Abstract

Endemic typhus caused by Rickettsia (R.) typhi is an emerging febrile disease that can be fatal due to multiple organ pathology. Here we analyzed the requirements for protection against R. typhi by T cells in the CB17 SCID model of infection. BALB/c wild-type mice generate CD4+ TH1 and cytotoxic CD8+ T cells both of which are sporadically reactivated in persistent infection. Either adoptively transferred CD8+ or CD4+ T cells protected R. typhi-infected CB17 SCID mice from death and provided long-term control. CD8+ T cells lacking either IFNγ or Perforin were still protective, demonstrating that the cytotoxic function of CD8+ T cells is not essential for protection. Immune wild-type CD4+ T cells produced high amounts of IFNγ, induced the release of nitric oxide in R. typhi-infected macrophages and inhibited bacterial growth in vitro via IFNγ and TNFα. However, adoptive transfer of CD4+IFNγ-/- T cells still protected 30–90% of R. typhi-infected CB17 SCID mice. These cells acquired a TH17 phenotype, producing high amounts of IL-17A and IL-22 in addition to TNFα, and inhibited bacterial growth in vitro. Surprisingly, the neutralization of either TNFα or IL-17A in CD4+IFNγ-/- T cell recipient mice did not alter bacterial elimination by these cells in vivo, led to faster recovery and enhanced survival compared to isotype-treated animals. Thus, collectively these data show that although CD4+ TH1 cells are clearly efficient in protection against R. typhi, CD4+ TH17 cells are similarly protective if the harmful effects of combined production of TNFα and IL-17A can be inhibited.

Highlights

  • Rickettsioses are emerging febrile diseases that can be fatal and are caused by obligate intracellular bacteria of the family of Rickettsiaceae

  • CD8+ and CD4+ TH1 as well as TH17 cells protect against Rickettsia typhi adoptively transferred CD8+ as well as CD4+ T cells that acquire a TH1 phenotype protect these animals from severe disease and death

  • We further analyzed the requirements for T cell-mediated protection and found that the cytotoxic function of CD8+ T cells is not essential for protection and that the release of IFNγ by these cells is more critical than the cytolytic activity for long-term control of the bacteria

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Summary

Introduction

Rickettsioses are emerging febrile diseases that can be fatal and are caused by obligate intracellular bacteria of the family of Rickettsiaceae. This family consists of two genera: Orientia with only one member (Orientia tsutsugamushi) and Rickettsia (R.) that is further subdivided into four groups: The spotted fever group (SFG) that contains the vast majority of rickettsiae (e.g. R_rickettsii, R. conorii), the typhus group (TG; R. prowazekii and R. typhi), the transitional group (R. felis, R. akari and R. australis) and the non-pathogenic ancestral group (R. bellii and R. canadensis) [1, 2]. After a 10–14 days period of latency patients suffer from high fever accompanied by headache, muscle and joint pain, nausea and vomiting Neurological symptoms such as confusion and stupor are common [4].

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