Cytokines and T-Lymphocute count in patients in the acute and chronic phases of Bartonella bacilliformis infection in an endemic area in peru: a pilot study

Abstract

SUMMARYHuman Bartonellosis has an acute phase characterized by fever and hemolytic anemia, and a chronic phase with bacillary angiomatosis-like lesions. This cross-sectional pilot study evaluated the immunology patterns using pre-and post-treatment samples in patients with Human Bartonellosis. Patients between five and 60 years of age, from endemic areas in Peru, in the acute or chronic phases were included. In patients in the acute phase of Bartonellosis a state of immune peripheral tolerance should be established for persistence of the infection. Our findings were that elevation of the anti-inflammatory cytokine IL-10 and numeric abnormalities of CD4 + and CD8 + T-Lymphocyte counts correlated significantly with an unfavorable immune state. During the chronic phase, the elevated levels of IFN-g and IL-4 observed in our series correlated with previous findings of endothelial invasion of B. henselae in animal models.

Immunosuppressive and angiogenic cytokine profile associated with Bartonella bacilliformis infection in post-outbreak and endemic areas of Carrion's disease in Peru

“…Indeed, an impairment of the cellular immune response in acute infection has been previously described [37]. These results, together with the associations with bacteremia described above, support the hypothesis that B .…”

Intruders below the Radar: Molecular Pathogenesis of Bartonella spp

“…Two studies confirmed increased levels of IL-10 in patients infected with B. bacilliformis (191,192), strongly suggesting that enhanced secretion of this cytokine could participate in the immunosuppression as observed for the modern species. The most drastic difference in the immunopathology of B. bacilliformis compared to that of the modern species is that the majority of infected erythrocytes are usually destroyed by mononuclear phagocytes during Oroya fever, a condition rarely observed in infections with other bartonellae.…”

“…Although the molecular aspects of immune modulation during infections with B. bacilliformis have been scarcely investigated, a transient immunosuppression, including CD4 ϩ T-cell lymphopenia and an impairment of cellular immunity during Oroya fever, seems established in the field (150,152,191,271) and is strikingly reminiscent of AIDS (417). Two studies confirmed increased levels of IL-10 in patients infected with B. bacilliformis (191,192), strongly suggesting that enhanced secretion of this cytokine could participate in the immunosuppression as observed for the modern species.…”

BartonellaInfection in Immunocompromised Hosts: Immunology of Vascular Infection and Vasoproliferation

“…Empiric data have shown that Bartonella initially evades the innate immune system because its surface molecules are not recognized by TLR-4 on dendritic cells or macrophages, [16], thereby allowing for establishment of what might lead to persistent infection. The LPS does not induce tumor necrosis factor alpha and has reduced stimulation of Toll-like receptor 2 (TLR2) and thus reduced endotoxicity [17, 18].…”

“…Acute infection in immune-competent subjects with CSD have revealed upregulation of proinflammatory (IL-2, IL-6) and anti-inflammatory (IL-10) cytokines [25]. On the contrary, low CD4 counts (a marker of immune-compromise) have been associated with elevated IL-10 levels during acute infection with Bartonella , a cytokine milieu that may allow an acute infection to persist especially given the anti-inflammatory nature of IL-10 [16, 25, 26]. Chronic infection is associated with elevated levels of Interferon-alfa and IL-4 in both animal [16, 27] and human studies of the bacillary angiomatosis [16], but not in immune-competent subjects with CSD [25].…”