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Infection and Immunity, April 2005, p. 2012-2019, Vol. 73, No. 4
0019-9567/05/$08.00+0 doi:10.1128/IAI.73.4.2012-2019.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Division of Infectious Disease, Department of Medicine,1 Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York2
Received 26 July 2004/ Returned for modification 10 September 2004/ Accepted 30 November 2004
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Fungal cell melanization could affect inflammatory responses directly and/or indirectly. The observation that synthetic melanin suppresses cytokine production in macrophages stimulated with lipopolysaccharide (16) suggests that melanins in fungal cells could influence the release of inflammatory mediators. However, melanins could also elicit foreign-body-like reactions since they are composed of insoluble polymers that are not easily degraded by macrophages. Consistent with this mechanism, injection of C. neoformans melanin ghosts into mice promotes granuloma formation (27). Given that melanins can reduce the susceptibility of fungal cells to oxidative damage (38), melanization may increase the survival of fungal cells in tissue, which could alter the inflammatory response by virtue of an increased microbial burden. Furthermore, since laccase can be released from the fungal cell (40), it could conceivably polymerize host substrates into melanin in tissue, which could affect local homeostasis and the immune response. For C. neoformans melanin, one study found that the immune response to C. neoformans strains differing in melanin production varied with respect to tumor necrosis factor alpha (TNF-
) levels and T-cell lymphoproliferation, suggesting that melanin contributed to virulence by interfering with the host inflammatory response (8).
In summary, there is a significant amount of evidence that melanins are powerful immunomodulators that possess both pro- and anti-inflammatory properties. Melanin effects on host immune function could represent a common mechanism of virulence for melanotic fungi that can be targeted for drug discovery. In this regard, inhibition of fungal melanization in mice with glyphosate was shown to be therapeutic in experimental cryptococcal infection (21). Melanin is immunogenic and elicits antibodies that can inhibit fungal growth (1, 22, 28). This study investigated how melanin may contribute to the virulence of C. neoformans by characterizing the early inflammatory changes in the lung associated with infection with melanized and nonmelanized cells. The results provide strong evidence that melanin may contribute to virulence through powerful effects on the host immune response.
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Intratracheal infection. Female 6- to 8-week-old BALB/c mice were obtained from the National Cancer Institute (Bethesda, Md.). Intratracheal infection was done as described previously (3). Mice were anesthetized with ketamine (10 mg/kg) and xylazine (125 mg/kg) in PBS administered intraperitoneally. Mice received 5 x 106 C. neoformans cells intratracheally or an equal number of melanin ghosts in 0.05 ml of PBS. In some experiments, mice naive to any manipulation were used. All animal work was done in accordance with the regulations of The Institute for Animal Studies at Albert Einstein College of Medicine.
CFU count determination and histological preparation. To determine the fungal burden in the lungs and spleen, mice were killed on days 2, 4, 7, and 14 and the lungs were removed, weighed, homogenized, and plated on SAB plates for CFU count determination. The right upper lung, which consists of approximately 10% of the lung mass, was placed in 10% formalin for histological examination. The other 90% of the lung was weighed and homogenized through a metal screen into 10 ml of PBS. Dilutions of the suspension were plated on SAB agar plates and incubated at 30°C for 48 h for CFU count determination (1 colony = 1 CFU).
Cytokine and chemokine analysis.
Five groups of mice were used for cytokine and chemokine analysis consisting of infection with melanized yeast cells, infection with nonmelanized yeast cells, melanin ghost inoculation, PBS inoculation, and use of naive uninfected mice. Cytokine and chemokine analysis of the laccase mutant used five groups: mice infected with 3501, 2E-TU-4, or 2E-TUC-4; mice inoculated with PBS; and naive mice. Mice were killed on days 2, 4, and 7 postinfection or postinoculation. The left lung was removed and homogenized for 60 s in 2 ml of PBS in the presence of protease inhibitors (Complete Mini; Boehringer Mannheim, Indianapolis, Ind.). The homogenates were centrifuged at 6,000 x g for 10 min, and the supernatant was collected and frozen at 80°C until tested for cytokine production. The supernatants were tested for interleukin-2 (IL-2), IL-4, IL-10, IL-12p70, TNF-
, gamma interferon (IFN-
), and MCP-1 with enzyme-linked immunosorbent assay kits (Pharmingen, San Diego, Calif.) with detection limits of 3.1, 7.8, 31.3, 62.5, 15.6, 31.3, and 15.6 pg/ml, respectively.
