Imperial College London

DrPascaleKropf

Faculty of MedicineDepartment of Infectious Disease

Reader in Immunology
 
 
 
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Contact

 

+44 (0)20 7594 1755p.kropf

 
 
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Location

 

120Praed StreetSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
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71 results found

Gimeno-Molina B, Bayar E, Mountain K, Love R, Lee Y, Muller I, Dell A, Haslam S, Grassi P, Wu G, MacIntyre D, Bennett P, Kropf P, Sykes Let al., 2023, The role of cervical neutrophils in cervicovaginal inflammation in women at high-risk of delivering preterm, 12th International Workshop Reunion Island Reproductive Immunology, Immunological tolerance and Immunology of preeclampsia, Publisher: ELSEVIER IRELAND LTD, Pages: 31-31, ISSN: 0165-0378

Conference paper

Yizengaw E, Nibret E, Yismaw G, Gashaw B, Tamiru D, Munshea A, Takele Y, Müller I, Chapman L, Weller R, Cotton JA, Kropf Pet al., 2023, Cutaneous leishmaniasis in a newly established treatment centre in the Lay Gayint district, Northwest Ethiopia, Skin Health and Disease, Vol: 3, Pages: 1-8, ISSN: 2690-442X

BACKGROUND: Cutaneous leishmaniasis (CL) is a neglected tropical disease that primarily affects the most vulnerable populations. In Ethiopia, where this study took place, CL is an important health problem, however, the incidence of CL is poorly monitored. OBJECTIVES: This study took place in a recently established CL treatment centre, at Nefas Mewcha Hospital, Lay Gayint. This area was considered to be endemic for CL, however, no cases of CL from Lay Gayint had previously been officially reported to the Amhara Regional Health Bureau. METHODS: Following a CL awareness campaign, a retrospective data review was performed of patients presenting to this centre between July 2019 and March 2021. Basic demographic and clinical data were collected by a nurse and recorded in the logbook of the CL treatment centre. RESULTS: Two hundred and one patients presented for diagnosis and treatment. The age of the patients ranged from 2 to 75 years and 63.2% were males. Most patients were between 10- and 19-years-old. The majority (79.1%) of the patients presented with localised cutaneous leishmaniasis and 20.9% with mucocutaneous leishmaniasis. 98% of the patients tested positive for Leishmania parasites by microscopy. CONCLUSIONS: This work underpinned how CL is a major public health problem in the Lay Gayint district. It also shows that raising awareness about CL in the community and providing diagnosis and treatment encouraged patients to travel to seek diagnosis and treatment.

Journal article

Takele Y, Mulaw T, Adem E, Womersley R, Kaforou M, Franssen SU, Michael levin, Taylor GP, Müller I, Cotton JA, Kropf Pet al., 2023, Recurrent visceral leishmaniasis relapses in HIV co-infected patients are characterised by less efficient immune responses and higher parasite load, iScience, Vol: 26, Pages: 1-22, ISSN: 2589-0042

Visceral leishmaniasis (VL) and HIV co-infection (VL/HIV) has emerged as a significant public health problem in Ethiopia, with up to 30% of patients with VL co-infected with HIV. These patients suffer from recurrent VL relapses and increased mortality. Those with a previous history of VL relapses (recurrent VL/HIV) experience increased VL relapses as compared to patients with HIV presenting with their first episode of VL (primary VL/HIV). Our aim was to identify drivers that account for the higher rate of VL relapses in patients with recurrent VL/HIV (n = 28) as compared to primary VL/HIV (n = 21). Our results show that the relapse-free survival in patients with recurrent VL/HIV was shorter, that they had higher parasite load, lower weight gain, and lower recovery of all blood cell lineages. Their poorer prognosis was characterized by lower production of IFN-gamma, lower CD4+ T cell counts, and higher expression of programmed cell death protein 1 (PD1) on T cells.

