The use of acute and chronic T. congolense rodent models has shed light on the importance of parasite sequestration in vascular pathogenesis and inflammation1. Yet, uncovering the determinants of parasite sequestration through the exclusive use of animal models is challenging, given the difficulties to disentangle the cellular and biophysical components of the whole organism. To overcome this challenge, we developed a 3D endothelialised bovine microvessel system. The devices consist of a 3D microfluidic network with a pre-defined geometry on a collagen scaffold fabricated by soft lithography and injection moulding (Fig. 1A). The system supports the growth of primary microvascular endothelial cells in lumenised microvessels, perfusable with T. congolense, which allows for the study of parasite sequestration under controlled conditions, including flow and endothelial cell type, independently of other host factors.
Our previous results showed that different parasite strains accumulate in various organotypic beds in mouse models, leading to distinct clinical presentations. Whilst T. congolense 1/148 parasites accumulate highly in the brain microvasculature, causing acute cerebral trypanosomiasis, IL3000 parasites present a tropism for the heart, and cause chronic, wasting disease1. To better understand this organ preference in vitro, we developed two microvessel systems: one mimicking the heart vasculature with bovine aorta endothelial cells (BAOEC) and one mimicking the brain with bovine brain microvascular endothelial cells (BBMVEC). Endothelial cell identity of both cell types was assessed by immunostaining on 2D monolayers. Both BBMVEC and BAOEC expressed adherens (VE-cadherin, ß-catenin) and tight junction markers (ZO-1), as well as the pan-endothelial cell marker, Von Willebrand factor, (Supplementary Fig. 1). We then seeded both endothelial cell types in a 13 x 13 microfluidic branched network of 120 µm microvessels. This geometry recapitulates a large range of flow velocities (42.5-fold range) and generates microvessels analogous to post-capillary venules in terms of surface-to-volume ratio (20 mm2/mm3). After 3 days in culture, BAOEC and BBMVEC form a 3D tubular geometry with empty lumens. Immunofluorescence labelling with junctional markers revealed that both cell types align with flow when grown in 3D. However, they are morphologically distinct: BAOEC are smaller and more rounded, whilst BBMVEC are bigger and more elongated with a higher aspect ratio (unpaired t-test, p < 0.001) (Fig. 1B). Nonetheless, they both express markers of adherens (VE-cadherin, ß-catenin) and tight junctions (ZO-1) (Fig. 1C and D). The actin cytoskeleton appears to be cortical on BAOEC, while more stress fibres are present on BBMVEC, probably due to the endothelial stretching found in brain microvascular models. In conclusion, we developed two in vitro microvessel systems mimicking heart and brain vasculature, with expected endothelial and junctional marker expression, to study organ-specific trypanosome sequestration.
T. congolense sequestration to 3D microvessels is dependent on wall shear stress, parasite strain and endothelial cell type
Blood flow velocity and the associated wall shear stress (WSS) varies along the hierarchical vascular bed. In healthy conditions, in the arteriovenous microcirculation, WSS ranges range between 5 and 40 dyn/cm2 in arterioles and capillaries, and 1 and 5 dyn/cm2 in venules6–8. However, in pathological conditions, such as when there is vascular obstruction, flow and WSS may reduce1,6. To assess the role of WSS and organotypic endothelial cell types in T. congolense sequestration, we first determined the flow mechanical stress that T. congolense parasites can withstand. To this end, we used a much simpler setup. BAOEC or BBMVEC were seeded into 6-channel µ-slides overnight at maximum confluence. Fluorescently-labelled T. congolense parasites were introduced and allowed to cytoadhere for 30 minutes, followed by perfusion with increasing flow rates to measure parasite binding strength against detachment (Fig. 2A). We observed that both 1/148 and IL3000 parasites remained bound to BAOEC, withstanding high WSS values. In fact, at WSS of 11.97 dyn/cm2, 25%±11 and 43%±21 of 1/148 and IL3000 parasites, respectively, remained sequestered (Fig. 2B). IL3000 presented similar binding kinetics to BBMVEC (51%±16 at maximum WSS) (Fig. 2C). Conversely, 1/148 presented a different behaviour on BBMVEC, with parasites being significantly released back to circulation when exposed to WSS forces higher than 0.6 dyn/cm2 (p-value < 0.001, 2-way ANOVA with Sidak’s correction for multiple comparisons). This shows that different parasite strains display heterogeneous binding behaviour to different endothelial beds and suggests that 1/148 presents lower sequestration strength to brain microvessels at physiological WSS.
