Some Opportunistic Parasitic Infections in AIDS: Candidiasis, Pneumocystosis, Cryptosporidiosis, Toxoplasmosis.

Almost 80% of patients with AIDS die from infections other than human immunodeficiency virus (HIV). These infections usually occur late in the course of disease when CD4(+) T-cell count has fallen below 200 permm(3) cells per milliliter. Most of these infections are caused by organisms that do not normally afflict healthy individuals and are thus considered to be opportunistic. In this article, Lloyd Kasper and Dominique Buzoni-Gatel review the host-parasite interaction for four important pathogens: Candida albicans and Pneumocystis carinii (usually non-invasive pathogens), Cryptosporidium parvum (invades the cells but remains localized in the gut) and Toxoplasma gondii (penetrates through the gut to cause systemic infection). These organisms, which generally cause limited or even insignificant clinical evidence of infection in the normal host, were chosen because of their high prevalence in AIDS patients and because they exhibit different invasive abilities. The reason why individuals with AIDS are susceptible to this particular group of pathogens is uncertain.

[1]  D. Kirsch,et al.  Pathogenicity of Candida albicans auxotrophic mutants in experimental infections , 1991, Infection and immunity.

[2]  M. Ollert,et al.  Mechanisms of adherence of Candida albicans to cultured human epidermal keratinocytes , 1993, Infection and immunity.

[3]  W. Brown,et al.  Activation of intestinal intraepithelial T lymphocytes in calves infected with Cryptosporidium parvum , 1997, Infection and immunity.

[4]  I. Khan,et al.  IL-15 augments CD8+ T cell-mediated immunity against Toxoplasma gondii infection in mice. , 1996, Journal of immunology.

[5]  L. Perryman,et al.  Effect of spleen cell populations on resolution of Cryptosporidium parvum infection in SCID mice , 1994, Infection and immunity.

[6]  E. Dei‐Cas,et al.  Pneumocystis carinii: an atypical fungal micro-organism. , 1996, Journal of medical and veterinary mycology : bi-monthly publication of the International Society for Human and Animal Mycology.

[7]  J. Barta,et al.  Identification of a 15-kilodalton surface glycoprotein on sporozoites of Cryptosporidium parvum , 1991, Infection and immunity.

[8]  A. Sher,et al.  Synergistic role of CD4+ and CD8+ T lymphocytes in IFN-gamma production and protective immunity induced by an attenuated Toxoplasma gondii vaccine. , 1991, Journal of immunology.

[9]  J. Dubremetz,et al.  Toxoplasma gondii microneme proteins: gene cloning and possible function. , 1996, Current topics in microbiology and immunology.

[10]  B. Palmer,et al.  Role of CD8+ lymphocytes in host defense against Pneumocystis carinii in mice. , 1996, The Journal of laboratory and clinical medicine.

[11]  E. Vanopdenbosch,et al.  Cryptosporidium parvum in calves: kinetics and immunoblot analysis of specific serum and local antibody responses (immunoglobulin A [IgA], IgG, and IgM) after natural and experimental infections , 1992, Infection and immunity.

[12]  A. Sher,et al.  Parasite-induced IL-12 stimulates early IFN-gamma synthesis and resistance during acute infection with Toxoplasma gondii. , 1994, Journal of immunology.

[13]  W. Martin,et al.  Evidence for Pneumocystis carinii binding to a cell-free substrate: role of the adhesive protein fibronectin. , 1994, The Journal of laboratory and clinical medicine.

[14]  D. Clark,et al.  The pathogenesis of cryptosporidiosis. , 1996, Parasitology today.

[15]  A. Sher,et al.  In Vivo Microbial Stimulation Induces Rapid CD40 Ligand–independent Production of Interleukin 12 by Dendritic Cells and their Redistribution to T Cell Areas , 1997, The Journal of experimental medicine.

[16]  G. Bancroft,et al.  Cryptosporidium infection in major histocompatibility complex congeneic strains of mice: variation in susceptibility and the role of T-cell cytokine responses , 1997, Parasitology Research.

