Aspectos clínicos, laboratoriais e epidemiológicos da leishmaniose tegumentar americana - casuística do Hospital Evandro Chagas/FIOC-RUZ/RJ no período de janeiro de 1987 a dezembro de 1991

Mattos, Marise

doi:10.1590/s0037-86821993000400013

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“…In the last two decades, more than 1,000,000 cases of TL were reported to the Pan American Health Organization (PAHO), with a yearly average greater than 50,000 cases. In Brazil, TL is mainly caused by Leishmania ( Viannia ) braziliensis and the most common clinical presentation is termed localized cutaneous leishmaniasis (LCL) [ 1 , 2 , 3 , 4 , 5 ]. LCL is characterized by one or a few painless ulcers in a single segment of the body, with infiltrated erythematous-violaceous raised borders and a base containing granulations with a small amount of purulent discharge.…”

Section: Introductionmentioning

confidence: 99%

Is There Any Difference in the In Situ Immune Response in Active Localized Cutaneous Leishmaniasis That Respond Well or Poorly to Meglumine Antimoniate Treatment or Spontaneously Heal?

et al. 2023

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Localized cutaneous leishmaniasis caused by Leishmania braziliensis can either respond well or poorly to the treatment or heal spontaneously; It seems to be dependent on the parasite and/or host factors, but the mechanisms are not fully understood. We evaluated the in situ immune response in eighty-two active lesions from fifty-eight patients prior to treatment classified as early spontaneous regression (SRL-n = 14); treatment responders (GRL-n = 20); and non-responders (before first treatment/relapse, PRL1/PRL2-n = 24 each). Immunohistochemistry was used to identify cell/functional markers which were correlated with the clinical characteristics. PRL showed significant differences in lesion number/size, clinical evolution, and positive parasitological examinations when compared with the other groups. SRL presented a more efficient immune response than GRL and PRL, with higher IFN-γ/NOS2 and a lower percentage of macrophages, neutrophils, NK, B cells, and Ki-67+ cells. Compared to SRL, PRL had fewer CD4+ Tcells and more CD163+ macrophages. PRL1 had more CD68+ macrophages and Ki-67+ cells but less IFN-γ than GRL. PRL present a less efficient immune profile, which could explain the poor treatment response, while SRL had a more balanced immune response profile for lesion healing. Altogether, these evaluations suggest a differentiated profile of the organization of the inflammatory process for lesions of different tegumentary leishmaniasis evolution.

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