Pneumocystis carinii (PC) pneumonia is a leading opportunistic infection found among HIV-infected individuals worldwide. Although CD4+ T cell deficiency clearly correlates with susceptibility to PC pneumonia, murine models of disease indicate that PC-directed Abs may prevent infection and/or inhibit growth of existing PC within the lungs. Recognition of PC by alveolar macrophages involves the β-glucan receptor Dectin-1 and macrophage effector function against PC is enhanced by Abs derived from PC-vaccinated hosts. We developed a fusion protein consisting of the extracellular domain of Dectin-1 linked to the Fc portion of murine IgG1, which we hypothesized would enhance host recognition and opsonic phagocytosis of PC. The recombinant protein, Dectin-Fc, is dimeric and the Ag recognition site identifies β-1,3 glucan linkages specifically and with high affinity (KD = 2.03 × 10−7 M). Dectin-Fc enhances RAW264.7 macrophage recognition of the β-glucan containing particulate zymosan in an FcγRII- and FcγRIII-dependent manner and preopsonization of PC organisms with Dectin-Fc increased alveolar and peritoneal macrophage-dependent killing of PC. SCID mice treated with a replication incompetent adenoviral vector expressing Dectin-Fc had attenuated growth of PC within the lungs, overall decreased PC lung burden, and diminished correlates of PC-related lung damage relative to SCID mice receiving a control vector. These findings demonstrate that targeting PC β-glucan with Dectin-Fc enhances host recognition and clearance of PC in the absence of B and T cells, and suggest that FcγR-based targeting of PC, via cell wall carbohydrate recognition, may promote resistance against PC pneumonia in the immunodeficient host.

Pneumocystis carinii (PC)3 pneumonia is a major cause of illness and death among the immunocompromised, most often observed in individuals infected with HIV. Although incidence of PC pneumonia has declined following the introduction of highly active antiretroviral therapy (HAART), it remains the most prevalent of opportunistic infections in industrialized countries (1). Further, the vast majority of the world’s 45 million infected with HIV are without access to HAART and at high risk for PC pneumonia (2, 3, 4, 5, 6). Individuals receiving chronic immunosuppressive therapy as a consequence of organ transplantation or autoimmune disease represent another growing, at-risk population for this opportunistic infection. The identification of dihydropteroate synthase mutations in PC isolates from humans (7) suggests the potential for resistance of PC organisms to existing chemotherapeutic strategies and additionally underscores the need for alternate, immune-based strategies against PC infection.

Murine models of PC infection, using the host specific pathogen P. carinii f. sp. muris, have demonstrated the potential utility of Ab-based immunity in host defense against PC. CD4+ T cell deficiency or blockade of CD40L renders mice susceptible to PC and is coincident with diminished IgG responses against PC (8, 9). μMT knockout mice, deficient in B cells, are also highly susceptible to PC pneumonia and signify the critical nature of B cells and their effectors in PC resistance (10). Adoptive transfer of serum from PC-vaccinated mice or mAbs directed against PC Ags can prevent the establishment of infection upon challenge (11, 12) or inhibit progression of existing PC pneumonia in early through late stages of disease (13). Interestingly, mice challenged with PC and thereafter depleted of CD4+ T cells have persistent anti-PC IgG and are able to resist infection given a subsequent exposure, suggesting that Ab-based immunity may be sufficient for preservation of anti-PC resistance in the setting of CD4+ T cell deficiency (14). PC-directed Abs likely function through multiple mechanisms to increase host resistance to infection and have been shown to significantly potentiate alveolar macrophage anti-PC effector function in vitro (15, 16, 17). Though recent studies suggest that PC-specific IgG is not absolutely required for host resistance, FcγR-deficient mice clear PC organisms with delayed kinetics (18). These observations suggest that PC-specific Abs may couple with FcγR-bearing cells to modulate aspects of host recognition and clearance of PC and illustrate the potential of Ab-based strategies against PC in the setting of immunodeficiency.

The specific Ags involved in Ab-based recognition and degradation of PC, identifying either cystic and/or trophozoite forms of the organism, are unclear. PC protein Ags under investigation as vaccine targets, such as the major surface glycoprotein complex and the surface-associated protease Kexin, exhibit interspecies- and intraspecies-specific variation (17, 19, 20), which may complicate potential vaccination strategies. Conserved pathogen-associated molecular patterns (PAMPs) of PC identified by innate immune cells include the major carbohydrates of the fungal cellular wall, β-glucan, and mannan. It is unknown whether these carbohydrate Ags could be effective targets of Ab-based responses. We have previously shown that the β-glucan receptor Dectin-1 is involved in alveolar macrophage recognition, nonopsonic phagocytosis, and killing of PC in vitro (16). RAW 264.7 macrophages overexpressing Dectin-1 bound PC organisms at higher levels than control cells, suggesting a critical, and possibly independent, role of this receptor in PC identification. In this study, we report on the potential of a recombinant protein, consisting of the extracellular domain of Dectin-1 fused to the murine IgG1 hinge through constant heavy (CH)2 and CH3 domains, as a novel strategy for the identification, specific targeting, and degradation of PC organisms.

Male C57BL/6 mice, 6–8 wk of age, were purchased from the National Cancer Institute, National Institutes of Health. Male B6.scid mice, 6–8 wk of age, were purchased from The Jackson Laboratory. All mice were maintained in a specific pathogen-free environment in microisolator cages within an American Association for Laboratory Animal Science-certified animal facility in the Rangos Research Center at the Children’s Hospital of Pittsburgh. Animal studies were reviewed and approved by the Children’s Hospital of Pittsburgh Animal Research and Care Committee.

