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Infection and Immunity, March 2008, p. 1200-1206, Vol. 76, No. 3
0019-9567/08/$08.00+0 doi:10.1128/IAI.00566-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Kota Arun Kumar,2
J. Mauricio Calvo-Calle,1,
Caroline Othoro,1
David Altszuler,1
Victor Nussenzweig,2 and
Elizabeth H. Nardin1*
Department of Medical Parasitology,1 Department of Pathology, Michael Hiedelberger Division of Immunology, New York University School of Medicine, New York, New York2
Received 18 April 2007/ Returned for modification 10 June 2007/ Accepted 17 December 2007
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In addition to antibody, gamma interferon (IFN-
) secreted by either CD8+ or Th1-type CD4+ T cells can block the development of intracellular hepatic-stage parasites by stimulating the upregulation of inducible nitric oxide synthase and the production of NO by the infected hepatocytes (14, 20, 44). In the murine malaria model, CD8+ T cells have been hypothesized to be essential for protection against sporozoite challenge following immunization with sporozoites or with subunit vaccines based on DNA and recombinant viral vectors (10, 55). In a previous study (56), β2-microglobulin knockout (β2M–/–) mice, which lack CD8+ T cells, were not protected following immunization with Plasmodium berghei sporozoites, leading to the conclusion that CD8+ T cells are essential for protective immunity and that redundant immune mechanisms are not elicited by attenuated sporozoites. These findings have led to significant effort in recent vaccine trials to elicit high levels of CD8+ T cells specific for circumsporozoite (CS) protein and other preerythrocytic-stage antigens (11, 15, 29).
In other infectious disease models, it has been shown that in the absence of CD8+ T cells, CD4+ T cells can mediate protective immunity (12, 13, 32). Moreover, malaria peptide subunit vaccines have been shown to effectively elicit CD4+-T-cell-mediated protective immunity against sporozoite challenge in the absence of CD8+-T-cell responses (5, 8, 28, 39, 53). Consistent with the results of these studies, we demonstrated that β2M–/– mice immunized with irradiated Plasmodium sporozoites could develop sterile immunity in the absence of CD8+ T cells, indicating that immune resistance can be mediated solely by class II-restricted effector mechanisms.
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Protective immunity. Sterile immunity was assayed by Giemsa-stained blood smears obtained on days 3 to 14 post-sporozoite challenge. Mice that failed to develop patent blood-stage infection during this period of time were considered to have developed sterile immunity.
To measure the hepatic-stage parasite burden, naïve or immunized mice were injected i.v. with 0.2 x 105 to 5 x 105 viable sporozoites and livers were obtained 40 to 42 h postchallenge. Total RNA was extracted, and 1 µg was reverse transcribed using species-specific primers for P. yoelii or P. berghei 18S rRNA as previously described (2, 3). Amounts of parasite rRNA were quantified by competitive (2, 27) or real-time (3) PCR. Results are expressed as the numbers of rRNA copies determined based on an rRNA plasmid standard or the percent reduction of rRNA in livers of immunized mice versus those of naïve controls. Statistical analysis was carried out using Student's t test.
Cellular assays.
The role of cell-mediated immunity in the protection of sporozoite-immunized β2M–/– mice was determined by the depletion of CD4+ T cells prior to sporozoite challenge. Immunized mice were injected with three doses of 300 µg of anti-CD4 monoclonal antibody (MAb; GK 1.5) or anti-CD8 MAb (2.43) as a control, starting 3 days prior to challenge with viable sporozoites. The depletion of CD4+ T cells was confirmed by fluorescence-activated cell sorter (FACS) analysis to be <1% of those in untreated mice. To deplete NK cells, mice were treated with a single injection of anti-asialoglyprotein 1 antiserum (Wako Chemicals, Richmond, VA) 1 day prior to challenge (9). IFN-
was depleted by i.v injection of 1 mg of anti-IFN-
MAb (DB-1) on days 0 and 1 post-sporozoite challenge (45). Results of cell or cytokine depletion were determined by measuring parasitemia in Giemsa-stained blood smears or by assaying parasite levels in the liver by real-time PCR.
