A malária permanece um sério problema de saúde em países subdesenvolvidos. O estágio sanguíneo da infecção é responsável por todos os sintomas associados com a malária. Recentemente, tem sido mostrado que receptores imunes inatos são capazes de detectar sinais de dano, tais como a adenosina trifosfato ATP. O receptor P2X7 detecta altas concentrações de ATP extracelular. Ao avaliarmos a parasitemia e os parâmetros clínicos da doença em camundongos C57BL/6 e P2X7-/-, observamos uma semelhança em ambos os grupos até o dia 7 p.i., mas após este período os camundongos P2X7-/- tiveram dificuldade de controlar a parasitemia e restaurar os parâmetros clínicos. O ineficiente controle da parasitemia durante o período agudo e crônico em camundongos P2X7-/- foi associado com a baixa produção de IFNγ. Além disso, o receptor P2X7 aumenta a expressão de T-bet em células Th1 e controla o número de células Tfh. Este estudo mostra que o equilíbrio mediado pelo receptor P2X7 entre os fatores de transcrição Bcl-6 e T-bet ajusta a imunidade celular e humoral na malária. / Malaria remains a serious healthcare problem in developing countries. The blood stage of infection is responsible for all symptoms associated with malaria. Recently, it has been shown that innate immune receptors are able to detect signals as adenosine triphosphate (ATP). P2X7 receptor detects high levels of extracellular ATP. Evaluating the parasitemia and clinical parameters in C57BL/6 (B6) and P2X7-/- mice, we observed a similarity in both groups to day 7 p.i., but after this period the P2X7-/- mice had difficulty in controlling the parasitemia and restoring the clinical parameters. The inefficient parasite control in acutely and chronically infected P2X7-/- mice was associated with low production of IFNγ. Furthermore, P2X7 receptor increases the expression of T-bet in Th1 cells and controls the Tfh cell number. This study provides a new insight into immunology by showing that the balance between T-bet and Bcl-6 transcriptional factors tunes the cellular and humoral immunity in malaria.

Durante a ativação policlonal induzida pelo P. chabaudi a maior fonte de IL-2 são as células CD4+ ativadas, além disso, acorre a expansão de células Treg. No dia 7 após a infecção, a ausência de células Treg leva a uma exacerbação da ativação de células CD4+, além de altos níveis de anticorpos anti-P.chabaudi e auto-anticorpos. A neutralização da IL-2, com Mab anti-IL-2 JES6-1, na fase aguda da infecção leva a uma redução no número de células Treg. No dia 20 de infecção, a freqüência de células CD4+ ativadas esteve elevada e as células Treg voltaram aos níveis basais. Experimentos in vitro mostraram que a neutralização da IL-2 não altera a proliferação antígeno-específica de células CD4+ da fase aguda da infecção, porém, em tempos tardios da infecção houve um drástico aumento na freqüência de células CD4+ que proliferam em resposta a eritrócitos parasitados. Podemos concluir que a IL-2 e as células Treg são capazes de limitar a ativação policlonal induzida pelo P. chabaudi ainda que com cinéticas distintas. / Polyclonal activation during P. chabaudi infection results on a huge IL-2 production by activated CD4+ T cells, besides a considerable expansion of Treg cells. At day 7 after infection in the absence of Treg cells there is an enhanced response of activated CD4+ T cells, an increase of Abs anti-P.chabaudi and autoantibody production. Neutralization of IL-2 with Mab anti-IL2 JES6-1 during acute infection reveals a markedly reduction in Treg-cells number. At day 20 of infection we can observe an increase on activated CD4+ T cells frequency. Moreover, Treg cells return to values similar to controls. IL-2 in vitro assays during acute infection results on Ag-specific CD4+ T cells proliferation, on the other hand, at the late infection, we observed a huge increase of CD4+ T cells frequency that strongly response to PRBC. Our findings suggest that IL-2 and Treg cells are capable of restricting PLA during P.chabaudi infection, although with different kinetics.

