Most of the studies of experimental cryptosporidiosis have been performed with rodents whose immune systems were impaired, e.g., neonatal mice (
14,
25,
35), rats immunosuppressed with dexamethasone (
27), or congenitally mutated nude (
21,
23) and SCID mice (
17,
34). More recent studies have used mice with targeted mutations for the genes of major histocompatibility complex class II (
1), CD40, CD40L (
7), or gamma interferon (IFN-γ) (
33,
38). The key role of IFN-γ in resistance to
C. parvum infection initially demonstrated with antibody depletion was confirmed more recently with IFN-γ knockout mice (GKO) (
6,
33,
34). However, the mechanisms whereby IFN-γ intervenes in the clearance of
C. parvum are still not well understood. Some possibilities, not mutually exclusive, include a direct toxic effect of IFN-γ on the parasite or the infected cells or the induction of other cytokines that can be toxic for the parasite or of chemoattractants for immune cells. Mead and You reported that susceptible BALB/c-GKO mice recover from infection whereas C57BL/6-GKO mice remain chronically infected (
24), suggesting that other immune components related to the genetic background of the mice play a role in the susceptibility of mice to
C. parvum infection.
To determine what IFN-γ-dependent components of the immune response could be involved in the clearance of infection, we compared differential cytokine expression in a healing neonatal mouse model and in a nonhealing mouse model (neonates and adults) of the same genetic background that was deficient in IFN-γ. The cytokine mRNA levels were measured by quantitative reverse transcription-PCR (RT-PCR) in the intestinal mucosa, at the site where parasites are actively multiplying. In this study, we report that the mRNA for both Th1- and Th2-type cytokines was up-regulated during C. parvuminfection and that Th1 cytokines play a major role in the resolution of infection in the C57BL/6 genetic background. The overexpression of tumor necrosis factor alpha (TNF-α) observed during infection in neonatal mice was absent in GKO adult mice. This prompted us to explore the role of TNF-α in protection against C. parvum in a model devoid of IFN-γ. Intraperitoneal injections of TNF-α during the first days of the infection resulted in a significant reduction in oocyst shedding, suggesting that TNF-α can take part in protective immunity against C. parvum.
DISCUSSION
The role of IFN-γ in enhancing resistance to
C. parvum was clearly demonstrated by several groups using administration of neutralizing IFN-γ antibody or GKO mice (
6,
22,
35). Recent findings showed that BALB/c-GKO mice were able to clear the parasite within 2 weeks after infection, suggesting that in the absence of IFN-γ, other mechanisms can lead to protection in BALB/c mice (
38). In chronically infected adult C57BL/6-GKO mice, these mechanisms, if they exist, are not sufficient to eliminate the infection. C57BL/6 mouse healing is therefore dependent on the presence of IFN-γ, but the way in which IFN-γ has its protective effect still needs to be clarified.
In this study, we investigated the effect of IFN-γ on other cytokines that could play a role in the resolution of infection using C57BL/6 neonates and neonatal and adult GKO mice. The balance between a Th1 and Th2 cytokine response often regulates the outcome of infection with many organisms (
15).
C. parvum infection of wild-type neonates induces strong up-regulation of IFN-γ, iNOS, and IL-12p40 mRNA expression in the mucosa, whereas in the adult GKO mice mRNA expression of IL-12p40 and iNOS was not increased or was poorly increased. Culshaw et al. previously reported that intraepithelial lymphocytes (IEL) could be a source of IFN-γ that conferred protection against cryptosporidiosis in mice (
8). Both IL-12 (
35) and NO (
19) have been shown to also participate in the clearance of infection. Urban et al. showed that the treatment of mice with IL-12 before experimental inoculation prevented or greatly reduced the severity of the infection via an IFN-γ-dependent mechanism. Our data show that the increase of IFN-γ mRNA expression preceded the maximum level of IL-12p40 mRNA expression, suggesting that IL-12 may not be the only cytokine participating in the initial increase in IFN-γ mRNA expression in the mucosa. IL-18, first designated IGIF (interferon gamma inducing factor), is another strong inductor of IFN-γ and is expressed in intestinal epithelial cells (
31). However, although a low level of mRNA expression was measured by RT-PCR, we did not observe any increase of the expression level during the infection. To release the IL-18 mature form, pro-IL-18 needs to be cleaved by a protease, ICE or caspase 1 (
10). IL-18 is unlikely to play a role in the initial IFN-γ response after
C. parvum infection, since injection of caspase 1 inhibitor in neonates did not modify the IFN-γ mRNA response (data not shown). A recent study by Leitch and He demonstrated a modest but significant role for reactive nitrogen produced by epithelial cells in limiting the severity and course of infection in neonatal mice (
19). Our results confirm the increased expression of iNOS in the ileum following infection of neonatal mice. Our results also extend those findings by demonstrating that IFN-γ is most probably responsible for the majority of iNOS mRNA up-regulation after infection. In fact, in the absence of IFN-γ, GKO neonates did not up-regulate iNOS mRNA levels compared to wild-type neonates by day 4 p.i. In addition, in adult GKO mice, iNOS mRNA expression was not strongly increased despite significant infection. The strong up-regulation of iNOS mRNA observed in surviving GKO neonates at day 9 p.i. was probably due to the presence of bacteria in the injured mucosa. Several in vitro studies reported that bacterial infections induce strong and rapid up-regulation of iNOS mRNA levels in intestinal epithelial cells (
28,
36). Moreover, in vitro stimulation of epithelial cells with IFN-γ increased iNOS mRNA levels and NO production, whereas
