Leishmaniose mucosa: aspectos clínicos e epidemiológicos

Lessa, Marcus Miranda; Lessa, Hélio A.; Castro, Thomas W.N.; Oliveira, Áureo Silva de; Scherifer, Albert; Machado, Paulo Roberto Lima; Carvalho, Edgar M.

doi:10.1590/s0034-72992007000600016

Cited by 49 publications

(52 citation statements)

References 8 publications

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“…In L. braziliensis infection, patients develop a strong Th1 immune response, and this exaggerated inflammatory response results in tissue damage (28). Both IFN-␥ and TNF-␣ are highly produced in CL, but while IFN-␥ may have a protective function (16), there are many lines of evidence that support a role for TNF-␣ in the pathology of cutaneous and mucosal lesions (9,10,(29)(30)(31)(32). Little attention has been given to the role of CD8 ϩ T cells in leishmaniasis.…”

Section: Discussionmentioning

confidence: 99%

Protective and Pathological Functions of CD8⁺T Cells in Leishmania braziliensis Infection

et al. 2015

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dCutaneous leishmaniasis (CL) caused by Leishmania braziliensis is characterized by a strong Th1 response that leads to skin lesion development. In areas where L. braziliensis transmission is endemic, up to 15% of healthy subjects have tested positive for delayed-type hypersensitivity to soluble leishmania antigen (SLA) and are considered to have subclinical (SC) infection. SC subjects produce less gamma interferon (IFN-␥) and tumor necrosis factor alpha (TNF-␣) than do CL patients, but they are able to control the infection. ؉ T cells was higher in CL than in SC cells. While the use of a granzyme B inhibitor decreased the number of apoptotic cells in the CL group, the use of z-VAD-FMK had no effect on the frequency of these cells. These results suggest that CL CD8 ؉ T cells are more cytotoxic and may be involved in pathology. L eishmaniasis is caused by infection with parasites of the genusLeishmania. Leishmaniasis is a neglected tropical disease; 214,000 new cases of cutaneous leishmaniasis (CL) are reported annually worldwide, and the estimated incidence of leishmaniasis is 690,000 to 1,200,000 cases. Approximately 67,000 cases are reported in South America, Central America, and the Caribbean (1). In mice, the majority of Leishmania-specific CD4 ϩ T cells differentiate into T-helper 1 (Th1) cells that secrete gamma interferon (IFN-␥) and contribute to the elimination of the parasite through the activation of macrophages (2, 3). Although protective immunity has predominantly been related to IFN-␥-producing CD4 ϩ T cells, infection with Leishmania also results in the activation and expansion of parasite-specific CD8 ϩ T cells (4, 5). Human CL caused by Leishmania braziliensis is characterized by a strong Th1 response with the production of high levels of IFN-␥ and tumor necrosis factor alpha (TNF-␣) (6, 7). This exaggerated Th1 response is associated with the development of lesions and the severity of the disease (6, 8-10). In patients with CL caused by L. braziliensis, there are more CD4 ϩ than CD8 ϩ T cells, but this ratio reaches an equilibrium due to the increase in CD8 ϩ T cells that occurs during the healing process (11). The enrichment of Leishmania-reactive CD8 ϩ T cells in older lesions suggests that these cells may play a role in the healing process (12). In contrast, other studies have associated CD8ϩ T cell functions with pathology. For example, the cytotoxicity mediated by CD8 ϩ T cells is greater in mucosal leishmaniasis (ML), a more severe form of L. braziliensis infection, than in CL (13,14). More recently, it was shown that the frequency with which CD8 ϩ T cells express granzyme in the lesions of CL patients is greater than that in patients in the early phase of CL (i.e., before the ulcer has developed) and that the frequency with which CD8 ϩ T cells express granzyme is directly associated with the intensity of the inflammatory reaction observed in CL ulcers (15,16). This controversy regarding the role of cytotoxicity in the pathogenesis of human leishmaniasis indicates that the functions of CD...

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Section: Discussionmentioning

confidence: 99%

Protective and Pathological Functions of CD8⁺T Cells in Leishmania braziliensis Infection

et al. 2015

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“…The parasite life cycle is heteroxenic and its vectors are hematophagous insects of the Phlebotominae subfamily, Lutzomya being the most common genus. [1][2][3] Between 1998 and 2008, approximately 282,000 cases of ACL were registered in Brazil, 2,240 of which were registered in the state of Mato Grosso do Sul. 4 Over the years, ACL has behaved as a classic occupational disease, typically affecting adult males exposed to forested regions.…”

Section: Introductionmentioning

confidence: 99%

“…This variation has been associated with the patient's immunological status and with the species of Leishmania. 3,[11][12][13] This aspect of the infection makes clinical diagnosis difficult, and there needs to be a strong proof of suspicion of the disease.…”

Section: Introductionmentioning

confidence: 99%

Leishmaniose tegumentar americana: estudo clínico, epidemiológico e laboratorial realizado no Hospital Universitário de Campo Grande, Mato Grosso do Sul, Brasil

Murback

Filho

Nascimento

et al. 2011

An. Bras. Dermatol.

