Cytokine patterns in the pathogenesis of human leishmaniasis.

Abstract

The host response to infection appears to be regulated by specific patterns of local cytokine production. In the mouse, resistance to many pathogens including Leishmania is associated with a THl cytokine profile, IL-2 and IFN-,y; whereas susceptibility to infection is associated with production of TH2 cytokines, IL4, IL-5, and IL-10. To determine the cytokine patterns of the local immune response to Leishmania infection in humans, we used the polymerase chain reaction to compare cytokine mRNAs in biopsy specimens of American cutaneous leishmaniasis. In localized cutaneous leishmaniasis and the Montenegro delayed-type hypersensitivity reaction, type 1 cytokine mRNAs such as IL-2, IFN-y, and lymphotoxin were relatively predominant. In the chronic and destructive mucocutaneous form of leishmaniasis, there was a mixture of type 1 and type 2 cytokines, with a striking abundance of IL4 mRNA in lesions. These results suggest that clinical course of infection with Leishmania braziliensis in man is associated with specific local patterns of cytokine production. (J. Clin. Invest. 1993.

Cytokine profile in Montenegro skin test of patients with localized cutaneous and mucocutaneous leishmaniasis

“…We suggest that the MST can be used as a mirror of the disease itself. These aspects have also been demonstrated by other authors in studies about the inflammatory response in the MST 16,22,26 . On the other hand, these studies did not compare the in situ MST immunopathological characteristics in the two forms of the disease.…”

“…MCL is characterized by a mixture of Th1 and Th2 responses, which has been well established by two investigators using different techniques, both in situ and in vitro 26 . The cytokines observed in MCL are IL-4, IL-5, IL-10 at a higher proportion in comparison to LCL 11,13,14 , but lower than in diffuse cutaneous leishmaniasis 4,22 .…”

“…Studies in this context have identified both Th1 and Th2-type cytokines in Leishmania antigen-stimulated peripheral blood mononuclear cell supernatant in LCL 11,13,15 and also in MCL 13 . PCR studies of lesion samples have shown Th1 profile LCL and both Th1 and Th2 in MCL 26 . On the other hand, immunohistochemistry analysis demonstrated both Th1 and Th2 -cytokine expression in LCL lesions 14 .…”

Expression of annexin A1 in Leishmania-infected skin and its correlation with histopathological features

“…The host immunological response determines to a signifi cant extent whether the infection persists or is cleared has high relevance for determining cure or persistence (5) (6) . In early infection, no macroscopic pathological changes occur in the epidermis (7) .…”

Perfil de isotipos de imunoglobulinas e subclasses de IgG na leishmaniose tegumentar americana

“…Em LTA, fica difícil de se estabelecer um padrão específico de resposta imune, pela complexidade da enfermidade. Em casos de leishmaniose cutânea (LC), foi observado um padrão misto TH1 e TH2 de resposta 21 com a detecção de anticorpos IgE 25 . Contudo, o papel de anticorpos específicos na imunidade anti-Leishmania ainda não está completamente esclarecido 26 .…”