Pre-existing Th1 immunity is abrogated by ongoing recruitment of monocytic host cells that are refractory to activation

<jats:p>Protective immunity against many infectious diseases develops following primary infection, called infection induced immunity (III), and provides a blueprint for vaccination. However, many vaccination strategies have failed. In the parasitic Leishmania major model of self-healing cutaneous disease, control of secondary challenge infection relies on pre-existing T helper (Th)1-dependent activation of skin-infiltrating monocytes for elimination of intracellular parasites. To better understand immune-evasion of pre-existing Th1 immunity by pathogens, we investigated the pathogen-niche established following non-healing challenge infection with the L. amazonensis parasite in a setting of pre-existing III. Following secondary challenge, pre-existing Th1 III initially controlled infection but ultimately failed. Loss of protection was not overtly STAT6- or IL-10-mediated. Rather, monocyte-lineage tracing revealed inflammatory monocyte-derived PD-L1+PD-L2+ macrophages provide an intracellular pathogen-niche and facilitate evasion of pre-existing Th1 immunity. Anti-PD-1 immune checkpoint blockade enhanced uninfected, but not infected, monocyte-derived cell activation and depletion of monocyte-derived precursors improved parasite control. These observations suggest that evasion of pre-existing Th1 immunity in this setting is not due to a failure of the Th1 response, but rather due to infected-cell intrinsic defects in activation.</jats:p>