Abstract

The balance between T helper (Th) 1 and Th2 cell responses is a major determinant of the outcome of experimental leishmaniasis, but polarized Th1 or Th2 responses are not sufficient to account for healing or nonhealing. Here we show that high arginase activity, a hallmark of nonhealing disease, is primarily expressed locally at the site of pathology. The high arginase activity causes local depletion of L-arginine, which impairs the capacity of T cells in the lesion to proliferate and to produce interferon-γ, while T cells in the local draining lymph nodes respond normally. Healing, induced by chemotherapy, resulted in control of arginase activity and reversal of local immunosuppression. Moreover, competitive inhibition of arginase as well as supplementation with L-arginine restored T cell effector functions and reduced pathology and parasite growth at the site of lesions. These results demonstrate that in nonhealing leishmaniasis, arginase-induced L-arginine depletion results in impaired T cell responses. Our results identify a novel mechanism in leishmaniasis that contributes to the failure to heal persistent lesions and suggest new approaches to therapy.

Highlights

  • The leishmaniases, a group of vector-borne parasitic diseases, represent a major public health problem worldwide

  • We show that arginase, an enzyme induced in Leishmania-infected macrophages, is highly expressed at the site of pathology in nonhealing lesions and causes local depletion of L-arginine, an amino acid that is essential for efficient T cell responses

  • This local reduction in L-arginine impairs the capacity of T cells in the lesion to proliferate and to produce interferon-c, one of the signals required for parasite killing

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Summary

Introduction

The leishmaniases, a group of vector-borne parasitic diseases, represent a major public health problem worldwide. The leishmaniases belong to the most neglected tropical diseases, affecting the poorest populations, for whom access to diagnosis and effective treatment are most difficult. Much effort has been put into the discovery of new drugs for the treatment of this pathology, but still the most widely used drugs remain the pentavalent antimonials, which were introduced 50 years ago. These drugs have many limitations, such as the long course of treatment, severe side effects and development of resistance. No efficient vaccine is available to date (http://www.who.int/leishmaniasis/en/)

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