[17]  K. Joiner,et al.  Laminin on Toxoplasma gondii mediates parasite binding to the beta 1 integrin receptor alpha 6 beta 1 on human foreskin fibroblasts and Chinese hamster ovary cells , 1992, Infection and immunity.

[18]  D. Bout,et al.  Adoptive transfer of gut intraepithelial lymphocytes protects against murine infection with Toxoplasma gondii. , 1997, Journal of immunology.

[19]  A. Sher,et al.  CD8+ T cells from mice vaccinated against Toxoplasma gondii are cytotoxic for parasite-infected or antigen-pulsed host cells. , 1991, Journal of immunology.

[20]  J. Standing,et al.  The role of alveolar macrophages in Pneumocystis carinii degradation and clearance from the lung. , 1997, The Journal of clinical investigation.

[21]  B. Palmer,et al.  Pneumocystis carinii pneumonia in scid mice induced by viable organisms propagated in vitro , 1996, Infection and immunity.

[22]  R. McLeod,et al.  Antibodies to Toxoplasma gondii major surface protein (SAG-1, P30) inhibit infection of host cells and are produced in murine intestine after peroral infection. , 1993, Journal of immunology.

[23]  M. Ghannoum,et al.  Evidence implicating phospholipase as a virulence factor of Candida albicans , 1995, Infection and immunity.

[24]  J. Schwartzman,et al.  A dichotomous role for nitric oxide during acute Toxoplasma gondii infection in mice. , 1997, Proceedings of the National Academy of Sciences of the United States of America.

[25]  D. Bout,et al.  Toxoplasma gondii oral infection induces specific cytotoxic CD8 alpha/beta+ Thy-1+ gut intraepithelial lymphocytes, lytic for parasite-infected enterocytes. , 1994, Journal of immunology.

[26]  E. Segal,et al.  Adherence of Candida albicans to human vaginal epithelial cells: inhibition by amino sugars. , 1982, Experimental cell biology.

[27]  L. Kasper,et al.  Attachment of Toxoplasma gondii to host cells involves major surface protein, SAG-1 (P30). , 1994, Experimental parasitology.

[28]  M. Hostetter,et al.  An integrin-like protein in Candida albicans: implications for pathogenesis. , 1996, Trends in microbiology.

[29]  C. Hunter,et al.  Enhancement of intracellular replication of Toxoplasma gondii by IL-6. Interactions with IFN-gamma and TNF-alpha. , 1994, Journal of immunology.

[30]  A. Sher,et al.  Inducible Nitric Oxide Is Essential for Host Control of Persistent but Not Acute Infection with the Intracellular Pathogen Toxoplasma gondii , 1997, The Journal of experimental medicine.

[31]  I. Khan,et al.  Interleukin-12 enhances murine survival against acute toxoplasmosis , 1994, Infection and immunity.

[32]  D. Mosser,et al.  Production of a hemolytic factor by Candida albicans , 1994, Infection and immunity.

[33]  C. Nombela,et al.  Reduced virulence of Candida albicans MKC1 mutants: a role for mitogen-activated protein kinase in pathogenesis , 1997, Infection and immunity.

[34]  M. Shaw,et al.  Lipid transfer from human epithelial cells to Pneumocystis carinii in vitro. , 1997, The Journal of infectious diseases.

[35]  U. Groß,et al.  Toxoplasma gondii virulence markers identified by random amplified polymorphic DNA polymerase chain reaction , 1997, Parasitology Research.

[36]  M. Puliti,et al.  Differential susceptibility of yeast and hyphal forms of Candida albicans to proteolytic activity of macrophages , 1995, Infection and immunity.

[37]  J. Cello,et al.  Treatment of severe diarrhea caused by Cryptosporidium parvum with oral bovine immunoglobulin concentrate in patients with AIDS. , 1996, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[38]  F. Bistoni,et al.  Augmentation of GG2EE macrophage cell line-mediated anti-Candida activity by gamma interferon, tumor necrosis factor, and interleukin-1 , 1990, Infection and immunity.