Serological assays. Antibody levels were determined by an enzyme-linked immunosorbent assay using P. yoelii recombinant CS protein or by an indirect immunofluorescence assay using air-dried sporozoites. Antibody function was evaluated by an in vivo or in vitro sporozoite neutralization assay (SNA) (17, 34). P. yoelii sporozoites were incubated for 45 min with preimmune or immune sera obtained from P. yoelii sporozoite-immunized β2M–/– or WT mice, the incubated sporozoites were injected into naïve BALB/c mice, and levels of liver-stage parasites at 42 h postinjection were determined by reverse transcriptase PCR (RT-PCR) (3).
For the in vitro SNA, 2 x 104 P. berghei sporozoites were preincubated on ice for 40 min with immune sera obtained from β2M–/– mice at various time points after immunization with irradiated P. berghei sporozoites. The preincubated sporozoites were added to confluent cultures of human HepG2 cells (16), and the development of intracellular hepatic-stage parasites was assayed at 40 h by real-time PCR (22).
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TABLE 1. Immunization with irradiated sporozoites elicits sterile immunity in β2M–/– mice
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Irradiated P. berghei sporozoites also elicited sterile immunity in the β2M–/– mice (Table 1). In two independent experiments, 75% (three of four) and 100% (eight of eight) of P. berghei sporozoite-immunized β2M–/– mice were protected against challenge with viable P. berghei sporozoites. A delayed prepatent period of 6.0 days in the single P. berghei-immunized infected β2M–/– mouse was observed, compared to 4.8 days in the naïve β2M–/– controls.
Reduction of liver parasite burden in sporozoite-immunized β2M–/– mice. Protection in the sporozoite-immunized β2M–/– mice was also reflected in the reduction of hepatic-stage parasites. Following P. yoelii sporozoite challenge, levels of parasite rRNA in the livers of P. yoelii-immunized β2M–/– mice were reduced 97% compared to those in the livers of nonimmune β2M–/– mice (Fig. 1A). The level of inhibition in the β2M–/– mice was comparable to that observed in sporozoite-immunized WT mice with normal levels of CD8+ T cells, in which the total level of parasite rRNA was reduced 96% compared to that in naïve WT controls.
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FIG. 1. Immunization with irradiated P. yoelii sporozoites reduces the liver-stage parasite burden in β2M–/– mice. (A) Immune (P. yoelii sporozoite-immunized [Py spz]) or naïve β2M–/– mice with a C57BL background and WT controls were challenged with 5 x 105 viable P. yoelii sporozoites, and levels of parasite 18S rRNA in the livers were determined 40 h postchallenge by a PCR competition assay (2). (B) Immune or naïve β2M–/– mice with a BALB/c background were challenged with 2 x 104 P. yoelii sporozoites, and levels of liver-stage parasites were measured by RT-PCR (3). Results are shown as the mean numbers of parasite 18S rRNA copies ± the standard deviations (SD).
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CD8+-T-cell-independent sporozoite-induced immunity was not restricted by the genetic background. Levels of parasite rRNA in the livers of β2M–/– BALB/c mice challenged after three immunizations with irradiated P. yoelii sporozoites were reduced 99% compared to those in controls (Fig. 1B). In the five immunized β2M–/– BALB/c mice, mean rRNA copy numbers were reduced 2 logs compared to those in unimmunized β2M–/– BALB/c controls, with 0.0614 x 107 rRNA copies compared to 5.93 x 107 rRNA copies, respectively. Therefore, even in strains in which the CD8+ T cells are believed to be the primary effector mechanism, significant protective immunity was elicited in the absence of CD8+ T cells.
