Dexamethasone-Induced Cytokine Changes Associated with Diminished Disease Severity in Horses Infected with Anaplasma phagocytophilum
ABSTRACTAnaplasma phagocytophilumis the zoonotic cause of granulocytic anaplasmosis. We hypothesized that immune response, specifically gamma interferon (IFN-γ), plays a role in disease severity. To test this, horses were infected andIFNGexpression was pharmacologically downregulated using corticosteroids. Eight horses were infected withA. phagocytophilum; 4 received dexamethasone on days 4 to 8 of infection. Clinical signs, hematologic parameters, and transcription of cytokine/chemokine genes were compared among treated and untreated horses. Infection was quantitated bymsp2real-time PCR and microscopy. As anticipated, there was significantly greater leukopenia, thrombocytopenia, and anemia in infected versus uninfected horses. TheA. phagocytophilumload was higher for dexamethasone-treated horses. Dexamethasone reducedIFNGtranscription by day 12 andIL-8andIL-18by days 7 to 9 and increasedIL-4on day 7. The ratio ofIL-10toIFNGwas increased by dexamethasone on day 9. There were no hematologic differences between the infected horses. Dexamethasone suppression of proinflammatory response resulted in delayed infection-induced limb edema and decreased icterus, anorexia, and reluctance to move between days 6 and 9 and lower fever on day 7. These results underscore the utility of the equine model of granulocytic anaplasmosis and suggest that Th1 proinflammatory response plays a role in worsening disease severity and that disease severity can be decreased by modulating proinflammatory response. A role for Th1 response and macrophage activation in hematologic derangements elicited byA. phagocytophilumis not supported by these data and remains unproven.