The design of the Dectin-Fc recombinant gene construct was modeled after the TNFR-IgG H chain, described by Peppel et al. (21). A PCR 3.1 plasmid containing the full-length murine Dectin-1 receptor, provided by G. Brown (University of Cape Town, Cape Town, South Africa), and the pACCKP2 plasmid containing the TNFR extracellular domain linked to murine IgG1 H chain (22) served as PCR templates. The cDNA encoding the extracellular domain of the Dectin-1 receptor, consisting of amino acids 69–244 (23), was amplified by PCR with oligonucleotide primers ggtaccga CGACACAATTCAGGG (corresponding to an engineered KpnI site, a frame spacer, and the 5′ end of the Dectin-1 receptor extracellular domain) and ggatccacgcggaaccag CAGTTCCTTCTCACAG (corresponding to the hexapeptide linker with thrombin cleavage site and the 3′ end of the dectin-1 receptor). The cDNA-encoding CH2-CH3 was amplified with primers ctggttccgcgtggatcc GTGCCCAGGGATTGTGGT (corresponding to the hexapeptide linker with thrombin cleavage site and the 5′ end of the IgG moiety) and gaattc TCATTTACCAGGAGAGTG (corresponding to an engineered EcoRI site, an antisense stop codon, and the 3′ end of the IgG moiety). cDNA products were isolated on an agarose gel and purified via extraction (Qiagen). The products were combined at a 1:1 ratio and subjected to five cycles of denaturation and reannealing to promote recombination of homologous regions. The 5′ primer for the dectin-1 receptor extracellular domain and the 3′ primer for the IgG moiety were used to amplify the recombinant product Dectin-Fc. The chimeric PCR product was isolated and purified via gel extraction and subcloned into the TOPO-TA Vector (Invitrogen Life Technologies). Using M13 primers, the Dectin-Fc DNA was amplified via PCR, digested with KpnI and EcoRI, and inserted in-frame into the multiple cloning site of pSecTag 2C mammalian expression vector (Invitrogen Life Technologies), containing the IgK leader sequence facilitating protein secretion. To confirm the fusion gene product, dideoxy sequencing was performed.

Ad-Dectin-Fc is an E1-E3 replication-deficient rAd5-based vector containing the entire pSecTag 2C-Dectin-Fc expression cassette. To generate Ad-Dectin-Fc, the Dectin-Fc expression cassette was amplified and inserted into the Invitrogen Gateway entry vector pENTR/D-TOPO, then shuttled in an exchange reaction using LR Clonase into pAd/CMV/V5 DEST (Invitrogen Life Technologies). The resultant plasmid was purified, digested with PacI to expose adenoviral ITR sequences, and then transfected into 911 cells supplying the E proteins required for adenovirus propagation. Viruses were purified and concentrated by either CsCl density gradient centrifugation or by membrane adsorption (Vivapure Adenopack; Sartorius), and titered by a plaque assay on 911 cells, as previously described (22, 24). The control AdLuciferase vector is identical but instead encodes the firefly luciferase gene and was obtained from the Pittsburgh Pre-Clinical Vector Core. The particle:PFU ratio was ∼100:1 and virus stocks contained <0.01 ng/ml endotoxin as determined by the QCL-1000 Limulus lysate assay (BioWhittaker).

For Dectin-Fc protein generation, 293 cells cultured in DMEM plus 10% FCS were transiently transfected with the pSecTag 2C-Dectin-Fc vector with Lipofectamine 2000 (Invitrogen Life Technologies). Supernatants were collected and cells were removed by centrifugation and passage of supernatant over a 0.2 μM low protein-binding filter. Supernatants were preserved at −80°C. For some experiments, Dectin-Fc was affinity purified over a column consisting of Sepharose beads conjugated to goat-anti-mouse H chain IgG (Sigma-Aldrich), and SDS-PAGE followed by Coomassie staining was used to confirm purity. Protein reactivity was studied by Western analysis. To evaluate protein structure, Dectin-Fc-conditioned supernatant was pretreated with 2-ME. Conditioned supernatant or purified protein was isolated on SDS-PAGE, transferred to nitrocellulose membranes, and blocked overnight with BSA (2% for tissue culture supernatant, 4–8% for mouse BAL, serum, or lung homogenate). Rat anti- murine-Dectin-1 (R&D Systems) followed by goat anti-rat IgG-AP (Santa Cruz Biotechnology), or goat anti-mouse IgG-AP (Bio-Rad), all at 1:2000 in blocking buffer, were used for immunodetection, and blots were developed with 5-bromo-4-chloro-3-indolyl phosphate/NBT reagent (Bio-Rad).

Laminarin and mannan (Sigma-Aldrich) were each dissolved in PBS and seeded to a Nunc Polysorp-treated 96-well plates at 0.025 mg/ml at 4°C for 48 h. As a negative control, β,1–3-glucan linkages of laminarin were hydrolyzed by pretreatment with laminarinase (β-1,3 endoglucosidase) isolated from Trichoderma sp. as per manufacturer’s protocol (Sigma- Aldrich) and similarly seeded at 0.025 mg/ml. The wells were washed, blocked for 2 h in PBS, 10% FBS, and 2.5% milk, then washed again. Dectin-Fc-conditioned supernatant or purified Dectin-Fc was dissolved in blocking buffer, serially diluted 1/2, and administered to wells in triplicate. After 2 h of incubation, wells were washed, and a 1/1000 dilution of goat-anti-mouse IgG-HRP was applied for 2 h. Wells were washed and developed with tetramethylbenzidine (TMB; BD Biosciences-BD Pharmingen) and the absorbance at 450 nm was measured and subtracted from baseline absorbance.

