manufacturing plants end up in domestic sewage, and industrial effluents can be discharged to surface water. Urban watersheds located in low and middle-income countries (LMIC), which lack sanitation infrastructure, are potential recipients of waste containing PFAS. Yet, only a few studies report PFAS occurrence in urban reservoirs and lakes, especially those located in the Global South due to resource limitations. This is the first study aimed to assess PFAS occurrence and ecological risks in Pampulha Lake, Brazil, a site which represents the reality of many other urban watersheds in LMIC as it is surrounded by densely populated areas and manufacturing plants. Surface water samples were collected monthly for 1 year from four sampling points at Pampulha Lake. Sample analysis was based on US Environmental Protection Agency Method 1633, which employs solid phase extraction followed by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). Species sensitivity distribution (SSD) curves were built to identify potentially susceptible species based on detected water concentrations. Bioaccumulation was estimated for fish tissue. Short-chain (perfluorobutanesulfonic acid, PFBS and perfluorohexanoic acid, PFHxA) and long-chain PFAS (perfluorodecanoic acid, PFDA; perfluorooctanoic acid, PFOA; perfluorododecanoic acid, PFDoA; and perfluorooctanesulfonic acid, PFOS) were detected at the µg L-1 range. Total PFAS concentrations in the wet season were generally higher than in the dry season, likely due to limited capacity of the treatment plant processing water from tributaries which receive raw sewage. More than 5 % of aquatic species are potentially susceptible to chronic effects of PFOS at detected concentrations (0.2-2.2 µg L-1). Predicted bioaccumulation of PFOS in fish was above advisory diet intake levels for humans. Results emphasize the need for studies related to PFAS occurrence in watersheds located in LMIC.

Neutrophil-mediated hypoxia drives pathogenic CD8+ T cell responses in cutaneous leishmaniasis.

Cutaneous leishmaniasis caused by Leishmania parasites exhibits a wide range of clinical manifestations. Although parasites influence disease severity, cytolytic CD8+ T cell responses mediate disease. Although these responses originate in the lymph node, we found that expression of the cytolytic effector molecule granzyme B was restricted to lesional CD8+ T cells in Leishmania-infected mice, suggesting that local cues within inflamed skin induced cytolytic function. Expression of Blimp-1 (Prdm1), a transcription factor necessary for cytolytic CD8+ T cell differentiation, was driven by hypoxia within the inflamed skin. Hypoxia was further enhanced by the recruitment of neutrophils that consumed oxygen to produce ROS and ultimately increased the hypoxic state and granzyme B expression in CD8+ T cells. Importantly, lesions from patients with cutaneous leishmaniasis exhibited hypoxia transcription signatures that correlated with the presence of neutrophils. Thus, targeting hypoxia-driven signals that support local differentiation of cytolytic CD8+ T cells may improve the prognosis for patients with cutaneous leishmaniasis, as well as for other inflammatory skin diseases in which cytolytic CD8+ T cells contribute to pathogenesis.

Continuous UV-C/H2O2 and UV-C/Chlorine applied to municipal secondary effluent and nanofiltration retentate: Removal of contaminants of emerging concern, ecotoxicity, and reuse potential.

As global effects of water scarcity raise concerns and environmental regulations evolve, contemporary wastewater treatment plants (WWTPs) face the challenge of effectively removing a diverse range of contaminants of emerging concern (CECs) from municipal effluents. This study focuses on the assessment of advanced oxidation processes (AOPs), specifically UV-C/H2O2 and UV-C/Chlorine, for the removal of 14 target CECs in municipal secondary effluent (MSE, spiked with 10 µg L-1 of each CEC) or in the subsequent MSE nanofiltration retentate (NFR, no spiking). Phototreatments were carried out in continuous mode operation, with a hydraulic retention time of 3.4 min, using a tube-in-tube membrane photoreactor. For both wastewater matrices, UV-C photolysis (3.3 kJ L-1) exhibited high efficacy in removing CECs susceptible to photolysis, although lower treatment performance was observed for NFR. In MSE, adding 10 mg L-1 of H2O2 or Cl2 enhanced treatment efficiency, with UV-C/H2O2 outperforming UV-C/Chlorine. Both UV-C/AOPs eliminated the chronic toxicity of MSE toward Chlorella vulgaris. In the NFR, not only was the degradation of target CECs diminished, but chronic toxicity to C. vulgaris persisted after both UV-C/AOPs, with UV-C/Chlorine increasing toxicity due to potential toxic by-products. Nanofiltration permeate (NFP) exhibited low CECs and microbial content. A single chlorine addition effectively controlled Escherichia coli regrowth for 3 days, proving NFP potential for safe reuse in crop irrigation (<1 CFU/100 mL for E. coli; <1 mg L-1 for free chlorine). These findings provide valuable insights into the applications and limitations of UV-C/H2O2 and UV-C/Chlorine for distinct wastewater treatment scenarios.

Occurrence of antibiotics, hormones and PFAs in surface water from a Nile tilapia aquaculture facility in a Brazilian hydroelectric reservoir.

