树突细胞与新生隐球菌

新生隐球菌( Cn) 是临床上重要的病原真菌, 树突细胞( DC) 则是最重要的抗原呈递细胞。作为宿主固有免疫和适应性免疫的联系枢纽,DC 对于识别病原、呈递抗原、诱导宿主免疫应答十分重要。许多研究证明,DC 可通过细胞表面的多种受体有效识别新生隐球菌抗原( CnAg) , 诱导宿主产生有效的细胞免疫应答。DC 本身也有一定的杀菌能力, 但DC 的不同亚群以及成熟状态对宿主的免疫防御功能有重要影响。另外, 隐球菌除具有甘露糖蛋白等主要免疫显性抗原外, 还有多种抑制机体保护性免疫应答的毒性因子。本文就近年来国内、外对两者之间复杂机制的研究进行概述。     

艾滋病合并新生隐球菌感染的研究进展

新生隐球菌感染是全世界艾滋病患者死亡的主要原因,尤其是在撒哈拉以南非洲地区发病率最高[1]。新生隐球菌除了容易感染HIV个体外,还易感染其他免疫功能低下的个体,如造血系统恶性肿瘤、器官移植后服用免疫抑制剂及免疫缺陷病患者。格特隐球菌主要侵犯免疫功能正常的个体,但也感染免疫功能低下患者如合并艾滋病毒的患者[2]。     

肾移植与隐球菌感染

肾移植是目前开展最广泛的器官移植项目,由于免疫抑制剂及糖皮质激素的大量使用,肾移植术后的真菌感染已经成为一个重要医学课题。隐球菌病是器官移植患者常见的深部真菌感染,本文对肾移植术后发生隐球菌感染的易感因素、临床表现以及治疗和预防等方面做一论述。     

抗病毒免疫和自身免疫中的浆细胞样树突状细胞

浆细胞样树突状细胞(pDCs)是一类重要的免疫细胞,在病毒感染应答中产生大量的Ⅰ型干扰素.pDCs通过特异性表达TLR7和TLR9识别病毒核酸,成为专职的Ⅰ型干扰素产生细胞.pDCs产生的Ⅰ型干扰素可以直接抑制病毒复制,同时使pDCs成为连接先天性免疫和获得性免疫的桥梁.由Toll样受体识别自身核酸导致的pDCs的异常活化,以及由此持续产生Ⅰ型干扰素的现象普遍发生在一些自身免疫性疾病中.在病毒感染性和自身免疫性疾病的治疗过程中,pDCs可以作为调控免疫系统的重要靶点发挥作用.     

隐球菌感染的免疫疗法

隐球菌属属于担子菌门一冬孢菌纲一黑粉菌目一黑粉菌科,包括37个不同种[1],其中能对人类致病的主要是新生隐球菌和格特隐球菌,而其他变种如罗伦隐球菌、浅白隐球菌等几乎不感染人类[2]。新生隐球菌感染好发于免疫低下的人群,包括HIV感染、接受实体器官移植以及接受其他免疫抑制剂治疗的人群。与新生隐球菌相反的是,格特隐球菌多发生在免疫正常的人群[3]。     

隐球菌形态学变化及其致病机制

致病真菌在与宿主相互作用过程中可能发生形态学变化,如菌丝形成.这种形态学变化有利于病原菌适应不同的外界环境,使其在宿主体内生存.外有荚膜包裹的隐球菌是隐球菌病的致病真菌.该菌可通过孢子吸人方式侵入宿主体内,其后又能通过增加自身荚膜厚度和形成巨大菌体来抵抗和逃避宿主的免疫防御功能.对隐球菌形态学变化意义的理解,有助于了解该病的致病机制,从而推动临床诊治发展.     

肺隐球菌病12例临床分析

目的 提高对隐球菌病的认识.方法 对确诊为肺隐球菌病的12例病例的临床资料进行回顾性分析.结果 12例病例中,男性8例,女性4例,年龄31～68岁,平均年龄(51.8±12.6)岁,6例伴有基础疾病,但无1例有鸟类接触史;有临床症状者10例,其中咳嗽8例,咯痰3例,胸痛4例,发热2例,有体征者仅2例;胸部影像表现为:1...     

