Decrease in anti‐Leishmania IgG3 and IgG1 after cutaneous leishmaniasis lesion healing is correlated with the time of clinical cure

Abstract

For better efficiency in the establishment of American tegumentary leishmaniasis clinical cure, the World Health Organization suggests that the clinical criteria are supported by serologic data. The present study aims to investigate the dynamics of IgG subclass production in clinical evolution post-treatment of cutaneous leishmaniasis (CL). Paired sera from 23 subjects with CL resulting from Leishmania braziliensis infection were studied during the active lesion phase (aCL) and after clinical cure post-therapy (hCL), which included an alternative protocol with a low dose of antimony. Anti-Leishmania IgG and its subclasses were measured using ELISA, and the immunoglobulin levels were correlated with patients' clinical data. All of the subjects were clinically healed and did not present relapse during follow-up. Serum levels of anti-Leishmania IgG (r = -0·79; P < 0·0001), IgG1 (r = -0·64, P < 0·001) and IgG3 (r = -0·42, P < 0·045) in hCL were negatively correlated with the duration of clinical cure. After 24 months of clinical cure, 73% of samples were negative for IgG1 and 78% were negative for IgG3. In conclusion, the detection of serum anti-Leishmania IgG1 and IgG3 is an improved laboratory strategy to aid in the decision of interruption of the ambulatory follow-up of CL patients.

Immune Activation and Bacterial Translocation: A Link between Impaired Immune Recovery and Frequent Visceral Leishmaniasis Relapses in HIV-Infected Patients

“…Interestingly, the IgG3 levels decreased among NR patients after VL treatment and remained decreased until the end of follow-up, very similar to what was observed for the CD4 + and CD8 + T lymphocyte activation levels. This result corroborates what has been described in the tegumentary form of leishmaniasis [39], suggesting IgG3 as a possible clinical remission marker for VL that deserves more attention.…”

“…An ELISA was performed as previously described by Fagundes-Silva et al (2012), with certain modification [39]. Briefly, the only difference was the antigen, since L .…”

Proteins Selected in Leishmania (Viannia) braziliensis by an Immunoproteomic Approach with Potential Serodiagnosis Applications for Tegumentary Leishmaniasis

“…Nowadays, the diagnosis of TL is based on clinical criteria associated with the laboratory diagnosis (8); however, problems related to the sensitivity of the tests have been described, since a significant percentage of patients are classified as false negative in the serological assays employing antigenic Leishmania preparations, due to the low levels of antileishmanial antibodies encountered in their serum samples (23). In relation to specificity, an important problem for the TL serodiagnosis resides in the crossreactivity of the antigens with sera from noninfected subjects living in areas of disease endemicity, as well as with serum samples from patients developing related pathologies, such as Chagas disease, which can present cross-reactivity in the serological analysis performed (42).…”

“…It is believed that the serum concentration of antileishmanial antibodies can be directly related to the parasite load and to the time of exposure to Leishmania antigens (21)(22)(23). Although the role of antibodies in TL is not completely understood, evidence has shown that the humoral response determined by specific IgG reactivity to Leishmania antigens could well be used as an indicator of the development of the disease, since some authors have positively correlated the clinical cure of disease with a decrease in the antileishmanial antibody titers, as well as to assist the clinical follow-up during and after healing by the treatment of the patients (23)(24)(25)(26)(27).…”

Systematic Review of Biomarkers To Monitor Therapeutic Response in Leishmaniasis

“…Anam et al (144) also hinted at a possible (diagnostic) role for L. donovani-specific IgG3 antibody isotype detection. While the IgG3 antibody level decreases significantly posttreatment (148,149), the pharmacodynamic value of this marker is probably very low, as the time to normalcy for IgGs is longer than 3 months for both CL and VL patients (150)(151)(152)(153)(154).…”