Effects of Meglumine Antimoniate Treatment on Cytokine Production in a Patient with Mucosal Leishmaniasis and Chagas Diseases Co-Infection

Rezende-Oliveira, Karine; Gómez-Hernández, César; Silva, Marcos Vinícius da; Oliveira, Rafael Faria de; Machado, Juliana Reis; Teixeira, Luciana de Almeida Silva; Castellano, Lúcio Roberto Cançado; Correia, Dalmo; Rodrigues, Virmondés

doi:10.3390/tropicalmed5020069

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…Chemotherapy for VL is limited to the use of a few licensed drugs, which show high toxicity ( 1 , 30 ). A direct effect of chemotherapy drugs on the immune cells, irrespective of the pathogen impact, was recently observed ( 31 – 34 ). The experimental chemotherapy for VL with immucillins was shown to induce a Th1 response through a direct effect on T cells ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

“…Sodium antimony gluconate (SAG) has been demonstrated to activate the innate and adaptive immune system by indirectly triggering pathways for ROS and nitric oxide (NO) generation, imparting resistance to Leishmania infection and reinfection ( 33 ). Moreover, in a patient co-infected with mucocutaneous leishmaniasis and Chagas disease, MA treatment promoted a downmodulation of TNF-α, IL-6, and IL-10 cytokine levels but an upregulation of IL-12 production and a decrease of the frequency of circulating Treg, indicating the promotion of immune responses toward a more protective profile to both diseases ( 34 ). In addition, LAMB was shown to be immunosuppressive in vitro and on protection mediated by cytotoxic CD8 T cells in murine listeriosis.…”

Section: Discussionmentioning

confidence: 99%

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CD4+ Th1 and Th17 responses and multifunctional CD8 T lymphocytes associated with cure or disease worsening in human visceral leishmaniasis

de Franca,

Rodrigues,

Barreto

et al. 2024

Front. Immunol.

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IntroductionIn VL, a proinflammatory phenotype is typically associated with enhanced phagocytosis and a Th1 mediated immune response resulting in infection control. In contrast, an anti-inflammatory phenotype, associated with a predominant regulatory response, typically enables intracellular multiplication of Leishmania parasites and disease progression.MethodsTo investigate the impact of chemotherapy on Th2 and Th17 immune responses in patients with visceral leishmaniasis (VL), we assessed all combinations of intracellular expression of IFN-γ, IL-10, IL-4 and IL-17 in the CD4+ and CD8+ T cell populations of peripheral blood mononuclear cell (PBMC) samples from patients, after antigenic stimulation with Leishmania lysate, throughout treatment and follow-up. As increases in spleen and liver sizes and decreases in hematocrit, hemogloblin, erythrocytes, monocytes, leukocytes and platelets levels are strongly related to the disease, we studied the correlations between the frequencies of T cells producing the afore mentioned cytokines, individually and in combination, and these variables, as markers of disease or cure.ResultsWe found that the frequency of IFN-γ-producingCD4+ T cells increased until the end of chemotherapy with Glucantime® or AmBisome ®, while IL-10, IL-4 and IL-17-producing CD4+ T cells peaked on day 7 following the start of treatment. Although the frequency of CD4+IL-17+ cells decreased during treatment an increase was observed after clinical cure. The frequency of CD4+ T cells producing only IFN-γ or IL-17 correlated with blood monocytes levels. Frequencies of double-producers of IFN-γ and IL-10 or IL-4 correlated positively with eosinophils and platelets levels. Together, this suggest that IFN-γ drives the immune response towards Th1 at cure. In contrast, and associated with disease or Th2 response, the frequency of CD4+ IL-10+ cells correlated positively with spleen sizes and negatively with circulating monocyte levels, while the frequency of CD4+ producing both IL-4 and IL-10 correlated negatively with platelets levels. The frequency of CD8+ single-producers of IFN-γ increased from day 21 to 90 while that of single-producers of IL-10 peaked on day 7, of IL-4 on day 30 and of IL-17, on day 180. IFN-γ expression in CD8+ single- and double-producers of cytokines was indicative of an immune response associated with cure. In contrast, frequencies of CD8+ double-producers of IL-4 and IL-10, IL-4 and IL-17 and IL-10 and IL-17 and producers of three and four cytokines, were associated with disease and were low after the cure. Frequencies of CD8+ T cells producing IFN-γ alone or with IL-17 were positively correlated with platelets levels. In contrast, as markers of disease: 1) frequencies of single producers of IL-10 correlated negatively with leukocytes levels, 2) frequencies of double producers of IL-4 and IL-10 correlated negatively with platelet, leukocyte, lymphocyte and circulating monocyte levels, 3) frequencies of triple-producers of IFN-γ, IL-4 and IL-10 correlated negatively with platelet, leukocyte and neutrophil levels and 4) frequencies of producers of IFN-γ, IL-4, IL-10 and IL-17 simultaneously correlated positively with spleen size, and negatively with leukocyte and neutrophil levels.DiscussionOur results confirmed that the clinical improvement of VL patients correlates with the decrease of an IL-4 and IL-10 CD4+Th2 response, the recovery of CD4+ Th1 and Th17 responses and the frequency of CD8+ single-producers of IFN-γ and double producers of IFN-γ and IL-17.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

CD4+ Th1 and Th17 responses and multifunctional CD8 T lymphocytes associated with cure or disease worsening in human visceral leishmaniasis

de Franca,

Rodrigues,

Barreto

et al. 2024

Front. Immunol.

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“…This study reinforces the need for systematic monitoring for Chagas disease reactivation after heart transplantation, and calls for specific randomized double-blinded controlled trials. A case report presents a patient with leishmaniasis and Chagas disease co-infection, and the treatment with meglumine antimoniate which modulated the patient’s immune response against both diseases positively [ 11 ].…”

mentioning

confidence: 99%

New Contributions to the Elimination of Chagas Disease as a Public Health Problem: Towards the Sustainable Development Goals by 2030

2021

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Chagas Disease and Leishmaniasis, Sympatric Zoonoses Present in Human from Rural Communities of Venezuela

Ferrer,

Aguilar,

Viettri

et al. 2024

Acta Parasit.

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Effects of Meglumine Antimoniate Treatment on Cytokine Production in a Patient with Mucosal Leishmaniasis and Chagas Diseases Co-Infection

Cited by 4 publications

References 24 publications

CD4+ Th1 and Th17 responses and multifunctional CD8 T lymphocytes associated with cure or disease worsening in human visceral leishmaniasis

CD4+ Th1 and Th17 responses and multifunctional CD8 T lymphocytes associated with cure or disease worsening in human visceral leishmaniasis

New Contributions to the Elimination of Chagas Disease as a Public Health Problem: Towards the Sustainable Development Goals by 2030

Chagas Disease and Leishmaniasis, Sympatric Zoonoses Present in Human from Rural Communities of Venezuela

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