No abstract

A common feature of severe Plasmodium falciparum infection is the increased systemic release of proinflammatory cytokines that contributes to the pathogenesis of malaria. Using human blood, we found that blood stage schizonts or soluble schizont extracts activated plasmacytoid dendritic cells (PDCs) to up-regulate CD86 expression and produce IFN-α. IFN-α production was also detected in malaria-infected patients, but the levels of circulating PDCs were markedly reduced, possibly because of schizont-stimulated up-regulation of CCR7, which is critical for PDC migration. The schizont-stimulated PDCs elicited a poor T cell response, but promoted γδ T cell proliferation and IFN-γ production. The schizont immune stimulatory effects could be reproduced using murine DCs and required the Toll-like receptor 9 (TLR9)-MyD88 signaling pathway. Although the only known TLR9 ligand is CpG motifs in pathogen DNA, the activity of the soluble schizont extract was far greater than that of schizont DNA, and it was heat labile and precipitable with ammonium sulfate, unlike the activity of bacterial DNA. These results demonstrate that schizont extracts contain a novel and previously unknown ligand for TLR9 and suggest that the stimulatory effects of this ligand on PDCs may play a key role in immunoregulation and immunopathogenesis of human falciparum malaria.

The ability of dendritic cells (DCs) to shape the adaptive immune response to viral infection is mediated largely by their maturation and activation state as determined by the surface expression of HLA molecules, costimulatory molecules, and cytokine production. Dengue is an emerging arboviral disease where the severity of illness is influenced by the adaptive immune response to the virus. In this report, we have demonstrated that dengue virus infects and replicates in immature human myeloid DCs. Exposure to live dengue virus led to maturation and activation of both the infected and surrounding, uninfected DCs and stimulated production of tumor necrosis factor alpha (TNF-␣) and alpha interferon (IFN-␣). Activation of the dengue virus-infected DCs was blunted compared to the surrounding, uninfected DCs, and dengue virus infection induced low-level release of interleukin-12 p70 (IL-12 p70), a key cytokine in the development of cell-mediated immunity (CMI). Dendritic cells (DCs) are bone marrow-derived cells that form a system of professional antigen-presenting cells and are an important component of the innate immune response. They are comprised of at least three distinct subpopulations, one in the lymphoid/plasmacytoid lineage and two in the myeloid lineage (1,20,26). Myeloid DCs are found in most nonlymphoid organs including the epidermis (Langerhans cells), dermis, gastrointestinal and respiratory mucosa, and the interstitia of vascular organs (37). Following the uptake and processing of antigen in the periphery, immature myeloid DCs differentiate to an activated/mature state and migrate to the T-cell-rich areas of lymphoid organs. Activated DCs are the unique stimulators of primary T-cell responses and potent stimulators of memory responses, and they produce an array of cytokines and chemokines (26,44,50,55). Thus, DCs are critical in the initiation of antimicrobial immunity, and they provide a crucial step in the development of adaptive immunity.Dengue is an emerging arboviral disease where the adaptive immune response plays a significant role in determining the severity of clinical illness. The dengue viruses are a group of four antigenically related mosquito-borne flaviviruses that produce a spectrum of clinical illness and significant morbidity throughout the tropics (30,35). Dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) represent the most severe and potentially life-threatening manifestations of a dengue viral infection. DHF/DSS is characterized by the rapid onset of plasma leakage and coagulopathy near the time of defervescence and viremia resolution. The most significant risk factor for the development of DHF/DSS is acquisition of a second, heterotypic dengue virus infection (3,11,13). During this second dengue virus infection, it is postulated that the preexisting, cross-reactive, adaptive immune response leads to excessive cytokine production, complement activation, and the release of other phlogistic factors which produce DHF/DSS. Both the humoral and cellular components of adaptive ...

Recent reports have demonstrated immune activation in dengue hemorrhagic fever (DHF) by cytokine and soluble receptor detection in blood. The goal of this study was to determine which cell types are activated and likely to be responsible for cytokine production. Whole blood specimens from 51 Thai children presenting within 72 h of fever onset and with detectable plasma dengue viral RNA were studied by flow cytometry. Absolute CD4 T cell, CD8 T cell, NK cell, and gammadelta T cell counts were decreased in children with DHF compared with those with dengue fever (DF) early in the course of illness. The percent of cells expressing CD69 was increased on CD8 T cells and NK cells in children who developed DHF more than in those with DF. These data directly demonstrate that cellular immune activation is present early in acute dengue and is related to disease severity.