Susceptibility of various animals to Pneumocystis carinii infection.

Pneumocystis carinii (Pc) is an important opportunistic pathogen of immune compromised hosts, and is known to infect various animals. The present study observed the infection status of 6 mammals and 3 strains of albino rats with Pc after suppression of their immunity. Methyl-prednisolone was injected once a week and tetracycline was supplied with water for 5 to 21 weeks. Hamsters, guinea pigs, rabbits, dogs, cats and pigs were negative by impression smear, and only the rats were found infected by Pc. All of the three strains of rats, Sprague-Dawley(SD), Wistar(W) and Fisher(F), were infected by Pc but W rats showed heavier degree of infection in earlier period than F or SD rats. The present findings suggest that W rat is the best among the animals used in the present study for production of Pc.     

Interstitial pneumonia in immunocompetent laboratory rats caused by natural infection with Pneumocystis carinii

Pneumocystis (P.) carinii is known to cause fatal pneumonia in immunocompromised rats. Cases of P. carinii interstitial pneumonia in immunocompetent rats have been shown histologically to present with perivascular lymphoid cuffs, which have previously been attributed to rat respiratory virus. This study aims to determine the prevalence and pathological characteristics of P. carinii in immunocompetent laboratory rats in experimental facilities in Japan. An epidemiological survey for this agent was performed using PCR to assess 1,981 immunocompetent rats from 594 facilities in Japan. We observed that 6 of the 1,981 rats (0.30%) from 4 out of 594 facilities (0.67%) were positive for P. carinii without infection of other known pathogens. Gross pulmonary lesions were found in 4 of the 6 affected rats. The lungs of these rats contained scattered dark red/gray foci. Histopathologically, the lungs exhibited interstitial pneumonia with lymphoid perivascular cuffs: Pneumocystis cysts were observed using Grocott’s methenamine silver stain. To our knowledge, this report is the first to reveal the prevalence of natural P. carinii infection in immunocompetent laboratory rats in Japan.     

Glucan Synthesis in Pneumocystis carinii

Rat-derived Pneumocystis carinii lysed with sodium deoxycholate catalysed the incorporation of uridine diphospho-glucose into an insoluble polymer. This enzyme activity was present in both the pellet and the supernatant when the P. carinii preparations were centrifuged. The polymer whose production was catalysed by the supernatant was examined by mass spectrometry and found to be an α 1→4 glucan, which is either unbranched or has relatively few branches. Polymer formation was completely inhibited by the addition of α amyloglucohydrolase to the supernatant. Polymer formation in the pellet of deoxycholate P. carinii preparations, unlike that in the supernatant, was partially resistant to α amyloglucohydrolase. The soluble glucan synthase activity in the supernatant was stable for more than 30 h at room temperature and was approximately 50 times more active on a cell-to-cell basis than the supernatant from deoxycholate preparations of the yeast Saccharomyces cerevisae.     

An improved rat model of Pneumocystis carinii pneumonia: induced infections in Pneumocystis-free animals.

An immunosuppressed rat model of Pneumocystis carinii pneumonia (PCP) is described that results in a predictable course of disease development which includes moderate P. carinii (Pc) infections in 2 to 3 weeks, heavy infections in 4 to 5 wk, and a high percentage of mortality due to PCP in 6 wk. The model also provides uninfected, immunosuppressed contemporary controls, an experimental compartment that is needed to correctly interpret results obtained from many different studies. Non-invasive intratracheal inoculation of cryopreserved parasites into Pc- and virus-free rats immunosuppressed by weekly injections of methylprednisolone are key features of the model that result in the development of consistent heavy Pc infections and very few secondary infections by bacteria and fungi. This model is useful for (1) maintaining isolates or strains of Pc over time, (2) producing large numbers of parasites for laboratory studies, and (3) evaluating the anti-Pc activity of experimental compounds and approved drugs.     

Developmental biology of Pneumocystis carinii, and alternative view on the life cycle of the parasite.

In this paper we present, based on elaborate ultrastructural studies, data on the existence of both intracellular and extracellular stages of Pneumocystis carinii, which result in a proposal of a new life cycle of the parasite. Up to now the formation of daughter cells in thick-walled pneumocysts is supposed to be the only way of multiplication. The present study shows that in rats treated with cortisone acetate the formation of daughter cells also takes place within thin-walled pneumocysts. In our opinion this way of multiplication is important for the understanding of the rapid increase in number of the parasites in an infected lung. The presence of pneumocysts inside the alveolar epithelial cells suggests that intracellular development of the parasites can occur, but the method of cell penetration, intracellular multiplication and parasite liberation is still unknown. Moreover our observations for the first time indicate a direct pathogenicity of the parasites in host cells.     

Diagnosis of Pneumocystis carinii pneumonia

Pneumocystis carinii is the prime opportunistic pathogen of our time, the leading cause of fatal pneumonia in the increasing number of immunosuppressed subjects encountered on oncology and transplant programmes' and in subjects with the acquired immuno-deficiency syndrome (AIDS).     

Immunopathogenesis of Pneumocystis carinii pneumonia

Pneumocystis carinii pneumonia (PCP) is a life-threatening infection that occurs in immunocompromised individuals, particularly those with advanced human immunodeficiency virus (HIV) infection. Interestingly, morbidity and mortality is related to the underlying cause of immunosuppression, with AIDS patients faring better than oncology patients for example. In addition, the prognosis of PCP has been correlated with markers of inflammation rather than with organism numbers. There is now increasing evidence that lung damage occurring during PCP is a result of the type and extent of the host inflammatory response to P. carinii rather than a result of direct damage by the organism. This review will discuss the experimental and clinical data demonstrating how the host-mediated inflammatory response to infection with P. carinii determines the ultimate outcome of PCP. A better understanding of the pathophysiology of PCP should lead to the development of improved therapies for the treatment of PCP.