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Infect Immun, March 1998, p. 1233-1236, Vol. 66, No. 3
0019-9567/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Transforming Growth Factor beta  and Immunosuppression in Experimental Visceral Leishmaniasis

Virmondes Rodrigues Jr.,1,* João Santana da Silva,2 and Antonio Campos-Neto3,4,*

Immunology Laboratory, Medical School of Triângulo Mineiro, Uberaba,1 MG, Department of Immunology, Medical School of Ribeirão Preto, Ribeirão Preto,2 SP, and Medical School of Itajubá,3 MG, Brazil, and Infectious Disease Research Institute, Seattle, Washington 981044

Received 26 September 1997/Returned for modification 13 November 1997/Accepted 3 December 1997

    ABSTRACT
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Hamsters infected with Leishmania donovani develop a disease similar to human kala-azar. They present hypergammaglobulinemia, and their T cells do not respond to parasite antigens. This unresponsiveness has been primarily ascribed to defects in antigen-presenting cells (APCs), because these cells are unable to stimulate proliferation of parasite-specific T cells from immunized animals. In this study, we show that APCs (adherent spleen cells) from L. donovani-infected hamsters produce high levels of the inhibitory cytokine transforming growth factor beta  (TGF-beta ). Immunohistochemical studies with an anti-TGF-beta monoclonal antibody (MAb) showed that this cytokine is abundantly produced in vivo by the spleen cells of infected animals. In addition, high levels of TGF-beta are produced in vitro by infected hamster cells, either spontaneously or after stimulation with parasite antigen or lipopolysaccharide. Furthermore, in vivo-infected adherent cells obtained from spleens of L. donovani-infected hamsters caused profound inhibition of the in vitro antigen-induced proliferative response of lymph node cells from hamsters immunized with leishmanial antigens. Moreover, this inhibition was totally abrogated by the anti-TGF-beta MAb. These results suggest that the immunosuppression observed in visceral leishmaniasis is, at least in part, due to the abundant production of TGF-beta during the course of the infection.

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The protozoa of the genus Leishmania are parasites responsible for diseases of major relevance in tropical and subtropical areas of the world (10, 14). In mammals, these parasites are strictly intracellular and infect mononuclear phagocytic and dendritic cells. The involvement of the immune system in human visceral leishmaniasis is characterized by increased serum immunoglobulin levels with high titers of antileishmania antibodies (6, 16, 17), hepatomegaly, splenomegaly, adenomegaly, negative skin test for leishmania antigens, and the absence of a proliferative response of peripheral blood mononuclear cells to Leishmania donovani antigens (20). The cause of this impaired specific immune response may be ascribed to any of the cell types involved in the immune response.

Hamsters have been used as a good model for the study of visceral leishmaniasis (4, 5, 7, 18, 22). After intracardiac or intraperitoneal infection, they present a progressive disease similar to human kala-azar, developing hypergammaglobulinemia due to B-cell polyclonal activation and the absence of a T-cell proliferative response to parasite antigens (4). The latter dysfunction has been attributed to the inability of the infected antigen-presenting cells (APCs) to stimulate the specific T cells (9, 13, 15, 21).

Transforming growth factor beta  (TGF-beta ) is a pleiotropic cytokine involved in many functions of resident tissue cells, but it largely inhibits some activity of immune cells. TGF-beta can mediate immunosuppression by inhibiting interleukin 2-dependent T- and B-cell proliferation and interleukin 2-dependent immunoglobulin production by B cells (11, 12) and macrophage activation (8, 23). In addition, TGF-beta has been implicated as a cytokine that promotes the in vitro replication and survival of leishmania within the macrophages and is an important factor for determining in vivo susceptibility to experimental infection of mice with species of leishmania that cause cutaneous and mucocutaneous infections in humans (1-3).

Most of the alterations induced by TGF-beta on the cellular immune response resemble those of our previous observation in the hamster infected with L. donovani (21). These studies indicated that the impairment of the immune response was caused by a defect in the antigen presentation by the APCs of L. donovani-infected animals.

