Humans are continuously exposed to airborne spores of the saprophytic fungus Aspergillus fumigatus. In healthy individuals, local pulmonary host defence mechanisms can efficiently eliminate the fungus without any overt symptoms. In contrast, A. fumigatus causes devastating infections in immunocompromised patients. However, local host immune responses against A. fumigatus lung infections in immunocompromised conditions have remained largely elusive.
Given the dynamic changes in immune cell subsets within tissues upon immunosuppressive therapy, we dissected the spatiotemporal pulmonary immune response after A. fumigatus infection to reveal basic immunological events that fail to effectively control the invasive fungal disease. In different immunocompromised murine models, myeloid but not lymphoid cells were strongly recruited upon infection. Notably, neutrophils and macrophages were recruited to infected lungs in different immunosuppressed regimens. Other myeloid cells, particularly dendritic cells and monocytes were only recruited in the corticosteroid model after infection. Lymphoid cells, particularly CD4+ or CD8+ T-cells and NK cells were highly reduced upon immunosuppression and were not recruited after A. fumigatus infection. Importantly, adoptive CD11b+ myeloid cell transfer rescued immunosuppressed mice from lethal A. fumigatus infection. These findings illustrate that CD11b+ myeloid cells are critical for anti-A. fumigatus defence under immunocompromised conditions.
Despite improved antifungal agents, invasive A. fumigatus lung infections cause a high rate morbidity and mortality in neutropenic patients. Granulocyte transfusions have been tested as an alternative therapy for the management of high-risk neutropenic patients with invasive A. fumigatus infections. To increase the granulocyte yield for transfusion, donors are treated with corticosteroids. Yet, the efficacy of granulocyte transfusion and the functional defence mechanisms of granulocytes collected from corticosteroid treated donors remain largely elusive.
We aimed to assess the efficacy of granulocyte transfusion and functional defence mechanisms of corticosteroid treated granulocytes using mouse models.
In this thesis, we show that transfusion of granulocytes from corticosteroid treated mice did not protect cyclophosphamide immunosuppressed mice against lethal A. fumigatus infection in contrast to granulocytes from untreated mice. Upon infection, increased levels of inflammatory cytokines helped to recruit granulocytes to the lungs without any recruitment defects in corticosteroid treated and infected mice or in cyclophosphamide immunosuppressed and infected mice that have received the granulocytes from corticosteroid treated mice. However, corticosteroid treated human or mouse neutrophils failed to form neutrophil extracellular traps (NETs) in in vitro and in vivo conditions. Further, corticosteroid treated granulocytes exhibited impaired ROS production against A. fumigatus. Notably, corticosteroids impaired the β-glucan receptor Dectin-1 (CLEC7A) on mouse and human granulocytes to efficiently recognize and phagocytize A. fumigatus, which markedly impaired fungal killing. We conclude that corticosteroid treatment of granulocyte donors for increasing neutrophil yields or patients with ongoing corticosteroid treatment could result in deleterious effects on granulocyte antifungal functions, thereby limiting the benefit of granulocyte transfusion therapies against invasive fungal infections. / Der Mensch kommt über die Atemluft in regelmäßigem Kontakt mit Sporen des saprophyitschen Pilzes Aspergillus fumigatus. Glücklicherweise eliminieren die lokalen Abwehrmechanismen der Lunge den Pilz in gesunden Individuen sehr effektiv und ohne offenkundige Symptome. In immunkomprimierten Patienten hingegen verursacht A. fumigatus verheerende Infektionen. Allerdings ist die lokale Immunreaktion gegen A.fumigatus-vermittelte Infektionen der Lunge unter immunsuppressiven
Bedingungen immer noch nicht ausreichend definiert.
In Anbetracht der dynamischen Veränderungen an Immunzellunterpopulationen im Gewebe nach
immunsuppressiver Therapie haben wir die zeitliche und örtliche pulmonale Immunreaktion nach A.
fumigatus infektion untersucht, um die grundlegenden immunologischen Geschehnisse aufzudecken, die
in dieser Situation zur unzureichenden Kontrolle des Pilzes führen. In anderen immunsupprimierten
Mausmodellen fand eine starke Rekrutierung myeloider Zellen nach Infektion statt. In besonderem
Maße wurden nach der Infektion Neutrophile und Makrophagen in die Lunge immunsupprimierter Mäuse
rekrutiert. Andere myeloide Zellen, insbesondere dendritische Zellen und Monozyten, wurden nur im
Corticosteroid-Modell nach Infektion rekrutiert. Lymphoide Zellen, insbesondere CD4+ oder CD8+
Zellen und NK Zellen, waren nach Immunsuppression stark reduziert und wurden nach Infektion mit A.
fumigatus nicht rekrutiert. Adoptiver Zelltransfer von CD11b+ myeloiden Zellen stellte die Abwehr
immunsupprimierter Mäuse gegen A. fumigatus wieder her, was die wesentliche Bedeutung dieser Zellen
in der Immunabwehr unterstreicht. Diese Erkenntnisse verdeutlichen, dass CD11b+ myeloide Zellen unter immunkomprimierten Bedingungen entscheidend für die Abwehr gegen A-fumigatus sind. ...
| Identifer | oai:union.ndltd.org:uni-wuerzburg.de/oai:opus.bibliothek.uni-wuerzburg.de:15093 |
| Date | January 2018 |
| Creators | Kalleda, Nataraja Swamy |
| Source Sets | University of Würzburg |
| Language | English |
| Detected Language | English |
| Type | doctoralthesis, doc-type:doctoralThesis |
| Format | application/pdf |
| Rights | https://creativecommons.org/licenses/by-sa/3.0/de/deed.de, info:eu-repo/semantics/openAccess |
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