CD8+T Cells Induce Fatal Brainstem Pathology during Cerebral Malaria via Luminal Antigen-Specific Engagement of Brain Vasculature

Phillip A. Swanson, Geoffrey T Hart, Matthew V. Russo, Debasis Nayak, Takele Yazew, Mirna Peña, Shahid M. Khan, Chris J. Janse, Susan K. Pierce, Dorian B. McGavern

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Cerebral malaria (CM) is a severe complication of Plasmodium falciparum infection that results in thousands of deaths each year, mostly in African children. The in vivo mechanisms underlying this fatal condition are not entirely understood. Using the animal model of experimental cerebral malaria (ECM), we sought mechanistic insights into the pathogenesis of CM. Fatal disease was associated with alterations in tight junction proteins, vascular breakdown in the meninges / parenchyma, edema, and ultimately neuronal cell death in the brainstem, which is consistent with cerebral herniation as a cause of death. At the peak of ECM, we revealed using intravital two-photon microscopy that myelomonocytic cells and parasite-specific CD8+T cells associated primarily with the luminal surface of CNS blood vessels. Myelomonocytic cells participated in the removal of parasitized red blood cells (pRBCs) from cerebral blood vessels, but were not required for the disease. Interestingly, the majority of disease-inducing parasite-specific CD8+T cells interacted with the lumen of brain vascular endothelial cells (ECs), where they were observed surveying, dividing, and arresting in a cognate peptide-MHC I dependent manner. These activities were critically dependent on IFN-γ, which was responsible for activating cerebrovascular ECs to upregulate adhesion and antigen-presenting molecules. Importantly, parasite-specific CD8+T cell interactions with cerebral vessels were impaired in chimeric mice rendered unable to present EC antigens on MHC I, and these mice were in turn resistant to fatal brainstem pathology. Moreover, anti-adhesion molecule (LFA-1 / VLA-4) therapy prevented fatal disease by rapidly displacing luminal CD8+T cells from cerebrovascular ECs without affecting extravascular T cells. These in vivo data demonstrate that parasite-specific CD8+T cell-induced fatal vascular breakdown and subsequent neuronal death during ECM is associated with luminal, antigen-dependent interactions with cerebrovasculature.

Original languageEnglish (US)
Article numbere1006022
JournalPLoS pathogens
Volume12
Issue number12
DOIs
StatePublished - Dec 1 2016

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Cerebral Malaria
Brain Stem
Pathology
T-Lymphocytes
Antigens
Blood Vessels
Brain
Parasites
Endothelial Cells
Integrin alpha4beta1
Tight Junction Proteins
Meninges
Lymphocyte Function-Associated Antigen-1
Plasmodium falciparum
Photons
Cell Communication
Malaria
Cause of Death
Microscopy
Edema

Cite this

CD8+T Cells Induce Fatal Brainstem Pathology during Cerebral Malaria via Luminal Antigen-Specific Engagement of Brain Vasculature. / Swanson, Phillip A.; Hart, Geoffrey T; Russo, Matthew V.; Nayak, Debasis; Yazew, Takele; Peña, Mirna; Khan, Shahid M.; Janse, Chris J.; Pierce, Susan K.; McGavern, Dorian B.

In: PLoS pathogens, Vol. 12, No. 12, e1006022, 01.12.2016.

Research output: Contribution to journalArticle

Swanson, PA, Hart, GT, Russo, MV, Nayak, D, Yazew, T, Peña, M, Khan, SM, Janse, CJ, Pierce, SK & McGavern, DB 2016, 'CD8+T Cells Induce Fatal Brainstem Pathology during Cerebral Malaria via Luminal Antigen-Specific Engagement of Brain Vasculature', PLoS pathogens, vol. 12, no. 12, e1006022. https://doi.org/10.1371/journal.ppat.1006022
Swanson, Phillip A. ; Hart, Geoffrey T ; Russo, Matthew V. ; Nayak, Debasis ; Yazew, Takele ; Peña, Mirna ; Khan, Shahid M. ; Janse, Chris J. ; Pierce, Susan K. ; McGavern, Dorian B. / CD8+T Cells Induce Fatal Brainstem Pathology during Cerebral Malaria via Luminal Antigen-Specific Engagement of Brain Vasculature. In: PLoS pathogens. 2016 ; Vol. 12, No. 12.
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abstract = "Cerebral malaria (CM) is a severe complication of Plasmodium falciparum infection that results in thousands of deaths each year, mostly in African children. The in vivo mechanisms underlying this fatal condition are not entirely understood. Using the animal model of experimental cerebral malaria (ECM), we sought mechanistic insights into the pathogenesis of CM. Fatal disease was associated with alterations in tight junction proteins, vascular breakdown in the meninges / parenchyma, edema, and ultimately neuronal cell death in the brainstem, which is consistent with cerebral herniation as a cause of death. At the peak of ECM, we revealed using intravital two-photon microscopy that myelomonocytic cells and parasite-specific CD8+T cells associated primarily with the luminal surface of CNS blood vessels. Myelomonocytic cells participated in the removal of parasitized red blood cells (pRBCs) from cerebral blood vessels, but were not required for the disease. Interestingly, the majority of disease-inducing parasite-specific CD8+T cells interacted with the lumen of brain vascular endothelial cells (ECs), where they were observed surveying, dividing, and arresting in a cognate peptide-MHC I dependent manner. These activities were critically dependent on IFN-γ, which was responsible for activating cerebrovascular ECs to upregulate adhesion and antigen-presenting molecules. Importantly, parasite-specific CD8+T cell interactions with cerebral vessels were impaired in chimeric mice rendered unable to present EC antigens on MHC I, and these mice were in turn resistant to fatal brainstem pathology. Moreover, anti-adhesion molecule (LFA-1 / VLA-4) therapy prevented fatal disease by rapidly displacing luminal CD8+T cells from cerebrovascular ECs without affecting extravascular T cells. These in vivo data demonstrate that parasite-specific CD8+T cell-induced fatal vascular breakdown and subsequent neuronal death during ECM is associated with luminal, antigen-dependent interactions with cerebrovasculature.",
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