Real-time surface plasmon resonance experiments were performed on a BIAcore 3000 Instrument with CM5 sensor chips (BIAcore) and all interactions were studied at 25°C. N-hydroxy succinimide/N,N-(3-dimethylaminopropyl)-N′-ethylcarbodimide hydrochloride amine coupling was used to immobilize goat anti-mouse Abs (Molecular Probes) diluted 1/50 in 10 mM sodium acetate (pH 5) and empty reactive sites were quenched with 1 M ethanolamine. Affinity purified Dectin-Fc (100 μg/ml) was captured by injection at a flow rate of 5 μl/min (total 35 μl). Laminarin was dissolved in PBS and diluted to 100, 2, or 0.2 μM in running buffer (10 mM HEPES (pH 8.0), 150 mM NaCl, 0.002% Tween 20), injected by KINJECT and allowed to reach equilibrium, after which only running buffer was applied. Immobilized goat anti-mouse Abs served as a control surface and nonspecific binding of laminarin was subtracted from the surface plasmon resonance signal in the active flow cell. The association rate constant (ka) and dissociation rate constant (kd) were calculated and the dissociation constant was determined (KD) using the BIAevaluation 3.1 software.

The PC inoculum was prepared as previously described (8, 24). Briefly, B6.scid mice with PC pneumonia were injected with a lethal dose of pentobarbital and the lungs were aseptically removed and frozen in 1 ml of PBS at −80°C. Lungs were mechanically dissociated in sterile PBS, filtered through sterile gauze, and pelleted at 500 × g for 10 min at 4°C. The pellet was resuspended in sterile PBS and a 1/5 dilution was stained by a modified Giemsa stain (Diff-Quik; Baxter). The number of PC cysts was quantified microscopically and the inoculum concentration was adjusted to 2 × 106 cysts/ml. Gram stains were performed on the inoculum preparations to exclude contamination with bacteria. For in vitro studies, aliquots of the inoculum were stored at concentrations of 106 cysts/ml at −80°C until use.

For peritoneal macrophage isolation, male C57BL/6 mice were administered 3% sterile thioglycolate i.p. After 3–5 days, mice were sacrificed and a peritoneal lavage was performed using 5 ml of PBS. The lavage fluid was centrifuged at 300 × g for 10 min, resuspended in RBC lysis buffer (Sigma-Aldrich) for 5 min, then washed, pelleted, and resuspended in RPMI 1640. Cell pellets were studied and enumerated using a hemacytometer. To isolate alveolar macrophages, male C57BL/6 mice were anesthetized with isoflurane and sacrificed via terminal exsanguination. With an intratracheal catheter, calcium and magnesium-free PBS was used to lavage lungs. A total of 10 ml was used per mouse in 0.5-ml increments with a 30 s dwell time. The lavage fluids were pooled and centrifuged at 300 × g for 10 min, and the cells were collected for the coculture assay. Cell preparations were generally >98% enriched for peritoneal or alveolar macrophages.

To assess macrophage surface association with zymosan, 105 RAW 264.7 cells were suspended in RPMI 1640 plus 10% FCS in 5-ml polystyrene tubes. Some groups were pretreated for 30 min with 5 μg of 2a11 (provided by G. Brown, as described in Ref. 25), a mAb with specific blocking activity against the murine Dectin-1 receptor, and/or 2.5 μg of FcγRII/III blocking Ab 2.4G2 (eBioscience), and maintained at 37°C. FITC-zymosan (Molecular Probes) was suspended in culture medium, sonicated, enumerated, and preopsonized with conditioned supernatant containing Dectin-Fc, control medium consisting of DMEM plus 10% FCS, or neat normal mouse serum, for 30 min at 4°C. Ten particles of preopsonized zymosan were administered per macrophage and allowed to incubate with macrophages at 37°C for 90 min. A total of 10,000 events were analyzed with a FACSAria flow cytometer for relative FITC intensity (BD Biosciences). Macrophages were distinguished from free zymosan by forward and side scatter profiles. Mean fluorescence intensity (MFI) was calculated by averaging all events across the macrophage live cell gate; fold changes were calculated by normalizing the observed MFI to the baseline MFI obtained from RAW cells incubated with zymosan preopsonized with control medium.

PC organisms were heat-fixed to glass slides and incubated with Dectin-Fc-conditioned medium or control medium. After primary incubation, organisms were extensively washed; bound Dectin-Fc was detected by incubating with Cy3-conjugated goat anti-mouse-IgG. Following additional washes, ProLong-mounting medium and coverslips were applied. Slides were examined under a Zeiss Axioplan 2 upright fluorescent deconvolution microscope and images were captured using 3I Slidebook version 4.0 software.