In vivo phagocytosis assay. BALB/c mice were infected intratracheally with melanized 3501, nonmelanized 3501, melanized Cap67, or nonmelanized Cap67 as described above. Mice were sacrificed 3 h later, and their lungs were subjected to lavage 10 times with 1 ml of PBS for a total volume of approximately 9 ml of bronchoalveolar lavage fluid. The cells were collected by centrifugation at 3,000 x g for 10 min. The supernatant was then decanted, and cells were suspended in 500 ml of Dulbecco's modified Eagle's medium. Cells were transferred to 4 wells of a 96-well plate and allowed to adhere at 37°C for 1 h. Supernatant was aspirated, and cells were fixed with 100 µl of ice-cold methanol and incubated at room temperature for 30 min. Methanol was aspirated and discarded. Cells were washed three times with 200 µl of PBS. Fifty microliters of a 1:20 dilution of Giemsa stain was added, and the mixture was kept at room temperature for 24 h. Cells were washed with PBS, and the percentage of macrophages with internalized C. neoformans was measured.
Preparation of lung leukocytes and FACS analysis. At days 2, 4, and 7 postinfection, lungs were excised, minced, homogenized with a sterile 70-µm nylon mesh (Becton Dickinson), and digested for 60 min at 10 ml/lung with digestion buffer containing RPMI medium, 10% fetal calf serum, 1 mg of collagenase (Boehringer Mannheim, Chicago, Ill.) per ml, and 30 µg of DNase I (Sigma, St. Louis, Mo.) per ml. The cell suspension was collected by centrifugation, and erythrocytes were lysed by suspension in ice-cold 0.17 M NH4Cl for 10 min. A 10-fold excess of RPMI solution was then added to make the solution isotonic, the cells were collected by centrifugation and suspended in staining buffer (PBS, 1% fetal bovine serum), and the number of cells was determined by counting in a hemocytometer chamber. For fluorescence-activated cell sorter (FACS) analysis, lung leukocytes (106) were stained for 30 min on ice with 100 µl of one of the following antibodies diluted in staining buffer: 2 µg of R-phycoerythrin-labeled anti-CD45 per ml, 5 µg of fluorescein isothiocyanate (FITC)-labeled anti-mouse CD4 per ml, 2 µg of Cy-Chrome-labeled anti-mouse CD8 per ml, 5 µg of FITC-labeled anti-mouse CD19 per ml, and 5 µg of FITC-labeled anti-mouse Mac-3 per ml (all monoclonal antibodies were from Pharmingen, San Diego, Calif.). The samples were washed twice in staining buffer and fixed in 1% paraformaldehyde. Stained samples were stored in the dark at 4°C until analyzed on a FASCalibur flow cytometer (Becton Dickinson, Mountain View, Calif.) with CellQuest software (Becton Dickinson). Live cells were gated as judged from forward and side laser scatter and CD45+ staining.
Statistics. All data were analyzed by Student's t test, the Kruskal-Wallis test (Primer; McGraw-Hill, New York, N.Y.), or log rank analysis (Sigmastat, Chicago, Ill.). For multiple comparisons, the P value was adjusted by the Bonferroni correction.
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FIG. 1. Lung fungal burdens (CFU per lung) of mice infected intratracheally with 5 x 106 C. neoformans cells. Panels: A, in vitro melanized and nonmelanized 3501 (#, P < 0.01); B, 2E-TU-4 and 2E-TUC-4 (**, P < 0.05 on day 2; *, P < 0.01 on days 4 and 7). The experiment was done twice, and the results were consistent. For each group, the sample size was 10 mice. Error bars denote the standard deviation of the mean.