Naturally-occurring CD4+Foxp3+ regulatory T cells (nTreg) play a central role in maintaining immune self-tolerance as well as modulating immunity towards pathogens. Pathogens may establish chronic infections in immunocompetent hosts by engaging nT reg in order to promote immunosuppression. The goal of the research described here is to test the hypothesis that nTreg modulate protective immunity to malaria, and consequentially affect susceptibility to the parasite. To investigate this question, the functional dynamics of CD4+Foxp3 + nTreg cells were evaluated in mice infected with blood-stage Plasmodium chabaudi AS. Adoptive transfer of nTreg to infected wild-type C57BL/6 (B6) mice or infection of transgenic B6 mice over-expressing Foxp3 resulted in increased parasitemia and reduced survival compared to control mice. Moreover, while resistant B6 mice exhibited decreased splenic nT reg frequencies at day 7 post infection, susceptible A/J mice maintained high numbers of nTreg at this time. Investigation of the effects of nTreg regulation on immune cell function in P. chabaudi AS-infected mice revealed that increased nTreg frequencies led to decreased malaria-specific lymphoproliferation and increased systemic levels of IL-10. Unlike B6 mice, increased splenic nTreg frequencies in infected A/J mice correlated with decreased effector T cell proliferation and IFN-gamma secretion, decreased B cell and NK cell proliferation as well as deficient IFN-gamma secretion by NK cells. Finally, nTreg proliferated within infected sites in both B6 and A/J mice, albeit to a greater extent in susceptible A/J mice. Altogether, these results demonstrate that nTreg suppressed anti-malarial immunity, and in turn promoted parasite growth and persistence.

The kinetics of production and role of tumor necrosis factor-alpha (TNF-$ alpha$) and nitric oxide (NO) during the early phase of blood-stage infection with Plasmodium chabaudi AS were investigated using two inbred strains of mice which differ in the level of resistance to this parasite. Analysis of the in vivo expression of TNF-$ alpha$ and inducible nitric oxide synthase (iNOS) revealed that, early during infection, resistant C57BL/6 mice, which clear the infection by 4 weeks, have higher levels of TNF-$ alpha$ and iNOS mRNA in the spleen and TNF-$ alpha$ mRNA in the liver than susceptible A/J mice which succumb to the disease 10 days after initiation of infection. Moreover, resistant mice expressed high levels of IFN-$ gamma$ (a Th1 marker) and low levels of IL-4 (a Th2 marker) mRNA in the spleen, whereas susceptible A/J mice had low levels of IFN-$ gamma$ but high levels of IL-4 mRNA in the spleen early during infection. Increased levels of NO$ sb3 sp-$ were detected in serum of resistant C57BL/6 mice only at the time of peak parasitemia. Furthermore, treatment of resistant C57BL/6 mice with anti-IFN-$ gamma$ and anti-TNF-$ alpha$ monoclonal antibody demonstrated that TNF-$ alpha$, either alone or in synergy with IFN-$ gamma$, plays a major role in the up-regulation of NO production during P. chabaudi AS malaria. Moreover, treatment with the iNOS inhibitor aminoguanidine, eliminated resistance of these mice to infection with P. chabaudi AS without affecting parasitemia, suggesting that NO may not be involved in parasite killing in vivo. Taken together, these results demonstrate that a Th1-associated increase in TNF-$ alpha$ early during infection, as occurs in resistant mice, leads to the up-regulation of NO production which is crucial for survival of the host. On the other hand, our results also suggest that a Th2 response, as occurs in susceptible mice, does not result in protective levels of TNF-$ alpha$ and NO. However, susceptible A/J mice were found to

Severe anemia is the most prevalent life-threatening complication of malaria infection. In addition to destruction of red blood cells (RBC), decreased RBC production or erythropoietic suppression has been shown to contribute to malarial anemia. The mechanism of this suppression is unknown, but it is considered to be multifactorial since erythropoietic suppression can be observed in the presence of both inflammatory mediators and parasite-derived factors. Experiments presented in this thesis aimed at determining the role of host cytokines released in response to blood-stage malaria infection and parasite-derived factors in erythropoietic suppression underlying the development of malarial anemia. Pro-inflammatory cytokines released during malaria infection have been proposed to play a central role in erythroid suppression. To dissect the discrete roles of these cytokines in the processes leading to anemia, mice were treated with CpG-oligodeoxynucleotides (CpG-ODN) which, like malaria infection in humans and experimental mouse models, induces an acute type 1 pro-inflammatory response. CpG-ODN treatment induced anemia, which was associated with suppressed erythropoiesis and reduced RBC survival. Importantly, CpG-ODN-induced IFN-gamma was found to be the major factor mediating erythropoietic suppression but not decreased RBC survival. We also studied the roles of Th1, Th2 and anti-inflammatory cytokines produced in response to Plasmodium chabaudi AS infection in the development of erythropoietic suppression during blood-stage malaria. Signal transducer and activator of transcription (STAT)6, required for signaling of the Th2 cytokines IL-4 and IL-13, was shown to play a critical role in malarial anemia by inhibiting the proliferation and differentiation of erythroid cells. We also observed that suppressed erythropoiesis is a general feature in mice infected with various rodent Plasmodium species that differ in their clinical manifestations and immune responses. Since parasite-derived factors have been shown to contribute to malarial pathogenesis including anemia, the contribution of P. falciparum - and P. yoelii-derived products to erythropoietic suppression was investigated. Both Plasmodium-derived and synthetic hemozoin (Hz) suppressed the proliferation but not the maturation of erythroid progenitor cells in vitro. However, P. yoelii-derived Hz but not synthetic Hz induced transient anemia in mice. These findings provide novel insights into the complex interactions between the parasite and host immune system and the regulation of erythropoiesis during severe malarial anemia.