CD4+ T cells elicited by sporozoite immunization protect β2M–/– mice. To examine the role of CD4+ T cells in protective immunity, P. yoelii-immunized β2M–/– mice with the C57BL background were depleted of CD4+ T cells prior to challenge. The appearance of patent blood-stage infection following the in vivo depletion of CD4+ T cells demonstrated that CD4+ T cells were required for the protection of the sporozoite-immunized β2M–/– mice (Fig. 2A). Only 12.5% of the immunized β2M–/– mice treated with anti-CD4 were protected against challenge. In contrast, protection was obtained in 89% (eight of nine) of the immunized β2M–/– mice not depleted of CD4+ T cells.
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FIG. 2. The depletion of CD4+ T cells inhibits immune protection in β2M–/– mice. P. yoelii (Py) sporozoite-immunized (spz imm) β2M–/– mice, with or without depleted T cells, were challenged. Protection was determined by measuring (A) parasitemia in daily blood smears or (B) levels of liver-stage parasites by RT-PCR. Pooled results from two independent experiments are shown (n, 8 to 9 mice total). Following treatment with anti-CD4 MAb GK 1.5, FACS analysis confirmed the depletion of CD4+ T cells, with 0.22% CD4+ T cells in treated versus 26% in untreated β2M–/– mice and 0.09% versus 21.7% in treated versus untreated WT mice, respectively. CD8+-T-cell levels in β2M–/– mice were 0.41%, versus 19.8% in WT mice. Anti-AsialoGM, anti-asialoglyprotein 1 antiserum.
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In contrast to that in β2M–/– mice, the depletion of CD4+ T cells in sporozoite-immunized WT mice with functioning CD8+ T cells did not abolish sporozoite-induced immunity (Fig. 2A). All of the sporozoite-immunized WT mice (nine of nine) treated with anti-CD4 MAb were protected, as were 100% of the untreated immunized WT mice (seven of seven). The prepatent periods for naïve WT and β2M–/– mice were similar, with means of 4.1 and 4.4 days, respectively. These findings indicate that, in the absence of the CD8+-T-cell-mediated immunity found in WT mice (10), CD4+ effector T cells play a dominant role in protective immunity.
Resistance to secondary challenge. CD4+ T cells also played a critical role in resistance to secondary challenge in P. yoelii sporozoite-immunized β2M–/– mice. One month after resisting primary P. yoelii sporozoite challenge (Table 1), the protected β2M–/– mice were rechallenged, with or without T-cell depletion. The immunized β2M–/– mice that had not been depleted of CD4+ T cells were fully protected against rechallenge and did not develop patent infections (Table 2). In contrast, the depletion of CD4+ T cells prior to rechallenge resulted in patent parasitemia similar to that in naïve controls (with a prepatent period of 4.75 days, versus 4.0 days in controls). Therefore, in B2M–/– mice, P. yoelii sporozoite-induced protection against rechallenge was CD4+-T-cell dependent, as found for resistance to the primary challenge (Fig. 2). In contrast, P. berghei-immunized β2M–/– mice were not protected following rechallenge, either with or without CD4+-T-cell depletion. These findings suggest that P. berghei sporozoites elicit a more transient immune response in the β2M–/– mice than P. yoelii sporozoites.
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TABLE 2. Results of rechallenge of β2M–/– mice immunized with P. yoelii or P. berghei sporozoites
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, which is produced by both CD4+ and CD8+ T cells, plays a critical role in the inhibition of hepatic-stage parasites (10, 14, 25, 44). To assess the role of IFN-
, P. yoelii sporozoite-immunized β2M–/– mice were treated with anti-murine IFN-
MAb prior to challenge. While >95% inhibition of hepatic-stage parasites occurred in the untreated immunized mice, protection in the mice treated with anti-IFN-
MAb was reduced to 69% compared to that in controls (Fig. 3). The mean number of rRNA copies in the anti-IFN-
-treated mice (0.87 x 107) was significantly higher than that in the untreated immunized β2M–/– mice (0.124 x 107; P = 0.04).
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FIG. 3. Treatment with anti-IFN- antibody reduces protective immunity in immunized β2M–/– mice. P. yoelii sporozoite-immunized β2M–/– mice were depleted of IFN- by i.v. injection of 1 mg of anti-IFN- MAb (MAb DB-1) on the day of sporozoite challenge and 24 h post-sporozoite challenge (45). Levels of rRNA in the livers were measured by RT-PCR at 40 h postchallenge. Results are shown as mean numbers of parasite 18S rRNA copies ± SD.