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FIG. 2. Masses of lungs infected intratracheally with 5 x 106 C. neoformans cells. Panels: A, in vitro melanized (Mel) and nonmelanized (Non-Mel) 3501 (*, P < 0.01; **, P < 0.05 [between melanized and non-melanized cells]; ^, P < 0.01; ^^, P < 0.05 [between ghosts and PBS]); B, 2E-TU-4 and 2E-TUC-4 (^, P < 0.05 on day 2). Error bars denote the standard deviation of the mean.
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, and IFN-
levels between melanized and nonmelanized infection groups or between mice inoculated with melanin ghosts and those that received a PBS inoculation (data not shown). However, larger changes were measured in IL-4, IL-12, and MCP-1 concentrations. The level of IL-4 in mice infected with melanized cells was approximately twice that measured in the lungs of mice infected with nonmelanized cells (Fig. 3). Lung IL-12 concentrations remained relatively constant in mice infected with the nonmelanized strain but fluctuated in mice infected with melanized cells such that it was higher at day 2, lower at day 4, and not different at day 7. Lung MCP-1 concentrations increased with the time of infection in both melanized and nonmelanized groups and was significantly higher in the melanized group only at day 7. In contrast, inoculation of melanin ghosts had relatively small effects on IL-4 or IL-12 levels but was associated with higher MCP-1 levels compared to those of the PBS control on days 2, 4, and 7 (Fig. 3C).
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FIG. 3. Cytokine concentrations per milliliter in lungs of mice infected intratracheally with 5 x 106 melanized (Mel) or nonmelanized (Non-Mel) C. neoformans cells. Panels: A, IL-4 (*, P < 0.01 between melanized and nonmelanized cells on days 2 and 7; ^, P < 0.01 between ghosts and PBS on days 4 and 7); B, IL-12 (**, P < 0.05 between melanized and nonmelanized cells on days 2 and 4); C, MCP-1 (*, P < 0.01 between melanized and nonmelanized cells on day 7; ^^, P < 0.05 between ghosts and PBS on days 2, 4, and 7). This experiment was done twice, and the results were consistent. For each group, the sample size was six mice. Error bars denote the standard deviation of the mean.
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and MCP-1 levels (Fig. 4). On day 7, the lungs of mice infected with 2E-TUC-4 had a modest yet significant increase in TNF-
levels relative to those of mice infected with 2E-TU-4. However, the level of MCP-1 in the lungs of 2E-TUC-4 mice was threefold higher than that in the lungs of 2E-TU-4 mice. A small increase in the IL-10 level was measured on day 7 of infection in lungs infected with 2E-TUC-4 relative to those infected with 2E-TU-4 (data not shown). No differences in IL-2 expression were detected between lungs infected with 2E-TU-4 and 2E-TUC-4.
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FIG. 4. Cytokine concentrations per milliliter in lungs of mice infected intratracheally with 5 x 106 2E-TU-4 or 2E-TUC-4 cells. Panels: A, IL-4; B, TNF- (^^, P < 0.05 between 2E-TUC-4 and 2E-TU-4 on day 7); C, IFN- ; D, MCP-1 (^, P < 0.01 between 2E-TU-4 and 2E-TUC-4 on day 7). Error bars denote the standard deviation of the mean.
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FIG. 5. Total leukocytes in the lungs of mice infected intratracheally with 5 x 106 melanized (Mel) or nonmelanized (Non-Mel) C. neoformans cells. Panels: A, day 2; B, day 4 (*, P < 0.05); C, day 7. Error bars denote the standard deviation of the mean.
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FIG. 6. Absolute differential of leukocytes determined by FACS analysis in lungs after intratracheal infection with 5 x 106 melanized (Mel) or nonmelanized (Non-Mel) C. neoformans cells. Panels: A, day 4 (**, P 0.05 between melanized and nonmelanized cells for CD4 and CD8 cells; #, P < 0.01 between ghosts and PBS for Mac-3-positive cells); B, day 7 (**, P < 0.05 between melanized and nonmelanized cells for CD19-positive cells; #, P < 0.01 between ghosts and PBS for CD19-positive cells). Error bars denote the standard deviation of the mean.