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A exposição limitada ao Plasmodium chabaudi induz proeminente imunidade celular, associada à proteção de células T da apoptose. Este estudo tem como objetivo verificar a influência da carga parasitária na geração e manutenção dos linfócitos T e B de memória ao P. chabaudi. Assim, camundongos C57BL/6 foram submetidos à infecção tratada (subpatente) ou não (patente) com cloroquina após a inoculação de 106 eritrócitos parasitados (EP) e analisados nos dias 0, 20, 60, 120 e 200. Com relação à memória de linfócitos T, no dia 20, as freqüências de células CD4+ memória/ativadas e respondedoras aos EP foram significativamente maiores nos animais do grupo subpatente. Os níveis máximos de IgG2a específica foram encontrados no dia 120 em ambos os grupos. O desafio dos animais com 108 EP mostrou que a imunidade protetora declina progressivamente, mas os grupos ainda são capazes de estabelecer resposta secundária eficiente que elimine o parasita. Assim, podemos concluir que a carga parasitária influencia a fase aguda, mas não impede a geração e manutenção das células T e B de memória. / One of the main characteristics of malaria is the intense policlonal activation of splenic T and B lymphocytes induced by the parasite and the consequent elimination, through apoptosis, of part of these cells. However, the limited exposure to the bloodstage malaria seems to induce a prominent cellular immunity, associated with the protection of T lymphocytes from apoptosis. With this in mind, this study aimed to verify the influence of the parasite load in the generation and maintenance of memory T and B cells specific for Plasmodium chabaudi chabaudi AS. In order to evaluate this idea, C57BL/6 mice were infected with 106 parasitized red blood cells (pRBC) and submitted to a patent (untreated) or subpatent infection (controlled with sub-curative doses of chloroquine every time parasitemia reached 1%). Splenocytes from these mice were analyzed at 20, 60, 120 and 200 days after infection, regarding the pRBC-specific T cell proliferation and the expression of surface molecules, as CD4, CD8, CD62L, CD45RB, CD44, CD45R-B220 and IgG. The parasitemia and the splenocyte phenotype were also monitored after the challenge with 108 pRBC. Regarding T cell memory, at day 20 of infection, the frequencies of effector/activated CD4+ T cells (CD62LLOW CD45RBLOW/HIGH) were significantly increased in animals from the patent group, which was strict linked with the highest cellular activation observed in these animals. On the other hand, the total numbers of pRBCproliferating T (CD4+ and CD8+) cells per spleen were approximately 3-fold increased in subpatent animals, indicating that these cells were protected from apoptosis as a result of the limited exposure to the parasite. However, in both groups, these parameters decreased to values similar to those in controls at day 200. The splenocytes from both groups produced Th1 cytokines in response to pRBC in all times of analysis, but at the early phase of infection, Th2 cytokines were also observed, but without differences between the infected groups. Regarding memory B cells, the frequency of sIgG+ cells was increased at day 20 of infection, when 11% and 9% of CD45R+ cells from patent and subpatent animals were positive, respectively. For both groups, specific IgG2a antibodies attained maximum serum levels at day 120, but at day 200, it is possible to observe a significant decrease of these levels only in the serum of patent mice. Moreover, at day 200 of infection, mice of subpatent group showed significantly higher amounts of IgG2a that recognized the intra-erythrocytic forms of the parasite and the surface of infected erythrocytes. Challenge of mice with 108 pRBC showed that protective immunity progressively decline with time and despite the higher levels of specific antibody in subpatent mice, both groups showed similar protection. In experiments of adoptive transference to CD28-/- mice, cells from 200-day infected mice were able to produce specific IgG2a antibodies, in a T CD4+ cell dependent way. In addition, we verified that CD45R+ cells of subpatent mice, when transferred to CD28-/- mice, secreted higher amounts of specific IgG2a and IgG1 antibodies, comparing to cells of patent mice. So, from this work, we can conclude that the parasite load has a great influence in the early immune response to P. chabaudi malaria and it also affects the generation and/or maintenance of memory B cells. Furthermore, according to our data, at least during the analyzed period, the loss of protective immunity against this parasite does not seem to be influenced by the acute-phase parasite load, but it can be a consequence of the progressive decline of T-cell memory response that occurs in patent and subpatent groups with time of infection.