Macrophages (106/ml) suspended in a volume of 100 μl of RPMI 1640 medium containing FCS were cocultured in round-bottom 96-well plates with PC (2 × 104 cysts/ml, 50 μl), yielding an effector to total PC organism ratio of 1:1 (estimated 1:10 cyst to trophozoite ratio). Before addition of PC, organisms were preopsonized with 50 μl of Dectin-Fc-conditioned supernatant/purified Dectin-Fc or 50 μl of DMEM plus 10% FCS. A viability control of PC incubated with control medium, consisting of DMEM plus 10% FCS, was included. The plates were spun at 2500 rpm to pellet PC organisms. The supernatants and cell pellets were collected and total RNA was isolated using TRIzol-LS reagent (Invitrogen Life Technologies). Viability of PC was analyzed with real-time PCR measurement of PC large subunit rRNA copy number (GenBank accession number AF257179) and quantified against a standard curve of known copy number of PC rRNA as previously described (16). This method detects viable PC organisms as evidenced by loss of detectable PC rRNA in heat-killed organisms or those exposed to trimethoprim/sulfamethoxazole.

SCID mice (6–8 wk) received adenovirus at 1 × 109 PFU periorbitally (total volume 100 μl) under isoflurane analgesia. Three days later, mice were anesthetized and challenged with PC at 2 × 105 cysts delivered intratracheally. At days 1, 5, 14, and 28 after PC challenge, mice were sacrificed by terminal exsanguination under isoflurane analgesia; serum and bronchoalveolar lavage fluid (BALF) was collected. Right lungs were preserved for quantification of PC lung burden. A portion of the left lung from individual mice was homogenized, normalized to a total protein content of 1 mg/ml, and MIP-2 concentrations were determined by ELISA (R&D Systems).

Total RNA was isolated from the right lung of infected mice by a single-step method using TRIzol reagent (Invitrogen Life Technologies) as per manufacturer’s instructions. Thereafter, RNA was transcribed to cDNA and real-time PCR was performed as previously described; copy numbers were quantified against a standard curve of known PC rRNA copy numbers (12, 26). This assay has a correlation coefficient of 0.98 with PC rRNA copy number.

Fluid from the lower respiratory tract was obtained by bronchoalveolar lavage of mice anesthetized with i.p. pentobarbital as described previously (21). The first milliliter of BALF from SCID mice infected with PC was collected at 5, 14, and 28 days was processed at 500 × g and supernatant was stored at −80°C until use. BALF samples were studied for Dectin-Fc expression or for relative lactate dehydrogenase (LDH) activity as determined with an LDH colorimetric assay kit (Sigma-Aldrich) detecting the reduction of substrate NAD → NADH. Absorbance was determined at 530 nM. The remaining cell pellet and an additional 9 ml of BALF was pooled and centrifuged at 800 × g for 10 min to collect cells and samples were cytospun onto slides, stained by modified Giemsa, and analyzed for leukocyte differential.

Data were analyzed using GraphPad statistical software. Comparisons between groups when data were normally distributed were made with the Student t test; comparisons among nonparametric data were made with the Mann-Whitney U test. The Wilcoxon rank-sum test was used when comparing experimental groups to a theoretical value. Significance was accepted at a value of p < 0.05.

A recombinant fusion gene consisting of the extracellular domain of the murine dectin-1 receptor (amino acids 69–244), a thrombin sensitive hexapeptide linker, and the murine IgG1 hinge and CH2 through CH3 domains, was constructed and inserted into the eukaryotic expression vector, pSecTag 2C, directing protein secretion (data not shown). The cloned portion of dectin-1 contains the entire, relatively compact, carbohydrate recognition domain (CRD) of the receptor, which includes two putative N-glycosylation sites. Western analysis of the supernatant generated from 293 transfectants revealed a 116-kDa product, reactive with both goat-anti-mouse IgG Abs (Fig. 1,A) and anti-murine dectin-1 Ab (Fig. 1,B). Under reducing conditions, the molecular mass of the protein product was halved, demonstrating that the recombinant protein adopts a disulfide-linked bivalent structure (Fig. 1,B). A schematic portrayal of the fusion protein itself is presented in Fig. 1 C. As the murine hinge plus Fc domain is 60 kDa, the extracellular domain of dectin-1 is roughly 28 kDa, in accordance with a previous report describing the molecular structure of the receptor (23).

To define the properties of the β-glucan molecular recognition site of Dectin-Fc, we assessed its ability to recognize laminarin, a ∼7.7-kDa water soluble carbohydrate β-glucan polymer isolated from Laminaria digitata. Laminarin contains primarily β-1,3 glucan linkages with some β-1,6 glucan linkages, similar in ratio to the β-glucan linkages found in the cellular wall of Saccharomyces cerevisiae and PC (27, 28, 29). In a study where dectin-1 was expressed exogenously in the nonphagocytic NIH3T3 cell line, laminarin was identified as the most potent competitive antagonist of zymosan recognition among a panel of carbohydrates, underscoring the molecular affinity of this carbohydrate for the dectin-1 receptor (30). By ELISA, we observed that extremely low concentrations of Dectin-Fc bound laminarin in a dose-dependent manner (Fig. 2). This effect was entirely lost upon specific hydrolysis of β-1,3 linkages with laminarinase. Thus, the Ag recognition site of Dectin-Fc displays high specificity toward the β-1,3 linkages of the β-glucan laminarin.