Journal article

Molina BG, Bayar E, Love RL, Merrick AV, Riani-El-Achhab S, Lee YS, Muller I, David AL, Terzidou V, Bennet PR, MacIntyre DA, Botto M, Kropf P, Sykes Let al., 2023, Cervical Shortening is Associated with Cervical Neutrophil Migration and Complement Activation, 70th Annual Meeting of the Society for Reproductive Investigation (SRI), Publisher: SPRINGER HEIDELBERG, Pages: 94A-95A, ISSN: 1933-7191

Conference paper

Gimeno-Molina B, Muller I, Kropf P, Sykes Let al., 2022, The role of neutrophils in pregnancy, term and preterm labour, Life, Vol: 12, ISSN: 2075-1729

Neutrophils are surveillance cells, and the first to react and migrate to sites of inflammation and infection following a chemotactic gradient. Neutrophils play a key role in both sterile inflammation and infection, performing a wide variety of effector functions such as degranulation, phagocytosis, ROS production and release of neutrophil extracellular traps (NETs). Healthy term labour requires a sterile pro-inflammatory process, whereas one of the most common causes of spontaneous preterm birth is microbial driven. Peripheral neutrophilia has long been described during pregnancy, and evidence exists demonstrating neutrophils infiltrating the cervix, uterus and foetal membranes during both term and preterm deliveries. Their presence supports a role in tissue remodelling via their effector functions. In this review, we describe the effector functions of neutrophils. We summarise the evidence to support their role in healthy pregnancy and labour and describe their potential contribution to microbial driven preterm birth.

Journal article

Takele Y, Adem E, Mulaw T, Müller I, Cotton JA, Kropf Pet al., 2022, Following successful anti-leishmanial treatment, neutrophil counts, CD10 expression and phagocytic capacity remain reduced in visceral leishmaniasis patients co-infected with HIV, PLoS Neglected Tropical Diseases, Vol: 16, ISSN: 1935-2727

Visceral leishmaniasis (VL) patients co-infected with HIV (VL/HIV patients) experience frequent treatment failures, VL relapses, opportunistic infections, and higher mortality. Their immune system remains profoundly suppressed after clinical cure and they maintain higher parasite load. This is in contrast with patients with VL alone (VL patients). Since neutrophils play a critical role in the control of Leishmania replication and the regulation of immune responses, we tested the hypothesis that neutrophil activation status and effector functions are fully restored in VL, but not in VL/HIV patients. Our results show the neutrophil counts and all activation markers and effector functions tested in our study were reduced at the time of diagnosis in VL and VL/HIV patients as compared to controls. CD62L, CD63, arginase 1 expression levels and reactive oxygen species production were restored at the end of treatment in both groups. However, neutrophil counts, CD10 expression and phagocytosis remained significantly lower throughout follow-up in VL/HIV patients; suggesting that dysregulated neutrophils contribute to the impaired host defence against pathogens in VL/HIV patients.

Journal article

Takele Y, Adem E, Franssen SU, Womersley RL, Kaforou MC, Levin ML, Mueller IC, Cotton JAL, Kropf PCet al., 2022, Impaired in vitro Interferon-gamma production in patients with visceral leishmaniasis is improved by inhibition of PD1/PDL-1 ligation, PLoS Neglected Tropical Diseases, Vol: 16, Pages: 1-12, ISSN: 1935-2727

Visceral leishmaniasis (VL) is a neglected tropical disease that causes substantial morbidity and mortality and is a growing health problem in Ethiopia, where this study took place. Most individuals infected with Leishmania donovani parasites will stay asymptomatic, but some develop VL that, if left untreated, is almost always fatal. This stage of the disease is associated with a profound immunosuppression, characterised by impaired production of Interferonγ (IFNγ), a cytokine that plays a key role in the control of Leishmania parasites, and high expression levels of an inhibitory receptor, programmed cell death 1 (PD1) on CD4+ T cells. Here, we tested the contribution of the interaction between the immune checkpoint PD1 and its ligand PDL-1 on the impaired production of IFNγ in VL patients. Our results show that in the blood of VL patients, not only CD4+, but also CD8+ T cells express high levels of PD1 at the time of VL diagnosis. Next, we identified PDL-1 expression on different monocyte subsets and neutrophils and show that PDL-1 levels were significantly increased in VL patients. PD1/PDL-1 inhibition resulted in significantly increased production of IFNγ, suggesting that therapy using immune checkpoint inhibitors might improve disease control in these patients.