In the present work, we extend these studies, aiming to investigate the mechanism involved in this defect. We focused on the immunoregulatory effect of TGF-beta on the APCs (adherent spleen cells) from L. donovani-infected hamsters. To achieve this proposal, we initially had to validate a standard human TGF-beta biological assay (19) for the hamster system. This validation was important because of the unavailability of an anti-hamster TGF-beta antibody. Because of the evolutionary conservation of TGF-beta , we tested the standard proliferation inhibition assay of CCL64 cells (mink lung epithelial cells) in the absence and in the presence of the mouse anti-human TGF-beta monoclonal antibody (MAb) 1D11.16 (Celtrix Pharmaceuticals, Inc., Santa Clara, Calif.). Normal hamster spleen cells were stimulated with lipopolysaccharide (1 µg/ml), and the presence of TGF-beta in the culture supernatants was analyzed 24 and 48 h later. Regardless of the incubation time, the culture supernatants caused, in a dose response manner, inhibition of the proliferation of the CCL64 cells ranging from 100% to no inhibition (not shown). More importantly, this activity was totally abrogated by the 1D11.16 MAb, therefore validating the use of this assay for the hamster system.

To evaluate the production of TGF-beta in L. donovani-infected hamsters, spleen cells were obtained from noninfected inbred CB hamsters (Charles River, Mass.) and from CB hamsters at 40 and 60 days after infection with 10 × 106 amastigote forms of L. donovani (amastigotes were freshly isolated from spleens of infected hamsters). The spontaneous production of TGF-beta was measured in the culture (Dulbecco's modified Eagle's medium [DMEM] plus 2% fetal calf serum [FCS]) supernatants after 48 h of incubation at 37°C. It is clear from the results shown in Fig. 1 that the spleen cells from hamsters infected for 40 or 60 days produced as much as 20 and 34 times more TGF-beta , respectively, than was produced by the cells from age- and sex-matched syngeneic normal hamsters. In addition, in vitro stimulation of these cells with 10 µg of a soluble L. donovani lysate antigen (SLdA) per ml (21) augmented two to three times the production of TGF-beta by the spleen cells from either noninfected or infected hamsters. These results are consistent with previous observations that showed that TGF-beta is produced by murine macrophages exposed to Leishmania braziliensis (1, 2). However, stimulation of the hamster cells with 1 µg of lipopolysaccharide (Pierce Chemical Company, Rockford, Ill.) augmented more than 10 times the production of TGF-beta by the cells from noninfected animals and less than 3 times the production for the cells of hamsters infected for 40 or 60 days (not shown), thus suggesting an exacerbated in vivo prestimulation of the hamster spleen cells by the infectious process.


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FIG. 1.   Spontaneous production of TGF-beta by spleen cells of noninfected or L. donovani-infected hamsters. Spleen mononuclear cells from hamsters infected for 40 and 60 days and from noninfected animals were suspended at 5 × 106 cells/ml in RPMI medium supplemented with 2% FCS plus antibiotics and cultured at 37°C for 48 h. Supernatants were analyzed for native TGF-beta (nonacidified) activity (A) with the proliferation inhibition assay of CCL64 cells (mink lung epithelial cells). CCL64 cells were cultured for 30 h in DMEM supplemented with 2% FCS in the presence of serial dilutions of supernatants. Proliferation was measured by incorporation of [3H]thymidine added during the last 6 h of incubation. An anti-TGF-beta -neutralizing MAb was used to confirm the specificity of the assay. Quantification of TGF-beta was performed with a standard curve obtained with recombinant human TGF-beta (B). Bars represent the arithmetic mean of the results from at least three hamsters per group, and lines give the standard errors.