Having shown that at least a proportion of both T. congolense 1/148 and IL3000 can withstand these forces, we tested the role of WSS in parasite sequestration. When perfused at a constant flow rate of 10µl/min, endothelial cells in the outer edge of the 13 x 13 grid are exposed to flow velocities that range from 0.4 to 15.2 mm/s, which translates into WSS values between 0.08 and 3.4 dyn/cm2. We perfused 3D aorta or brain microvessels with 1.5 million fluorescently-labelled parasites of either IL3000 or 1/148 strains (Fig. 2D and Video 1). Following a 15-minute perfusion, unbound parasites were washed under flow for 10 minutes and microvessels were fixed and stained for subsequent microscopical analysis and binding quantification.
Parasites presented widespread cytoadhesion to 3D microvessels by live microscopy (video 1). Scanning electron microscopy showed that parasites sequester to the luminal side of the endothelial cells lining the 3D vessels on top of the collagen matrix (Fig. 2E). Within the 3D microvessel, a smooth, empty lumen was surrounded by tightly clustered endothelial cells, to which the parasites sequestered (Fig. 2E). In agreement with previous literature9, close interaction between the flagellum and the endothelial cell was observed (Fig. 2F). Several microfilaments, which have been previously reported, coming out of the endothelial cell and surrounding the parasite cell body could also be observed (Fig. 2F).
Having confirmed that parasites sequester to the 3D microvessels, we proceeded with binding quantifications. Since we were using fluorescently-labelled parasites, we calculated the area occupied by parasite binding (obtained from the total fluorescence area) as a proxy for the number of sequestered parasites because these two variables (number of sequestered parasites and fluorescence area) correlate highly to each other (R2 = 0.91, Pearson’s correlation, p-value < 0.001) (Fig. 2G). Overall, IL3000 parasites presented higher sequestration to bovine aorta microvessels than 1/148 (p-value < 0.0001, ordinary one-way ANOVA with Tukey’s multiple comparisons test), whilst both strains showed similar binding levels to bovine brain microvessels (Fig. 2H). Despite these variations, T. congolense sequestration, regardless of the strain and endothelial bed, is significantly higher than sequestration of Plasmodium falciparum HB3var03 to human 3D brain microvessels, a malaria parasite line associated to severe and cerebral malaria in humans5,10,11. Even though P. falciparum was perfused at higher concentrations, T, congolense 1/148 presented a 5-fold higher binding, and IL3000 a 15-fold. These results highlight the affinity and extend of binding of T. congolense compared to other parasitic disease that affect brain microvessels.
Sequestration of both strains to aorta 3D microvessels negatively correlated with WSS (Fig. 2I). More specifically, IL3000 presented high binding level at WSS of 0.5 dyn/cm2 and below, then it slowly decreased when it reached a WSS of 1 dyn/cm2, after which it plateaued. In contrast, 1/148 displayed lower binding levels than those of IL3000 across all WSS regions, being significantly lower in the range between 0.25 and 0.8 dyn/cm2 (p-value = 0.02 for WSS values of 0.5–0.8 and p-value = 0.001 for WSS values 0.25 to 0.45, 2-way ANOVA with Sidak’s correction for multiple comparisons) (Fig. 2I). These observations agree with findings in mouse models, where T. congolense IL3000 shows higher sequestration to the heart microvasculature than 1/1481. When exposed to bovine brain microvessels, IL3000 sequestration followed the same binding pattern than in aorta microvessels and reached similar sequestration levels (Fig. 2J). However, 1/148 presented a different sequestration pattern with two independent sequestration peaks. First, sequestration was dramatically high at 0.08 dyn/cm2, representing accumulations in 40% of the total vessel area 12867µm2 ± 4483 of sequestration area, which is 3 times what was observed for IL3000 (i.e. 4365µm2 ± 719) (p-value = 0.03, 2-way ANOVA with Sidak’s correction for multiple comparisons). Then, there was also non-significant sequestration bump at 1.4 dyn/cm2. When comparing 1/148 sequestration across different vascular beds, we observed that 1/148 parasites bound similarly to aorta and brain at WSS higher than 0.25 dyn/cm2 but presented significantly more binding to brain at pathological WSS levels of less than 0.25 (Fig. 2K) (p-value = 0.03, 2-way ANOVA with Sidak’s correction for multiple comparisons). Interestingly, in the mouse model of acute cerebral trypanosomiasis, T. congolense 1/148 preferentially sequesters in the small capillaries of the brain, often leading to vascular occlusion and vessel blockage1, which greatly reduce blood flow and the associated WSS. We conclude that T. congolense sequestration is dependent on flow mechanical properties, irrespective of the parasite strain and endothelial cell organotype. Nevertheless, parasite strains display distinct sequestration behaviours, which may be important for the clinical outcome.
