Objectives: Cryptococcus neoformans is the most important fungal pathogen causing CNS-related mortality and morbidity world-wide. Treatment of C. neoformans CNS infections is very challenging. There is increasing evidence suggesting that paradoxical responses to therapy are mediated by patients? own immune response to the fungus supported by beneficial effects of anti-inflammatory therapy. However, the use of broad anti- inflammatory (steroid) therapy is controversial because cryptococcosis is predominantly a disease of immunocompromised population. Using model of CNS- crytptococcosis in mice we will investigate CNS damage during cerebral cryptococcosis which we propose is a result of collaboration between myeloid cells with the CNS recruited T-cells. Our studies will define the mechanisms by which these cells are recruited to the CNS and cause detrimental CNS pathology. Hypothesis: CCR2-axis signaling recruits monocytes into the CNS, which further promotes T-cells recruitment and polarization facilitating fatal CNS damage. We further propose that Nitric oxide (NO) is central effector product of monocyte derived cells (MoC) activated by Th1 cells, which induces CNS pathology. To test distinct parts of this hypothesis in our mouse model we will:
Aim 1. Determine whether CCR2-dependent MoC accumulation and activation drive CNS pathology. a) To establish the how CCR2-axis affects the kinetics of MoC accumulation and activation in the CNS during CME; b) To assess the contribution of the CCR2 axis/MoC to the development of CNS damage, neurological symptoms and mortality during CME; c)To provide additional mechanistic proof of concept that CCR2+ monocytes induce CNS injury in CME.
Aim 2 : Establish that CCR2+ MoC promote a Th1 response in the CNS during CME: a) To determine whether MoC produce CXCR3 ligands and to assess whether T-cell recruitment into the CNS is mediated via CXCR3-signaling; b) To determine whether CCR2+ MoC contribute to T-cell recruitment, activation, and polarization; c) To assess whether the adoptive transfer Th1 cells from the infected CCR2+/+ mice into CCR2-/- mice restores CME-associated damage.
Aim 3. Determine whether iNOS/NO from CCR2+ MoC is required to mediate pathological CNS tissue damage observed during CME: a) To specifically test whether iNOS induction in CCR2+MoC mechanistically contribute to CNS pathology observed in CME; b) To determine whether IFN?/IFN?R signaling in CCR2+ MoC is required to induce iNOS in these cells and the effect of IFN?/IFN?R signaling on subsequent CNS damage. Research Plan and Methods: This proposal will utilize our novel mouse model of CM, which accurately recapitulates severe paradoxical immune responses experienced by patients with C. neoformans CNS infection. We have previously shown that ultra-polarized IFN?-producing CD4+ T cells accumulate in the CNS and contribute to CNS pathology and mortality. In proposed work, we will use our in vivo model of C. neoformans CNS infection along with in genetically modified mice to test specific aspects of our hypothesis, in vitro T cell co-cultures, while in vivo adoptive cell transfers will help us to define the types of CNS tissue injury and the role of CCR2+ and myeloid cells and other subsets of myeloid cells in CNS immune pathology. Specifically, these strategies will use genetically deficient mice, including those lacking CCR2 (CCR2-/- - receptor selectively removed from CCR2+ cells (CCR2?R-/-), CXCR3-signaling (CXCR3-/-), and mice unabel to make nitric oxide globally (iNOS-/-) or only in CCR2+ cells CCR2-NOS-/-). The outcomes of our experiment manipulations will be measured by a) analysis of fungal burdens b) analysis of neurological symptoms and mortality c) flow cytometric analysis of infiltrating immune cells, d) analysis of mononuclear phagocyte polarization profile and effector functions, e) gene expression analysis and f) histology. Overall, these studies will provide significant insight on T cell mediated pathology during fungal CNS infections and are likely to identify new biomarkers or therapeutic opportunities.