Journal article

Molina B, Bayar E, Lee Y, Muller I, Botto M, MacIntyre D, Bennett P, Kropf P, Sykes Let al., 2022, Cervicovaginal inflammation and neutrophil infiltration/activation in women at high-risk of prematurity, Publisher: WILEY, Pages: 54-54, ISSN: 1470-0328

Conference paper

Chan D, Bennett P, Lee YS, Kundu S, Teoh TG, Adan M, Ahmed S, Brown RG, David A, Lewis H, Gimeno- Molina B, Norman J, Stock S, Terzidou V, Kropf P, Botto M, MacIntyre D, Sykes Let al., 2022, Microbial-driven preterm labour involves crosstalk between the innate and adaptive immune response, Nature Communications, Vol: 13, ISSN: 2041-1723

There has been a surge in studies implicating a role of vaginal microbiota in spontaneous preterm birth (sPTB), but most are associative without mechanistic insight. Here we show a comprehensive approach to understand the causative factors of preterm birth, based on the integration of longitudinal vaginal microbiota and cervicovaginal fluid (CVF) immunophenotype data collected from 133 women at high-risk of sPTB. We show that vaginal depletion of Lactobacillus species and high bacterial diversity leads to increased mannose binding lectin (MBL), IgM, IgG, C3b, C5, IL-8, IL-6 and IL-1β and to increased risk of sPTB. Cervical shortening, which often precedes preterm birth, is associated with Lactobacillus iners and elevated levels of IgM, C3b, C5, C5a and IL-6. These data demonstrate a role for the complement system in microbial-driven sPTB and provide a scientific rationale for the development of live biotherapeutics and complement therapeutics to prevent sPTB.

Journal article

Takele Y, Mulaw, Adem, Shaw E, Franssen, Womersley R, Kaforou M, Taylor G, Levin M, Muller I, Cotton, Kropf Pet al., 2022, Immunological factors, but not clinical features, predict visceral leishmaniasis relapse in patients co-infected with HIV, Cell Reports Medicine, Vol: 3, ISSN: 2666-3791

Visceral leishmaniasis (VL) has emerged as a clinically important opportunistic infection in HIV patients, as VL/HIV co-infected patients suffer from frequent VL relapse. Here, we follow cohorts of VL patients with or without HIV in Ethiopia. By the end of the study 78.1% of VL/HIV, but none of the VL patients, experience VL relapse. Despite clinically defined cure, VL/HIV patients maintain higher parasite loads, lower BMI, hepatosplenomegaly and pancytopenia. We identify three immunological markers associated with VL relapse in VL/HIV patients: i) failure to restore antigen-specific production of IFNg, ii) persistently lower CD4+ T cell counts, and iii) higher expression of PD1 on CD4+ and CD8+ T cells. We show that these three markers, that can be measured in primary hospital settings in Ethiopia, combine well in predicting VL relapse. The use of our prediction model has the potential to improve disease management and patient care.

Journal article

Chan D, Bennett PR, Lee YS, Teoh TG, Adan M, Ahmed SM, Brown RG, David AL, Lewis H, Gimeno-Molina B, Norman JE, Stock SJ, Terzidou V, Kropf P, Botto M, MacIntyre DA, Sykes Let al., 2021, Microbial-Driven Preterm Labour Involves Crosstalk between the Innate and Adaptive Immune Response., Publisher: SPRINGER HEIDELBERG, Pages: 108A-109A, ISSN: 1933-7191

Conference paper

Franssen SU, Takele Y, Adem E, Sanders MJ, Müller I, Kropf P, Cotton JAet al., 2021, Diversity and within-host evolution of Leishmania donovani from visceral Leishmaniasis patients with and without HIV coinfection in northern Ethiopia., mBio, Vol: 12, Pages: 1-19, ISSN: 2150-7511

Visceral leishmaniasis (VL) is a fatal disease and a growing public health problem in East Africa, where Ethiopia has one of the highest VL burdens. The largest focus of VL in Ethiopia is driven by high prevalence in migrant agricultural workers and associated with a high rate of coinfection with HIV. This coinfection makes VL more difficult to treat successfully and is associated with a high rate of relapse, with VL/HIV patients frequently experiencing many relapses of VL before succumbing to this infection. We present genome-wide data on Leishmania donovani isolates from a longitudinal study of cohorts of VL and VL/HIV patients reporting to a single clinic in Ethiopia. Extensive clinical data allow us to investigate the influence of coinfection and relapse on the populations of parasites infecting these patients. We find that the same parasite population is responsible for both VL and VL/HIV infections and that, in most cases, disease relapse is caused by recrudescence of the population of parasites that caused primary VL. Complex, multiclonal infections are present in both primary and relapse cases, but the infrapopulation of parasites within a patient loses genetic diversity between primary disease presentation and subsequent relapses, presumably due to a population bottleneck induced by treatment. These data suggest that VL/HIV relapses are not caused by genetically distinct parasite infections or by reinfection. Treatment of VL does not lead to sterile cure, and in VL/HIV, the infecting parasites are able to reestablish after clinically successful treatment, leading to repeated relapse of VL. IMPORTANCE Visceral leishmaniasis (VL) is the second largest cause of deaths due to parasite infections and a growing problem in East Africa. In Ethiopia, it is particularly associated with migrant workers moving from regions of nonendemicity for seasonal agricultural work and is frequently found as a coinfection with HIV, which leads to frequent VL relapse following trea