To demonstrate the in vivo production of TGF-beta , we performed an immunohistochemical assay with the 1D11.16 MAb. Spleen sections (4 µm thick) from L. donovani-infected and noninfected animals were fixed with acetone and incubated with the 1D11.16 MAb for 4 h at room temperature. The sections were washed four times with phosphate-buffered saline (PBS) containing 0.05% Tween 20 and incubated with a rabbit anti-mouse immunoglobulin-peroxidase conjugate (Pierce Chemical Company) for 1 h at room temperature. The slides were washed four times and incubated with 1 mg of diaminobenzidine (Pierce Chemical Company) per ml and 0.01% hydrogen peroxide in 100 mM Tris-HCl (pH 7.2). The results (Fig. 2) show massive production of TGF-beta in the spleens from the infected animals, largely present both in the cytoplasm of mononuclear cells and in the intercellular space. In contrast, the presence of this cytokine was barely noticeable in the spleens from age- and sex-matched syngeneic noninfected controls.


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FIG. 2.   Detection of TGF-beta production in vivo in spleens of L. donovani-infected hamsters. Spleen sections (4 µm thick) from noninfected hamsters (A) and from hamsters infected with L. donovani for 60 days (B) were fixed with acetone and incubated with anti-TGF-beta MAb 1D11.16, washed four times with PBS plus 0.05% Tween 20, and incubated with a rabbit anti-mouse immunoglobulin-peroxidase conjugate for 1 h at room temperature. The slides were washed and incubated with 1 mg of diaminobenzidine per ml and 0.01% hydrogen peroxide in Tris-HCl (0.1 M [pH 7.2]). Brown granules indicate the presence of TGF-beta in the spleens of infected animals. Magnification, ×500.

We and others have previously shown that the antigen presentation by L. donovani-infected cells is greatly impaired (9, 13, 15, 21). Because the spleen cells from L. donovani-infected hamsters produced large quantities of TGF-beta , we tested the possibility that the production of this antiproliferative cytokine by infected cells was responsible for the observed inability of these cells to perform antigen presentation. To investigate this possibility, noninfected CB hamsters were initially immunized in the footpad with SLdA in complete Freund's adjuvent, and the draining lymph nodes were harvested 10 days later. Lymph node cells (2 × 105/well in 96-well flat-bottom microtiter culture plates) were obtained and stimulated to proliferate with SLdA in the absence and in the presence of adherent spleen cells obtained from either noninfected or L. donovani-infected hamsters. Adherent spleen cells were obtained by incubating mononuclear spleen cells (5 × 105) for 2 h in the wells of 96-well flat-bottom microtiter culture plates. Nonadherent cells were then removed by three consecutive washes with RPMI medium plus 10% FCS. In addition, some cultures received the 1D11.16 MAb or an isotype-matched immunoglobulin control. Figure 3 shows that adherent cells from the infected hamsters inhibited practically 100% of the specific proliferative response of the lymph node cells from L. donovani-immunized animals. More importantly, the anti-TGF-beta MAb 1D11.16 totally restored the responsiveness of the lymph node cells to the leishmanial antigens, thus pointing to a strong participation of TGF-beta as an inhibitory cytokine produced by adherent spleen cells of L. donovani-infected hamsters. No inhibition of the proliferative response was observed when adherent spleen cells from noninfected hamsters were used. In addition, no restoration of the proliferation was achieved when an isotype-matched control of the 1D11.16 MAb was added to the cell cultures (not shown). These results expand those related to the L. donovani complex, with previous observations pointing to a pathological role of TGF-beta in the course of infection of mice infected with dermotropic Leishmania (1-3). However, in these studies, the inhibitory effect of TGF-beta appeared relatively early (a few days) after infection, suggesting that this cytokine is involved in the regulation and development of a pervasive immune response at the initiation of the infection. In contrast, because in the present studies the involvement of TGF-beta was detected only late in the infection, it is more likely that the role of this cytokine in visceral leishmaniasis is to maintain or to exacerbate the characteristic immunosuppression observed in this disease.