We next determined the affinity of the Dectin-Fc CRD for β-glucan linkages with real-time surface plasmon resonance measurements (BIAcore). Affinity purified Dectin-Fc was captured with immobilized goat-anti-mouse Abs; laminarin was applied at various doses (0.2, 2, and 100 μM) and studied for interactions with the Dectin-Fc Ag-binding site (Fig. 3). As expected, laminarin bound Dectin-Fc and binding was dose dependent. The rate of association (ka) was 5.6 × 103−1s−1 and the rate of dissociation (kd) was 1.14 × 10−3/s, signifying that the stability of the complex slightly exceeds its capacity to form. An overall equilibrium dissociation constant (KD) of 2.03 × 10−7 M was calculated, demonstrating high-affinity binding of Dectin-Fc to laminarin, similar in quality to various carbohydrate directed Abs or lectin receptors for their ligands (31, 32, 33, 34, 35).

To address the potential of Dectin-Fc to enhance macrophage recognition of particulate β-glucan, we evaluated whether Dectin-Fc could enhance RAW264.7 macrophage recognition of fungal PAMP-containing particulate zymosan. Zymosan is an insoluble cellular wall polysaccharide derived from S. cerevisiae, composed mostly of β-glucan and mannan (36). FITC-labeled zymosan was preopsonized with either Dectin-Fc-conditioned medium, control medium, or normal mouse serum and added to macrophages for 90 min, and macrophage-associated FITC fluorescence was determined by flow cytometry as a correlate of cellular association with zymosan. As demonstrated in Fig. 4,A, we observed enhanced binding by macrophages of zymosan opsonized with normal mouse serum, which increases baseline binding of zymosan predominantly via CR3-based recognition (25). However, we observed even further enhancement of macrophage recognition when zymosan was instead preopsonized with Dectin-Fc (Fig. 4,A). Analysis of the average macrophage MFI showed that recognition of zymosan by RAW cells was significantly inhibited by Dectin-1 receptor blocking Ab 2a11, as previously reported (25), and that Ab-mediated blockade of FcγRII and FcγRIII did not perturb FITC-zymosan association from baseline levels (Fig. 4,B). Yet, Dectin-Fc enhanced the average cellular MFI by 27% from baseline levels (Fig. 4,B), and the observed increased recognition of Dectin-Fc preopsonized zymosan was entirely lost upon blockade of macrophage FcγRII and FcγRIII (Fig. 4,B). As murine IgG1 immune complexes signal primarily through FcγRII and FcγRIII (37), we conclude that Dectin-Fc-opsonized zymosan was recognized through binding at these receptors. Interestingly, when the Dectin-1 receptor on macrophages was blocked, recognition of Dectin-Fc preopsonized zymosan was further enhanced (Fig. 4 B). Although the mechanism through which this occurs is unclear, it raises the possibility that immune-complex associated, multimerized FcRs generate stronger or more prolonged macrophage associations with zymosan relative to that which occurs under competitive binding with the Dectin-1 receptor. Thus, Dectin-Fc enhances recognition of zymosan by macrophages, and in the absence of cellular Dectin-1 receptor recognition, by promoting binding through FcγRII and FcγRIII.

The cellular wall of the PC cyst consists of a thick electron-lucent layer composed predominantly of β-glucan, buried below a thin, electron-dense surface layer consisting mainly of mannan and glycoprotein (27, 38). Despite a seemingly shielded location, it is believed that PC β-glucan is sufficiently exposed to permit recognition by the innate immune system via Dectin-1 (16) and other pattern recognition receptors, such as the lactosylceramide-associated β-glucan receptor (39). Indeed, the specific interaction of PC β-glucan with these innate receptors has been demonstrated to influence patterns of cytokine and chemokine expression, such as the elicitation of the neutrophil chemoattractant MIP-2. By fluorescent deconvolution microscopy, we observed that Dectin-Fc bound to the surface of PC cysts (Fig. 5 A). This observation demonstrates the accessibility of Dectin-Fc to β-glucan ligands on PC organisms.

As we observed specific binding of Dectin-Fc to PC organisms, we evaluated whether Dectin-Fc could enhance the recognition and degradation of Pneumocystis organisms by FcγRII/III-bearing cells. We studied decreases in absolute quantities of PC large rRNA copy numbers in the presence or absence of macrophages as a correlate of in vitro PC killing, a methodology validated by previous work (16, 40). PC organisms were isolated from infected murine lung homogenates and were preopsonized with Dectin-Fc, then administered to macrophages at a 1:1 PC organism to effector cell ratio for 24 h. In studies with thioglycolate-elicited peritoneal macrophages, preopsonization of PC organisms with Dectin-Fc diminished overall copy numbers by 3-fold relative to organisms preopsonized with control medium (Fig. 5,B). When macrophages were pretreated with an Ab blocking activity at the Dectin-1 receptor, killing of Dectin-Fc preopsonized PC occurred to a similar degree. This observation suggested that Dectin-Fc promoted PC killing independent of native Dectin-1 recognition. Additional blockade of FcγRII and FcγRIII abrogated the killing effect, indicating that Dectin-Fc-dependent targeting of PC toward FcγRII and FcγRIII was responsible for the diminished PC rRNA signal. Resident alveolar macrophages appeared to have a moderately higher level of effector activity against Dectin-Fc preopsonized PC compared with recruited peritoneal macrophages, decreasing PC rRNA copy numbers by nearly 10-fold relative to medium opsonized PC (Fig. 5, C and D). We hypothesize that differences between alveolar and elicited peritoneal macrophage populations in responses such as phagocytosis, reactive oxide species generation, and Ab-dependent killing may be responsible for the enhanced effector function against Dectin-Fc preopsonized PC by alveolar macrophages. We conclude from these studies that primary murine macrophages have enhanced recognition and killing of Dectin-Fc preopsonized PC that is mediated via FcγRII and FcγRIII and this occurs independently of dectin-1-based recognition.