A exposição limitada ao Plasmodium chabaudi induz proeminente imunidade celular, associada à proteção de células T da apoptose. Este estudo tem como objetivo verificar a influência da carga parasitária na geração e manutenção dos linfócitos T e B de memória ao P. chabaudi. Assim, camundongos C57BL/6 foram submetidos à infecção tratada (subpatente) ou não (patente) com cloroquina após a inoculação de 106 eritrócitos parasitados (EP) e analisados nos dias 0, 20, 60, 120 e 200. Com relação à memória de linfócitos T, no dia 20, as freqüências de células CD4+ memória/ativadas e respondedoras aos EP foram significativamente maiores nos animais do grupo subpatente. Os níveis máximos de IgG2a específica foram encontrados no dia 120 em ambos os grupos. O desafio dos animais com 108 EP mostrou que a imunidade protetora declina progressivamente, mas os grupos ainda são capazes de estabelecer resposta secundária eficiente que elimine o parasita. Assim, podemos concluir que a carga parasitária influencia a fase aguda, mas não impede a geração e manutenção das células T e B de memória. / One of the main characteristics of malaria is the intense policlonal activation of splenic T and B lymphocytes induced by the parasite and the consequent elimination, through apoptosis, of part of these cells. However, the limited exposure to the bloodstage malaria seems to induce a prominent cellular immunity, associated with the protection of T lymphocytes from apoptosis. With this in mind, this study aimed to verify the influence of the parasite load in the generation and maintenance of memory T and B cells specific for Plasmodium chabaudi chabaudi AS. In order to evaluate this idea, C57BL/6 mice were infected with 106 parasitized red blood cells (pRBC) and submitted to a patent (untreated) or subpatent infection (controlled with sub-curative doses of chloroquine every time parasitemia reached 1%). Splenocytes from these mice were analyzed at 20, 60, 120 and 200 days after infection, regarding the pRBC-specific T cell proliferation and the expression of surface molecules, as CD4, CD8, CD62L, CD45RB, CD44, CD45R-B220 and IgG. The parasitemia and the splenocyte phenotype were also monitored after the challenge with 108 pRBC. Regarding T cell memory, at day 20 of infection, the frequencies of effector/activated CD4+ T cells (CD62LLOW CD45RBLOW/HIGH) were significantly increased in animals from the patent group, which was strict linked with the highest cellular activation observed in these animals. On the other hand, the total numbers of pRBCproliferating T (CD4+ and CD8+) cells per spleen were approximately 3-fold increased in subpatent animals, indicating that these cells were protected from apoptosis as a result of the limited exposure to the parasite. However, in both groups, these parameters decreased to values similar to those in controls at day 200. The splenocytes from both groups produced Th1 cytokines in response to pRBC in all times of analysis, but at the early phase of infection, Th2 cytokines were also observed, but without differences between the infected groups. Regarding memory B cells, the frequency of sIgG+ cells was increased at day 20 of infection, when 11% and 9% of CD45R+ cells from patent and subpatent animals were positive, respectively. For both groups, specific IgG2a antibodies attained maximum serum levels at day 120, but at day 200, it is possible to observe a significant decrease of these levels only in the serum of patent mice. Moreover, at day 200 of infection, mice of subpatent group showed significantly higher amounts of IgG2a that recognized the intra-erythrocytic forms of the parasite and the surface of infected erythrocytes. Challenge of mice with 108 pRBC showed that protective immunity progressively decline with time and despite the higher levels of specific antibody in subpatent mice, both groups showed similar protection. In experiments of adoptive transference to CD28-/- mice, cells from 200-day infected mice were able to produce specific IgG2a antibodies, in a T CD4+ cell dependent way. In addition, we verified that CD45R+ cells of subpatent mice, when transferred to CD28-/- mice, secreted higher amounts of specific IgG2a and IgG1 antibodies, comparing to cells of patent mice. So, from this work, we can conclude that the parasite load has a great influence in the early immune response to P. chabaudi malaria and it also affects the generation and/or maintenance of memory B cells. Furthermore, according to our data, at least during the analyzed period, the loss of protective immunity against this parasite does not seem to be influenced by the acute-phase parasite load, but it can be a consequence of the progressive decline of T-cell memory response that occurs in patent and subpatent groups with time of infection.