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FIG. 3.   Inhibition of antigen-induced proliferative response of lymph node cells from immunized hamsters by adherent spleen cells from L. donovani-infected hamsters. CB hamsters were immunized in the footpad with soluble L. donovani lysate antigen in complete Freund's adjuvant, and the draining lymph nodes were harvested 10 days later. Lymph node cells were obtained and stimulated to proliferate with L. donovani antigens in the absence of additional adherent spleen cells (Ln), in the presence of adherent spleen cells obtained from noninfected hamsters (Ln + normal Ad) or from L. donovani-infected hamsters (Ln + infected Ad), or in the presence of adherent spleen cells obtained from L. donovani-infected hamsters plus the anti-TGF-beta MAb 1D11.16 (Ln + infected Ad + anti-TGF-beta ). Cultures were either nonstimulated (medium) or stimulated with 10 µg of SLdA, and proliferation was measured by incorporation of [3H]thymidine added during the last 6 h of incubation in a 3-day assay. Bars represent the arithmetic mean of triplicate cultures, and lines give the standard errors. The results shown are representative of two independent experiments. One-way analysis of variance was used to analyze the results. Statistical significance was set up at P < 0.01. *, P < 0.01 versus Ln + normal Ad or Ln + infected Ad + anti-TGF-beta .

    ACKNOWLEDGMENTS

We thank Fundação de Ensino e Pesquisa de Uberaba for financial support.

    FOOTNOTES

* Corresponding author. Mailing address for Antonio Campos-Neto: Infectious Disease Research Institute, 1124 Columbia St., Seattle, WA 98104-2015. Phone: (206) 667-5799. Fax: (206) 667-5715. E-mail: acampos{at}corixa.com. Mailing address for Virmondes Rodrigues, Faculdade de Medicina do Triângulo Mineiro, Laboratório de Immunologia, Rua Frei Paulino 30, Uberaba, MG 38025-180, Brazil. Phone: 55 34 312-7722. Fax: 55 34 312-6640. E-mail: vrodrigues{at}mednet.com.br.