Journal article

Abera EA, Tajebe F, Getahun M, Kiflie A, Hailu A, Diro E, Takele Y, Shkedy Z, Deressa T, Modolell M, Munder M, Mueller I, Kropf Pet al., 2019, Successful treatment of human visceral leishmaniasis restores antigen-specific IFN-gamma, but not IL-10 production, 17th International Congress of Immunology of the International-Union-of-Immunological-Societies (IUIS), Publisher: WILEY, Pages: 1186-1187, ISSN: 0014-2980

Conference paper

Thurairajah S, Alqurashi M, Chan D, Akers R, Teoh TG, Bennett PR, Muller I, Kropf P, Sykes Let al., 2019, Characterisation of Peripheral Blood Neutrophil Phenotype and Effector Functions during Pregnancy, Labour and in Women at High Risk of Preterm Labour., 66th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: SAGE PUBLICATIONS INC, Pages: 123A-123A, ISSN: 1933-7191

Conference paper

Alqurashi M, Thurairajah S, Adan M, Chan D, Teoh TG, Bennett PR, Muller I, Kropf P, Sykes Let al., 2019, Characterisation of Normal and Low Density Granulocytes in Pregnancy, Term Labour, and Women at High Risk of Preterm Labour., 66th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: SAGE PUBLICATIONS INC, Pages: 122A-123A, ISSN: 1933-7191

Conference paper

Taslimi Y, Sadeghipour P, Habibzadeh S, Mashayekhi V, Mortazavi H, Muller I, Lane ME, Kropf P, Rafati Set al., 2017, A novel non-invasive diagnostic sampling technique for cutaneous leishmaniasis, PLoS Neglected Tropical Diseases, Vol: 11, ISSN: 1935-2727

Accurate diagnosis of cutaneous leishmaniasis (CL) is important for chemotherapy and epidemiological studies. Common approaches for Leishmania detection involve the invasive collection of specimens for direct identification of amastigotes by microscopy and the culturing of promastigotes from infected tissues. Although these techniques are highly specific, they require highly skilled health workers and have the inherent risks of all invasive procedures, such as pain and risk of bacterial and fungal super-infection. Therefore, it is essential to reduce discomfort, potential infection and scarring caused by invasive diagnostic approaches especially for children. In this report, we present a novel non-invasive method, that is painless, rapid and user-friendly, using sequential tape strips for sampling and isolation of DNA from the surface of active and healed skin lesions of CL patients. A total of 119 patients suspected of suffering from cutaneous leishmaniasis with different clinical manifestations were recruited and samples were collected both from their lesions and from uninfected areas. In addition, 15 fungal-infected lesions and 54 areas of healthy skin were examined. The duration of sampling is short (less than one minute) and species identification by PCR is highly specific and sensitive. The sequential tape stripping sampling method is a sensitive, non-invasive and cost-effective alternative to traditional diagnostic assays and it is suitable for field studies as well as for use in health care centers.

