INTRODUCTION
Visceral leishmaniasis (VL) is responsible for 50,000–90,000 new cases a year, and the majority (>94%) of reported new cases occur in seven countries. It is caused by two parasite species,
L. donovani, which is associated with infections mainly in Africa and in Southern Asia, and
L. infantum, which is associated with infections in South America, the Middle East, and Southern Europe. Both host and parasite genetics contribute to the manifestation of disease in infected individuals, and factors such as the
Leishmania species, health status of the host, and urbanization may contribute to the disease progression and pathogenesis. VL is lethal if left untreated, and is often associated with anemia, thrombocytopenia, hepatosplenomegaly, and downregulation of immunity in both humans (
1,
2) and preclinical rodent models (
3,
4). There are significant differences in the pathogenesis of human VL between India, East Africa, and Brazil. Lymphadenopathy is common in East Africa but rare in India; post-kala azar dermal leishmaniasis (PKDL) is frequent in East Africa and less so in India but does not occur in Brazil. On the other hand, severe bleeding, and coagulopathy, often linked to disseminated intravascular coagulation (DIC), has been reported in VL in Brazil, where it is a major risk factor for death, whereas in India and Sudan, bleeding is most commonly limited to epistaxis. The severity of VL in patients from Brazil, including coagulopathies, has been associated with a higher concentration of serum inflammatory cytokines, although this is ineffective in the control of parasite proliferation (
5,
6). A study of parasite burden in patients infected with
L. infantum revealed a direct correlation between burden and clinical outcome, disease severity and mortality risk (
7,
8). How and which parasite factors influence the outcome of infection and the development of distinct clinical conditions, however, remains elusive.
In the last few years, attempts to identify blood signatures in infected patients using transcriptomics helped to define general pathways involved in the host response of symptomatic individuals, such as T-lymphocyte activation and type I-interferon signaling in VL patients infected with
L. infantum (
9), or enrichment of genes associated with erythrocyte function in active cases of VL patients infected with
L. donovani (
9). One transcriptomics approach is dual sequencing, which allows for both pathogen and host responses to be characterized simultaneously within the same biological sample and can enable a greater understanding of the host–pathogen interactions. Dual RNA-seq has been used to investigate gene expression changes in
in vivo models of
Mycobacterium tuberculosis infected murine lungs (
10), infection of the fish
Epinephelus coioides with
Pseudomonas plecoglossicida (
11), and neutrophil recruitment in
Streptococcus pneumoniae murine infections (
12).
In the study of leishmaniasis, dual RNA-seq has been used to analyze the parasite–macrophage interaction
in vitro (
13–15), and in human lesion material from
L. braziliensis-infected patients (
16). In contrast, dual RNA-seq has not to date been applied to the study of visceral leishmaniasis in animal models. In addition, while previous studies have examined the host transcriptional response to
L. donovani (
17) and
L. infantum (
18) infection in mice, as well as hamsters infected with
L. donovani (
19), direct comparisons of the host response between these two visceralizing species has not been reported previously. Likewise, although both
L. donovani (
20) and
L. infantum (
21) have been well characterized in terms of gene expression related to stage specific differentiation, it is not known if these two parasites react similarly to the stresses associated with mammalian infection.
L. donovani and
L. infantum are geographically and phylogenetic divergent (
22,
23), while having similar parasitism in mice, infecting liver, spleen, and bone marrow (
17,
18).
Given the potential for distinct pathologies to be provoked by L. donovani and L. infantum infection and the potential diversity of tissue gene expression and tissue-specific immunopathology, we aimed to investigate simultaneously the host and parasite global gene expression changes within key target organs in infected mice. We performed dual RNA-seq analysis to compile a complete list of differentially expressed host genes (DEGs) as well as the species-specific parasite expressed genes (SSPEG). Our data indicate extensive similarity in host response, but with some infection-specific differences. In contrast, L. donovani and L. infantum isolated from spleen and liver show very few differences in gene expression.
