After vaccination with tetanus toxoid (TT), TT-specific immune responses in humans infected with Schistosoma mansoni were assessed. Peripheral blood mononuclear cells (PBMC) from vaccinated infected subjects and vaccinated uninfected controls were evaluated for their ability to produce cytokines characteristic of Th1 or Th2 cells (interferon [IFN]-gamma or interleukin [IL]-4, respectively) after in vitro restimulation with TT. TT-specific IFN-gamma production by PBMC from infected subjects was inversely related to infection intensity and was significantly lower than TT-specific IFN-gamma production by control PBMC. PBMC from all of the infected subjects and 3 of the 5 controls analyzed by reverse transcriptase-polymerase chain reaction transcribed the IL-4 gene in response to TT restimulation. Together, these results suggest that S. mansoni-infected persons mount a Th2-like response to the bystander antigen TT, while uninfected persons mount a Th1- or Th0-like response.

SummaryThe initial immune response to &histosoma mansoni eggs presumably results in IL-4 production, as schistosome eggs are strong Th2-inducing antigens and the differentiation of antigen-specific Th2 cells is largely dependent on the presence of IL-4 during priming of naive Th cells. Consistent with this concept, mtraperitoneal injection of mice with schistosome eggs results in an upregulation of IL-4 production by peritoneal exudate cells (PECs) within 12 h. Egg-induced IL-4 is rapidly bound by its receptor, suggesting that this cytokine is utilized by a cell type present at the site of antigen deposition or is complexed to soluble receptor. The peak of early IL-4 production is accompanied by a local eosinophilia and the apparent disappearance of mast cells. Studies utilizang either IL-4, IL-5, or mast cell-deficient mice indicate that the eosinophilia is dependent on mast cells and IL-5 and independent of IL-4. Strikingly, egg-induced IL-4 producnon as absent in animals lacking the early peritoneal eosmophilia. Immunocytochemical analysis of PEC following egg injecnon indicates that the eosinophils themselves make IL-4. These data strongly suggest that egg-induced IL-5 plays an essential role in recruiting eosinophils to the site of antigen deposition and that it is these eosinophils that then directly produce early IL-4.

The lymphocyte proliferative response and cytokine production to S. mansoni antigen in vitro were evaluated in 22 schistosomiasis patients living in an area endemic for this disease. The majority of patients (86%) showed no lymphocyte proliferative response and none of them showed interferon-gamma (IFN-gamma) production, following in vitro stimulation with soluble adult worm antigen preparation (SWAP). In contrast, interleukin (IL)-5 (2038 +/- 1757 pg/ml) and IL-10 (867 +/- 762 pg/ml) were detected in peripheral blood mononuclear cell (PBMC) cultures stimulated with SWAP. Moreover, mRNA for IL-4 was detected in SWAP-stimulated PBMC from 4 of 6 patients evaluated. Restoration of lymphoproliferative response was achieved in 4 of 6 patients by adding anti-IL-10 monoclonal antibody (mAb) to PBMC cultures [mean stimulation index (SI) in the presence of antigen = 2.7 +/- 2.9; SI in the presence of antigen plus anti-IL-10, 21 +/- 16]. Restoration of IFN-gamma production by addition of anti-IL-10 mAb was achieved in 4 of 12 patients evaluated (248, 350, 687 and 710 pg/ml). Moreover, the addition of IL-10 to PBMC cultures of 3 schistosomiasis patients and 2 cured subjects who had high lymphoproliferative responses to SWAP resulted in the suppression of these responses by 90%, and completely suppressed IFN-gamma production in one of the subjects, whose PBMC produced IFN-gamma after stimulation with SWAP. The presence of IL-4 mRNA, high levels of IL-5, and the absence of IFN-gamma in PBMC culture supernatants from infected patients, supports the conclusion that patients living in an endemic area of schistosomiasis express a predominant T helper type 2 response. The high levels of IL-10 and the ability of neutralizing anti-IL-10 mAb to restore T cell responses indicate that this cytokine plays an important role in the modulation of T cell responses in schistosomiasis.

McKenzie RC, Sabin E. Aberrant signalling and transcription factor activation as an explanation for the defective growth control and differentiation of keratinocytes in psoriasis: a hypothesis. Exp Dermatol 2003: 12: 337-345. # Blackwell Munksgaard, 2003 Abstract: Psoriasis is a chronic inflammatory skin disease characterized by the accumulation of red, scaly plaques on the skin. The plaques result from hyperproliferation and incomplete differentiation of keratinocytes (KC) in a process that seems to be driven, in part by skin-infiltrating leucocytes. We believe that the KC have inherent defects in intracellular signalling which could be usefully targeted to allow the development of more effective therapies. We suggest that there are defects in the regulation of the transcription factors: signal transducer and activator of transcription (STAT-1a), interferon regulated factor-1 (IRF-1) and NFkB which lead to loss of growth and differentiation control when the cells are subjected to physico-chemical and immunological stress. We also highlight recent studies that suggest that peroxisome proliferatoractivated receptors, the notch receptor and defects in calcium and other ion transporting proteins may contribute to impairment in the ability of psoriatic KC to differentiate. The role of these systems in the development of the psoriatic phenotype and tests of these hypotheses are proposed.