Journal article

Tajebe F, Getahun M, Adem E, Hailu A, Lemma M, Fikre H, Raynes J, Tamiru A, Mulugeta Z, Diro E, Toulza F, Shkedy Z, Ayele T, Modolell M, Munder M, Mueller I, Takele Y, Kropf Pet al., 2017, Disease severity in patients with visceral leishmaniasis is not altered by co-infection with intestinal parasites, PLoS Neglected Tropical Diseases, Vol: 11, ISSN: 1935-2727

Visceral leishmaniasis (VL) is a neglected tropical disease that affects the poorest communities and can cause substantial morbidity and mortality. Visceral leishmaniasis is characterized by the presence of Leishmania parasites in the spleen, liver and bone marrow, hepatosplenomegaly, pancytopenia, prolonged fever, systemic inflammation and low body mass index (BMI). The factors impacting on the severity of VL are poorly characterized. Here we performed a cross-sectional study to assess whether co-infection of VL patients with intestinal parasites influences disease severity, assessed with clinical and haematological data, inflammation, cytokine profiles and BMI. Data from VL patients was similar to VL patients co-infected with intestinal parasites, suggesting that co-infection of VL patients with intestinal parasites does not alter disease severity.

Journal article

Mortazavi H, Sadeghipour P, Taslimi Y, Habibzadeh S, Zali F, Zahedifard F, Rahmati J, Kamyab K, Ghandi N, Zamanian A, Reza Tohidinik H, Muller I, Kropf P, Rafati Set al., 2016, Comparing acute and chronic human cutaneous leishmaniasis caused by Leishmania major and Leishmania tropica focusing on arginase activity., Journal of the European Academy of Dermatology and Venereology, Vol: 30, Pages: 2118-2121, ISSN: 1468-3083

BACKGROUND: Cutaneous leishmaniasis (CL) in Iran is mainly caused by Leishmania major (L. major) and L. tropica. Arginase mediated L-arginine metabolism is an important issue in Leishmania parasite propagation. Arginase activity in human CL due to L. major and L. tropica have not been studied up to now. OBJECTIVES: We aimed to compare the clinical and laboratory aspects of acute and chronic CL, focussing on arginase activity. METHODS: In this case-control study, 30 patients with acute CL (duration ≤ 1 year), 13 patients with chronic CL (duration ≥ 2 year) and 11 healthy controls were recruited. Arginase activity was measured in skin biopsies of lesions, peripheral blood polymorphonuclear cells (PMNs), peripheral blood mononuclear cells (PBMCs) and plasma by standard methods. RESULTS: The median of arginase activity in the acute lesions was higher than in chronic samples and significantly higher than in healthy controls (P = 0.008). PMNs of both acute and chronic patients showed higher levels of arginase activity as compared to the levels in PBMCs and plasma. The median of arginase activity in the PMNs of patients with chronic CL was higher than that of patients with acute CL and significantly higher than that of the healthy controls (P = 0.010). CONCLUSION: The level of arginase activity in lesions of patients with acute and chronic CL was higher than the skin of healthy controls. The highest level of arginase activity was observed in PMNs from patients with chronic CL. This suggests that the high level of arginase activity in PMNs of patients with chronic CL may contribute to the chronicity.

Journal article

Yizengaw E, Getahun M, Tajebe F, Cruz Cervera E, Adem E, Mesfin G, Hailu A, Van der Auwera G, Yardley V, Lemma M, Skhedy Z, Diro E, Yeshanew A, Melkamu R, Mengesha B, Modolell M, Munder M, Muller I, Takele Y, Kropf Pet al., 2016, Visceral leishmaniasis patients display altered composition and maturity of neutrophils as well as impaired neutrophil effector functions, Frontiers in Immunology, Vol: 7, ISSN: 1664-3224

Immunologically, active visceral leishmaniasis (VL) is characterised by profound immunosuppression, severe systemic inflammatoryresponses and an impaired capacity to control parasite replication. Neutrophils are highly versatile cells, which play a crucial rolein the induction as well as the resolution of inflammation, the control of pathogen replication and the regulation of immuneresponses. Neutrophil functions have been investigated in human cutaneous leishmaniasis, however, their role in human visceralleishmaniasis is poorly understood.In the present study we evaluated the activation status and effector functions of neutrophils in patients with active VL and aftersuccessful anti-leishmanial treatment. Our results show that neutrophils are highly activated and have degranulated; high levels ofarginase, myeloperoxidase and elastase, all contained in neutrophils’ granules, were found in the plasma of VL patients. Inaddition, we show that a large proportion of these cells are immature. We also analysed effector functions of neutrophils that areessential for pathogen clearance and show that neutrophils have an impaired capacity to release neutrophil extracellular traps,produce reactive oxygen species and phagocytose bacterial particles, but not Leishmania parasites.Our results suggest that impaired effector functions, increased activation and immaturity of neutrophils play a key role in thepathogenesis of VL.

