Soluble Antigen Arrays Displaying Mimotopes Direct the Response of Diabetogenic T Cells

This document is the Accepted Manuscript version of a Published Work that appeared in final form in ACS Chemical Biology, copyright © American Chemical Society after peer review and technical editing by the publisher. To access the final edited and published work see https://doi.org/10.1021/acschembio.9b00090.Type 1 diabetes (T1D) is an autoimmune disorder which develops when insulin-producing, pancreatic beta cells are destroyed by an aberrant immune response. Current therapies for T1D either treat symptoms or cause global immunosuppression, which leave patients at risk of developing long-term complications or vulnerable to foreign pathogens. Antigen-specific immunotherapies have emerged as a selective approach for autoimmune diseases by inducing tolerance while mitigating global immunosuppression. We previously reported SAgAs with multiple copies of a multiple sclerosis (MS) autoantigen grafted onto hyaluronic acid (HA) as an efficacious therapy in experimental autoimmune encephalomyelitis. While the immune response of MS is distinct from T1D, the mechanism of SAgAs was hypothesized to be similar and via induction of immune tolerance to diabetes antigens. We synthesized SAgAs composed of HA polymer backbone conjugated with multiple copies of the T1D autoantigen mimotope p79 using aminooxy chemistry (SAgAp79) or using copper-catalyzed alkyne-azide cycloaddition (cSAgAp79) chemistry. SAgAs constructed using the hydrolyzable aminooxy linkage, thus capable of releasing p79, exhibited physicochemical properties similar to the triazole linkage. Both SAgAp79 versions showed high specificity and efficacy in stimulating epitope-specific T cells. SAgAs can be taken up by most immune cell populations but do not induce their maturation, and conventional dendritic cells are responsible for the brunt of antigen presentation within splenocytes. cSAgAp79 was more stimulatory than SAgAp79 both in vitro and in vivo, an effect that was ascribed to the peptide modification rather than the type of linkage. In summary, we provide here the first proof-of-principle that SAgA therapy could also be applicable to T1D.NIH T32 GM008545Juvenile Diabetes Research Foundation (2-SRA-2017-312-S-B)NIH Shared Instrumentation Grant # S10RR024664NSF Major Research Instrumentation Award # 1625923NIH S10OD020056Diabetes Research Center grant P30DK063608NIH HHSN272201300006

Antileishmanial Potential of Crude Plant Extracts Derived from Medicinal Plants in Palestine

Herbal and traditional medicine is commonly and widely used in Palestine. There has been no ethno pharmacological study to document the usefulness of traditional or medicinal plants from Palestine against leishmaniasis, a spectrum of severe parasitic diseases that occur worldwide and is caused by protozoa of the genus Leishmania. The aim of the present study was to collect and analyze some of the traditionally used medicinal plants from Palestine against Leishmania major parasites that cause cutaneous leishmaniasis. Plant materials were collected during spring and summer of the year 2011, identified and the voucher numbers were kept at Al-Quds University Gardens (AQUG). The whole plant (except roots), flowers, fruits or seeds were collected, washed with distilled water, air dried in the shade for 20 days and then powdered in an electric grinder. For each plant species, alcoholic and dimethyl sulfoxide extracts were tested in vitro against L. major promastigotes and their antileishmanial activities were evaluated by Alamar Blue bioassay. Twenty plant species belonging to14 families were examined for their in vitro anti-parasitic effect against L. major. Among the total crude extracts tested; five were found to have various levels of activities (20%), some extracts having significant antileishmanial activity with IC50 values ranging from 8.83 to 100 μg/mL. The most active crude extracts were from the shoots of Artemisia inculta and Malva sylvestris with activity of 84.1%, IC50 = 8.8 μg/mL. And 90.1%, IC50 = 19.5 μg/mL respectively. The results demonstrate that the crude extracts of Artemisia inculta and Malva sylvestris showed promising antileishmanial activity, further and extensive studies should be carried out; particularly bio-guided fractionation to identify the active fraction and further chemical characterization of structureThe authors gratefully thank the Deutscher Akademischer Austauschdienst (DAAD) and Zamallah program for providing travel grant. IMIB - Institute for Molecular Infection Biology, for providing support to validate this work at Würzburg University, financial support by the Deutsche Forschungsgemeinschaft (SFB 630) given To HM is gratefully acknowledge