伏立康唑治疗隐球菌病的研究进展

伏立康唑是新型的三唑类抗真菌药,现对隐球菌体外药敏试验、动物实验以及治疗隐球菌病的临床应用作一综述.     

隐球菌感染诊治专家共识

1简介 隐球菌属在真菌分类学上归人半知菌亚门、芽孢菌纲、隐球酵母目、隐球酵母科,引起人类感染的隐球菌主要是新生隐球菌和格特隐球菌。两种隐球菌的无性繁殖体均为无菌丝的单芽孢酵母样菌,在体外为无荚膜或仅有小荚膜,进入人体内后很快形成厚荚膜,有荚膜的隐球菌菌体直径明显增加,致病力明显增强。     

Human plasmacytoid dendritic cells express an atrial natriuretic peptide receptor, guanylyl cyclase-A

Atrial natriuretic peptide is a cardiovascular hormone secreted mainly by the cardiac atria and regulates the volume–pressure homeostasis. The action of ANP is mediated by GC-A. We previously reported that human monocyte-derived dendritic cells express GC-A and respond to ANP with polarization toward a Th2-inducing phenotype. In the present study, we explored the possibility that pDC are subjected to immunoregulation via the ANP/GC-A system. We examined GC-A expression on blood pDC and found that GC-A was not expressed on fresh pDC but was induced after stimulation with CpG-oligodeoxynucleotide AAC-30, IL-3, or interleukin-3 plus CD40 ligand. Activated pDC responded to ANP with an increase in cGMP production, indicating that GC-A expressed on pDC was functional. We investigated whether tonsillar pDC express GC-A by immunohistochemistry and immunofluorescence staining. We found that GC-A⁺ HLA-DR⁺ cells were present in the T-cell areas and the perivascular areas. Flow cytometric analysis with tonsillar cells confirmed that lineage⁻ CD123^high pDC express GC-A. These results indicate that the ANP/GC-A system is involved in immune regulation through pDC in secondary lymphoid organs.     

Molecular dissection of plasmacytoid dendritic cell activation in vivo during a viral infection

Plasmacytoid dendritic cells (pDC) are the major source of type I interferons (IFN‐I) during viral infections, in response to triggering of endosomal Toll‐like receptors (TLRs) 7 or 9 by viral single‐stranded RNA or unmethylated CpG DNA, respectively. Synthetic ligands have been used to disentangle the underlying signaling pathways. The adaptor protein AP3 is necessary to transport molecular complexes of TLRs, synthetic CpG DNA, and MyD88 into endosomal compartments allowing interferon regulatory factor 7 (IRF7) recruitment whose phosphorylation then initiates IFN‐I production. High basal expression of IRF7 by pDC and its further enhancement by positive IFN‐I feedback signaling appear to be necessary for robust cytokine production. In contrast, we show here that in vivo during mouse cytomegalovirus (MCMV) infection pDC produce high amounts of IFN‐I downstream of the TLR9‐to‐MyD88‐to‐IRF7 signaling pathway without requiring IFN‐I positive feedback, high IRF7 expression, or AP3‐driven endosomal routing of TLRs. Hence, the current model of the molecular requirements for professional IFN‐I production by pDC, established by using synthetic TLR ligands, does not strictly apply to a physiological viral infection.     

Modulation of respiratory dendritic cells during Klebsiella pneumonia infection

Background

Klebsiella pneumoniae is a leading cause of severe hospital-acquired respiratory tract infections and death but little is known regarding the modulation of respiratory dendritic cell (DC) subsets. Plasmacytoid DC (pDC) are specialized type 1 interferon producing cells and considered to be classical mediators of antiviral immunity.

Method

By using multiparameter flow cytometry analysis we have analysed the modulation of respiratory DC subsets after intratracheal Klebsiella pneumonia infection.