Editor:  J. M. Mansfield

    REFERENCES
Top
Abstract
Text
References

1. Barral, A., M. Barral-Netto, E. C. Yong, C. E. Brownell, D. R. Twardzik, and S. G. Reed. 1993. Transforming growth factor beta  as a virulence mechanism for Leishmania braziliensis. Proc. Natl. Acad. Sci. USA 90:3442-3446[Abstract/Free Full Text].
2. Barral, A., M. Teixeira, P. Reis, V. Vinhas, J. Costa, H. Lessa, A. L. Bittencourt, S. Reed, E. M. Carvalho, and M. Barral-Netto. Transforming growth factor beta  in human cutaneous leishmaniasis. Am. J. Pathol. 147:947-954.
3. Barral-Netto, M., A. Barral, C. E. Brownell, Y. A. Skeiky, L. R. Ellingsworth, D. R. Twardzik, and S. G. Reed. 1992. Transforming growth factor beta  in leishmania infection: a parasite escape mechanism. Science 257:545-548[Abstract/Free Full Text].
4. Bunn-Moreno, M., E. D. Madeira, K. Miller, J. A. Menezes, and A. Campos-Neto. 1985. Hypergammaglobulinemia in Leishmania donovani infected hamsters: possible association with a polyclonal activator of B cells and with suppression of T cell function. Clin. Exp. Immunol. 59:427-434[Medline].
5. Campos-Neto, A., and M. M. Bunn-Moreno. 1982. Polyclonal B cell activation in hamsters infected with parasites of the genus Leishmania. Infect. Immun. 38:871-876[Abstract/Free Full Text].
6. Chaves, J., and R. G. Ferri. 1966. Immunoglobulins in visceral leishmaniasis. Rev. Inst. Med. Trop. São Paulo 8:225-227[Medline].
7. Clinton, B. A., L. A. Stauber, and N. C. Palczuk. 1969. Leishmania donovani. I. Antibody response to chicken ovalbumin by infected golden hamsters. Exp. Parasitol. 25:171-180[Medline].
8. Ding, A., C. F. Nathan, J. Graycar, R. Derynck, D. J. Stuehr, and S. Srimal. 1990. Macrophage deactivating factor and transforming growth factors beta 1, beta 2, and beta 3 inhibit induction of macrophage nitrogen oxide synthesis by IFN-gamma . J. Immunol. 145:940-944[Abstract].
9. Fruth, U., N. Solioz, and J. A. Louis. 1993. Leishmania major interferes with antigen presentation by infected macrophages. J. Immunol. 150:1857-1864[Abstract].
10. Grimaldi, G., Jr., and R. B. Tesh. 1993. Leishmaniasis of the New World: current concepts and implications for future research. Clin. Microbiol. Rev. 6:230-250[Abstract/Free Full Text].
11. Kehrl, J. H., A. B. Roberts, L. M. Wakefield, S. Jakowlew, M. B. Sporn, and A. S. Fauci. 1986. Transforming growth factor beta  is an important immunomodulatory protein for human B lymphocytes. J. Immunol. 137:3855-3860[Abstract].
12. Kehrl, J. H., L. M. Wakefield, A. B. Roberts, S. Jakowlew, M. Alvarez-Mon, R. Derynck, M. B. Sporin, and A. S. Fauci. 1986. Production of transforming growth factor beta  by human T lymphocytes and its potential role in the regulation of T cell growth. J. Exp. Med. 163:1037-1050[Abstract/Free Full Text].
13. Kima, P. E., L. Soong, C. Chicarro, N. H. Ruddle, and D. McMahon-Pratt. 1996. Leishmania-infected macrophages sequester endogenously synthesized parasite antigens from presentation to CD4+ T cells. Eur. J. Immunol. 26:3163-3169[Medline].
14. Laison, R., and J. J. Shaw. 1978. Epidemiology and ecology of leishmaniasis in Latin America. Nature 273:595-600[Medline].
15. López, J. A., J. H. LeBowitz, S. M. Beverly, H.-G. Rammensee, and P. Overath. 1992. Leishmania mexicana promastigotes induce cytotoxic T lymphocytes in vivo that do not recognize infected macrophages. Eur. J. Immunol. 23:217-223.
16. Manson-Bahr, P. E. C. 1961. Immunity in kala-azar. Trans. R. Soc. Trop. Med. Hyg. 55:550-555.
17. Mayrink, W., F. G. Araujo, and P. A. Magalhães. 1967. Fluorescent antibody test in visceral leishmaniasis. Rev. Inst. Med. Trop. São Paulo 9:172-174[Medline].
18. Nickol, A. D., and P. F. Bonventre. 1985. Immunosuppression associated with visceral leishmaniasis of hamsters. Parasite Immunol. 7:439-449[Medline].
19. Ranchalis, J. E., L. Gentry, S. M. Seyedin, J. McPherson, A. Purchio, and D. R. Twardzik. 1987. Bone-derived and recombinant transforming growth factor beta  are potent inhibitors of tumor cell growth. Biochem. Biophys. Res. Commun. 148:783-789[Medline].
20. Rezai, H. R., S. M. Ardehsli, G. Armirhakimi, and A. Kharazmi. 1978. Immunological features of kala-azar. Am. J. Trop. Med. Hyg. 27:1079-1083.
21. Rodrigues, V., Jr., J. S. Santana, and A. Campos-Neto. 1992. Selective inability of spleen antigen presenting cells from Leishmania donovani infected hamsters to mediate specific T cell proliferation to parasite antigens. Parasite Immunol. 14:49-58[Medline].
22. Sartori, A., A. V. Oliveira, M. C. Roque-Barreira, M. A. Rossi, and A. Campos-Neto. 1987. Immune complex glomerulonephritis in experimental kala-azar. Parasite Immunol. 9:93-103[Medline].
23. Tsunawaki, S., M. Sporn, A. Ding, and C. F. Nathan. 1988. Deactivation of macrophages by transforming growth factor beta . Nature 334:260-262[Medline].


Infect Immun, March 1998, p. 1233-1236, Vol. 66, No. 3
0019-9567/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.



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