T. congolense sequestration can be prevented by interfering with cAMP homeostasis
Having established the role of WSS in sequestration, we asked how we could interfere with sequestration in vitro. It has been previously suggested that cAMP phosphodiesterase inhibition results in lower T. congolense sequestration4. Therefore, we attempted to reproduce that phenotype by treating IL3000 parasites with 10µM or 20µM of NPD-1015, an inhibitor of cAMP phosphodiesterases PDEB1 and PDEB212) that interferes with cAMP homeostasis, increasing the cAMP intracellular levels in the parasite and resulting in growth arrest13. After 24 hours, the drug was removed, and parasites were added to a 2D monolayer of BAOEC and allowed to sequester. Subsequently, we washed unbound parasites and quantified the number of sequestered parasites by microscopy (Fig. 3A and B). Treatment did not affect the health of parasites; we observed vigorous parasite motility and did not detect abnormal cell debris in the wells. However, there was a significant growth arrest upon NPD-1015 treatment: whilst untreated parasites proliferated 82%±14 over 24 hours, parasites treated with 10µM NPD-1015 grew only 42%±4 and those treated with 20µM NPD-1015 did not proliferate at all (-7%±10) (p-value = 0.0026, one-way ANOVA with Tukey’s correction for multiple comparisons) (Fig. 3C).
We observed that parasite exposed to 10µM of NPD-1015 presented a 5-fold lower binding (p-value < 0.0001, one-way ANOVA with Tukey’s correction for multiple comparisons), whilst exposure to 20µM of NPD-1015 decreased binding levels 20 times (p-value < 0.0001, one-way ANOVA with Tukey’s correction for multiple comparisons) (Fig. 3B and D). As we washed the drug before adding the parasites to the endothelial cell monolayers, we ensured that any effect observed is parasite-derived. We then asked if NPD-1015 could revert binding of sequestered parasites. Therefore, we co-cultured T. congolense IL3000 parasites in a 2D BAOEC monolayer for 24 hours. Subsequently, we removed non-sequestered parasites by washing and added 20µM of NPD-1015 for 24 hours longer. We observed a reduction of sequestration, indicating that NPD-1015 induced detachment of parasites. This suggests that increasing intracellular cAMP not only prevents sequestration, but also reverts it (Fig. 3E).
We then used the 3D microvessels system to test whether a similar binding reduction occurred under flow. For that, we incubated parasites with 20µM NPD-1015 and after 24 hours perfused the microvessels with treated parasites (Fig. 3F). Overall, there was a 25% reduction of sequestration (p-value = 0.03, unpaired t-test) (Fig. 3G), consistent with our previous observation in the 2D assay, but with a lower effect than in EC monolayers, suggesting that the tridimensional architecture of the microvessel or the presence of flow might increase cytoadhesion efficiency. Although NPD-1015 treatment did not affect parasite sequestration dependence on WSS (Fig. 3H), an increase in parasitic cAMP significantly reduced parasite binding in regions exposed to a range of WSS between 0.25 and 1.4 dyn/cm2. No differences in binding were observed when the parasite was exposed to a WSS below 0.25 dyn/cm2. In conclusion, we showed that interfering with cAMP homeostasis is sufficient to both prevent and revert sequestration, and this effect is more pronounced under specific flow mechanical cues.
Sequestered parasites proliferate more in the mammalian host and have similar transmission ability to non-sequestered parasites
Next, we hypothesised that sequestration provides an adaptive advantage for T. congolense, so that sequestered parasites proliferate faster than non-sequestered. To test that, we examined the cell cycle distribution of sequestered and non-sequestered IL3000 parasites, grown in vitro, on plastic, without endothelial cells, by quantifying the kinetoplast and nuclei number in each trypanosome cell. (Fig. 4A). We noticed that the population of sequestered parasites contained a higher proportion of proliferating parasites, which typically can be distinguished by having with two kinetoplasts and one nucleus (2K1N, 20%±8 vs. 5%±4) relative to non-sequestered population (p-value < 0.0001, one-way ANOVA with Tukey’s correction for multiple comparisons) (Fig. 4A), suggesting that sequestered parasites divide more frequently than non-sequestered parasites. Parasites in S phase (i.e. with kinetoplast butterfly-shaped) were considered as 2K1N. We did not observe statistically significant differences in the number of mitotic parasites (2K2N configuration).
