Apoptotic mimicry by an obligate intracellular parasite downregulates macrophage microbicidal activity

Programmed cell death by apoptosis of unnecessary or potentially harmful cells is clearly beneficial to multicellular organisms [1]. Proper functioning of such a program demands that the removal of dying cells proceed without an inflammatory reaction [2]. Phosphatidylserine (PS) is one of the ligands displayed by apoptotic cells that participates in their noninflammatory removal when recognized by neighboring phagocytes [3]. PS ligation induces the release of transforming growth factor-beta (TGF-beta), an anti inflammatory cytokine that mediates the suppression of macrophage-mediated inflammation [4]. In Hydra vulgaris, an organism that stands at the base of metazoan evolution, the selective advantage provided by apoptosis lies in the fact that Hydra can survive recycling apoptotic cells by phagocytosis [5]. In unicellular organisms, it has been proposed that altruistic death benefits clonal populations of yeasts [6] and trypanosomatids [7-9]. Now we show that advantageous features of the apoptotic process can operate without death as the necessary outcome. Leishmania spp are able to evade the killing activity of phagocytes and establish themselves as obligate intracellular parasites. Amastigotes, responsible for disease propagation, similar to apoptotic cells, inhibit macrophage activity by exposing PS. Exposed PS participates in amastigote internalization. Recognition of this moiety by macrophages induces TGF-beta secretion and IL-10 synthesis, inhibits NO production, and increases susceptibility to intracellular leishmanial growth.