DISCUSSION
We used dual RNA-seq to address the following main questions in experimental VL: (i) are there any transcriptional differences between the parasites L. infantum and L. donovani in different tissues, and (ii) what are the similarities and differences in the liver and spleen between infection with L. infantum and L. donovani compared to uninfected animals. We compiled a complete list of expressed genes for two different visceralizing parasite species, L. donovani and L. infantum, and two infected organs, the liver and spleen, at a single time point of infection. This time point was chosen to reflect both the establishment of chronic splenic pathology and the onset of hepatic host resistance, from the commonly used BALB/c mouse model.
The identification of genes expressed by amastigotes in the parasitized tissues in chronic infections could help to narrow down the panel of genes within their genomes when looking for potential virulence factors and/or drug targets. Surprisingly, the sets of expressed genes were nearly identical in the two parasite species, collected from the two organs. Considering that in the mouse model, the infection is contained and resolved in the liver while parasite burdens increase in the spleen, one might have expected that different sets of expressed genes would be mobilized by the parasite to respond to those differing tissue microenvironments. In Leishmania, however, gene-expression regulation can also occur at the posttranscriptional level, making it possible that tissue-specific signatures of parasite genes would be preferentially identified in proteomics studies.
Previously validated virulence factors such as cysteine peptidase B (CPB) and tryparedoxin 1 were among the top 50 most highly abundant mRNAs in the liver, with cysteine peptidase C (cathepsin B-like peptidase) and cysteine peptidase A (CPA) among the top 100. This supports the high dependence of
Leishmania amastigotes on papain-like cysteine peptidases in the mammalian host. In the spleen, tryparedoxin 1, tryparedoxin 2, and trypanothione reductase were among the top 100 most highly abundant mRNAs, suggesting that in the spleen, amastigotes adapt their transcriptional response to deal with an increase in environmental oxidative stress. This is in line with a previous study comparing a virulent
L. donovani strain from Sri Lanka with its avirulent counterpart that causes cutaneous leishmaniasis in which increases in stress response proteins and antioxidants were associated with changes in virulence and survival in visceral organs (
39). On the other hand, we did not observe the expression of the protein kinases (LdBPK361580 and LdBPK361590) associated with the visceral-virulent phenotype in a recent genomic study in the same visceral versus cutaneous model (
40).
Only 310 parasite genes out of the 4,998 expressed in the liver showed cumulative counts above 50 for both species, suggesting that low expressed genes would not be captured within this data, and statistically significant differences may not bear true biological differences when few reads are available. This can result in exaggerated significance values and larger log2FC for lowly expressed genes with few counts assigned to the gene. This was not the case for the SPPEGs we identified. Of note, there was no expression of the double-strand break repair Rad21, reported as having increased expression in amastigotes by comparative transcriptomics of
L. infantum and
L. major (
41). In addition, out of 8 protein kinases (PKAC1, MPK15, MPK10, EF2A2, PK4, CK2A1, CRK8, TOR3) recently identified as specific for amastigote infection and key for the survival of
L. mexicana in the mouse (
42), there was no expression detected for MPK15 and PK4 in the liver or spleen amastigotes, while the expression of PKAC1 and EF2A2 was detected solely in spleen amastigotes. The expression of the parasite Inhibitor of Serine Peptidase (ISP2) was not detected (zero counts) in either liver or spleen amastigotes, in agreement with the prediction that its expression disfavors parasite development of
L. donovani in macrophages (
43).
In a recent dual-seq analysis of murine macrophages infected
in vitro with virulent and avirulent
L. donovani strains, the authors reported 96 parasite genes that were DE between the virulent and avirulent strains, with significant increases in proline oxidase, protein kinases and calpain-like peptidases in virulent parasites (
14). The expression of the calpain-like gene (LDBPK_310430), reported by these authors as increased in virulent
L. donovani, was below our cutoff for detection of expression in liver or spleen amastigotes. However, we observed high expression of another calpain-like gene (LdBPK_270510, within top 200) by parasites in the spleen and in the liver, which likely reflects heterogeneity among parasite strains regarding the expression of the individual members of the large family of calpain-like genes. In contrast, the authors identified tryparedoxin as upregulated in amastigotes of the avirulent strain compared to their virulent strain, which is discrepant with our findings of the high tryparedoxin mRNA abundance by amastigotes in the tissues of infected mice.