Journal article

Takele Y, Adem E, Getahun M, Tajebe F, Kiflie A, Hailu A, Raynes J, Mengesha B, Ayele TA, Shkedy Z, Lemma M, Diro E, Toulza F, Modolell M, Munder M, Müller I, Kropf Pet al., 2016, Malnutrition in Healthy Individuals Results in Increased Mixed Cytokine Profiles, Altered Neutrophil Subsets and Function, PLOS One, Vol: 11, ISSN: 1932-6203

Malnutrition is commonly associated with increased infectious disease susceptibility and severity. Whereas malnutrition might enhance the incidence of disease as well as its severity, active infection can in turn exacerbate malnutrition. Therefore, in a malnourished individual suffering from a severe infection, it is not possible to determine the contribution of the pre-existing malnutrition and/or the infection itself to increased disease severity. In the current study we focussed on two groups of malnourished, but otherwise healthy individuals: moderately malnourished (BMI: 18.4-16.5) and severely malnourished (BMI <16.5) and compared several immune parameters with those of individuals with a normal BMI (≥18.5). Our results show a similar haematological profile in all three groups, as well as a similar ratio of CD4+ and CD8+ T cells. We found significant correlations between low BMI and increased levels of T helper (Th) 1 (Interferon (IFN)-γ, (interleukin (IL)-2, IL-12), Th2 (IL-4, IL-5, IL-13), as well as IL-10, IL-33 and tumor necrosis factor-α, but not IL-8 or C reactive protein. The activities of arginase, an enzyme associated with immunosuppression, were similar in plasma, peripheral blood mononuclear cells (PBMC) and neutrophils from all groups and no differences in the expression levels of CD3ζ, a marker of T cell activation, were observed in CD4+ and CD8+T cells. Furthermore, whereas the capacity of neutrophils from the malnourished groups to phagocytose particles was not impaired, their capacity to produce reactive oxygen species was impaired. Finally we evaluated the frequency of a subpopulation of low-density neutrophils and show that they are significantly increased in the malnourished individuals. These differences were more pronounced in the severely malnourished group. In summary, our results show that even in the absence of apparent infections, healthy malnourished individuals display dysfunctional immune responses that might

Journal article

Adem E, Tajebe F, Getahun M, Kiflie A, Diro E, Hailu A, Shkedy Z, Mengesha B, Mulaw T, Atnafu S, Deressa T, Mathewos B, Abate E, Modolell M, Munder M, Müller I, Takele Y, Kropf Pet al., 2016, Successful treatment of human visceral leishmaniasis restores antigen-specific IFN-γ, but not IL-10 production, PLOS Neglected Tropical Diseases, Vol: 10, Pages: e0004468-e0004468, ISSN: 1935-2735

One of the key immunological characteristics of active visceral leishmaniasis (VL) is a profound immunosuppression and impaired production of Interferon-γ (IFN-γ). However, recent studies from Bihar in India showed using a whole blood assay, that whole blood cells have maintained the capacity to produce IFN-γ. Here we tested the hypothesis that a population of low-density granulocytes (LDG) might contribute to T cell responses hyporesponsiveness via the release of arginase. Our results show that this population is affected by the anticoagulant used to collect blood: the frequency of LDGs is significantly lower when the blood is collected with heparin as compared to EDTA; however, the anticoagulant does not impact on the levels of arginase released. Next, we assessed the capacity of whole blood cells from patients with active VL to produce IFN-γ and IL-10 in response to antigen-specific and polyclonal activation. Our results show that whole blood cells produce low or levels below detection limit of IFN-γ and IL-10, however, after successful treatment of VL patients, these cells gradually regain their capacity to produce IFN-γ, but not IL-10, in response to activation. These results suggest that in contrast to VL patients from Bihar, India, whole blood cells from VL patients from Gondar, Ethiopia, have lost their ability to produce IFN-γ during active VL and that active disease is not associated with sustained levels of IL-10 production following stimulation.