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FIG. 7. Total numbers of leukocytes in the lungs of mice infected with 5 x 106 2E-TU-4 or 2E-TUC-4 cells. Panels: A, day 2 (*, P < 0.01 between 2E-TUC-4 and 2E-TU-4); B, day 4 (**, P < 0.05 between 2E-TUC-4 and 2E-TU-4); C, day 7. Error bars denote the standard deviation of the mean.
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FIG. 8. Percentages of macrophages with ingested cryptococci from alveolar lavage 3 h postinfection intratracheally with 5 x 106 melanized or nonmelanized C. neoformans cells. The differences between the melanized (mel) and nonmelanized (non-mel) encapsulated cryptococci and the melanized and nonmelanized nonencapsulated strain Cap67 cryptococci were statistically significant (P < 0.01 for melanized 3501 versus non-melanized 3501 and melanized Cap67 versus nonmelanized Cap67). The value above each bar represents the total number of internalized C. neoformans cells divided by the total number of macrophages with internalized C. neoformans. Error bars denote the standard deviation of the mean.
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Comparison of organ fungal burdens in mice infected with melanized and nonmelanized C. neoformans cells revealed a difference in CFU counts only on day 7. The absence of significant differences in CFU counts at days 2, 4, and 14 strongly argues against a role for melanin in protecting C. neoformans cells against the type of effector cells found in the lungs at the early stages of infection. Given that in vivo melanization takes at least 3 days (29), one would have expected lower lung CFU counts if melanin were protecting C. neoformans cells against the fungicidal mechanisms of lung macrophages and early responder effector cells in the lung. The difference in CFU counts observed at day 7 results from a reduction in the CFU counts in lungs infected with nonmelanized cells, relative to those infected with melanized cells, and indicates killing of yeast cells in lungs infected with nonmelanized cells. The fact that day 7 is coincident with the development of a strong cellular inflammatory response suggests that this effect reflects either resistance to killing of C. neoformans cells in mice infected with melanized cells or a less effective immune response in the presence of melanized cells. However, the effect appears to be transient since at day 14 lung CFU counts in mice infected with melanized cells and those infected with nonmelanized cells were comparable, a phenomenon that could reflect the disappearance of differences as melanization occurs under in vivo conditions. In this regard, we note that melanin ghosts can be recovered from mice infected with nonmelanized cells by day 3 of infection (29).
Comparison of the inflammatory responses to melanized and nonmelanized C. neoformans cells revealed significant differences in cellular recruitment and lung cytokine content. There was a slight but significant increase in the number of leukocytes in the lungs of mice infected with melanized C. neoformans cells at day 4 but not at day 2 or 7. However, the concentrations of IL-4 and MCP-1 were significantly higher in the lungs of mice infected with melanized cells whereas there was no significant difference in IL-2, TNF-
, or IFN-
. The finding of higher IL-4 levels in the lungs of mice infected with melanized cells suggests that the presence of melanin tilts the polarity of the response toward Th2. Since control of C. neoformans infection in the lung is associated with strong Th1 responses (13), the altered cytokine milieu suggests a potential explanation for the transiently higher CFU counts observed in mice infected with melanized cells. However, we note that instillation of melanin alone into the lungs elicited only minimal inflammatory and cytokine changes relative to those observed with an active C. neoformans infection. Hence, the effects observed on cellular recruitment and cytokine production reflect a requirement for both melanin and live C. neoformans cells.