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FIG. 4. Sporozoite-neutralizing antibodies in sera of β2M–/– mice immunized with P. yoelii or P. berghei irradiated sporozoites. (A) Viable P. yoelii sporozoites were incubated for 45 min at 37°C with sera from P. yoelii sporozoite-immunized β2M–/– mice prior to injection into naïve recipients (2 x 104 sporozoites/mouse). Livers were obtained 40 h postchallenge, and levels of parasite rRNA were measured by RT-PCR. (B) Viable P. berghei sporozoites were incubated with sera obtained from eight β2M–/– mice following the first or fourth immunization with irradiated P. berghei sporozoites. The sporozoites incubated with sera (2 x 104) were added to HepG2 hepatoma cell cultures, and levels of P. berghei 18S rRNA were measured by RT-PCR after 48 h of incubation. Means ± SD are shown for the seven of eight anti-P. berghei serum samples that had positive SNA activity (>80% inhibition). Controls included P. berghei sporozoites incubated with 25 µg/ml of MAb 3D11, specific for P. berghei CS protein repeats, or negative control MAb 2A10, specific for P. falciparum CS protein repeats (33, 57).
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Immune protection was observed in β2M–/– mice with the C57BL (H-2b) background, as well as those with the BALB/c (H-2d) genetic background, in which CD8+ T cells are a primary effector mechanism for WT mice (10). Therefore, class II-mediated mechanisms can function in different genetic backgrounds to protect against sporozoite challenge. This finding is consistent with the presence of redundant immune mechanisms that can protect the host against Plasmodium when one effector mechanism is absent or defective, as found previously for other pathogens (12, 13, 32).
In the absence of CD8+ T cells, CD4+ T cells play a critical role in protection against sporozoite challenge. The depletion of CD4+ T cells prior to the challenge of sporozoite-immunized β2M–/– mice abolished immune resistance, as measured either by the development of patent blood-stage parasitemia or by increased liver-stage parasite burdens (Fig. 2). In contrast to that in β2M–/– mice, however, the depletion of CD4+ T cells in WT mice did not inhibit immunity (Fig. 2A), suggesting that CD4+-T-cell effector mechanisms provide a default protective mechanism that is functional when CD8+ T cells are lacking. These findings are consistent with results from studies demonstrating that protective immunity can be elicited with malaria peptide immunogens that lack CD8+-T-cell epitopes (5, 28, 53, 54), showing that protection against sporozoite challenge can be obtained when only CD4+ T cells are elicited.
CD4+ T cells can potentially function by directly targeting liver-stage parasites via cytotoxic mechanisms or cytokine production. While the majority of cytotoxic cells isolated from sporozoite-immunized mice have been CD8+ (41, 43), a protective cytotoxic CD4+-T-cell clone in the P. berghei malaria model has been characterized (51). Cytolytic CD4+-T-cell clones have also been isolated from human volunteers immunized with irradiated P. falciparum sporozoites or P. falciparum CS peptide vaccines (4, 30). Increased numbers of cytotoxic CD4+ T cells have been found in virus-infected β2M–/– mice (26). However, preliminary studies did not detect lytic activity with spleen cells derived from the sporozoite-immunized β2M–/– mice (data not shown).
Nonlytic CD4+ T cells derived from peptide-immunized mice can also protect against sporozoite challenge by IFN-
production in some, but not all, cases (5, 8, 28, 39, 53). IFN-
is a potent cytokine inhibitor of intracellular hepatic-stage parasites (14, 44). Human volunteers immunized with P. falciparum sporozoites or CS peptides develop predominantly Th1-type CD4+-T-cell clones that produce high levels of IFN-
(4, 31). The presence of CS-specific CD4+ T cells producing IFN-
has been correlated with protection against P. falciparum in volunteers immunized with RTS,S vaccine and in individuals with naturally acquired immunity (24, 38, 50). In the present study, treatment of the P. yoelii-immunized β2M–/– mice with anti-IFN-
significantly reduced, but did not completely abolish, protective immunity (Fig. 3). Increased concentrations and/or more frequent treatment with anti-IFN-
MAb may be required if high levels of IFN-
are produced by the murine CD4+ T cells following sporozoite challenge.