To test whether sequestered parasites divide more frequently in vivo, we used intravital microscopy data previously collected from mice infected with either T. congolense 1/148 or IL30001. In 1/148 infections, we analysed video recordings from 8 major organs (i.e. adipose tissue, brain, heart, liver, lungs, kidneys, spleen) at days 1–6 post-infection, corresponding to the timepoint after which infected animals start developing acute cerebral trypanosomiasis. In IL3000 infections, we analysed data from the same organs, but at the first peak of parasitaemia, the interval between the first and the second peaks of parasitaemia, where peripheral parasitaemia is barely detected, and the second peak of parasitaemia (Fig. 4B). Before image acquisition, Hoechst and FITC-Dextran were injected intravenously into the mice, to allow detection of intravascular parasites and their DNA using intravital microscopy (Fig. 4C). We differentiated between sequestered and non-sequestered parasites based on their displacement during the video as previously described1. We observed that, overall, sequestered parasites were more often found replicating and dividing (i.e. 2K1N or 2K2N) than non-sequestered parasites (p-value < 0.0001, one-way ANOVA with Tukey’s correction for multiple comparisons) in both 1/148 and IL3000 infections (Fig. 4D). This shows that sequestered parasites divide more than non-sequestered parasites, irrespective of the parasite strain.
Finally, we asked whether the tissue microenvironment might affect parasite division (Supplementary Fig. 2). In both IL3000 and 1/148 mouse infections, we observed an enrichment of dividing parasites (2K1N and 2K2N) in all organs, regardless of the parasite strain, except on lung and kidney for 1/148. Therefore, we conclude that the association between sequestration and T. congolense cell division is neither strain- nor endothelial cell organotype-dependent.
Given our results suggesting that sequestration facilitates parasite proliferation (or vice-versa) and recent work suggesting that non-sequestered parasites may be growth-arrested, insect-transmissible forms4, we tested the ability of sequestered and non-sequestered parasites to differentiate into procyclic (insect) forms (Fig. 4E). We separated in vitro sequestered from non-sequestered parasites, incubated them in differentiation trypanosome media (DTM), at 27ºC, without CO2, and followed parasite differentiation and growth for 5 days (Fig. 4E). We observed that both sequestered and non-sequestered parasites could successfully differentiate into procyclic forms with similar dynamics, reaching similar procyclic parasite number within 5 days (Fig. 4F). Procyclic parasites were identified by their morphology (pointy and elongated cells, with the flagellum starting from the mid body) and motility (not sequestering, fast swimmers). We also quantified their proliferation rate over 24 hours after procyclic differentiation and did not observe any difference (Fig. 4G). Since cell cycle arrest precedes procyclic differentiation in the related organism T. brucei14, we forced T. congolense cell cycle arrest with the administration of NPD-1015 24 hours before induction of differentiation. Again, we did not observe any difference in the ability of each parasite population to differentiate into procyclic forms (Fig. 4F) or of differentiated procyclic forms to grow (Fig. 4G). Finally, we assessed the ability of sequestered, non-sequestered, and NPD-1015-treated bloodstream form parasites to infect tsetse flies. As T. brucei PDEB1 gene deletion was shown to disrupt social motility15 and pH taxis16 of procyclic parasites, we thoroughly washed the parasites to before feeding them to the flies, removing any traces of NPD-1015. Furthermore, we fed the tsetse flies with a low inoculum (105 parasites/ mL blood) to increase the probability of observing differences in fly-infectivity. The lower inoculum, the higher the proportion of parasites that must be competent to achieve infection. In contrast, with a higher inoculum, even a small proportion of fly-infective trypanosomes could represent enough parssites to saturate fly infection rates and mask potential differences between groups. We observed that sequestered and non-sequestered parasites infected similar proportions of flies (37 ± 3% and 26 ± 9%, respectively), whereas NPD-1015-treated parasites infected significantly fewer flies (12 ± 4%) (p-value = 0.0043, one-way ANOVA with Tukey’s correction for multiple comparisons) (Fig. 4H). Moreover, despite similar overall infection rates between sequestered and non-sequestered parasites, we observed that the former resulted in heavier infections (higher parasite load in the midguts) than both non-sequestered and NPD-1015-treated parasites (q-value = 0.0002, < 0.0001, = 0.021, respectively, 2-way ANOVA with Benjamin, Krieger and Yekutieli method correction for false discovery rate) (Fig. 4I).
