The inability of
sodium antimony gluconate (SAG)-unresponsive
kala-azar patients to clear Leishmania donovani (LD)
infection despite SAG
therapy is partly due to an ill-defined immune-dysfunction. Since dendritic cells (DCs) typically initiate anti-leishmanial immunity, a role for DCs in aberrant LD clearance was investigated. Accordingly, regulation of SAG-induced activation of murine DCs following
infection with LD isolates exhibiting two distinct phenotypes such as
antimony-resistant (Sb(R)LD) and
antimony-sensitive (Sb(S)LD) was compared in vitro. Unlike Sb(S)LD,
infection of DCs with Sb(R)LD induced more
IL-10 production and inhibited SAG-induced secretion of proinflammatory
cytokines, up-regulation of co-stimulatory molecules and leishmanicidal effects. Sb(R)LD inhibited these effects of SAG by blocking activation of PI3K/AKT and
NF-kappaB pathways. In contrast, Sb(S)LD failed to block activation of SAG (20 microg/ml)-induced PI3K/AKT pathway; which continued to stimulate
NF-kappaB signaling, induce leishmanicidal effects and promote DC activation. Notably, prolonged incubation of DCs with Sb(S)LD also inhibited SAG (20 microg/ml)-induced activation of PI3K/AKT and
NF-kappaB pathways and leishmanicidal effects, which was restored by increasing the dose of SAG to 40 microg/ml. In contrast, Sb(R)LD inhibited these SAG-induced events regardless of duration of DC exposure to Sb(R)LD or dose of SAG. Interestingly, the inhibitory effects of isogenic Sb(S)LD expressing
ATP-binding cassette (
ABC) transporter MRPA on SAG-induced leishmanicidal effects mimicked that of Sb(R)LD to some extent, although
antimony resistance in clinical LD isolates is known to be multifactorial. Furthermore,
NF-kappaB was found to transcriptionally regulate expression of murine gammaglutamylcysteine
synthetase heavy-chain (mgammaGCS(hc)) gene, presumably an important regulator of
antimony resistance. Importantly, Sb(R)LD but not Sb(S)LD blocked SAG-induced mgammaGCS expression in DCs by preventing
NF-kappaB binding to the mgammaGCS(hc) promoter. Our findings demonstrate that Sb(R)LD but not Sb(S)LD prevents SAG-induced DC activation by suppressing a PI3K-dependent
NF-kappaB pathway and provide the evidence for differential host-pathogen interaction mediated by Sb(R)LD and Sb(S)LD.