Abstract

Data from a variety of experimental models suggest that natural killer (NK) cells require signals from accessory cells in order to respond optimally to pathogens, but the precise identity of the cells able to provide such signals depends upon the nature of the infectious organism. Here we show that the ability of human NK cells to produce interferon-γ in response to stimulation by Plasmodium falciparum–infected red blood cells (iRBCs) is strictly dependent upon multiple, contact-dependent and cytokine-mediated signals derived from both monocytes and myeloid dendritic cells (mDCs). Contrary to some previous reports, we find that both monocytes and mDCs express an activated phenotype following short-term incubation with iRBCs and secrete pro-inflammatory cytokines. The magnitude of the NK cell response (and of the KIR− CD56bright NK cell population in particular) is tightly correlated with resting levels of accessory cell maturation, indicating that heterogeneity of the NK response to malaria is a reflection of deep-rooted heterogeneity in the human innate immune system. Moreover, we show that NK cells are required to maintain the maturation status of resting mDCs and monocytes, providing additional evidence for reciprocal regulation of NK cells and accessory cells. However, NK cell–derived signals are not required for activation of accessory cells by either iRBCs or bacterial lipolysaccharide. Together, these data suggest that there may be differences in the sequence of events required for activation of NK cells by non-viral pathogens compared to the classical model of NK activation by virus-infected or major histocompatibility complex–deficient cells. These findings have far-reaching implications for the study of immunity to infection in human populations.

Highlights

  • After years of neglect, in which the adaptive immune response to malaria was investigated in great depth with a view to rational development of antimalarial vaccines, the innate immune response to malaria has recently come under scrutiny

  • We have previously shown that cloned natural killer (NK) cell lines are unable to respond to Plasmodium falciparum– infected red blood cell (iRBC) in the absence of accessory cells that are present among peripheral blood mononuclear cell (PBMC) [8]

  • We have shown that up-regulation of surface CD69 expression is a marker of partial activation of NK cells [9], and as expected, up-regulation of CD69 was consistently seen on NK cells within the iRBC-stimulated PBMC population (Figure 1D)

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Summary

Introduction

In which the adaptive immune response to malaria was investigated in great depth with a view to rational development of antimalarial vaccines, the innate immune response to malaria has recently come under scrutiny. We have shown that human natural killer (NK) cells can be an important early source of IFN-c after exposure of leukocytes to Plasmodium falciparum–infected red blood cells (iRBCs) [7,8,9], this response is extremely heterogeneous [8,9]. Following exposure to iRBCs, both human DCs and monocytes secrete the immunosuppressive cytokine interleukin-10 (IL-10) [13,14], have an impaired ability to mature in response to lipopolysaccharides (LPS) and other ligands [13,15,16,17], and are unable to present antigen to T cells [13]. DCs from children with acute malaria infection have reduced human leukocyte antigen (HLA)–DR expression [18]

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