Public Health Relevance

Cryptococcus is a ubiquitous inhaled fungal pathogen which causes substantial morbidity and mortality in Veterans and other patients worldwide. Veterans have increased risk of infection due to higher rates of immunocompromising medical conditions relative to the general population (HIV and use of immune suppressive therapies). Current therapies for patients infected with Cryptococcus are lengthy, highly toxic, often ineffective, and may actually contribute to inflammatory complications. These complications are linked to pathological tissue damage, mortality, and/or development of lasting disabilities in these patients. This proposal will define the immune mechanisms underlying detrimental immune responses during cryptococcal CNS infection using an experimental model; our broader objective is to identify therapies we can use to treat Veterans suffering from CME. Our results will be also relevant to other CNS infections caused by pathogens to which Veterans are exposed to during deployment (malaria, tuberculosis meningitis and CNS viruses).

Agency
National Institute of Health (NIH)
Institute
Veterans Affairs (VA)
Type
Non-HHS Research Projects (I01)
Project #
2I01BX000656-09
Application #
9664495
Study Section
Special Emphasis Panel (ZRD1)
Project Start
2010-04-01
Project End
2022-12-31
Budget Start
2019-01-01
Budget End
2019-12-31
Support Year
9
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Veterans Health Administration
Department
Type
DUNS #
096318480
City
Ann Arbor
State
MI
Country
United States
Zip Code
48105
Teitz-Tennenbaum, Seagal; Viglianti, Steven P; Roussey, Jonathan A et al. (2018) Autocrine IL-10 Signaling Promotes Dendritic Cell Type-2 Activation and Persistence of Murine Cryptococcal Lung Infection. J Immunol 201:2004-2015
So, Yee-Seul; Jang, Juyeong; Park, Goun et al. (2018) Sho1 and Msb2 Play Complementary but Distinct Roles in Stress Responses, Sexual Differentiation, and Pathogenicity of Cryptococcus neoformans. Front Microbiol 9:2958
Wang, Shiwen; Yang, Feng; Li, Dong et al. (2018) Clinical application of a multiplex genetic pathogen detection system remaps the aetiology of diarrhoeal infections in Shanghai. Gut Pathog 10:37
Neal, Lori M; Xing, Enze; Xu, Jintao et al. (2017) CD4+ T Cells Orchestrate Lethal Immune Pathology despite Fungal Clearance during Cryptococcus neoformans Meningoencephalitis. MBio 8:
Xu, Jintao; Flaczyk, Adam; Neal, Lori M et al. (2017) Scavenger Receptor MARCO Orchestrates Early Defenses and Contributes to Fungal Containment during Cryptococcal Infection. J Immunol 198:3548-3557
Roussey, Jonathan A; Viglianti, Steven P; Teitz-Tennenbaum, Seagal et al. (2017) Anti-PD-1 Antibody Treatment Promotes Clearance of Persistent Cryptococcal Lung Infection in Mice. J Immunol 199:3535-3546
Xu, Jintao; Flaczyk, Adam; Neal, Lori M et al. (2017) Exploitation of Scavenger Receptor, Macrophage Receptor with Collagenous Structure, by Cryptococcus neoformans Promotes Alternative Activation of Pulmonary Lymph Node CD11b+ Conventional Dendritic Cells and Non-Protective Th2 Bias. Front Immunol 8:1231
Neal, Lori M; Qiu, Yafeng; Chung, Jooho et al. (2017) T Cell-Restricted Notch Signaling Contributes to Pulmonary Th1 and Th2 Immunity during Cryptococcus neoformans Infection. J Immunol 199:643-655
Malachowski, Antoni N; Yosri, Mohamed; Park, Goun et al. (2016) Systemic Approach to Virulence Gene Network Analysis for Gaining New Insight into Cryptococcal Virulence. Front Microbiol 7:1652
Zhang, Yanmei; Wang, Shiwen; Hu, Binjie et al. (2016) Direct detection of Helicobacter pylori in biopsy specimens using a high-throughput multiple genetic detection system. Future Microbiol 11:1521-1534

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