C. parvum infection alone did not (unpublished data).
In both wild-type neonates and GKO (neonatal and adult) mice, mRNA expression levels for IL-4 and IL-10 increased during infection. In IFN-γ-deficient mice,
C. parvum infection did not result in a shift to a higher level of Th2 cytokine mRNA expression, as observed for other infectious agents like herpesvirus or influenza virus (
5,
12). It was assumed that the increased level of IL-4 mRNA observed in our study with infected neonatal and knockout (KO) mice was produced by intraepithelial lymphocytes, as shown by Aguirre et al. (
2). The role of IL-4 in the termination of infection was demonstrated using antibody depletion and C57BL/6 IL-4 KO mice. However, increased expression of IL-10 has never been observed in murine or bovine mucosa infected by
C. parvum, and its role in protection has not been demonstrated. Thus, the role of IL-10 in the resolution of
C. parvum infection deserves to be investigated. However, the presence of IL-4 and IL-10 in the mucosa during the infection of adult C57BL/6-GKO mice did not prevent the chronic infection, suggesting that in the C57BL/6 mice, the Th1 cytokine response is indispensable for the clearance of the parasite.
C. parvum infection results in mucosal inflammation of the intestine with infiltration of inflammatory cells, such as monocytes and neutrophils (
11). The extent of the inflammation in the mucosa is generally related to the severity of infection. Members of our laboratory and others have previously shown that
C. parvum-infected epithelial cells can participate in mucosal inflammation by producing C-X-C chemokines (IL-8 and Gro-α) (
18,
29). Proinflammatory cytokines like IL-1β and TNF-α, produced by many different cell types, can induce and amplify the secretion of various chemokines and therefore promote the recruitment of inflammatory cells in the mucosa. Our finding that IL-1β and TNF-α transcripts were produced in response to
C. parvum infection in wild-type neonates confirms the findings of Seydel et al. using the human intestinal xenograft model (
29). Our results extend those findings by demonstrating that IL-6 and GM-CSF transcripts are also produced in response to
C. parvum infection. In the complete absence of IFN-γ,
C. parvum infection resulted in a more extensive inflammation of the ileum than in the wild-type neonates. In adult GKO mice, expression of the proinflammatory cytokine was elevated except for TNF-α mRNA, which was undetectable despite severe infection. Moreover, TNF-α mRNA up-regulation at day 4 p.i. was lower in GKO neonates (1.1×) than in wild-type neonates (5×). The recent study of Smith et al. (
30), who demonstrated the absence of TNF-α mRNA in the splenocytes of C57BL/6-GKO mice after infection with
C. parvum, is consistent with our results with GKO adult mice. It seems likely, therefore, that IFN-γ could contribute to the overexpression of TNF-α mRNA observed in the ileum during
C. parvum infection. In this study, we demonstrated that exogenous TNF-α significantly decreased excretion of oocysts in infected adult C57BL/6-GKO mice which did not overexpress this proinflammatory cytokine, suggesting that TNF-α could participate in protection against
C. parvum. Despite increased expression of TNF-α mRNA levels by moribund GKO neonates at day 9 p.i., none survived more than 10 days p.i. We hypothesize that the increased TNF-α mRNA levels in moribund mice were probably not related only to
C. parvum infection and, in any case, the TNF-α would have been produced too late to have an effect on the extent of infection, since at this time point there was already extensive damage to the intestine. The role of TNF-α in cryptosporidiosis had already been studied with mice, but the injection of neutralizing TNF-α-specific antibody did not affect the course of infection (
6,
21). The discrepancy between these results and our new findings that TNF-α can participate in protection may be due to the presence of IFN-γ in mice, which may mask any ameliorating effects of TNF-α. Furthermore, it should be emphasized that the mouse strain can have a large effect on the outcome of infection. Smith et al. showed that an increase of TNF-α mRNA occurs in the splenocytes of infected BALB/c-GKO mice, contrary to what is observed in C57BL/6-GKO mice (
30). The fact that the BALB/c-GKO strain can resolve infection is in favor of a role of TNF-α in the resolution of cryptosporidiosis. Moreover, the role of TNF-α in the control of infection has already been demonstrated for leishmania (
32,
37) and
Trichuris muris (
4) disease. Many different cell types in the mucosa can release this cytokine, including IEL, which are in close contact with epithelial cells. TNF-α can be chemotactic and activate inflammatory cells and IEL. Moreover, TNF-α can induce the death of infected or senescent epithelial cells by apoptosis (
13). We recently showed that the infection of intestinal epithelial cells by
C. parvum induced apoptosis (
20,
26); however, the involvement of TNF-α in this mechanism remains to be demonstrated in vivo.
In conclusion, the mucosal immune response to C. parvum in C57BL/6 neonatal and GKO mice demonstrates a concomitant Th1 and Th2 cytokine mRNA expression, with a crucial role for IFN-γ in the resolution of the infection. IFN-γ acts most probably via more than one single mechanism. IL-12 and NO have been reported to participate in the protection of mice against C. parvum. In this study, we showed that IFN-γ facilitates the up-regulation of IL-12, iNOS, and TNF-α mRNA expression in the intestinal mucosa after C. parvum infection. The injection of exogenous TNF-α in C57BL/6-GKO mice, which significantly decreased oocyst shedding, suggests that this cytokine may take part in the IFN-γ-mediated protective immune response.