The advancement of holistic, integrative medicine is a significant link that has been identified between metabolic alterations in immune cells and their ability to modulate immune cell phenotype in infectious diseases. Immuno-metabolism offers fresh perspectives for elucidating the pathogenesis of prevalent infectious diseases in humans. Moreover, it provides promising techniques for the development of vaccines and drugs by identifying novel targets for intervention1. Metabolic reprogramming of immune cells is identified across various infectious diseases, including leishmaniasis. Leishmania spp. is responsible for causing leishmaniasis, of which Leishmania major (L. major) causes cutaneous leishmaniasis (CL). L. major parasites elicit a significant impact on the metabolism of host cells, particularly in macrophages, for proliferation and survival as intracellular parasites2. Macrophages can typically polarize into either classically activated (M1) or alternatively activated (M2) subsets where M1 cells possess high pro-inflammatory cytokine secretion and production of nitric oxide (NO) through the metabolism of nitrogen species. M2 cells exhibit elevated levels of anti-inflammatory cytokines and display high arginase activity through nitrogen metabolism3. Thus, both phenotypes not only differ through their immune response but also in their metabolic pathways.
Systems biology of leishmaniasis aims to identify molecular targets for designing novel therapeutics through drug designing and development. Reconstruction of signaling networks and metabolic pathways aids in understanding leishmaniasis as a holistic model and draws insight for the identification of the principal component driving the diseased state. Mathematical modeling is one of the most favored applied analytical approaches for understanding the complexities of leishmaniasis4. Immunometabolic networks and mathematical models enabled the identification of succinate dehydrogenase (SDHA) as a key component of the M1 phenotype, which is expressed to eliminate the parasite5. Synthetic biology has applications in diagnostics, vaccine development and therapeutics in leishmaniasis. Metabolism targeting immune response modulation may be achieved through synthetic biology tools. For modulation of inositol phosphoryl ceramide synthase which regulates sphingolipid metabolism and alters host immune signaling, a genetic circuit that possessed bistable behavior was used to synthetically tune the intrinsic robustness of L. major infection model6,7. Hence, systems and synthetic biology can provide a model-based genetic engineering platform for the development of precision medicine in the Leishmania model system.
M1 phenotype is marked by the expression of immuno-metabolic signaling networks where the production of inflammatory cytokines and metabolic pathways synergistically enhances parasite elimination. M1 polarization signifies the production of pro-inflammatory cytokines such as Interleukin-12 (IL-12), interferon-gamma (IFN-γ), and Tumor necrosis factor alpha (TNF-α). Metabolic pathways that are highly enriched in the M1 phenotype include glycolysis, pentose phosphate pathway, and truncated tricarboxylic acid cycle (TCA cycle)5. The truncated TCA cycle directs parasite elimination machinery through increased succinate and citrate levels, which guide the production of NO3. Accumulation of succinate by SDHA leads to activation of transcription factor hypoxia-inducible factor 1-alpha (HIF-1α), which induces the production of IL-1β8. In the M2 phenotype, fatty acid oxidation, increase in glutamine utilization, and enhanced oxidative phosphorylation of glucose are observed along with the production of anti-inflammatory cytokines such as Interleukin-10 (IL-10), Transforming growth factor beta (TGF-β), Interleukin-4 (IL-4) and Interleukin-13 (IL-13)3. M2 exhibits elongated mitochondria as a distinctive feature, leading to enhanced efficiency in energy generation. They utilize fatty acids, glucose, and glutamine as substrates to fuel the TCA cycle, thereby generating ATP through oxidative phosphorylation at a higher rate to promote parasite growth and proliferation9. SDHA enzyme responsible for succinate accumulation through truncated TCA can not only promote NO production but also initiate a succinate-dependent oxygen consumption through electron transport10. In Leishmania-infected macrophages, SDHA gets downregulated by 2.17 fold, indicating aerobic respiration might also be downregulated11. In order to increase succinate consumption to induce pro-inflammatory cytokine-mediated NO production and promote parasite elimination, expression of SDHA is essential.
The synthetic circuit offers precision-targeted therapies that may alter the diseased system to achieve a bistable oscillation that may restore healthy phenotype at the spatiotemporal level. The synthetic circuit delivery and expression make the system dynamic and robust. One pivotal factor contributing to the advancement of synthetic biology lies in the ability to assemble genetic parts and elements in a modular fashion to enable the generation of intricate architectures and tailored functionalities12. Constraints associated with traditional expression techniques have spurred the emergence of tetracycline operon-based inducible plasmid synthetic circuits, thus allowing rapid evaluation of plasmid and easy delivery across various cell types13. The tetracycline-responsive repressor (TetR) protein, when existing as a dimer, exhibits strong binding affinity to the tet operon (TetO), effectively suppressing transcription. However, upon the interaction of its ligand, doxycycline (dox), TetR undergoes a structural alteration, resulting in its dissociation from TetO, consequently allowing transcription to proceed unimpeded. This circuit can exhibit protein translation control14. Therefore, through the defined methodology, the designed tetracycline operon-based inducible plasmid synthetic circuit was enabled to express SDHA in the pEGFP-N1 vector. Evaluation of the transformation efficiency of the circuit and its yield provided insights into the competence of delivery. Through restriction digestion of the vector, the determination of the cloning efficiency was confirmed. Further, a transfected RAW264.7 mouse macrophage cell line derived from peritoneal macrophages of Balb/c mice was observed for doxycycline dose-dependent green fluorescent protein (GFP) expression in transfected cells. Additionally, the parasite elimination effect in transfected cells was corroborated with an expression of the synthetic circuit. Moreover, induction and expression of pro-inflammatory cytokines were observed, which was directed through an increase in the time point of infection in the synthetic circuit transfected and induced cells, which was directly associated with the functioning of the synthetic circuit.