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Kappagoda, C.

Publications and source records attributed to Kappagoda, C..

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The human Toll-like receptor 2 (TLR2) response during pathogenic Leptospira infection

BackgroundHuman innate immune responses are triggered through the interaction of human pattern recognition receptors and pathogen-associated molecular patterns. The role of toll-like receptor2 (TLR2) in mice innate immune response to leptospirosis is well established, while human studies are limited. The present study aimed to determine the TLR2 response among confirmed cases of leptospirosis. Methodology/Principle findingsThe study has two components. Clinically suspected patients of leptospirosis were confirmed using a previously validated qPCR assay. Total RNA was extracted from patients RNA-stabilized whole blood samples. Human TLR2 gene expression (RT-qPCR) analysis was carried out using an exon-exon spanning primer pair, using CFX Maestro software. The first set of patient samples was used to calculate the Relative Normalized Expression ({Delta}{Delta}Cq value) of the TLR2 gene in comparison to a healthy control sample and normalized by the reference gene GAPDH (Glyceraldehyde-3-phosphate dehydrogenase). Secondly, recruited patient samples were subjected to TLR2 gene expression analysis and compared to healthy controls and normalized by the reference genes Beta-2-microglobulin(B2M), Hypoxanthine phosphoribosyltransferase 1 (HPRT 1). In the initial cohort of 64 confirmed leptospirosis cases, 18 were selected for human TLR2 gene expression analysis based on criteria of leptospiremia and RNA yield. Within this group, one individual exhibited a down-regulation of TLR2 gene (Expression/{Delta}{Delta}Cq=0.01352), whereas the remaining subjects presented no significant change in gene expression. In a subsequent cohort of 23 confirmed cases, 13 were chosen for similar analysis. Among these, three patients demonstrated down-regulation of TLR2 gene expression, with Expression/{Delta}{Delta}Cq values of 0.86574, 0.47200, and 0.28579, respectively. No TLR2 gene expression was noted in the other patients within this second group. ConclusionsOur investigation into the acute phase of leptospirosis using human clinical samples has revealed a downregulation of TLR2 gene expression. This observation contrasts to the upregulation commonly reported in the majority of in-vitro and in-vivo studies of Leptospira infection. These preliminary findings prompt a need for further research to explore the mechanisms underlying TLR2s role in the pathogenesis of leptospirosis, which may differ in clinical settings compared to laboratory models. Author SummaryThe human immune system employs pattern recognition receptors like toll-like receptor 2 (TLR2) to detect and combat infections such as leptospirosis. While TLR2s role is well-documented in mice, its function in the human response to leptospirosis remains unclear. Our study evaluated TLR2 activity in patients with confirmed leptospirosis. We conducted a genetic analysis of blood samples from these patients, comparing TLR2 gene activity against healthy individuals, with standard reference genes for accuracy. Contrary to expectations and existing laboratory data, we observed a decrease in TLR2 activity in some patients. This suggests that human TLR2 responses in actual infections may diverge from established laboratory models. These findings indicate a need for further study to understand the human immune response to leptospirosis, which may significantly differ from that observed in controlled experimental settings.

immunology↗

Role of toll-like receptor 2 during infection of Leptospira spp.: A systematic review.

BackgroundPresent systematic review was conducted to determine the role of the Toll-like receptor 2 during Leptospira infection in in-vitro, in-vivo, and ex-vivo experimental models and human studies. MethodsOriginal articles published in English up to March 2022 that examined the response of Toll-like receptor 2 during leptospirosis were selected. PubMed, Web of Science, Scopus, Trip, and Google Scholar were used to search the literature. The National Institute of Health Quality Assessment tool, Systematic Review Centre for Laboratory Animal Experimentation risk of bias tool, and Office of Health Assessment and Translation extended tool were used to assess the risk of bias and the quality of the studies. ResultsOut of 2406 studies, only 32 were selected for the systematic review. These comprised 3 human studies, 14 in-vitro studies, 5 in-vivo studies, and 3 ex-vivo studies. 7 studies employed combined models that encompassed human, in-vivo, in-vitro, and ex-vivo. In our analysis, we assessed the response of Toll-like receptor 2 (TLR2) through various indicators, including TLR2 receptor/mRNA expression and indirect TLR2 involvement via the secretion/mRNA expression of cytokines, chemokines, and immune effectors. Notably, we identified increased TLR2 expression and the secretion/mRNA expression of several cytokines (IL6, IL8, IL-1{beta}, TNF, IFN{gamma}, IL10, CCL2/MCP-1, CCL10, COX2, CXCL1/KC, CXCL2/MIP2) and immune effectors (hBD2, iNOS, Fibronectin, Oxygen, and Nitrogen reactive species) as key aspects of host TLR2 responses during leptospirosis. Besides the role of TLR2 in response to leptospirosis, the involvement of TLR4 and TLR5 was identified in in-vitro and in-vivo studies. IL6, IL10, IL-1{beta}, TNF, MIP, CCL2, CCL10, COX2, MCP1, IFN{gamma}, iNOS, NO, anti-Leptospira IgG were triggered through TLR4. Furthermore, TNF secretion was stimulated through TLR5. In addition to the role of TLR2, our review revealed the involvement of TLR4 and TLR5 in in-vitro and in-vivo studies. Specifically, the activation of TLR4 triggered responses including IL6, IL10, IL-1{beta}, TNF, MIP, CCL2, CCL10, COX2, MCP1, IFN{gamma}, iNOS, NO, and anti-Leptospira IgG. DiscussionRecognition of pathogen-associated molecular patterns through TLR2 triggers the secretion of cytokines/chemokines and immune mediators, facilitating the eradication of Leptospira infection. However, excessive amounts of these compounds can harm host tissues; therefore, regulating immune mediators through TLR2 using agonists or antagonists at an optimal level is important for mitigating tissue damage and promoting effective immune responses. In addition to TLR2, TLR4 and TLR5 were found to play defensive roles in in-vitro and in-vivo studies against Leptospira infection. OtherO_ST_ABSFundingC_ST_ABSNo funding received for this study. RegistrationPROSPERO 2022 CRD42022307480 Author summaryLeptospirosis is a globally widespread, infectious zoonosis caused by a spiral shape bacterium belonging to the genus Leptospira. Pathogenic Leptospira spp. play a significant role in infecting humans resulting in a wide range of clinical symptoms ranging from febrile illness to multi-organ failures. Different host immune responses are the key contributors to the disease development, pathogenesis factors of the infectious organism, and epidemiological factors. Host immune responses initiate by interacting with the pathogens molecular patterns and the host immune cell receptors. In global literature, Toll-like receptors are the mainly studied host pattern recognition receptors, with Toll-like receptor 2 plays a crucial role in mediating the human immune responses. Although there are narrative reviews regarding the role of Toll-like receptor 2, it is worth systematically reviewing it with methodological rigor. The secretion of the cytokines/chemokine and immune mediators will facilitate the elimination of bacterial infection. However, excessive amounts of these compounds can harm host tissues; therefore, regulating immune mediators through Toll-like receptor 2 using agonists or antagonists at an optimal level is essential. Despite the disease burden, the lack of advanced treatments and efficient diagnostic methods hinders disease management. Exploring host immune responses against the disease through Toll-like receptor 2 could provide valuable insights for the development of therapeutic strategies.

immunology↗