Depletion of CD4+ T cells but not inhibition of the protective activity of IFN-gamma prevents cure of toxoplasmosis mediated by drug therapy in mice.
Toxoplasmosis is a frequent opportunistic infection in patients with AIDS. In these patients the major immune deficiencies are a severe depletion of CD4+ T lymphocytes and an impaired capacity to produce IFN-gamma. A mouse model was developed and used to study the effects that depletion of CD4+ T cells and/or inhibition of the protective activity of IFN-gamma have on the effectiveness of the drug therapy for toxoplasmosis. Infection of mice with a lethal inoculum of Toxoplasma gondii cysts followed by treatment with the hydroxynaphthoquinone 566C80 or with sulfadiazine resulted in 100% survival whereas untreated controls had 100% mortality within 15 days of infection. Administration of antiserum to IFN-gamma resulted in early death of untreated mice and in 30% mortality in those treated. Administration of mAb to CD4+ T cells followed by infection with T. gondii prevented the development of both antibody and cell-mediated immune responses against the parasite. These mice resisted the acute infection while undergoing specific treatment. Discontinuation of the treatment, however, resulted in reactivation of the infection and the majority of the animals died within 17 days of suspension of the treatment. Administration of antiserum to IFN-gamma or to CD4+ T cells 24 h but not 15 days after conclusion of the treatment also resulted in mortality. These results indicate that successful treatment of toxoplasmosis depends on the status of the immune system, particularly of CD4+ T cells. Although it is speculative to compare results obtained in mice to the situation in humans, our work suggests that restoration of a competent immune response is of crucial importance for a successful treatment of toxoplasmosis in immunocompromised individuals.
Research Institute, Palo Alto Medical Foundation, CA 94301.
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Araujo
D000818:Animals; D000913:Antibodies, Protozoan / Q000096:biosynthesis; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D053626:Atovaquone; D015496:CD4-Positive T-Lymphocytes / Q000502:physiology*; D004195:Disease Models, Animal; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006968:Hypersensitivity, Delayed / Q000473:pathology; D007111:Immunity, Cellular; D007371:Interferon-gamma / Q000502:physiology*; D008212:Lymphocyte Depletion / Q000009:adverse effects*; D051379:Mice; D009285:Naphthoquinones / Q000627:therapeutic use; D014124:Toxoplasmosis, Animal / Q000188:drug therapy* / Q000276:immunology; D017211:Treatment Failure
D000913:Antibodies, Protozoan; D000981:Antiprotozoal Agents; D009285:Naphthoquinones; D007371:Interferon-gamma; D053626:Atovaquone