New rat model of Pneumocystis carinii infection.

Rats free of latent Pneumocystis carinii organisms were immunosuppressed with adrenal corticosteroids and transtracheally injected with P. carinii. These animals subsequently developed P. carinii pneumonia. Infection was accomplished by using organisms from infected rat lung or from culture. Diffuse infection was produced with no significant differences in the numbers of organisms found in various lobes of the lungs. Infections progressed over time so that by 6 weeks postinoculation all animals were heavily infected. Infection by transtracheal injection has three advantages over current models. First, transtracheal injection provides a reliable model which is not dependent on naturally occurring latent Pneumocystis infection. Second, transtracheal injection allows the perpetuation of specific Pneumocystis strains. Third, transtracheal injection is a more rapid and economical means of producing severe Pneumocystis pneumonia.     

Improved rat model for studying Pneumocystis carinii pneumonia.

Sprague-Dawley rats treated for 8 weeks with cortisone acetate (25 mg per rat twice weekly) were immunosuppressed to variable degrees. A total of 55% lost over 12% of their initial body weight, had cortisol concentrations in serum more than five times greater than those of the controls, and had markedly depressed ratios of helper to non-helper T cells, in both the spleen and peripheral blood. Animals that gained weight during immunosuppression had cortisol concentrations in serum only three times higher than those of the controls, had normal ratios of helper to non-helper T cells in the spleen, and had only modestly reduced T-cell ratios in peripheral blood. The degree of Pneumocystis pneumonia was evaluated in impression smears and sections of lungs taken from immunosuppressed rats. Pneumocystis infections were more severe in the rats that showed the greatest weight loss. Weight change during immunosuppression may therefore be used as a reliable means for predicting the degree of Pneumocystis infection in living rats. This protocol allows the selection of uniformly infected rats for studies assessing drug therapy of Pneumocystis pneumonia.     

Effect of CD40 ligand and other immunomodulators on Pneumocystis carinii infection in rat model

The corticosteroid-treated animal is well established as an experimental model for the study of Pneumocystis carinii pneumonitis (PCP). Latent or acquired infection with P. carinii in the murine lung progresses to fatal pneumonitis when the host is profoundly immunocompromized. In this study the effects of five immunomodulators; recombinant CD40 ligand (CD40L), bryostatin 1, recombinant FLT3 ligand (FLT3L), recombinant granulocyte colony-stimulating factor (G-CSF) and recombinant interleukin-15 (IL-15) were investigated against PCP in a dexamethasone immunosuppressed Sprague-Dawley rat model. The majority of rats (70%) treated with CD40L at the onset of dexamethasone immunosuppression were protected against PCP. When CD40L was given after 10 days of immunosuppression, only 40% of the rats resolved the infection. However, 95% of the control animals developed PCP. Immunosuppressed rats treated with bryostatin 1, an immune activator had a partial (50%) protection against P. carinii infection. In contrast, daily administration of FLT3L, IL-15 or G-CSF provided no protection against P. carinii infection.     

Cavia porcellus as a model for experimental infection by Trypanosoma cruzi

The guinea pig (Cavia porcellus) is a natural reservoir for Trypanosoma cruzi but has seldom been used as an experimental infection model. We developed a guinea pig infection model for acute and chronic Chagas disease. Seventy-two guinea pigs were inoculated intradermally with 10(4) trypomastigotes of T. cruzi strain Y (experimental group); 18 guinea pigs were used as control group. Eight animals from the experimental group and two from the control group were sacrificed 5, 15, 20, 25, 40, 55, 115, 165, and 365 days after inoculation. During the acute phase (15 to 55 days), we observed parasitemia (with a peak on day 20) and positive IgM and IgG Western blots with anti-shed acute-phase antigen bands. The cardiac tissue showed vasculitis, necrosis (on days 40 to 55), moderate to severe inflammation, and abundant amastigote nests. Smaller numbers of amastigote nests were also present in kidney, brain, and other organs. In the early chronic phase (115 to 165 days), parasitemia disappeared and anti-T. cruzi IgG antibodies were still detectable. In cardiac tissue, the number of amastigote nests and the grade of inflammation decreased. In the chronic phase (365 days), the cardiac tissue showed vasculitis and fibrosis; detectable parasite DNA was associated with higher grades of inflammation. The experimental T. cruzi infection model in guinea pigs shows kinetics and pathologic changes similar to those of the human disease.     

Use of semiquantitative PCR to assess onset and treatment of Pneumocystis carinii infection in rat model.

