Immunological determinants of clinical outcome in Peruvian patients with tegumentary leishmaniasis treated with pentavalent antimonials
| Autor: | Alexandro Llanos-Cuentas, Carlo Chizzolini, Jean-Michel Dayer, Anne Maurer-Cecchini, Marleen Boelaert, Coralie Alexandrenne, François Chappuis, Gianfranco Tulliano, Jorge Arevalo, Simonne De Doncker, Louis Loutan, Saskia Decuypere, Jean-Claude Dujardin |
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| Rok vydání: | 2009 |
| Předmět: |
Antimony
Male T-Lymphocytes medicine.medical_treatment America Latin Macrophages/immunology Cytokines/biosynthesis 0302 clinical medicine Peru Interferon gamma Prospective Studies Child Leishmaniasis Skin ddc:616 Aged 80 and over 0303 health sciences Interleukin-13 Treatment outcomes Middle Aged Protozoal diseases Interleukin-10 3. Good health Interleukin 10 Treatment Outcome Infectious Diseases Cytokine medicine.anatomical_structure Leishmaniasis Cutaneous/drug therapy/immunology Child Preschool Interleukin 13 Cytokines Female Drug therapy Antimony/therapeutic use medicine.drug Adult Skin/pathology Adolescent mRNA T cell 030231 tropical medicine Immunology Antiprotozoal Agents Leishmaniasis Cutaneous Microbiology Young Adult Interferon-gamma 03 medical and health sciences Immune system Tegumentary Cutaneous leishmaniasis Antiprotozoal Agents/therapeutic use medicine Animals Humans Immune response ddc:613 Aged 030304 developmental biology Antimonials Tumor necrosis factor alpha business.industry Gene Expression Profiling T-cells Macrophages Infant T-Lymphocytes/immunology medicine.disease Parasitology Human medicine Interleukin-4 Fungal and Parasitic Infections business |
| Zdroj: | Infection and immunity Infection and Immunity, Vol. 77, No 5 (2009) pp. 2022-9 |
| ISSN: | 0019-9567 |
| DOI: | 10.1128/IAI.01513-08 |
| Popis: | The mechanisms linking the immune response to cutaneous and mucosal leishmaniasis (CL and ML, respectively) lesions and the response to treatment are incompletely understood. Our aims were to prospectively assess, by quantitative reverse transcription-PCR, the levels of mRNA for gamma interferon, tumor necrosis factor alpha, interleukin-10 (IL-10), IL-4, and IL-13, as well as the presence of T cells (CD2) and macrophages (CD68), in CL and ML lesions and to follow their changes in response to treatment with pentavalent antimonials. The leishmanin skin test (LST) was performed on all CL and ML patients before treatment. The patient population included individuals living in areas of Peru where the disease is endemic, i.e., 129 with CL and 43 with ML. Compared to CL patients, the LST induration size was larger, the levels of all cytokine mRNAs but IL-10 were higher, T-cell mRNA was similar, and macrophage mRNA was lower in ML patients. The proportion of CL patients with an LST induration size of >8 mm was higher among responders to treatment. In CL, the pretreatment levels of cytokine mRNAs did not discriminate between responders and nonresponders; however, treatment was more often accompanied by a reduction in the levels of T-cell and cytokine mRNAs in responders than in nonresponders. Furthermore, the production of cytokines per T cell and macrophage decreased with treatment but IL-10 production remained high in nonresponders. Overall, these findings point to complex relationships among New World Leishmania parasites, skin and mucosal immune responses, and treatment outcome. The persistence of high levels of IL-10 in CL is characteristically associated with a poor response to treatment. |
| Databáze: | OpenAIRE |
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