To study the effect of Dectin-Fc on PC infection in vivo, we developed a replication incompetent type 5 adenovirus, Ad-Dectin-Fc, containing the entire Dectin-Fc expression cassette, including an Igκ leader sequence facilitating protein secretion upon cellular transduction. As IgG protein administered directly into the lungs is rapidly degraded (41), we considered adenoviral-based transgene delivery of Dectin-Fc as a more appropriate system to evaluate the effect of Dectin-Fc on this chronic, slow-growing infection. Systemic administration of adenoviral vectors encoding transgenes leads to high and prolonged levels of transgene protein in the lungs in the absence of virus (42) and mice deficient in CD4+ T cells do not mount significant neutralizing Ab responses against adenoviruses (43), underscoring the suitability of gene transfer as an effective means for long-term expression of Dectin-Fc in the setting of immunodeficiency. SCID mice were treated with either Ad-Dectin-Fc or an identical adenovirus expressing firefly luciferase (Ad-luciferase), i.v., at 1 × 109 PFU. Serum and lung homogenate were analyzed for Dectin-Fc protein expression at various points after adenoviral treatment (Fig. 6 A). The fusion protein was detected in mice at high levels in both compartments by 4 days after treatment through at least 31 days after treatment. It is well-established that IgG crosses mucosal barriers, presumably through transcytosis or interactions with FcRn (44), to function in secretions. Dectin-Fc was also observed in the BALF, demonstrating the presence of the fusion protein within the mucosal surfaces and within compartments typical of murine IgG.

To assess the ability of Dectin-Fc to enhance host clearance of PC, SCID mice were treated with Ad-Dectin-Fc or Ad-luciferase i.v. and rested for 3 days, followed by intratracheal challenge with 2 × 105 PC cysts. Mice were then sacrificed at specific time points after challenge and studied for PC burden within the lungs by assessment of total copy numbers of PC large rRNA subunit (Fig. 6,B). Despite equivalent cyst counts for the inoculum between studies, PC rRNA counts were significantly different and this may be due to the challenge of quantifying noncystic PC forms. In a first experiment, 14 days after PC challenge, an average of 25% of the original inoculum is present in the Ad-luciferase-treated mice while the Ad-Dectin-Fc-treated mice contained only an average of 6.9% of the original inoculum. In a second experiment, 28 days after PC infection, mice treated with Ad-luciferase contained a substantially higher quantity of PC in the lungs at an average of 549% of original inoculum relative to the Ad-Dectin-Fc-treated mice (averaging at 139% of the inoculum). A third study, performed where a single inoculum was administered and mice were analyzed at serial time points, confirmed the inhibition of the growth kinetics of the PC organism within the lungs of mice receiving a control vector compared with mice receiving Dectin-Fc (Fig. 6 C). Hence, treatment of mice with Dectin-Fc before PC infection considerably diminished the growth of the organism within the lungs, contributing to the ability of the SCID host to prevent PC multiplication within the lung environment. The efficacy of Dectin-Fc to inhibit PC growth is most apparent at later stages of PC infection, as innate host clearance mechanisms lose their capacity to control PC replication within the lungs.

Although hyperinflammatory responses mediated by CD8+ T cells generate significant lung damage and dysfunction in the murine response to PC (45), SCID mice suffer lung damage at late stages of pneumonia as a consequence of uncontrolled PC replication and immunodysregulation (46, 47). We assessed the capacity of Dectin-Fc to limit correlates of pulmonary damage associated with PC infection by assessing the presence of intracellular enzymes in the alveolar fluid. BALF collected from the study described in Fig. 6,C was analyzed over the time course of infection for LDH activity. We observed significantly decreased levels of BALF LDH in mice treated with Dectin-Fc, compared with control mice, even as early as 5 days after PC challenge, when there is low PC burden (Fig. 7,A). As a significant portion of the PC inoculum is cleared soon after intratracheal instillation, as we (Fig. 6,C) and others previously observed (14), it is possible that targeting of PC to myeloid cells via FcγR-dependent host recognition contributed to this phenotype. Twenty-eight days after PC challenge, when there is a significantly higher PC burden in the lungs of control mice relative to Dectin-Fc-treated mice, BALF LDH was nearly twice as high in control mice relative to mice receiving Dectin-Fc, suggesting that Dectin-Fc limited both PC burden and cellular damage associated with infection. Also by day 28 postchallenge, there were significant differences in the quantities of neutrophils observed in the BALF, with decreased levels in mice receiving Dectin-Fc (Fig. 7 B). It has been shown that SCID mice recruit high numbers of neutrophils into the lungs at late stages of PC infection which is correlative with lung damage (46) and in humans with PC pneumonia, increased BALF neutrophil counts are associated with poor prognosis (48, 49). MIP-2, a neutrophil chemoattractant secreted by alveolar macrophages and airway epithelial cells in response to PC β-glucan (16, 39), and TNF-α, a proinflammatory cytokine also secreted by alveolar macrophages in response to PC β-glucan (50), were also measured in the lung homogenate. Though the differences were not statistically significant, we observed a trend toward higher levels of both cytokines in the lungs of control mice relative to Dectin-Fc-treated mice (e.g., MIP-2 averaging 155 ± 57 pg in the control group, 60 ± 21 pg in the Dectin-Fc group; TNF-α levels were similar). Taken together, these data suggest that correlates of pulmonary damage associated with PC infection are limited by Dectin-Fc and this may be due to enhanced clearance of PC and/or direction of PC organisms toward FcγR-dependent recognition and degradation within the lungs.