Zoonotic Transmission of Tuberculosis Between Pastoralists and Their Livestock in South-East Ethiopia

Despite huge global efforts in tuberculosis (TB) control, pastoral areas remain under-investigated. During two years sputum and fine needle aspirate (FNA) specimens were collected from 260 Ethiopian pastoralists of Oromia and Somali Regional States with suspected pulmonary TB and from 32 cases with suspected TB lymphadenitis. In parallel, 207 suspected tuberculous lesions were collected from cattle, camels and goats at abattoirs. All specimens were processed and cultured for mycobacteria; samples with acid-fast stained bacilli (AFB) were further characterized by molecular methods including genus and deletion typing as well as spoligotyping. Non-tuberculous mycobacteria (NTM) were sequenced at the 16S rDNA locus. Culturing of AFB from human sputum and FNA samples gave a yield of 174 (67%) and 9 (28%) isolates, respectively. Molecular typing was performed on 173 of these isolates and 160 were confirmed as Mycobacterium tuberculosis, three as M. bovis, and the remaining 10 were typed as NTMs. Similarly, 48 AFB isolates (23%) yielded from tuberculous lesions of livestock, of which 39 were molecular typed, including 24 M. bovis and 4 NTMs from cattle, 1 M. tuberculosis and 1 NTM from camels and 9 NTMs from goats. Isolation of M. bovis from humans and M. tuberculosis from livestock suggests transmission between livestock and humans in the pastoral areas of South-East Ethiopi

Investigation of the high rates of extrapulmonary tuberculosis in Ethiopia reveals no single driving factor and minimal evidence for zoonotic transmission of Mycobacterium bovis infection

Ethiopia, a high tuberculosis (TB) burden country, reports one of the highest incidence rates of extra-pulmonary TB dominated by cervical lymphadenitis (TBLN). Infection with Mycobacterium bovis has previously been excluded as the main reason for the high rate of extrapulmonary TB in Ethiopia.; Here we examined demographic and clinical characteristics of 953 pulmonary (PTB) and 1198 TBLN patients visiting 11 health facilities in distinct geographic areas of Ethiopia. Clinical characteristics were also correlated with genotypes of the causative agent, Mycobacterium tuberculosis.; No major patient or bacterial strain factor could be identified as being responsible for the high rate of TBLN, and there was no association with HIV infection. However, analysis of the demographic data of involved patients showed that having regular and direct contact with live animals was more associated with TBLN than with PTB, although no M. bovis was isolated from patients with TBLN. Among PTB patients, those infected with Lineage 4 reported "contact with other TB patient" more often than patients infected with Lineage 3 did (OR = 1.6, CI 95% 1.0-2.7; p = 0.064). High fever, in contrast to low and moderate fever, was significantly associated with Lineage 4 (OR = 2.3; p = 0.024). On the other hand, TBLN cases infected with Lineage 4 tended to get milder symptoms overall for the constitutional symptoms than those infected with Lineage 3.; The study suggests a complex role for multiple interacting factors in the epidemiology of extrapulmonary TB in Ethiopia, including factors that can only be derived from population-based studies, which may prove to be significant for TB control in Ethiopia

Pathogen- and Host-Directed Antileishmanial Effects Mediated by Polyhexanide (PHMB)