We found only 4 SSPEGs between
L. donovani and
L. infantum, two of which were hypotheticals. The orthologue of the Lmsp7, a SSPEG expressed by
L. infantum, is identified as an snRNA binding protein in
Trypanosoma sp., and might represent a hub in the regulation of expression of other genes at the posttranscriptional level. Another SSPEG with increased expression in
L. infantum is a ubiquitous enzyme involved in the generation of unsaturated fatty acids, including linoleic acid. Of relevance, exogenous linoleic acid was reported to decrease
L. donovani survival in infected macrophages (
44) and to enhance the inflammatory response of macrophages infected with
L. donovani through LPO (
45). However, we do not know if or how altered levels of unsaturated lipids in the parasite itself could affect infection.
In general, we found discrepancies between the expression of parasite genes previously associated with parasite virulence in transcriptomic studies in models of macrophage infections
in vitro and the expression in amastigotes in the tissues of infected mice described here. This highlights the importance of care when extrapolating data from
in vitro studies to an
in vivo setting and by extension potentially limits the extrapolations of our findings in the mouse to human disease. A great deal of data on the immune response to visceral
Leishmania species are available in mouse models of infection, especially in those employing the use of knockout mice. Although the kinetics of the expression of cytokines and chemokines were previously addressed in BALB/c mice infected with
L. donovani (
17), a comparative paired analysis with
L. infantum infections was not available. Here, we found most of the immune-related genes reported as upregulated at day 32 for mice infected with
L. donovani, in both infections, denoting that the host responds to both parasite species in a similar manner. Adding to this picture, we observed significant upregulation of IL-27. The anti-inflammatory properties of IL-27 have been implicated in the prevention of protective Th1 responses to
L. donovani and
L. infantum, while limiting tissue damage (
46). A linked cooperative action between IL-27 and IL-10 as a deactivating immunomodulatory arm during experimental visceral infection was recently proposed (
47). In this study, IL-27 was responsible for reducing the levels of TNF and IFNγ required for parasite control, therefore favoring infection. However, we found abundant mRNA for
Tnf and
Ifng in the livers of infected mice, despite abundant
Il27 and
Il10 mRNA, suggesting that in the liver, IL-10 and IL-27 may be insufficient to attenuate the inflammatory response associated with parasite control. Considering that the relative amounts of cytokines/chemokines in tissues, as well as of their cell surface receptors, are highly susceptible to posttranslational control by proteolysis, for example, our findings for the mRNA expression levels might not fully reflect the true nature of the tissue environment. Indeed, proteases known to inactivate cytokines or to cleave surface receptors, such as neutrophil elastase, were DEG in the infected organs.
Among the unique species-specific host DEGs, two might further impact the tissue microenvironment in ways that cannot not be verified by RNA-seq. Arachidonate 5-lipoxygenase, which was uniquely upregulated in the L. donovani-infected spleen, plays a dual role in inflammation due to its ability to enhance or to decrease the levels of lipid mediators, eicosanoids, and therefore the levels of pro- versus anti-inflammatory mediators that cannot be inferred based on gene expression alone. Furthermore, this enzyme can act as a hub for many cellular downstream responses related to migration and maturation, because it participates in dendritic cell migration, wound healing, and monocyte adhesion to the endothelium. Changes in cellular migration and adhesion, for instance, cannot be addressed by RNA-seq. On the other hand, aldehyde oxygenase 1 (AOX1), uniquely upregulated in the L. infantum-infected spleen, and highlighted in the network analyses, has a broad oxidase activity, and can be a prominent source of superoxide generation, as well as contribute to nitric oxide (NO) production. Those findings reveal a greater chance for an enhanced oxidized environment in L. infantum infection, which could in turn contribute to the inactivation of certain cytokines, peptidase inhibitors, and other players in tissue remodeling. We did not address potential nuances in tissue pathology, which requires detailed histological analyses.
