Abstract

Development of immunoprotection against visceral leishmaniasis (VL) focused on the identification of antigens capable of inducing a Th1 immune response. Alternatively, antigens targeting the CD8 and T-regulatory responses are also relevant in VL pathogenesis and worthy of being included in a preventive human vaccine. We assessed in active and cured patients and VL asymptomatic subjects the clinical signs and cytokine responses to the Leishmania donovani nucleoside hydrolase NH36 antigen and its N-(F1), central (F2) and C-terminal (F3) domains. As markers of VL resistance, the F2 induced the highest levels of IFN-γ, IL-1β, and TNF-α and, together with F1, the strongest secretion of IL-17, IL-6, and IL-10 in DTH+ and cured subjects. F2 also promoted the highest frequencies of CD3+CD4+IL-2+TNF-α−IFN-γ−, CD3+CD4+IL-2+TNF-α+IFN-γ−, CD3+CD4+IL-2+TNF-α−IFN-γ+, and CD3+CD4+IL-2+TNF-α+IFN-γ+ T cells in cured and asymptomatic subjects. Consistent with this, the IFN-γ increase was correlated with decreased spleen (R = −0.428, P = 0.05) and liver sizes (R = −0.428, P = 0.05) and with increased hematocrit counts (R = 0.532, P = 0.015) in response to F1 domain, and with increased hematocrit (R = 0.512, P 0.02) and hemoglobin counts (R = 0.434, P = 0.05) in response to F2. Additionally, IL-17 increases were associated with decreased spleen and liver sizes in response to F1 (R = −0.595, P = 0.005) and F2 (R = −0.462, P = 0.04). Conversely, F1 and F3 increased the CD3+CD8+IL-2+TNF-α−IFN-γ−, CD3+CD8+IL-2+TNF-α+IFN-γ−, and CD3+CD8+IL-2+TNF-α+IFN-γ+ T cell frequencies of VL patients correlated with increased spleen and liver sizes and decreased hemoglobin and hematocrit values. Therefore, cure and acquired resistance to VL correlate with the CD4+-Th1 and Th-17 T-cell responses to F2 and F1 domains. Clinical VL outcomes, by contrast, correlate with CD8+ T-cell responses against F3 and F1, potentially involved in control of the early infection. The in silico-predicted NH36 epitopes are conserved and bind to many HL-DR and HLA and B allotypes. No human vaccine against Leishmania is available thus far. In this investigation, we identified the NH36 domains and epitopes that induce CD4+ and CD8+ T cell responses, which could be used to potentiate a human universal T-epitope vaccine against leishmaniasis.

Highlights

  • Visceral leishmaniasis (VL) is a severe chronic vector-borne protozoan disease

  • Each bacterial clone codifying for the sequences of the recombinant NH36 and its F1, F2, and F3 domains was cultured into 2 l of bacterial culture media and induced for expression with IPTG

  • We show that serum antibodies of mice vaccinated with NH36, F1, F2, or F3 domains and saponin recognize the SLA antigen of L. infantum chagasi in an ELISA assay, indicating that NH36 is an antigenic component of SLA (Figure S2 in Supplementary Material)

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Summary

Introduction

Visceral leishmaniasis (VL) is a severe chronic vector-borne protozoan disease. 400,000 new cases of VL and 30,000 deaths are reported annually (1), and the worldwide incidence is increasing due to co-infection with HIV and the expanded geographical range of the insect vector subsequent to global warming (2). The disease is caused by Leishmania donovani in India, Asia, and East Africa; by Leishmania infantum chagasi in America; and by Leishmania infantum in the Middle East, Central Asia, China, and the Mediterranean (2). Bangladesh, India, Nepal, Sudan, Ethiopia, and Brazil concentrate 90% of the VL worldwide incidence (2). Clinical findings of VL range from asymptomatic cases with self-resolving infection and an anti-Leishmania integral immune response to severe cases characterized by intermittent fever, malaise, weight loss, cachexia, hepatomegaly, splenomegaly, hypergammaglobulinemia, anemia, leukopenia, thrombocytopenia, strong suppression of the CD4+ T-cell immune response, and death, if untreated (3). Chemotherapy is highly toxic, and the long-term use of this treatment can select for resistant parasites (4)

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