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FUNDAMENTOS: Leishmaniose Tegumentar Americana é zoonose de manifestações clínicas variadas, em expansão no Brasil, sendo o estado de Mato Grosso do Sul importante área endêmica. OBJETIVOS: Avaliar clínica, epidemiológica e laboratorialmente pacientes com Leishmaniose Tegumentar Americana , atendidos no Hospital Universitário Maria Aparecida Pedrossian, Universidade Federal de Mato Grosso do Sul, Brasil (HU/UFMS). MÉTODOS: Trata-se de um estudo observacional do tipo transversal com abordagem descritiva e analítica. Foram avaliados, retrospectivamente, dados de pacientes suspeitos de Leishmaniose Tegumentar Americana , atendidos no HU/UFMS de 1998 a 2008, e encaminhados ao Laboratório de Parasitologia/UFMS para complementação diagnóstica. Para a inclusão neste estudo foram considerados critérios clínicos e laboratoriais. RESULTADOS: Quarenta e sete pacientes foram incluídos no estudo. Houve predominância de homens de 45 a 59 anos, com a forma cutânea, lesão única, ulcerada, em áreas expostas do corpo e com duração menor que seis meses. O comprometimento de mucosas foi crescente com o aumento da idade e maior em pacientes que procuraram atendimento tardiamente. Intradermorreação de Montenegro foi o exame de maior sensibilidade e o encontro do parasito mostrou-se mais difícil em lesões antigas. CONCLUSÃO: Suspeição diagnóstica precoce é de extrema importância para diagnóstico preciso. Associação de exame parasitológico e imunológico torna mais seguro o diagnóstico laboratorial.

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“…Pode acometer o ser humano no momento em que este participa acidentalmente do ciclo silvestre de manutenção da doença, por meio de atividades que necessitem de sua entrada no ambiente de mata ou mesmo devido à existência de moradias localizadas perigosamente próximas à borda da floresta ou até mesmo no interior da mesma. Contudo, atualmente há cada vez mais evidências da transmissão peridomiciliar, por sugestiva adaptação do vetor ao redor das residências 1,2,3,4,5,6,7,8,9 , como conseqüência das modificações no meio ambiente pelo homem, levando à migração de algumas espécies de Leishmania e de seus vetores para as imediações dos domicílios 10 , mesmo em áreas mais urbanizadas 11,12 .…”

Section: Introductionunclassified

Epidemiologia da leishmaniose tegumentar americana no Estado do Acre, Amazônia brasileira

Silva

Muniz

2009

Cad. Saúde Pública

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Leishmaniose mucosa: aspectos clínicos e epidemiológicos

Abstract: Lei shmaniasis has been documented in several countries, with an estimated prevalence of 12 million people and

Cited by 49 publications

References 8 publications

Protective and Pathological Functions of CD8⁺T Cells in Leishmania braziliensis Infection

Protective and Pathological Functions of CD8⁺T Cells in Leishmania braziliensis Infection

Leishmaniose tegumentar americana: estudo clínico, epidemiológico e laboratorial realizado no Hospital Universitário de Campo Grande, Mato Grosso do Sul, Brasil

Epidemiologia da leishmaniose tegumentar americana no Estado do Acre, Amazônia brasileira

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Leishmaniose mucosa: aspectos clínicos e epidemiológicos

Abstract: Lei shmaniasis has been documented in several countries, with an estimated prevalence of 12 million people and

Cited by 49 publications

References 8 publications

Protective and Pathological Functions of CD8+T Cells in Leishmania braziliensis Infection

Protective and Pathological Functions of CD8+T Cells in Leishmania braziliensis Infection

Leishmaniose tegumentar americana: estudo clínico, epidemiológico e laboratorial realizado no Hospital Universitário de Campo Grande, Mato Grosso do Sul, Brasil

Epidemiologia da leishmaniose tegumentar americana no Estado do Acre, Amazônia brasileira

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Protective and Pathological Functions of CD8⁺T Cells in Leishmania braziliensis Infection

Protective and Pathological Functions of CD8⁺T Cells in Leishmania braziliensis Infection