In vitro studies have shown that melanized encapsulated C. neoformans cells are more resistant to antibody-mediated phagocytosis than nonmelanized cells are (38). This phenomenon was not understood, but subsequent studies suggested that melanization imparts a significant negative charge on both encapsulated and nonencapsulated cells (18). In this study, we revisited that question by measuring the efficiency of ingestion of melanized and nonmelanized encapsulated and nonencapsulated cells in the lung. Prior studies have shown that encapsulated C. neoformans cells are rapidly ingested in alveolar spaces after intratracheal infection in nonimmune mice (5). Melanized encapsulated cells were ingested less efficiently by alveolar macrophages than were nonmelanized cells, whereas the opposite was observed for melanized and nonmelanized nonencapsulated cells. This phenomenon could be relevant since there is evidence that C. neoformans cells are melanized in the environment, and consequently, initial infection may occur with melanized cells (24). For encapsulated cells, this phenomenon parallels the prior in vitro observations (38) and may reflect an increased negative charge on cryptococcal cells. Paradoxically, melanization enhanced phagocytosis of nonencapsulated cells. Although melanization increases the charge of nonencapsulated cells, any electrostatic effects on the efficiency of phagocytosis may be overwhelmed by the fact that melanin is also a potent activator of the alternative complement pathway (27). Hence, increased melanin activation of the complement system may have been responsible for the significantly enhanced opsonization of melanized nonencapsulated cells relative to that of nonmelanized nonencapsulated cells. Differences in the efficiency of phagocytosis of melanized and nonmelanized cells could translate into differences in the immune response since fungal cell ingestion can affect antigen presentation, cytokine production, dendritic cell activation, intracellular fungal growth, and macrophage cell viability (4, 34-37).
In another experiment, we compared the responses to C. neoformans strains sufficient and deficient in laccase, which catalyzes the formation of melanin from L-dopa and other precursors. The comparison of 2E-TU-4 to 2E-TUC-4 revealed that infection with the complemented strain resulted in a greater fungal burden, as would be expected from the fact that laccase is an important virulence factor. However, the comparison of cytokine levels in mice infected with strains 2E-TU and 2E-TUC revealed few differences, with the notable exception of the MCP-1 level, which was threefold higher in lungs infected with 2E-TUC. The higher MCP-1 level correlated with increased numbers of leukocytes and Mac-3-positive cells in the lungs, a finding consistent with the proinflammatory properties of this chemokine. Our results obtained with the 2E-TU-4 pair showing a greater burden in lungs infected with 2E-TUC-4 differ from the finding that these strains produced similar lung fungal burdens in another strain of mice (25). Since mouse strains can differ greatly in their responses to C. neoformans infection (7, 9), we attribute the differences between our results and those of the other study to differences in host genetic backgrounds. However, the finding of relatively few changes in the inflammatory response is similar to and consistent with the findings of that study (25).
Comparison of the immune response parameters measured after instillation of ghosts into the lungs and pulmonary infection with melanized and nonmelanized cells and the 2E-TU-4 strains revealed changes that were not always consistent from one group to the other. For example, the changes in IL-12, TNF-
, and MCP-1 levels were different for these groups, suggesting that factors other than melanin were influencing the immune response. The differences between the experiments with the 2E-TU-4 strains and the experiments comparing infection with melanized and nonmelanized cells may reflect the initial effects of melanin on the immune response, an event that would not be expected in the 2E-TU-4 experiment, where the initial infection used nonmelanized cells. Furthermore, laccase not only catalyzes the synthesis of melanin but also has direct effects on macrophages (14). Since pulmonary macrophages produce critical early inflammatory signals, laccase effects on macrophage function could translate into additional effects on the inflammatory response. The differences between mice infected with live cells and those instilled with melanin ghost particles are understandable if one considers that one involves active infection with a replicating microbe and the other involves a response to melanin particles in the lungs. Despite the intergroup variation in the inflammatory response, the presence of fungal melanin and/or laccase consistently affected the inflammatory response relative to conditions under which these components where not present.
In summary, melanized cells and cells capable of melanization elicited inflammatory changes different from those elicited by nonmelanized cells and laccase-deficient cells. Our results provide strong evidence that melanin pigment can have immunomodulatory effects during the course of a cryptococcal infection that could contribute to virulence. Therapeutic strategies that inhibit the formation of melanin (21) or specifically target melanin (1, 28) may prove useful as adjunctive therapy for diseases caused by melanotic fungi.
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receptor II for presentation to T lymphocytes. Infect. Immun. 70:5972-5981.
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