Johnson, Aaron J

Abstract Cerebral malaria is a serious health complication that can arise during Plasmodium infections. Symptoms of human cerebral malaria (HCM) include coma, permanent neurological deficits, and potentially death. While the mechanism is not well understood, brain swelling and edema have been shown to correlate with a poor disease outcome for afflicted individuals. This work attempts to identify the cellular changes occurring during breakdown of the blood-brain barrier (BBB) by utilizing the murine model of experimental cerebral malaria (ECM). Previous work determined that the tight junctions claudin-5 and occludin, proteins essential for regulating BBB integrity, were disorganized on cerebral endothelial cells during ECM. Here, we focus on the constituents of the BBB to characterize the changes occuring within endothelial cells during disease progression. Importantly, endothelial cell changes were not strictly induced by parasitic infection itself, but also required the presence of functional CD8 T cells. Using perforin deficient mice to impair CD8 T cell effector function, we demonstrate that brain endothelial cells retain the characteristics of uninfected animals in contrast to wild-type infected mice. Interestingly, the CD8 T cells appear to be acting independently of direct killing as there is not an increase in activation of the apoptotic pathway nor is there an increase in dead or dying endothelial cells. From these data we propose that non-cytotoxic CD8 T cell functions are required for ECM induction.