BACKGROUND:Cutaneous leishmaniasis (CL) is a neglected tropical disease caused by protozoan parasites of the genus Leishmania. CL causes enormous suffering in many countries worldwide. There is no licensed vaccine against CL, and the chemotherapy options show limited efficacy and high toxicity. Localization of the parasites inside host cells is a barrier to most standard chemo- and immune-based interventions. Hence, novel drugs, which are safe, effective and readily accessible to third-world countries and/or drug delivery technologies for effective CL treatments are desperately needed. METHODOLOGY/PRINCIPAL FINDINGS:Here we evaluated the antileishmanial properties and delivery potential of polyhexamethylene biguanide (PHMB; polyhexanide), a widely used antimicrobial and wound antiseptic, in the Leishmania model. PHMB showed an inherent antileishmanial activity at submicromolar concentrations. Our data revealed that PHMB kills Leishmania major (L. major) via a dual mechanism involving disruption of membrane integrity and selective chromosome condensation and damage. PHMB's DNA binding and host cell entry properties were further exploited to improve the delivery and immunomodulatory activities of unmethylated cytosine-phosphate-guanine oligodeoxynucleotides (CpG ODN). PHMB spontaneously bound CpG ODN, forming stable nanopolyplexes that enhanced uptake of CpG ODN, potentiated antimicrobial killing and reduced host cell toxicity of PHMB. CONCLUSIONS:Given its low cost and long history of safe topical use, PHMB holds promise as a drug for CL therapy and delivery vehicle for nucleic acid immunomodulators

Bovine tuberculosis at a cattle-small ruminant-human interface in Meskan, Gurage region, Central Ethiopia

ABSTRACT: BACKGROUND: Bovine tuberculosis (BTB) is endemic in Ethiopian cattle. The aim of this study was to assess BTB prevalence at an intensive contact interface in Meskan Woreda (district) in cattle, small ruminants and suspected TB-lymphadenitis (TBLN) human patients. METHODS: The comparative intradermal test (CIDT) was carried out for all animals involved in the cross-sectional study and results interpreted using a < 4 mm and a < 2 mm cut-off. One PPD positive goat was slaughtered and lymph nodes subjected to culture and molecular typing. In the same villages, people with lymphadenitis were subjected to clinical examination. Fine needle aspirates (FNA) were taken from suspected TBLN and analyzed by smear microscopy and molecular typing. RESULTS: A total of 1214 cattle and 406 small ruminants were tested for BTB. In cattle, overall individual prevalence (< 2 mm cut-off) was 6.8% (CI: 5.4-8.5%) with 100% herd prevalence. Only three small ruminants (2 sheep and 1 goat) were reactors. The overall individual prevalence in small ruminants (< 2 mm cut-off) was 0.4% (CI: 0.03-5.1%) with 25% herd prevalence. Cattle from owners with PPD positive small ruminants were all PPD negative. 83% of the owners kept their sheep and goats inside their house at night and 5% drank regularly goat milk.FNAs were taken from 33 TBLN suspected cases out of a total of 127 screened individuals with lymph node swellings. Based on cytology results, 12 were confirmed TBLN cases. Nine out of 33 cultures were AFB positive. Culture positive samples were subjected to molecular typing and they all yielded M. tuberculosis. M. tuberculosis was also isolated from the goat that was slaughtered. CONCLUSIONS: This study highlighted a low BTB prevalence in sheep and goats despite intensive contact with cattle reactors. TBLN in humans was caused entirely by M. tuberculosis, the human pathogen. M. tuberculosis seems to circulate also in livestock but their role at the interface is unknow

Use of Polyhexanide and Nanomedicine Approach for Effective Treatments of Cutaneous Leishmaniasis