The β-glucan receptor Dectin-1 is critically involved in innate immune responses against PC (16), as well as Candida albicans (51, 52) Aspergillus fumigatus (53, 54), and Coccidioides posadasii (55). Two recent reports show that Dectin-1-deficient mice have compromised clearance of PC (56) and C. albicans (57) as well as attenuated macrophage responses to these fungal organisms. In these fungal pathogens, β-glucan is the major component of the inner cellular wall, contributing to cellular rigidity and structure, and eliciting host proinflammatory responses upon exposure to the innate immune system (58). Notably, the PC cyst contains high amounts of cellular wall β-glucan while the trophozoite form does not (27, 59, 60). Yet, the echinocandins, a class of synthetically modified lipopeptides that inhibit the fungal-specific enzyme β-1,3-glucan synthase, rapidly diminish PC organisms in rodent models of infection (60, 61). Given the abundance and apparent accessibility of PC β-glucan, as well as its potentially critical role in the fungal life cycle, we considered immune-based strategies targeting this defined cell wall component as a novel therapy for PC pneumonia.

As macrophages overexpressing Dectin-1 have enhanced recognition and uptake of PC organisms relative to normal macrophages, we hypothesized that the CRD of Dectin-1 might be a sufficient targeting structure for PC identification. Immunoprotective Abs against PC enhance effector function at the level of the myeloid cell and, as production of PC-specific IgG1 is most perturbed by murine CD4+ T cell dysfunction (62), we chose to couple the Dectin-1 CRD with the murine IgG1 Fc fragment to promote recognition and signaling through FcγRs. We expected that Dectin-Fc would function similarly to an Ab and would promote host recognition and clearance of PC organisms by enhancing the effector function of FcγR-bearing cells.

The recombinant protein, Dectin-Fc, demonstrated specific binding to laminarin, a β-glucan-containing glycosidic linkages analogous in stoichiometry to that observed in the PC cyst wall (27). Hydrolysis of β-1,3 linkages of laminarin entirely blocked Dectin-Fc recognition, indicating its specificity for these glycosidic bonds. Characterization of the Dectin-Fc CRD with surface plasmon resonance measurements revealed a KD of 2.03 × 10−7 M for laminarin, suggestive of high-affinity interaction. The observed affinity of Dectin-Fc for β-glucan is similar, if not somewhat higher, than that observed for lectin receptors; this may be attributable to the dimeric nature of the fusion protein. For example, the interaction of SIGN-R, a major mannose receptor on peritoneal macrophages, with terminal mannose epitopes is characterized by a KD of 9 × 10−6 M (31) while E-selectin, a receptor mediating tethering of granulocytes to the vascular membrane via recognition of E-selectin-ligand-1, possesses a KD of 6.2 × 10−5 M (32). The Ag-binding sites of anti-carbohydrate Abs, such as those directed against either Chlamydia or Shigella LPS O Ags, possess KD values ranging from 10−5 to 10−6 M (33, 34), while murine anti-carbohydrate Ab responses from conjugate vaccines against meningococcemia yielded KD estimates ranging from 10−6 to 10−9 for Ag (35) The affinity of Dectin-Fc for β-glucan, thus, falls within a range typical for anti-carbohydrate Abs and lectin receptors for their ligands.

Preopsonization of zymosan with Dectin-Fc enhanced baseline macrophage recognition of these particles and this phenotype was lost upon blockade of the primary receptors for murine IgG1, FcγRII, and FcγRIII. Our study demonstrates the sufficiency of the Dectin-1 CRD as a targeting epitope for particulate β-glucan in vitro and is in accordance with evidence suggesting that TLR2 and TLR6, receptors that cooperate with dectin-1 and regulate MyD88- and NF-κB-dependent signaling in response to zymosan, are not required for the actual β-glucan recognition event mediated by Dectin-1 (63). As anticipated, Dectin-Fc bound to PC cysts, demonstrating that the PC cell wall β-glucan is accessible and recognized by this fusion protein. Our observation is in line with studies demonstrating an abundance of PC β-glucan in the inner cyst wall (27) and previous observations that overexpression of the Dectin-1 receptor in RAW macrophages enhanced binding and recognition of PC cysts (16). We have previously shown that Dectin-Fc binds A. fumigatus swollen conidia (53) and our current study now extends the immunolocalization of Dectin-Fc to PC cysts.

Dectin-Fc increased killing of PC by alveolar and elicited peritoneal macrophages and such levels were sustained when macrophage Dectin-1 receptors and were blocked. Apparent efficacy was lost when FcγRII and FcγRIII were additionally blocked, demonstrating that Dectin-Fc targets PC for degradation through these receptors. The importance of alveolar macrophages in PC degradation and clearance is well-documented (16, 64, 65), yet optimal macrophage-dependent clearance requires coordination with B and T cell-dependent responses against PC, as macrophages and other innate cells are ultimately insufficient in the control of infection. The development of a fusion protein capable of recognizing PC β-glucan coupled with the capacity for FcγR-dependent targeting represents a novel mechanism for the enhancement of baseline macrophage effector function against PC, in the absence of B and T cell-dependent immune responses against the pathogen.