In summary, our data suggest that sequestration is associated to higher proliferation rates in the mammalian host and heavier infections in the vector, which might affect transmission potential, even though both sequestered and non-sequestered parasites are fly-transmissible.
T. congolense sequestered parasites show distinct transcriptomes to non-sequestered
The striking differences in cell cycle stage between sequestered and non-sequestered parasites both in vitro and in vivo, suggest that these two parasite forms are intrinsically distinct. Therefore, we compared their gene expression profiles during acute cerebral trypanosomiasis in vivo. We infected C57BL/6J mice with 2000 T. congolense 1/148 parasites17 and, at the first peak of parasitaemia (day 6 post-infection), we collected systemic blood and three organs: the brain, the adipose tissue, and the kidney. From these samples, we extracted total RNA and performed multiplexed trypanosome targeted RNA sequencing based on the spliced-leader18 enrichment (SL-seq)19,20. These organs were chosen because the parasite population in their vasculature is predominantly in its sequestered form1. Therefore, we obtained transcriptomes of non-sequestered parasites from systemic blood samples, whereas sequestered parasites enriched transcriptomes were obtained from the tissues.
First, we removed the sequencing reads that mapped to the mouse genome. Then, we mapped the remaining reads to the annotated T. congolense IL3000 genome21 (Supplementary file 1), given that genome homology analysis shows that IL3000 and 1/148 strains have 94.8%±2.8 nucleotide sequence identity (Supplementary Fig. 3). We compared the transcriptomes from parasites of each tissue and blood to see if we were able to detect significant tissue-specific differences. We observed that the transcriptomes of non-sequestered parasites (from the systemic blood) clustered together (Fig. 5A). Correlation analysis further showed that transcriptomes of sequestered parasites were more different from non-sequestered parasites, than sequestered parasites collected from different tissues (R2 = 0.58–0.61 vs. 0.91–0.96, Pearson’s correlation). Therefore, in subsequent analyses, we compared the transcriptomes of sequestered parasites irrespective of the tissue they derived from to the group of non-sequestered parasites. We detected 523 differentially expressed genes, of which 323 were upregulated in sequestered parasites (Fig. 5B). Upregulated genes included phosphatidic acid phosphatase, DNA repair protein, sister chromatid cohesion C-terminus, UDP-Gal/UDP-GlcNAc-dependent glycosyltransferase (UGT), transferrin receptor-like proteins (both Fam14 and 15) and the orthologue to flagellum attachment zone protein (FAZP). Downregulated genes included those encoding for ALBA and other RNA-binding proteins, PAD-like genes (protein associated with differentiation), amastin, cAMP phosphodiesterase A, and PLAC8 family (Fig. 5B).
We asked if genes previously identified as upregulated in T. congolense parasites upon silencing of a negative regulator of differentiation to insect-transmissible forms (TcoREG9.1)4, and that therefore could be assumed to be characteristic of insect-transmissible parasites, were enriched within our dataset. We did not find compelling evidence of enrichment (Fig. 5C). Based on what we know from T. brucei, at the peak of infection, the population of parasites is expected to contain more insect-transmissible forms than in the ascending phase of infection22. Therefore, we also tested a gene set comprising genes upregulated in the first peak infection compared to the ascending phase of infection22, but also did not find any evidence of enrichment. Together, these results corroborate our previous observation that T. congolense sequestration (or their lack of) is not associated with transmission ability.
Given that sequestration is a physical interaction between the parasite and the endothelial cell and considering that the T. congolense cell surface is tightly packed with the major antigen, variant surface glycoprotein (VSG), we specifically looked for changes in their expression. VSGs cannot be accurately characterised using standard differential expression tools, so we used the software VAPPER23 to profile them in sequestered and non-sequestered parasites. T. congolense VSGs cluster into 15 phylogenetically-distinct lineages (or phylotypes), between which genetic recombination is rare24. We found genes from all phylotypes being expressed at the mRNA level, consistent with previous observations in insect forms (Fig. 5D). However, we found that genes belonging to VSG phylotype 8 were predominantly expressed in sequestered parasites, irrespective of the mouse organ, whereas genes from phylotypes 11 and 14 were more abundant in non-sequestered parasites (p-value < 0.0001, 2-way ANOVA with Sidak’s multiple comparisons test) (Fig. 5D and 5E). These results suggest functional differentiation amongst the VSG repertoire and a role of phylotype 8 genes in sequestration.
Our results support the conclusions that sequestered and non-sequestered T. congolense bloodstream forms present different transcriptomes, and that sequestration might be directly linked to VSG expression.