Despite huge suffering caused by cutaneous leishmaniasis (CL), there is no effective and affordable treatment strategy against CL and no licensed vaccines. The current treatments show limited efficacy and high toxicity. Improved therapies through discovery of novel drugs and/or an alternative treatment approaches are/is urgently needed. We aimed at identifying a novel antileishmanial agent and developing an innovative nanoparticle (NP) based platform for safe and effective treatments against CL. We discovered that polyhexanide (PHMB), a widely used antimicrobial polymer and wound antisepsis, shows an inherent antileishmanial activity at submicromolar concentrations. PHMB appears to kill L. major parasites via a dual mechanism involving disruption of membrane integrity and selective chromosome condensation. However, host chromosomes binding appear to be limited by exclusion from mammalian cell nuclei. Moreover, we attempted to establish effective drug delivery systems that overcome the various shortcomings in the present treatment of CL. In this scenario, we initially studied the cellular interactions of NPs and their uptake mechanisms into mammalian cells before applying them in drug delivery system. We obtained clear evidence for the involvement of multiple endocytic routes to internalize NPs. Physicochemical properties of NPs, cell type, temperature and pathogenesis of the target diseases were shown to be determinant factors. Thereafter, a mechanism based host- and pathogen-directed combination therapy comprising PHMB and CpG ODN immunomodulator was established for overall synergistic effect against CL. It simultaneously targets the pathogen and the host immunity with effective delivery system. The results show that PHMB binds to CpG ODN and form stable nanopolyplexes for efficient cell entry and therapy. The nanopolyplexes displayed enhanced cellular uptake and antileishmanial potency while drastically reducing the toxicity against mammalian cells. In conclusion, our findings clearly indicate that PHMB can be used as effective candidate drug against CL and as non-viral delivery of immunomodulatorynucleic acids. Moreover, our proof-of concept study showed nanomedicine approaches are effective strategy to challenge CL and other human diseases

Die Verwendung von Polyhexaniden und Konzepten der Nanomedizin zur effektiven Behandlung kutaner Leishmaniose