Results

Data indicate that pDCs and MoDC were markedly elevated in the post acute pneumonia phase when compared to mock-infected controls. Analysis of draining mediastinal lymph nodes revealed a rapid increase of activated CD103⁺ DC, CD11b⁺ DC and MoDC within 48 h post infection. Lung pDC identification during bacterial pneumonia was confirmed by extended phenotyping for 120G8, mPDCA-1 and Siglec-H expression and by demonstration of high Interferon-alpha producing capacity after cell sorting. Cytokine expression analysis of ex vivo-sorted respiratory DC subpopulations from infected animals revealed elevated Interferon-alpha in pDC, elevated IFN-gamma, IL-4 and IL-13 in CD103⁺ DC and IL-19 and IL-12p35 in CD11b⁺ DC subsets in comparison to CD11c⁺ MHC-class II^low cells indicating distinct functional roles. Antigen-specific naive CD4⁺ T cell stimulatory capacity of purified respiratory DC subsets was analysed in a model system with purified ovalbumin T cell receptor transgenic naive CD4⁺ responder T cells and respiratory DC subsets, pulsed with ovalbumin and matured with Klebsiella pneumoniae lysate. CD103⁺ DC and CD11b⁺ DC subsets represented the most potent naive CD4⁺ T helper cell activators.

Conclusion

These results provide novel insight into the activation of respiratory DC subsets during Klebsiella pneumonia infection. The detection of increased respiratory pDC numbers in bacterial pneumonia may indicate possible novel pDC functions with respect to lung repair and regeneration.     

Plasmacytoid dendritic cells in antiviral immunity and autoimmunity

Plasmacytoid dendritic cells (pDCs) represent a unique and crucial immune cell population capable of producing large amounts of type I interferons (IFNs) in response to viral infection. The function of pDCs as the professional type I IFN-producing cells is linked to their selective expression of Toll-like receptor 7 (TLR7) and TLR9, which sense viral nucleic acids within the endosomal compartments. Type I IFNs produced by pDCs not only directly inhibit viral replication but also play an essential role in linking the innate and adaptive immune system. The aberrant activation of pDCs by self nucleic acids through TLR signaling and the ongoing production of type I IFNs do occur in some autoimmune diseases. Therefore, pDC may serve as an attractive target for therapeutic manipulations of the immune system to treat viral infectious diseases and autoimmune diseases.     

Maturation of function in dendritic cells for tolerance and immunity

The capacity of antigen presenting dendritic cells (DC) to function in both tolerance and immunity is now well documented. The function and characteristics of different DC subsets are reviewed here and their capacity to activate T cells under different conditions of maturation and activation is discussed. The immunogenic potential of exosomes produced by DC is also considered in light of evidence that the capacity of exosomes to activate T cells for tolerance or immunity appears to mirror that of the parent DC. A model is proposed whereby exosomes produced by immature DC can function to maintain peripheral tolerance, while exosomes produced by more mature DC can stimulate effector T cells.     

Regulation of TLR7/9 signaling in plasmacytoid dendritic cells

Plasmacytoid dendritic cells (pDCs), also known as type I interferon (IFN)-producing cells, are specialized immune cells characterized by their extraordinary capabilities of mounting rapid and massive type I IFN response to nucleic acids derived from virus, bacteria or dead cells. PDCs selectively express endosomal Toll-like receptor (TLR) 7 and TLR9, which sense viral RNA and DNA respectively. Following type I IFN and cytokine responses, pDCs differentiate into antigen presenting cells and acquire the ability to regulate T cell-mediated adaptive immunity. The functions of pDCs have been implicated not only in antiviral innate immunity but also in immune tolerance, inflammation and tumor microenvironments. In this review, we will focus on TLR7/9 signaling and their regulation by pDC-specific receptors.     

The avidity of tumor‐specific T cells amplified by a plasmacytoid dendritic cell‐based assay can predict the clinical evolution of melanoma patients

The advent of immune checkpoint blockers and targeted therapies has changed the outcome of melanoma. However, many patients experience relapses, emphasizing the need for predictive and prognostic biomarkers. We developed a strategy based on plasmacytoid dendritic cells (pDCs) loaded with melanoma tumor antigens that allows eliciting highly efficient antitumor T‐cell responses. We used it to investigate antitumor T‐cell functionality in peripheral blood mononuclear cells and tumor‐infiltrating lymphocytes from melanoma patients. The pDCs elicited tumor‐specific T cells in different proportions and displaying diverse functional features, dependent upon the stage of the disease, but independent of the histological parameters at diagnosis. Strikingly, the avidity of the MelA‐specific T cells triggered by the pDCs was found to predict patient relapse time and overall survival. Our findings highlighted unexplored aspects of antitumor T‐cell responsiveness in melanoma, and revealed for the first time the structural avidity of tumor‐specific T cells as a crucial feature for predicting clinical evolution.     