Transcriptomics analyses in the hamster model of infection have identified mRNAs for regulatory cytokines (
IL-4,
IL-10, and
IL-21), arginase (
Arg1), and low nitric oxide production by macrophages as key factors of immunopathology and parasite persistence (
19,
28). In the mouse, we observed significant increases in
IL-10 and
IL-21 mRNA accumulation in the spleens of infected mice, but differently from what is seen in hamsters (
28),
Nos2 was likewise highly increased in mice, whereas
Arg1 and
Arg2 (log2FC0.9, FDR = 0.5) were not altered compared to uninfected control, despite high parasite loads. This highlights a major difference between the mouse and hamster models, and suggests that in the mouse, additional mechanisms beyond the nitric oxide–arginase axis may be pivotal to allow disease progression in the spleen. In common with the hamster studies, we observed enrichment in IFN-associated pathways, which were shown to unexpectedly promote parasite burden in
ex vivo splenic hamster macrophages. Also, in common with the hamster studies, we found a highly inflammatory pattern of gene expression, which contrasts with
in vitro studies with murine or human macrophages that report mainly suppressive effects induced by the parasite. This highlights that an inflammatory environment in the tissue could have a profound effect in splenic macrophages. Although in hamsters infected with
L. donovani,
IDO-1 expression was highly upregulated both in the whole spleen tissue and in isolated splenic macrophages (
19), we found only a modest increase in
IDO-1 in the
L. donovani-infected mouse spleen (log2FC2.2, FDR < 0.01) while no significant induction was observed in the
L. infantum-infected spleen (log2FC1.62, FDR < 0.1). The enrichment in the tryptophan pathway found specifically for
L. donovani-infected spleens is consistent with increased
IDO-1 and with the kynurenine (KYNU) pathway for tryptophan catabolism. Adding to this picture, enzymes for phenylalanine and tyrosine metabolism were likewise among the
L. donovani-induced unique DEGs, revealing an enrichment of genes related to nutritional metabolism. Intriguingly, such changes in
IDO-1 and nutritional metabolism are also found in leprosy (
38), and we have recently described at the cellular level a close parallel of gene expression in macrophages infected
in vitro with
L. donovani (
48) with that described for macrophages infected with
M. leprae (
49), including the induction of Type-I IFNs and OASL2.
The pathophysiology of bleeding has been attributed to disseminated intravascular coagulation (DIC). DIC is a disorder of the fibrinolytic and hemostatic systems that manifests as the generation of numerous and widespread microthrombi in the vasculature. Due to the increased spread and lack of compensatory control, DIC leads to eventual exhaustion of these pathways, resulting in propensity for diffuse bleeding and end organ complications. DIC is associated with numerous clinical diseases where excess cytokine production is observed, notably sepsis, and it has been suggested that VL in Brazil represents a slow-to-develop systemic inflammatory syndrome. Although the mouse model is not suited to address bleeding phenotypes nor DIC in the context of
Leishmania infections, there was a significant enrichment of pathways related to coagulation and hemostasis in the infected animals, both in the liver and spleen. This is compatible with the major changes in the vascular architecture of those organs in infected animals and might reflect the host attempts to minimize tissue damage caused by excessive inflammation and coagulopathies. In the spleen, there was significant enrichment of pathways in both directions of clotting, i.e., formation and dissolution of fibrin clots, which may account for a better control of a bleeding phenotype in the mouse. A more robust response to visceralizing
Leishmania toward an equilibrium of hemostasis might be a key feature distinguishing the mouse model from human infections. Of note, several serpin genes (9 genes), which encode serine protease inhibitors, which inactivate enzymes of the coagulation cascade, including thrombin (
50), and act on tissue remodeling (
51), were significantly upregulated in infected mice. Serpins are also associated with attenuation of inflammation independently of their protease inhibitory properties (
52). The role of microbial serpins in the control of hemorrhage and inflammation in a mouse model of lethal viral sepsis associated with DIC was recently reported, where clot inhibitors had moderate effects (
53–55). In addition,
SERPIN3G, which is implicated in the control of inflammation, is highly upregulated (log2FC4). In conjunction, higher accumulation of serpins could contribute to ensure hemostasis and to attenuate inflammation in response to infection.
In summary, we provide a comprehensive paired data set of parasite and host genes associated with infections with L. donovani or L. infantum in the mouse model. Although the host responded to both infections broadly in the same way, in the liver and spleen, we identified hundreds of host genes that were specifically DE in infections with either parasite species, which can serve as a source to address specific pathways of interest.