[39]  K. HayGlass,et al.  The role of humoral immunity in Cryptosporidium spp. infection. Studies with B cell-depleted mice. , 1990, Journal of immunology.

[40]  S. Filler,et al.  Candida albicans stimulates cytokine production and leukocyte adhesion molecule expression by endothelial cells , 1996, Infection and immunity.

[41]  R. Bontrop,et al.  Correlation of major histocompatibility complex with opportunistic infections in simian immunodeficiency virus-infected rhesus monkeys. , 1997, Laboratory investigation; a journal of technical methods and pathology.

[42]  D. Hamer,et al.  Attachment of Cryptosporidium parvum sporozoites to MDCK cells in vitro , 1994, Infection and immunity.

[43]  Y. Suzuki,et al.  IL-4 is protective against development of toxoplasmic encephalitis. , 1996, Journal of immunology.

[44]  F. Finkelman,et al.  Cryptosporidium infection in an adult mouse model. Independent roles for IFN-gamma and CD4+ T lymphocytes in protective immunity. , 1991, Journal of immunology.

[45]  P J O'Donoghue,et al.  Cryptosporidium and cryptosporidiosis in man and animals. , 1995, International journal for parasitology.

[46]  J. Papadimitriou,et al.  Murine Candidiasis. Pathogenesis and host responses in genetically distinct inbred mice , 1987, Immunology and cell biology.

[47]  I. Khan,et al.  IL-7 stimulates protective immunity in mice against the intracellular pathogen, Toxoplasma gondii. , 1995, Journal of immunology.

[48]  J. Standing,et al.  Vitronectin binds to Pneumocystis carinii and mediates organism attachment to cultured lung epithelial cells , 1993, Infection and immunity.

[49]  J. Blackwell,et al.  Influence of genes within the MHC on mortality and brain cyst development in mice infected with Toxoplasma gondii: kinetics of immune regulation in BALB H‐2 congenic mice , 1993, Parasite immunology.

[50]  G. Bancroft,et al.  Cryptosporidium muris in adult mice: adoptive transfer of immunity and protective roles of CD4 versus CD8 cells , 1994, Infection and immunity.

[51]  R. McLeod,et al.  Definitive identification of a gene that confers resistance against Toxoplasma cyst burden and encephalitis. , 1995, Immunology.

[52]  K. Joiner,et al.  Laminin enhances binding of Toxoplasma gondii tachyzoites to J774 murine macrophage cells , 1992, Infection and immunity.

[53]  B. Garvy,et al.  Role of gamma interferon in the host immune and inflammatory responses to Pneumocystis carinii infection , 1997, Infection and immunity.

[54]  L. Sibley,et al.  Acute virulence in mice is associated with markers on chromosome VIII in Toxoplasma gondii , 1996, Infection and immunity.

[55]  S. Klotz,et al.  A fibronectin receptor on Candida albicans mediates adherence of the fungus to extracellular matrix. , 1991, The Journal of infectious diseases.

[56]  E. Lucht,et al.  Opportunistic oral infections in patients infected with HIV‐1 , 1996 .

[57]  S. Tomavo The major surface proteins of Toxoplasma gondii: structures and functions. , 1996, Current topics in microbiology and immunology.

[58]  G. Bancroft,et al.  Immunity to Cryptosporidium muris infection in mice is expressed through gut CD4+ intraepithelial lymphocytes , 1996, Infection and immunity.

[59]  R. McLeod,et al.  Genetic regulation of early survival and cyst number after peroral Toxoplasma gondii infection of A x B/B x A recombinant inbred and B10 congenic mice. , 1989, Journal of immunology.

[60]  C. Hunter,et al.  Production of gamma interferon by natural killer cells from Toxoplasma gondii-infected SCID mice: regulation by interleukin-10, interleukin-12, and tumor necrosis factor alpha , 1994, Infection and immunity.