Plasmodium infection cure cycles induce modulation of conventional dendritic cells

Malaria is one of the most widespread human infectious diseases worldwide and a cause of mortality. It is difficult to induce immunological memory against the malarial parasite Plasmodium. The immunity to clinical malaria disease is acquired with multiple infection and treatment cycles, along with substantial reduction in parasite burden. However, the mechanism of the acquired immunity remains largely unclear. Conventional DCs (cDCs) play a pivotal role in orchestration of immune responses. The purpose of this study is to analyze the characterization of cDCs after the infection and cure treatment cycles. Mice were infected with the lethal rodent malarial parasite Plasmodium berghei ANKA, which was followed by cure treatment with the antimalarial drug pyrimethamine. This was then followed by a challenge with live parasites. The mice that went through infection cure cycles showed significant immune response, demonstrating robust immunological memory against malaria parasites. We investigated the cytokine production capacity of splenic cDCs in both naive and infection cure mice by stimulating purified splenic cDCs with LPS (TLR4 agonist) or CpG (TLR9 agonist). The capacity of cytokine production was found to be significantly decreased in infection cure mice. The suppression of cytokine production was sustained for a long term (6 months). Moreover, the surface expression of MHC Class II molecules was significantly lower in infection cure mice than in naive mice. These results suggest that Plasmodium infection and cure treatment resulted in strong immunological memory and modulation of full functionality of cDCs.     

Identification of dendritic cell subsets responding to genital infection by Chlamydia muridarum

Dendritic cells (DCs) are central for the induction of T-cell responses needed for chlamydial eradication. Here, we report the activation of two DC subsets: a classical CD11b+ (cDC) and plasmacytoid (pDC) during genital infection with Chlamydia muridarum . Genital infection induced an influx of cDC and pDC into the genital tract and its draining lymph node (iliac lymph nodes, ILN) as well as colocalization with T cells in the ILN. Genital infection with C. muridarum also stimulated high levels of costimulatory molecules on cDC central for the activation of naïve T cells in vivo . In contrast, pDC expressed low levels of most costimulatory molecules in vivo and did not secrete cytokines associated with the production of T helper (Th)1 cells in vitro . However, pDC upregulated inducible costimulatory ligand expression and produced IL-6 and IL-10 in response to chlamydial exposure in vitro . Our findings show that these two DC subsets likely have different functions in vivo . cDCs are prepared for induction of antichlamydial T-cell responses, whereas pDCs have characteristics associated with the differentiation of non-Th1 cell subsets.     

Donor lung derived myeloid and plasmacytoid dendritic cells differentially regulate T cell proliferation and cytokine production

Background

Direct allorecognition, i.e., donor lung-derived dendritic cells (DCs) stimulating recipient-derived T lymphocytes, is believed to be the key mechanism of lung allograft rejection. Myeloid (cDCs) and plasmacytoid (pDCs) are believed to have differential effects on T cell activation. However, the roles of each DC type on T cell activation and rejection pathology post lung transplantation are unknown.

Methods

Using transgenic mice and antibody depletion techniques, either or both cell types were depleted in lungs of donor BALB/c mice (H-2^d) prior to transplanting into C57BL/6 mice (H-2^b), followed by an assessment of rejection pathology, and pDC or cDC-induced proliferation and cytokine production in C57BL/6-derived mediastinal lymph node T cells (CD3+).

Results

Depleting either DC type had modest effect on rejection pathology and T cell proliferation. In contrast, T cells from mice that received grafts depleted of both DCs did not proliferate and this was associated with significantly reduced acute rejection scores compared to all other groups. cDCs were potent inducers of IFNγ, whereas both cDCs and pDCs induced IL-10. Both cell types had variable effects on IL-17A production.

Conclusion

Collectively, the data show that direct allorecognition by donor lung pDCs and cDCs have differential effects on T cell proliferation and cytokine production. Depletion of both donor lung cDC and pDC could prevent the severity of acute rejection episodes.