Journal article

Jarvis JN, Meintjes G, Bicanic T, Buffa V, Hogan L, Mo S, Tomlinson G, Kropf P, Noursadeghi M, Harrison TSet al., 2015, Cerebrospinal fluid cytokine profiles predict risk of early mortality and immune reconstitution inflammatory syndrome in HIV-associated cryptococcal meningitis, Plos Pathogens, Vol: 11, ISSN: 1553-7374

Understanding the host immune response during cryptococcal meningitis (CM) is of criticalimportance for the development of immunomodulatory therapies. We profiled the cerebrospinalfluid (CSF) immune-response in ninety patients with HIV-associated CM, and examinedassociations between immune phenotype and clinical outcome. CSF cytokine,chemokine, and macrophage activation marker concentrations were assayed at diseasepresentation, and associations between these parameters and microbiological and clinicaloutcomes were examined using principal component analysis (PCA). PCA demonstrated aco-correlated CSF cytokine and chemokine response consisting primarily of Th1, Th2, andTh17-type cytokines. The presence of this CSF cytokine response was associated with evidenceof increased macrophage activation, more rapid clearance of Cryptococci from CSF,and survival at 2 weeks. The key components of this protective immune-response were interleukin(IL)-6 and interferon-γ, IL-4, IL-10 and IL-17 levels also made a modest positivecontribution to the PC1 score. A second component of co-correlated chemokines was identifiedby PCA, consisting primarily of monocyte chemotactic protein-1 (MCP-1) and macrophageinflammatory protein-1α (MIP-1α). High CSF chemokine concentrations wereassociated with low peripheral CD4 cell counts and CSF lymphocyte counts and were predictiveof immune reconstitution inflammatory syndrome (IRIS). In conclusion CSF cytokineand chemokine profiles predict risk of early mortality and IRIS in HIV-associated CM. Wespeculate that the presence of even minimal Cryptococcus-specific Th1-type CD4+ T-cellresponses lead to increased recruitment of circulating lymphocytes and monocytes into the central nervous system (CNS), more effective activation of CNS macrophages and microglialcells, and faster organism clearance; while high CNS chemokine levels may predisposeto over recruitment or inappropriate recruitment of immune cells to the CNS and IRISfollowing peri

Journal article

Rath M, Mueller I, Kropf P, Closs EI, Munder Met al., 2014, Metabolism via arginase or nitric oxide synthase: two competing arginine pathways in macrophages, Frontiers in Immunology, Vol: 5, ISSN: 1664-3224

Macrophages play a major role in the immune system, both as antimicrobial effector cellsand as immunoregulatory cells, which induce, suppress or modulate adaptive immuneresponses. These key aspects of macrophage biology are fundamentally driven by thephenotype of macrophage arginine metabolism that is prevalent in an evolving or ongoingimmune response. M1 macrophages express the enzyme nitric oxide synthase, whichmetabolizes arginine to nitric oxide (NO) and citrulline. NO can be metabolized to furtherdownstream reactive nitrogen species, while citrulline might be reused for efficient NOsynthesis via the citrulline–NO cycle. M2 macrophages are characterized by expression ofthe enzyme arginase, which hydrolyzes arginine to ornithine and urea. The arginase pathwaylimits arginine availability for NO synthesis and ornithine itself can further feed into theimportant downstream pathways of polyamine and proline syntheses, which are importantfor cellular proliferation and tissue repair. M1 versus M2 polarization leads to opposing outcomesof inflammatory reactions, but depending on the context, M1 and M2 macrophagescan be both pro- and anti-inflammatory. Notably, M1/M2 macrophage polarization can bedriven by microbial infection or innate danger signals without any influence of adaptiveimmune cells, secondarily driving the T helper (Th)1/Th2 polarization of the evolving adaptiveimmune response. Since both arginine metabolic pathways cross-inhibit each other onthe level of the respective arginine break-down products andTh1 andTh2 lymphocytes candrive or amplify macrophage M1/M2 dichotomy via cytokine activation, this forms the basisof a self-sustaining M1/M2 polarization of the whole immune response. Understanding thearginine metabolism of M1/M2 macrophage phenotypes is therefore central to find newpossibilities to manipulate immune responses in infection, autoimmune diseases, chronicinflammatory conditions, and cancer.

