Leishmaniasis is a chronic parasitic infection of humans that has emerged as a significant health care problem wold-wide. Using a well- characterized mouse model of healing or progressive cutaneous infection in leishmaniasis to investigations on how IL-12 is regulated by the accessory cell receptor protein, CD40. CD40 is activated by antigen-specific T cells bearing the CD40 ligand and induces IL-12 necessary for Th1 CD4+ cellular responses and cure. Our preliminary data demonstrate CD40-dependent increased synthesis of IL-12 in healing leishmaniasis and show that susceptible BALB/c mice underproduce IL-12 due to CD40 dysfunction and/or decreased accessory cell numbers as disease progresses. We hypothesize that a wide range of CD40 dependent responses jointly promote cure, whereas CD40 dysfunction maintains susceptibility. Our second goal is to use insights gained in these studies to design immunotherapies effective against progressive leishmaniasis, a disease mediated by inappropriate Th2 T cell responses that are IL-12 unresponsive. We hypothesize that the T cell response can be """"""""reset"""""""" to an IL-12 responsive state by transient CD4+ cell depletion or that in vivo activation of CD40 by soluble ligand or monoclonal antibody will induce therapeutic microbicidal responses and/or restore IL-12 regulatory effects. Preliminary data support the effectiveness of these proposed immunotherapies.
Our specific aims are to: 1. Determine the molecular and cellular basis of IL-12 production during healing or progressive leishmaniasis in resistant C57BL/6 and susceptible BALB c mice. 2. Determine the full range of protective immune responses dependent on CD40. 3. Identify the lesion(s) responsible for strain dependent differences in IL-12 production during leishmaniasis.
These aims are significant in that they address biologic mechanisms responsible for coordinating complex immune responses important in defense against intracellular parasitism and implicated in autoimmunity and transplant rejection. The proposed strategies for reversing pathologic Th- 2 cell responses by """"""""resetting"""""""" the T cell response are novel approaches that may be widely applicable to immunotherapy of other Th2-mediated diseases, including severe atopic disorders and helminth-induced pathology.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
2R01AI035979-05
Application #
2611255
Study Section
Tropical Medicine and Parasitology Study Section (TMP)
Project Start
1994-09-01
Project End
2002-05-31
Budget Start
1998-06-01
Budget End
1999-05-31
Support Year
5
Fiscal Year
1998
Total Cost
Indirect Cost
Name
Case Western Reserve University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
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Murray, Henry W; Moreira, Andre L; Lu, Cristina M et al. (2003) Determinants of response to interleukin-10 receptor blockade immunotherapy in experimental visceral leishmaniasis. J Infect Dis 188:458-64
Khatri, Saloni; Lass, Jonathan H; Heinzel, Fred P et al. (2002) Regulation of endotoxin-induced keratitis by PECAM-1, MIP-2, and toll-like receptor 4. Invest Ophthalmol Vis Sci 43:2278-84

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