The use of semiquantitative PCR (SQPCR) to assess Pneumocystis carinii pneumonia (PCP) infection and its response to treatment was studied with rats. Groups of eight rats were immunosuppressed with steroids for 3 to 12 weeks. Untreated controls were maintained for the same periods. Three groups of rats were treated with pentamidine, three groups were treated with trimethoprim-sulfamethoxazole, and three groups of rats were tapered from steroids. At various times during suppression, rats from the different groups were sacrificed. At necropsy, lungs were lavaged to obtain bronchoalveolar fluids and then homogenized. Bronchoalveolar fluids and homogenates were assayed by cyst counting and SQPCR. An increase in the SQPCR signal was seen throughout immunosuppression, with a slow decrease upon the withdrawal of steroids and a faster decrease with drug treatment. SQPCR results with lung homogenates and bronchoalveolar fluids strongly correlated with each other and with cyst counts. These results warrant investigation of SQPCR for assessing treatment results of human P. carinii pneumonia infection.     

Pneumocystis carinii infection in a HIV infection department]

To determine the prevalence of Pneumocystis carinii in the HIV-infection department, a simultaneous survey was made of 33 HIV-infected patients at various stages of the disease, of close relatives that were nursing the patients in the unit (n-7), and of medical staff of the department (n-20). Patients with toxic infections who were on another floor of the same hospital and medical students were examined as a control group. For detection of P. carinii antigen, smears from the deep airways were tested in the immunofluorescence. P. carinii was detected in 87.7% of HIV-infected patients, in 71.4% of their relatives and in 80.0% of the medical staff, in 16.6% of control patients and 27.7% of students. The main type of the infectious process in pneumocystosis is its carriage; 2 patients at a stage of relapses (IIIB) that corresponds to AIDS were recorded as having pneumocystis pneumonia.     

Mouse model for Pneumocystis carinii pneumonia that uses natural transmission to initiate infection.

Animal models for Pneumocystis carinii, for the most part, have been limited to immunosuppressed rats and ferrets, while a dependable mouse model has been more difficult to develop. A P. carinii mouse model has now been established with several strains of mice, including C3Heb/FeJ, C3HeN, BALB/c, DBA/2N, and BALB/c nu/nu (athymic). In lieu of using invasive methods for initiating P. carinii infections, mice harboring P. carinii transmitted the disease to mice without latent infection via short-term cohabitation. After the exposure period, the seed mice were sacrificed to confirm the presence of acute P. carinii pneumonia. Acute infections in recipient mice developed at approximately 7 to 8 weeks, while control unseeded littermates remained uninfected. All recipient mice and their littermates were maintained in isolation hoods to eliminate the possibility of exposure to other sources of P. carinii. This approach allows investigators to consistently transmit P. carinii to mice and to select the strain of mouse desired for use in a particular study. The results presented here suggest that more attention should be given to the potential for patient-to-patient transmission of P. carinii in immunocompromised patients such as those with AIDS.     

A radiometric assay for diagnosing lytic antibodies in Trypanosoma cruzi infection

Infective forms of Trypanosoma cruzi were used to evaluate the complement-mediated lysis (CoML) of the parasites in the presence of anti-T. cruzi sera. Parasites released to the supernatant from infected Vero cell monolayers were used. Cultures of 1–3×10⁶ parasites/ml were incubated for 24 h in the presence of 10 Ci/ml of ³H-uridine. Under these conditions 10⁵ parasites used for each determination incorporated about 9600 dpm of the radioactive material. The release of tritium from labelled parasites after incubation with antiserum and complement correlated with the percentage of lysed parasites evaluated by optical microscopy. Normal sera from humans, a guinea pig, a rabbit, and mice were tested as complement sources. Only human sera were suitable for the evaluation of CoML in the presence of antisera, and the levels of lysis attained depended on the serum donor.     

Pneumocystis carinii infection of the small intestine.

Extrapulmonary Pneumocystis carinii infections are rare in comparison to other opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS). In recent years, however, the number of reported cases of extrapulmonary pneumocystosis has increased. It is therefore important for physicians to recognize the various presentations of extrapulmonary P carinii infection. This article reports a case in which the initial clinically detected AIDS-related infection was extrapulmonary P carinii infection of the small intestine diagnosed after perforation of the jejunum.     

Trypanosoma cruzi infection in B-cell-deficient rats.

The effect of neonatally initiated injections of anti-mu rabbit antiserum on immunity of rats against Trypanosoma cruzi infection was investigated in vivo. Anti-mu treatment resulted in a loss of immunoglobulin M (IgM) and IgG2a synthesis and, subsequently, of antibody production. These rats so treated were shown to be significantly more susceptible to the acute phase of the infection than the control rats treated with normal rabbit serum, as measured by increased parasitemia and mortality. These results indicate the essential role of antibodies, probably in association with complement or effector cells or both, in immunity to acute Chagas' disease.     

Serological observations of Pneumocystis carinii infection in humans.

Serological examinations of Pneumocystis carinii antigen and antibody were performed in adult patients with P. carinii pneumonia. The antibody titer was assayed by indirect immunofluorescence, and antigenemia was detected by counterimmunoelectrophoresis. Profiles of the time course of antibody levels in serum indicated that development of the antibody occurred at an early stage of pneumonia and that peak titers were obtained during the febrile stage.