Journal article

Corware K, Yardley V, Mack C, Schuster S, Al-Hassi H, Herath S, Bergin P, Modolell M, Munder M, Mueller I, Kropf Pet al., 2014, Protein energy malnutrition increases arginase activity in monocytes and macrophages, Nutrition & Metabolism, Vol: 11, ISSN: 1743-7075

Background: Protein energy malnutrition is commonly associated with immune dysfunctions and is a major factorin susceptibility to infectious diseases.Methods: In this study, we evaluated the impact of protein energy malnutrition on the capacity of monocytes andmacrophages to upregulate arginase, an enzyme associated with immunosuppression and increased pathogenreplication.Results: Our results show that monocytes and macrophages are significantly increased in the bone marrow andblood of mice fed on a protein low diet. No alteration in the capacity of bone marrow derived macrophagesisolated from malnourished mice to phagocytose particles, to produce the microbicidal molecule nitric oxide andto kill intracellular Leishmania parasites was detected. However, macrophages and monocytes from malnourished miceexpress significantly more arginase both in vitro and in vivo. Using an experimental model of visceral leishmaniasis, weshow that following protein energy malnutrition, the increased parasite burden measured in the spleen of these micecoincided with increased arginase activity and that macrophages provide a more permissive environment for parasitegrowth.Conclusions: Taken together, these results identify a novel mechanism in protein energy malnutrition that mightcontributes to increased susceptibility to infectious diseases by upregulating arginase activity in myeloid cells.

Journal article

Kapp K, Pruefer S, Michel CS, Habermeier A, Luckner-Minden C, Giese T, Bomalaski J, Langhans C-D, Kropf P, Mueller I, Closs E, Radsak MP, Munder Met al., 2014, Granulocyte functions are independent of arginine availability, JOURNAL OF LEUKOCYTE BIOLOGY, Vol: 96, Pages: 1047-1053, ISSN: 0741-5400

Journal article

Ssemaganda A, Kindinger L, Bergin P, Nielsen L, Mpendo J, Ssetaala A, Kiwanuka N, Munder M, Teoh TG, Kropf P, Mueller Iet al., 2014, Characterization of neutrophil subsets in healthy human pregnancies, PLOS One, Vol: 9, ISSN: 1932-6203

We have previously shown that in successful pregnancies increased arginase activity is a mechanism that contributes to the suppression of the maternal immune system. We identified the main type of arginase-expressing cells as a population of activated low-density granulocytes (LDGs) in peripheral blood mononuclear cells and in term placentae. In the present study, we analyzed the phenotype of LDGs and compared it to the phenotype of normal density granulocytes (NDGs) in maternal peripheral blood, placental biopsies and cord blood. Our data reveal that only LDGs but no NDGs could be detected in placental biopsies. Phenotypically, NDGs and LDGs from both maternal and cord blood expressed different levels of maturation, activation and degranulation markers. NDGs from the maternal and cord blood were phenotypically similar, while maternal, cord and placental LDGs showed different expression levels of CD66b. LDGs present in cord blood expressed higher levels of arginase compared to maternal and placental LDGs. In summary, our results show that in maternal and cord blood, two phenotypically different populations of neutrophils can be identified, whereas in term placentae, only activated neutrophils are present.

Journal article

Conceicao-Silva F, Morgado FN, Fernandes Pimentel MI, Ferreira e Vasconcellos EDC, Schubach AO, Valete-Rosalino CM, Kropf P, Mueller Iet al., 2013, Two women presenting worsening cutaneous ulcers during pregnancy: diagnosis, immune response, and follow-up, PLOS Neglected Tropical Diseases, Vol: 7, ISSN: 1935-2735

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Glass DG, McAlinden N, Kropf P, Wright AJ, Millington ORet al., 2013, Optical tweezers: manipulating and quantifying immune cell interactions to understand the importance of L-arginine on T-cell function, Annual Congress of the British-Society-for-Immunology, Publisher: WILEY-BLACKWELL, Pages: 139-139, ISSN: 0019-2805

Conference paper

Cloke T, Munder M, Bergin P, Herath S, Modolell M, Taylor G, Mueller I, Kropf Pet al., 2013, Phenotypic Alteration of Neutrophils in the Blood of HIV Seropositive Patients, PLOS ONE, Vol: 8, ISSN: 1932-6203

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Kapp K, Pruefer S, Habermeier A, Luckner-Minden C, Bomalaski J, Kropf P, Mueller I, Closs E, Radsak M, Munder Met al., 2013, GRANULOCYTE FUNCTION IS NOT IMPAIRED BY ARGININE DEFICIENCY, Publisher: FERRATA STORTI FOUNDATION, Pages: 423-423, ISSN: 0390-6078

Conference paper

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