This thesis reports the results of a large number of experiments which were designed to elucidate the mechanisms whereby Gambian children, suffering from acute Plasmodium falciparum malaria may eventually control their infections. These experiments were carried out in vitro and success or failure of the various test systems was judged by their effect on parasite multiplication. Early in the course of these investiqations it was demonstrated that mononuclear cells from these children could cooperate with antibodies present in their serum to bring about a marked reduction in parasite growth. The efficiency of this antibody-dependent cellular cytotoxicity (ADCC) mechanism was related to levels of parasitaemia in the children, being greater in convalescent children than in those with acute malaria. Attempts were now made to identify the effector cells in this ADCC. Purified T and B cells were ineffective and although purified adherent cells (A) had an effect, it was much less than that mediated by the undepleted mononuclear cell population. Adherent cells were, however, fully effective in ADCC if they were exposed to the supernatant from T cells non-specifically activated by PHA. Thus cell cooperation leading to activation appears to play an important role in this system. Finally, experiments were set up to determine whether activated mononuclear cells could exert an inhibitory effect on parasite multiplication which was independent of anti-malarial antibody. It was shown that depression of parasite growth could be achieved by mononuclear cells, either from the children or from Europeans, if these cells were exposed to supernatants of previously stimulated mononuclear cells. These findings can be assembled to provide a tentative model of the development of protective responses in vivo. Perhaps following phagocytosis of parasite antigens and their presentation on the cell surface, T cells become activated: they may cooperate with B cells to produce parasite specific antibodies; they may also activate other mononuclear cells (non T, non B) to become effector cells. These cells, either alone, or perhaps more efficiently in cooperation with antibody, are able to kill parasites by the release of toxic factors, and the infection is brought under control. Finally, large amounts of specific antibodies of appropriate isotypes are synthesized. Acting as opsonins or by activating complement, they may serve to destroy remaining parasites. Their continued presence, by preventing merozoite penetration, may provide at least a temporary defense against reinfection. It is assumed that Gambian adults who have suffered repeated malaria infections and are now immune are defended by their possession of circulating IgG antibodies and B memory cells of all appropriate specificities.

Background: Both the innate and adaptive immune systems contribute to autoimmune injury in multiple sclerosis (MS). We have been particularly interested in elucidating the role of the innate γδ T-cell population in MS pathogenesis. In particular, some γδ T-cells that express Fc receptors (FcR), such as CD16, that bind antibody are more prominent with MS disease progression and have been shown to exert cytolysis via antibody-dependent cellular cytotoxicity (ADCC). We postulated that if there were also relevant and detectable antibodies in MS patients that might engage these FcR-bearing γδ T-cells then this might be a purported mechanism of neuro-axonal injury. A search for antibodies specific to axonal elements in MS revealed the presence of antibodies to neurofascin (Nfasc). Methods: Anti-Nfasc antibody titres, and concentrations of the light and heavy chains of neurofilament (NfL and NfH, respectively), markers of neuro-axonal injury, were measured in the sera and cerebrospinal fluid (CSF) of MS patients using enzyme-linked immunosorbent assays (ELISA), including those that underwent autologous hematopoietic stem cell transplantation (aHSCT), both prior to and yearly for 3 years thereafter. HeLa cells were transfected with the axonal variant of Nfasc, Nfasc-186, and were utilized as targets in ADCC assays involving γδ T-cells as the effectors, and anti-Nfasc antibodies that were enriched from MS patient sera. Results: Positive anti-Nfasc antibody titres were detected in of 22% and 25% of MS patient sera and CSF, respectively. The most elevated serum titres were in secondary progressive MS (SPMS), and highest CSF titres in relapsing-remitting MS (RRMS) (p<0.05 and p<0.0001, respectively, vs. other neurological disease [OND] controls). Patient serum and CSF antibody titres correlated and, in the CSF, the titres correlated positively with the concentration of NfL. Though NfL and NfH concentrations declined markedly following aHSCT in the CSF, anti-Nfasc antibody titres failed to decline. When co-cultured with CD16+ γδ T-cells in the presence of MS patient-derived anti-Nfasc antibodies, the percent specific cytolysis of the Nfasc-transfected HeLa cells was significantly greater than that of the non-transfected control HeLa cells, at 18% and 1%, respectively, indicating cytolytic kill via ADCC. Summary: Anti-Nfasc antibodies were detectable in the sera and CSF of MS patients, and rarely in OND controls, suggesting they are relevant to MS. Higher titres in the serum support peripheral synthesis, while higher CSF titres in the relapsing phase, that correlate with serum titres, imply that antibodies access the CNS during periods of active inflammation that are associated with disruption of the blood-CSF barrier. CSF anti-Nfasc antibody titres correlated strongly with the release of NfL, suggesting that axonal injury could be related to the presence of Nfasc-specific antibodies. Following aHSCT, CSF NfL and NfH release were reduced without concomitant CSF anti-Nfasc antibody reductions, suggesting that the presence alone of anti-Nfasc antibodies is not enough to cause axonal injury. Indeed, when co-cultured with CD16+ γδ T-cells in the presence of MS patient-derived anti-Nfasc antibodies, the percent specific cytolysis of the Nfasc-transfected HeLa cells was significantly greater than that of the non-transfected control HeLa cells, proving that FcR-bearing γδ T-cells can cause axonal damage by lysing axonal membranes via ADCC, when armed with axon-specific antibodies such as anti-Nfasc. This is the first report of γδ T-cell-mediated cytolysis by ADCC using both γδ T-cells and antibodies derived from MS patients.

Since being identified as the cause of AIDS in 1983, HIV-1 infection has reached pandemic proportions. Despite public awareness about prevention, the growing incidence of HIV-1 infection and the limitations of current antiretroviral therapy underscore the imperative need for a vaccine. Understanding the basis of an immune response that controls infection or provides sterilizing immunity remains a major goal in the search for effective vaccines or immunotherapies. Research into correlates of immunity to HIV-1 have largely focused on CD8⁺ T cells or neutralising antibodies (NAbs) but to date these responses have not proved effective in containing viral replication in vaccinees who become infected. Natural killer cells (NKs), monocytes (MCs), and neutrophils (PMNs) are cells of the innate immune system with intrinsic cytotoxic function that can be enhanced by antibodies (Abs) in what is termed antibody-dependent cellular cytotoxicity (ADCC). In my studies I investigated the production of PMNs from human stem cells, the elimination of HIV-1 infected cells by these effector cells, the modulation of cellular cytotoxicity by Ab, and characterized how Abs facilitate a potent ADCC response. I developed a novel flow cytometry assay to measure cytotoxic activity against HIV-1 infected CD4⁺ T cells. Using this, effector cells were shown to have different cytotoxic capacities which were enhanced by Ab. Comparing ADCC mediated by patient serum revealed that higher levels correlated with IgG binding to infected cells. I observed no correlation between serum-mediated ADCC and markers of disease progression including patient status, viral RNA load, CD4⁺ T cell count, or NAb titers. The data presented here have implications for acquisition and control of early HIV-1 infection by NKs, MCs, and PMNs prior to activation of an adaptive immune response, at later stages in the presence of HIV-1-specific Abs, and are relevant to vaccine-induced anti- HIV-1 Ab-based effector mechanisms.

No description available.