Researching the Role of Immune Checkpoints, IDO1 and PDL1, to Study Cutaneous Leishmaniasis

In this interview we speak with Dr. Nidhi Dey about immune checkpoints, IDO1 and PDL1.

What are IDO1 and PDL1, and how are they relevant to the study of cutaneous leishmaniasis?

IDO1 and PDL1 are immune checkpoints that serve as regulators of the immune system. These checkpoints are relevant because they can suppress T-cell function. T-cells are a crucial component of the immune response against the parasite causing the disease.

IDO1 and PDL1 can inhibit the activity of T-cells, which may hinder the body's ability to combat the parasite effectively. Understanding how these immune checkpoints function is essential for potentially developing therapies that target these checkpoints and enhance the immune response against the parasite.

In a recent study conducted on patients with cutaneous leishmaniasis, it was observed that the transcripts of IDO1 and PDL1 were downregulated, meaning their expression was reduced upon treatment. This finding is significant because it suggests that treatment has the potential to reduce the inhibitory effects of IDO1 and PDL1 on T-cell function.

As IDO1 and PDL1 suppress the immune response, their downregulation indicates an improved ability of the immune system to combat the parasite. This reduction in immune checkpoint expression is a positive outcome that may contribute to a more effective immune response and better treatment outcomes for patients.

PDL1 can be used as a prognostic for treatment duration. Can you elaborate on how this information can impact patient care?

The discovery that PDL1 expression serves as a prognostic marker for treatment duration has important implications for patient care. Patients with reduced PDL1 expression upon treatment were observed to respond to therapy more rapidly.

This information can be utilized to assess the progress of treatment in individual patients. By monitoring PDL1 expression, healthcare providers can identify patients who are likely to recover faster.

This data can be used to optimize treatment strategies, potentially reducing the duration of treatment, minimizing patient discomfort, and improving overall patient outcomes.

What techniques were used in the study to analyze the spatial distribution of IDO1 and PDL1 in the skin tissue of patients with cutaneous leishmaniasis?

The study employed several techniques to analyze the spatial distribution of IDO1 and PDL1 in the skin tissue of patients with cutaneous leishmaniasis. These techniques included low-resolution transcriptome profiling - NanoString DSP, spatial transriptomics using 10x Genomics Visium technology, whole slide imaging and single-cell image analysis with StrataQuest, TissueGnostics.

These methods allowed researchers to examine the location and expression of IDO1 and PDL1 within the tissue samples. By using multiplexed imaging and transcriptome profiling, they could gain insights into how these immune checkpoints were distributed within the skin lesions.

What meaning does neighborhood analysis of IDO1 and PDL1-positive cells have?

During this study, it was found that among top cell types neighboring IDO+PDL1+ cells are CD8 memory T cells which indicates that IDO+PDL1+ cells signal to the neighboring T cells by reducing their T-cell function. Among other cell types regulatory T cells, dendritic cells and type 1 IFN macrophages were detected in the close vicinity.

In comparison with other leishmaniasis models in India and Brazil, common genes were identified in correlation with IDO1 and PDL1. What are the implications of these common genes for future research or therapy development?

Identifying common genes correlated with IDO1 and PDL1 across different leishmaniasis models suggests that these genes play a fundamental role in the disease, irrespective of the specific strain.

The identified common genes may serve as targets for therapy applicable across various leishmaniasis strains. This could expedite the development of new treatments that are effective against a wide range of leishmaniasis variants, potentially improving therapeutic outcomes and broadening the scope of research for this infectious disease.

Can you explain the concept of host-directed therapies in the context of cutaneous leishmaniasis and how IDO1 and PDL1 fit into this approach?

Host-directed therapies involve targeting the host's immune response to enhance the outcome of an infectious disease. In the context of cutaneous leishmaniasis, IDO1 and PDL1 fit into this approach because they are immune checkpoints that inhibit T-cell function.

By targeting these immune checkpoints with specific therapies such as immunotherapy or small molecule inhibitors, it is possible to boost the host's immune response against the parasite.

This approach aims to reduce the suppression of T-cell function, enabling the immune system to mount a more effective defense against the parasite. Therefore, IDO1 and PDL1 represent potential targets for host-directed therapies in the treatment of cutaneous leishmaniasis.

What potential treatment options, such as immunotherapy or small molecule inhibitors, are available for targeting IDO1 and PDL1 in the treatment of cutaneous leishmaniasis?

In the treatment of cutaneous leishmaniasis, potential treatment options for targeting IDO1 and PDL1 include immunotherapy and small molecule inhibitors. PDL1 antibodies that are FDA-approved are already available in the market and are considered a form of immunotherapy.

Additionally, small molecule inhibitors targeting IDO1 are in various phases of clinical trials. These therapies are designed to counteract the inhibitory effects of IDO1 and PDL1 on T-cell function, potentially enhancing the immune response against the parasite causing the disease.

Utilizing these treatment options may lead to more effective and targeted approaches for managing cutaneous leishmaniasis.

What was the role of CD68, a myeloid marker, in the analysis of IDO1 and PDL1 expression in skin tissue, and how does it relate to parasite burden?

The parasite infects macrophages and CD68, a myeloid marker, was used in the study to identify myeloid cells in the skin tissue. Infected macrophages were found to express IDO1 and PDL1. The analysis, performed with StrataQuest image analysis software, revealed a positive correlation between the expression of IDO1 and PDL1 and the amastigote burden, which represents the parasite load.

This suggests that macrophages, which express IDO1 and PDL1, are particularly affected by the parasite burden in cutaneous leishmaniasis, and as they were found to neighbor memory T cells, they are likely to reduce T-cell function which leads to parasite survival.  

How might the study's findings on the role of immune checkpoints in cutaneous leishmaniasis impact clinical practice or the development of new therapies?

The study's findings on the role of immune checkpoints, IDO1 and PDL1, in cutaneous leishmaniasis have several potential impacts on clinical practice and the development of new therapies. Understanding the significance of these immune checkpoints can lead to the development of targeted therapies that enhance the immune response and improve treatment outcomes.

Clinically, the use of PDL1 as a prognostic marker for treatment duration can optimize treatment plans, reducing treatment duration and improving patient care. Overall, these findings advance our understanding of cutaneous leishmaniasis and offer promising avenues for the development of more effective therapies, potentially improving the management and outcomes of this infectious disease.

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