[61]  P. Sundstrom,et al.  Expression of surface hydrophobic proteins by Candida albicans in vivo , 1995, Infection and immunity.

[62]  W. Martin,et al.  Human surfactant protein A enhances attachment of Pneumocystis carinii to rat alveolar macrophages. , 1996, American journal of respiratory cell and molecular biology.

[63]  A. Loyens,et al.  The MIC1 microneme protein of Toxoplasma gondii contains a duplicated receptor-like domain and binds to host cell surface. , 1996, Molecular and biochemical parasitology.

[64]  M. Ciccozzi,et al.  Elevated aspartic proteinase secretion and experimental pathogenicity of Candida albicans isolates from oral cavities of subjects infected with human immunodeficiency virus , 1996, Infection and immunity.

[65]  C. Petersen,et al.  Anti-Cryptosporidium parvum antibodies inhibit infectivity in vitro and in vivo , 1993 .

[66]  E. Olson,et al.  Vitronectin, fibronectin, and gp120 antibody enhance macrophage release of TNF-alpha in response to Pneumocystis carinii. , 1994, Journal of immunology.

[67]  K. McIntyre,et al.  Interleukin 1: an important mediator of host resistance against Pneumocystis carinii , 1992, The Journal of experimental medicine.

[68]  J. Sobel,et al.  Adherence of Candida albicans to human vaginal and buccal epithelial cells. , 1981, The Journal of infectious diseases.

[69]  S. T. Pottratz,et al.  Gamma‐interferon inhibits Pneumocystis carinii attachment to lung cells by decreasing expression of lung cell‐surface integrins , 1997, European journal of clinical investigation.

[70]  I. Khan,et al.  Production of nitric oxide (NO) is not essential for protection against acute Toxoplasma gondii infection in IRF-1-/- mice. , 1996, Journal of immunology.

[71]  A. Mencacci,et al.  CD4+ T-helper-cell responses in mice with low-level Candida albicans infection , 1996, Infection and immunity.

[72]  J. Standing,et al.  Pneumocystis carinii stimulates tumor necrosis factor-alpha release from alveolar macrophages through a beta-glucan-mediated mechanism. , 1993, Journal of immunology.

[73]  R. Helmke,et al.  Pneumocystis carinii induces an oxidative burst in alveolar macrophages , 1992, Infection and immunity.

[74]  I. Khan,et al.  Antigen-specific CD8+ T cell clone protects against acute Toxoplasma gondii infection in mice. , 1994, Journal of immunology.

[75]  V. Cama,et al.  Bovine antibody against Cryptosporidium parvum elicits a circumsporozoite precipitate-like reaction and has immunotherapeutic effect against persistent cryptosporidiosis in SCID mice , 1994, Infection and immunity.

[76]  J. Grimwood,et al.  Attachment of Toxoplasma gondii to host cells is host cell cycle dependent , 1996, Infection and immunity.

[77]  M. Puliti,et al.  Tumor necrosis factor as an autocrine and paracrine signal controlling the macrophage secretory response to Candida albicans , 1994, Infection and immunity.

[78]  S. Witkin Inhibition of Candida‐Induced Lymphocyte Proliferation by Antibody to Candida albicans , 1986, Obstetrics and gynecology.

[79]  A. Capron,et al.  Similarities between the primary structures of two distinct major surface proteins of Toxoplasma gondii. , 1994, The Journal of biological chemistry.

[80]  J. Stringer,et al.  Pneumocystis carinii: what is it, exactly? , 1996, Clinical microbiology reviews.

[81]  M. Dardé Biodiversity in Toxoplasma gondii. , 1996, Current topics in microbiology and immunology.

[82]  Y. Suzuki,et al.  The effect of anti-IFN-gamma antibody on the protective effect of Lyt-2+ immune T cells against toxoplasmosis in mice. , 1990, Journal of immunology.