Despite huge suffering caused by cutaneous leishmaniasis (CL), there is no effective and affordable treatment strategy against CL and no licensed vaccines. The current treatments show limited efficacy and high toxicity. Improved therapies through discovery of novel drugs and/or an alternative treatment approaches are/is urgently needed. We aimed at identifying a novel antileishmanial agent and developing an innovative nanoparticle (NP) based platform for safe and effective treatments against CL. We discovered that polyhexanide (PHMB), a widely used antimicrobial polymer and wound antisepsis, shows an inherent antileishmanial activity at submicromolar concentrations. PHMB appears to kill L. major parasites via a dual mechanism involving disruption of membrane integrity and selective chromosome condensation. However, host chromosomes binding appear to be limited by exclusion from mammalian cell nuclei. Moreover, we attempted to establish effective drug delivery systems that overcome the various shortcomings in the present treatment of CL. In this scenario, we initially studied the cellular interactions of NPs and their uptake mechanisms into mammalian cells before applying them in drug delivery system. We obtained clear evidence for the involvement of multiple endocytic routes to internalize NPs. Physicochemical properties of NPs, cell type, temperature and pathogenesis of the target diseases were shown to be determinant factors. Thereafter, a mechanism based host- and pathogen-directed combination therapy comprising PHMB and CpG ODN immunomodulator was established for overall synergistic effect against CL. It simultaneously targets the pathogen and the host immunity with effective delivery system. The results show that PHMB binds to CpG ODN and form stable nanopolyplexes for efficient cell entry and therapy. The nanopolyplexes displayed enhanced cellular uptake and antileishmanial potency while drastically reducing the toxicity against mammalian cells. In conclusion, our findings clearly indicate that PHMB can be used as effective candidate drug against CL and as non-viral delivery of immunomodulatorynucleic acids. Moreover, our proof-of concept study showed nanomedicine approaches are effective strategy to challenge CL and other human diseases.Obgleich enorme Leiden mit der kutanen Leishmaniose einhergehen stehen bis dato keine wirkungsvollen und erschwinglichen Therapien oder zugelassene Impfstoffe zur Verfügung. Die derzeitigen Behandlungsmethoden sind kaum effektiv und zeichnen sich vor allem durch ihre enormen Nebenwirkungen aus. Aus diesem Grund ist die Erforschung neuartiger Wirkstoffe und Therapieansätze gegen kutane Leishmaniose zwingend notwendig. Die vorliegende Arbeit beschreibt die Entdeckung eines neuen antileishmanialen Wirkstoffes und die Etablierung eines innovativen und auf Nanopartikeln basierenden Verfahrens zur sicheren und effizienten Behandlung der kutanen Leishmaniose. Das Polyhexanid, welches bereits Verwendung als antimikrobielles Polymer und als Wundantiseptikum findet, weist bereits in submikromolaren Konzentrationen eine immanente antileishmaniale Wirkung auf. Den Beobachtungen zu Folge beeinflusst das Polyhexanid die Integrität der parasitären Zellmembran und führt zur selektiven Chromosomenkondensation des Parasiten Leishmania major. Eine potentielle Chromosomenmodifikation in der Säugetierzelle wird durch den Ausschluss des Polyhexanides aus dem Zellkern verhindert. Um die zahlreichen Mängel der aktuellen Behandlungsmethoden gegen kutane Leishmaniose zu überwinden, wurde zudem ein effizientes System der Wirkstoffabgabe etabliert. Diesbezüglich wurden zunächst die zellulären Wechselwirkungen der Nanopartikel und deren Aufnahme in die Säugtierzelle untersucht ehe diese als Vehikel für den Wirkstoff verwendet wurden. Es konnte gezeigt werden, dass die Nanopartikel über mehrere endozytische Wege internalisiert werden. Physikochemische Eigenschaften der Nanopartikel, der Zelltyp, die Temperatur und erregerspezifische Pathogenese gehören zu den beeinflussenden Faktoren. Daraufhin wurde eine Kombinationstherapie bestehend aus Polyhexaniden und dem unmethylierten Immunmodulator Zystein-Phosphat-Guanin Oligodeoxynukleotid mit synergistischen antileishmanialen Auswirkungen, etabliert. Dies gestattet eine gegen den Erreger zielgerichtete Behandlung und die zeitgleiche Stimulierung der Wirtsimmunität. Die Bildung eines stabilen Nanopolyplexes bestehend aus dem Polyhexanid und dem oben genannten Immunmodulator befähigen die effiziente Aufnahme in die Zelle und somit die Behandlung. Der Nanopolyplex ermöglicht eine verbesserte Aufnahme in die Zelle und antileishmaniale Wirksamkeit wohingegen die Toxizität gegenüber Säugetierzellen drastisch reduziert ist. Zusammenfassend lässt sich feststellen, dass Polyhexanide als effizienter Wirkstoffkandidat gegen kutane Leishmaniose und als nicht-viraler Träger von immunmodulatorischen Nukleinsäuren zu betrachten sind. Zugleich wurde gezeigt, dass die Nanomedizin einen wertvollen Beitrag zur Bekämpfung der kutanen Leishmaniose und sicherlich auch anderer Krankheitserregern leisten kann

Epitope-based precision immunotherapy of Type 1 diabetes

Antigen-specific immunotherapies (ASITs) address important clinical needs in treating autoimmune diseases. However, Type 1 diabetes is a heterogeneous disease wherein patient characteristics influence responsiveness to ASITs. Targeting not only disease-relevant T cell populations, but also specific groups of patients using precision medicine is a new goal toward achieving effective treatment. HLA-restricted peptides provide advantages over protein as antigens, however, methods for profiling antigen-specific T cells need to improve in sensitivity, depth, and throughput to facilitate epitope selection. Delivery approaches are highly diverse, illustrating the many ways relevant antigen-presenting cell populations and anatomical locations can be targeted for tolerance induction. The role of persistence of antigen presentation in promoting durable antigen-specific tolerance requires further investigation. Based on the outcome of ASIT trials, the field is moving toward using patient-specific variations to improve efficacy, but challenges still lie on the path to delivering more effective and safer treatment to the T1D patient population