Adenoviral delivery of Dectin-Fc in SCID mice significantly reduced the kinetics of PC growth and overall PC burden within the lungs by 28 days postchallenge and led to decreased pulmonary LDH and BALF neutrophils, correlates of PC-related lung damage. These findings demonstrate that Dectin-Fc promotes PC recognition and clearance in vivo and increases the specificity of the immune response, presumably through enhancement of FcγR-dependent clearance mechanisms directed by macrophages. Because the ability of Dectin-Fc to inhibit PC growth is most apparent at late stages of PC infection, as innate host clearance mechanisms lose their capacity to control PC replication within the lungs, our studies suggest that Dectin-Fc may improve the clearance of existing PC lung infections.

Though there was significantly altered growth and an overall reduction of PC burden in SCID mice treated with Dectin-Fc, the establishment of infection could not be prevented. This observation may be a consequence of the expression pattern and relative exposure of β-glucan by PC in the context of the lung environment. Although we have shown that PC β-glucan can be targeted in vitro by macrophages both in this study and in previous work (16), β-glucan may not be present or sufficiently exposed by the as-yet uncharacterized infectious form(s) of the organism, leading to early escape from Dectin-Fc-dependent recognition. In the course of PC infection, soluble β-glucan is shed into the blood and BALF (66) and this may additionally contribute to evasion mechanisms inhibiting β-glucan-dependent recognition of PC organisms. Further, pulmonary collectins target fungal cellular wall carbohydrates and these may compete with Dectin-Fc for binding to PC β-glucan. In particular, surfactant protein D (SP-D) targets β-1,6-linked glucan (67) and recognition of these PC cell wall epitopes by SP-D may inhibit binding of Dectin-Fc to its primary target, β-1,3-linked glucan. Notably, SP-D-deficient mice clear PC more rapidly than wild-type mice (68) and while SP-D is capable of binding PC, it appears to inhibit macrophage internalization (69), underscoring the advantages of harnessing macrophage effector function in β-glucan targeting strategies.

Abs and IgG Fc-based targeting molecules directed at fungal cellular wall carbohydrates are emerging as important mediators of host defense against a various fungal species. Natural IgG Abs directed against mannan have been shown to enhance complement protein 3 binding to C. albicans, through both direct and alternative pathways (70, 71). Others have demonstrated that a mannose receptor human IgG1 fusion protein increased internalization of PC organisms by human polymorphonuclear cells (72), underscoring the ability of carbohydrate-directed Fc-fusion proteins to enhance myeloid cell function. In a recent study, a novel vaccine, consisting of laminarin conjugated to a diphtheria toxoid carrier, generated β-glucan specific IgG that protected against vaginal candidiasis as well as lethal hemogenous challenges of C. albicans and A. fumigatus in mice (73). Interestingly, as β-glucan-specific IgG diminished growth of these fungal species in the absence of effector cells in vitro, one mechanism through which these Abs may function is via direct antimicrobial effects. This study demonstrated that high-affinity β-glucan directed IgG, presumably requiring CD4+ T cell-dependent B cell costimulation, targeted antigenically conserved β-glucan to enhance host clearance of two very different fungal pathogens. Our studies demonstrate that an additional fungal pathogen, PC, can be effectively targeted via β-glucan recognition with an IgG1 Fc-fusion protein, increasing macrophage killing of PC organisms and significantly reducing PC burden within the lungs of SCID mice.

Models of vaccination against PC have demonstrated that immunity carried by Abs can protect CD4+ T cell-deficient hosts (14) and strategies to develop Ab responses against PC within the actual setting of CD4+ T cell deficiency are emerging (12, 17). Targeting PC β-glucan with Dectin-Fc by passive vaccination, as demonstrated here through adenoviral delivery, may complement these evolving approaches. By targeting PC specifically to FcRs on myeloid cells such as dendritic cells, Dectin-Fc could potentially improve aspects of PC Ag presentation to residual CD4+ T cells. Also, as Dectin-Fc recognizes what is thought to be the most inflammatory component of fungal cell wall (58) and recognition of PC by dectin-1 leads to the elicitation of host chemotactic factors such as MIP-2 (16), this fusion protein could function to limit potentially detrimental host responses to PC pneumonia, such as excessive neutrophil recruitment into the lungs (48).

Our work supports the concept that Ab-dependent targeting of β-glucan may be a promising strategy against PC infection in the immunocompromised host. Continued effort to understand the potential of fungal carbohydrates as targets of protective immunity, or as Ags in the generation of protective immunity, may inform on optimal vaccination strategies against PC pneumonia.

We thank Gordon D. Brown for providing the full-length murine dectin-1 receptor PCR3.1 plasmid. We are very grateful to Lynne Bauer, Alison J. Logar, and Julie Bindas for technical assistance, and the members of the Kolls and Steele laboratories for helpful discussion.

The authors have no financial conflict of interest.

The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

1

This work was supported by National Institutes of Health Grants 5R01HL061271-08 and 5P01HL076100-030002 (to J.K.K.), 5R01HL080317-02 (to C.S.), and F30ES015413-01 (to R.R.R.).

3

Abbreviations used in this paper: PC, Pneumocystis carinii; HAART, highly active antiretroviral therapy; TMB, tetramethylbenzidine; MFI, mean fluorescence intensity; BALF, bronchoalveolar lavage fluid; LDH, lactate dehydrogenase; CRD, carbohydrate recognition domain; PAMP, pathogen-associated molecular pattern; SP-D, surfactant protein D; CH, constant heavy.

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