Oxidative stress is thought to be involved in the mechanism of nerve cell death in Parkinson's disease (PD). Among several toxic oxidative species, nitric oxide (NO) has been proposed as a key element on the basis of the increased density of glial cells expressing inducible nitric oxide synthase (iNOS) in the substantia nigra (SN) of patients with PD. However, the mechanism of iNOS induction in the CNS is poorly understood, especially under pathological conditions. Because cytokines and FcepsilonRII/CD23 antigen have been implicated in the induction of iNOS in the immune system, we investigated their role in glial cells in vitro and in the SN of patients with PD and matched control subjects. We show that, in vitro, interferon-gamma (IFN-gamma) together with interleukin-1beta (Il-1beta) and tumor necrosis factor-alpha (TNF-alpha) can induce the expression of CD23 in glial cells. Ligation of CD23 with specific antibodies resulted in the induction of iNOS and the subsequent release of NO. The activation of CD23 also led to an upregulation of TNF-alpha production, which was dependent on NO release. In the SN of PD patients, a significant increase in the density of glial cells expressing TNF-alpha, Il-1beta, and IFN-gamma was observed. Furthermore, although CD23 was not detectable in the SN of control subjects, it was found in both astroglial and microglial cells in parkinsonian patients. Altogether, these data demonstrate the existence of a cytokine/CD23-dependent activation pathway of iNOS and of proinflammatory mediators in glial cells and their involvement in the pathophysiology of PD.

Serum IgE concentrations and the expression of the low-affinity receptor for IgE (FceRHl/CD23) Nitric oxide (NO) generated by activated murine macrophages is cytostatic or cytotoxic for a variety of pathogens, including Leishmania major, Plasmodium falciparum, Schistosoma mansoni, Trypanosoma cruzi, and Toxoplasma gondii (1-6). NO is generated from the oxidation of the terminal guanido nitrogen atom(s) of L-arginine by an NADPH-dependent enzyme, the NO synthase (NOS) (7-9). In murine macrophages, NOS activity is induced by lipopolysaccharide (LPS) (9) IgE-IC) or by a specific monoclonal antibody (mAb) to CD23 (CD23 mAb) promotes the generation of cGMP. Simultaneous measurement of the generation of nitrite (NO-j) indicated that the enhanced production of cGMP is consequent to activation of the L-arginine:NO pathway.The low-affinity receptor for IgE (FceRII/CD23) is also expressed on normal human monocytes/macrophages after their activation in vivo (22,23). Studies in patients infected with Leishmania braziliensis or in disease-free, immunoreactive donors have shown both in situ CD23 expression and serum IgE concentrations to be increased in these conditions (23). We have, therefore, studied whether cell activation through ligation of the membrane receptor CD23 induces the L-arginine:NO pathway and results in leishmanicidal activity in human macrophages. MATERIALS AND METHODSReagents. The following reagents were used: recombinant human interleukin 4 (IL-4; a gift from J. Banchereau, Schering-Plough); IFN--y (a gift from J. M. Mencia-Huerta, Institut Beaufour, Paris); TNF-a and anti-TNF-a mAb (Genzyme); human IgE (Stallergene, Paris), and goat anti-human IgE (Nordic, Tilburg, The Netherlands). Polymyxin B, LPS (Escherichia coli 055, L-2880), NG-monomethyl-L-arginine (L-NMMA), D-NMMA, L-arginine, D-arginine, superoxide dismutase (SOD), and catalase were all obtained from Sigma.Cells. Human mononuclear cells were obtained by Ficoll gradient separation of peripheral blood leukocytes from healthy volunteers. Monocytes were separated from lymphocytes by adherence to plastic dishes coated with fetal calf serum as described (24). After this procedure, >90% of cells expressed CD14 antigen and displayed cytochemical characteristics of monocytes (24). The cells were then incubated in Dulbecco's modified Eagle's medium (DMEM) supplemented with nonessential L-amino acids, sodium pyruvate, glutamine, penicillin, streptomycin, and 10% (vol/vol) fetal calf serum (all from GIBCO). The culture medium was routinely controlled for the absence of a direct activation effect on human monocytes (CD23 expression and TNF-a production as activation Abbreviations: mAb, monoclonal antibody; CD23 mAb, anti-CD23 mAb; IgE-IC, IgE-anti-IgE immune complexes; L-NMMA, NA3-monomethyl-L-arginine; LPS, lipopolysaccharide; NOS, NO synthase; iNOS, inducible NOS; IFN-y, interferon y; IL, interleukin; TNF-a, tumor necrosis factor ai; SOD, superoxide dismutase; HPRT, hypoxanthine phosphoribosyltransferase. tTo whom reprint requests should be ad...

During Plasmodium falciparum infection leading to cerebral malaria, cytokine production and cytoadherence of parasitized erythrocytes (PRBCs) to postcapillary venules are involved. We demonstrate that PRBC adhesion induces apoptosis in human endothelial cells (HLECs). PRBC adhesion modulated HLEC gene expression in tumor necrosis factor-alpha superfamily genes (Fas, Fas L, and DR-6) and apoptosis-related genes (Bad, Bax, caspase-3,SARP 2, DFF45/ICAD, IFN-gamma receptor 2, Bcl-w, Bik, and iNOS). Apoptosis was confirmed by (1) morphological modifications by electron microscopy, (2) annexin V binding, (3) DNA degradation, by measuring intracytoplasmic nucleosomes, and (4) caspase activity. The apoptotic stimulus was physical contact between HLECs and PRBCs and not parasite-secreted molecules. In addition, it was found that cytoplasmic (caspase 8) and mitochondrial (caspase 9) pathways were involved in this process. These data not only describe the direct apoptotic effect of PRBC adhesion on endothelial cells but also provide new useful tools that allow an evaluation of potential pharmaceuticals.