This study assessed the occurrence of five antibiotics, three hormones, caffeine, and long and short-chain perfluoroalkyl and polyfluoroalkyl substances (PFASs) in surface water and feedstuff samples obtained from aquaculture cages in Três Marias reservoir in Brazil. This is the first work to evaluate the presence of PFAS in surface water used for aquaculture in Brazil. Solid-phase extraction and low temperature partitioning extraction followed by liquid chromatography coupled to mass spectrometry (LC-MS) were performed to process and analyze surface water samples and feedstuff, respectively. The ecotoxicological risk quotient was calculated for target compounds detected in water. Ciprofloxacin and caffeine were detected in all surface water samples. Pharmaceutical drugs ranged from 0.7 ng L-1 (trimethoprim) to 389.2 ng L -1 (ß-estradiol). Estrone (10.24 ng g-1) and ß-estradiol (66.20 ng g-1) were also found in feedstuff. Four PFASs (PFOA, PFDoA, PFTeDA, and PFBS) were detected (9.40-15.2 µg L-1) at levels higher than reported in studies conducted worldwide. Ecotoxicological risk assessment indicated high risks for caffeine and PFOA, PFDoA, and PFTeDA with RQ values from 10 to 103. These findings reveal risks to biodiversity, ecosystem integrity and human health considering possible intake of these contaminants by fish consumption due to potential bioaccumulation of these substances. Hence, it is critical to conduct more studies in this direction in Brazil and other low and middle-low-income countries.

Removal of ethylenthiourea and 1,2,4-triazole pesticide metabolites from water by adsorption in commercial activated carbons.

This study evaluated the adsorption capacity of ethylenthiourea (ETU) and 1H-1,2,4-triazole (1,2,4-T) for two commercial activated carbons: charcoal-powdered activated carbon (CPAC) and bovine bone-powdered activated carbon (BPAC). The tests were conducted at a bench scale, with ETU and 1,2,4-T diluted in water, for isotherm and adsorption kinetic studies. The removal of the compounds was accompanied by a total organic carbon (TOC) analysis and ultraviolet (UV) reduction analysis. The coals were characterized by their surface area using nitrogen adsorption/desorption, by a scanning electron microscopy and energy-dispersive X-ray spectroscopy (SEM/EDS) and by a zero charge point analysis (pHpcz). The results showed that adsorption kinetics followed a pseudo-second-order model for both coals, and the adsorption isotherms for CPAC and BPAC were adjusted to the Langmuir and Freundlich isotherms, respectively. The CPAC removed approximately 77% of the ETU and 76% of the 1,2,4-T. The BPAC was ineffective at removing the contaminants.

LED-irradiated photo-Fenton process on pollutant removal: outcomes, trends, and limitations.

This manuscript critically reviews the state of the art on the application of photo-Fenton processes irradiated by light-emitting diode arrays (LED) with a focus on the removal of contaminants of emerging concern (CEC) from aqueous matrices. LEDs are clean, low-cost radiation sources with longer lifespan compared to mercury lamps. This study covers the influence of LED sources, wavelengths, and dose upon CEC removal, and the potential for disinfection, abatement of antibiotic-resistant bacteria (ARB), and genes (ARG). The bibliographic search was performed in Scopus database using keyword combinations and resulted in a portfolio containing 52 relevant articles published between 2010-2023. According to reviewed papers, LED photoreactor design has evolved in the past decade aiming to improve CEC degradation in aqueous matrices while reducing construction and operation costs, and energy consumption. Among several reactors (annular, fluidized bed, parallel plate, wireless, pathway systems, and microreactor) surveyed for their performance and scalability, LED chips and strips are particularly suitable for application due to their wide emission angle (≈120°) and small size (mm2), which allow for, respectively, efficient illumination coverage and flexible arrangement and design. LED microreactors are very efficient in the degradation of contaminants and scalable with reduced area requirements. Although most studies were performed in synthetic solutions and at laboratory scale, the externally LED irradiated cylindrical reactor was successful for application in full-scale municipal water treatment plants. Future studies should focus on evaluating CEC removal in wastewater using scalable devices for continuous operation of solar photo-Fenton at night.

CCR5 promotes the migration of CD8+ T cells to the leishmanial lesions.

Cytolytic CD8+ T cells mediate immunopathology in cutaneous leishmaniasis without controlling parasites. Here, we identify factors involved in CD8+ T cell migration to the lesion that could be targeted to ameliorate disease severity. CCR5 was the most highly expressed chemokine receptor in patient lesions, and the high expression of CCL3 and CCL4, CCR5 ligands, was associated with delayed healing of lesions. To test the requirement for CCR5, Leishmania-infected Rag1-/- mice were reconstituted with CCR5-/- CD8+ T cells. We found that these mice developed smaller lesions accompanied by a reduction in CD8+ T cell numbers compared to controls. We confirmed these findings by showing that the inhibition of CCR5 with maraviroc, a selective inhibitor of CCR5, reduced lesion development without affecting the parasite burden. Together, these results reveal that CD8+ T cells migrate to leishmanial lesions in a CCR5-dependent manner and that blocking CCR5 prevents CD8+ T cell-mediated pathology.

Regulatory T cells control Staphylococcus aureus and disease severity of cutaneous leishmaniasis.

Cutaneous leishmaniasis causes alterations in the skin microbiota, leading to pathologic immune responses and delayed healing. However, it is not known how these microbiota-driven immune responses are regulated. Here, we report that depletion of Foxp3+ regulatory T cells (Tregs) in Staphylococcus aureus-colonized mice resulted in less IL-17 and an IFN-γ-dependent skin inflammation with impaired S. aureus immunity. Similarly, reducing Tregs in S. aureus-colonized and Leishmania braziliensis-infected mice increased IFN-γ, S. aureus, and disease severity. Importantly, analysis of lesions from L. braziliensis patients revealed that low FOXP3 gene expression is associated with high IFNG expression, S. aureus burden, and delayed lesion resolution compared to patients with high FOXP3 expression. Thus, we found a critical role for Tregs in regulating the balance between IL-17 and IFN-γ in the skin, which influences both bacterial burden and disease. These results have clinical ramifications for cutaneous leishmaniasis and other skin diseases associated with a dysregulated microbiome when Tregs are limited or dysfunctional.