Alternatively, a combination of T cells and antibody may mediate resistance in the sporozoite-immunized β2M–/– mice. Antibody titers in immunized β2M–/– and WT mice were similar, and high levels of sporozoite-neutralizing activity were present in the immune sera (Fig. 4). A role for antibodies, in addition to CD4+ T cells, in the sporozoite-immunized β2M–/– mice was suggested by the reduced levels of liver-stage parasites in the immunized β2M–/– mice treated with anti-CD4 MAb compared to those in naïve controls (Fig. 2B). The passive transfer of anti-sporozoite antibody and immune cells has been shown to protect naïve WT recipients against sporozoite challenge more effectively than the transfer of either serum or cells alone (40, 45). The IFN-
produced by CD4+ T cells may activate macrophages to enhance the clearance of antibody-immobilized or opsonized sporozoites (7, 36). In recent studies, the presence of CS-specific opsonizing antibodies in the sera of RTS,S-immunized volunteers correlated with protection against P. falciparum sporozoite challenge (46). Antibody may function synergistically with T cells by significantly reducing the number of sporozoites that reach the liver, thereby facilitating CD4+ T-cell clearance of a smaller number of hepatic exoerythrocytic forms, either by direct cytotoxicity or by production of inhibitory cytokines.
Regardless of the immune mechanism, the high levels of sterile immunity obtained in the sporozoite-immunized β2M–/– mice demonstrate that strong immune resistance can be obtained in the absence of CD8+ T cells. These findings are in contrast to those of a previous study using P. berghei, in which CD8+ T cells were proposed to be the sole effector mechanism functioning in sporozoite-induced immunity based on the failure of immunization with P. berghei sporozoites to protect β2M–/– mice (56). The present studies used a different immunization regime, with higher priming doses of P. berghei sporozoites, more frequent booster doses, and a longer interval between sporozoite immunizations, which most likely increased protective immunity. The rechallenge study results (Table 2), however, suggest that class II-mediated immunity elicited by P. berghei sporozoites was less robust than that elicited by P. yoelii sporozoites. The lower infectivity of P. berghei sporozoites and the nonspecific inflammation elicited by P. berghei but not P. yoelii sporozoites may modulate adaptive immune responses in this rodent malaria model (2, 19).
P. yoelii is believed to provide a more accurate model for human malaria, with infectious-sporozoite inocula that are logs lower than that required for P. berghei (2, 19). The high levels of sterile immunity obtained in P. yoelii sporozoite-immunized β2M–/– mice indicate that class II-mediated immunity effectively protects against highly infective sporozoite challenge. Recent studies with transgenic mice expressing the CS protein suggest that this protein is the immunodominant antigen in sporozoite-induced protective immunity (23). That CS-specific class II-mediated immune resistance may function in humans is suggested by results from phase II trials of the CS-based RTS,S vaccine. Protection in the RTS,S-immunized volunteers was positively correlated with anti-repeat antibody and strong CD4+ Th1 responses in the absence of vigorous CD8+-T-cell responses (1, 18, 24, 46, 48).
The protective CD4+ T cells and sporozoite-neutralizing antibodies induced by sporozoite immunization of β2M–/– mice suggest that subunit vaccines eliciting strong class II-mediated immunity may provide effective preerythrocytic vaccines for human malaria.
These studies were supported by NIH AI025085 and AI045138.
Published ahead of print on 26 December 2007. ![]()
Present address: Regeneron Pharmaceuticals Inc., Old Saw Mill River Rd., Tarrytown, NY. ![]()
Present address: University of Massachusetts School of Medicine, Worcester, MA. ![]()
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