Cytokines and visceral leishmaniasis: a comparison of plasma cytokine profiles between the clinical forms of visceral leishmaniasis

Abstract

It is not well established whether cytokine production differs in response to different clinical forms of visceral leishmaniasis (VL). In this work, we performed a cross-sectional study to investigate the plasma levels of cytokines &#91;interferon (IFN)-&#947;, tumour necrosis factor (TNF)-&#945;, interleukin (IL)-2, IL-4, IL-10 and IL-12&#93; involved in the pathogenesis of VL in 80 subjects from VL endemic areas, including subjects with active VL, subjects with asymptomatic infection, subjects with cured VL and uninfected controls. The patients were recruited by sampling from a referral hospital and by random selection from a population-based cohort study. The results showed significant differences in the plasma concentration of all cytokines between the groups (p < 0.05). Patients with the active disease had higher plasma levels of IL-10, IL-4, INF-&#947; and TNF-&#945; relative to the other groups and they produced more IL-12 than asymptomatic and cured subjects. Only the IL-2 concentration was higher in the asymptomatic and cured subjects relative to the patients with active disease (p < 0.05). Our results suggest that these cytokines can be used as markers in epidemiological studies conducted in endemic areas to distinguish between different clinical forms of VL. However, their usefulness should be confirmed in investigations conducted in other endemic areas

Clinical Manifestations of Visceral Leishmaniasis (American Visceral Leishmaniasis)

“…American visceral leishmaniasis is similar to that found in the Mediterranean region regarding the etiologic agent, the animals reservoir, domestic and wild canidae, and the concentration of cases in people under 10 years old [3]. The signs and symptoms are also similar whatever the region the disease is found.…”

“…Anemia seems to occur when the spleen becomes palpable and progresses with its gradual increase; this opinion is shared by others [27,28]. Anemia is one of the most remarkable manifestations of visceral leishmaniasis, and the pathogenesis of this anemia, caused in part by the destruction of red blood cells, is multifactorial (splenic phagocytosis of opsonized erythrocytes, hemodilution, and increased destruction of normal red blood cells by hypersplenism) [3]. In addition, there is a bone marrow failure to replenish red blood cells removed from the circulation, which can be attributed to poor nutrition and infection extension.…”

“…with an average of 140,020 ± 103,049 platelets/mm 3 . Except the leukocytes, all these averages are below normal values.…”

“…Some differences are observed such as blackened skin (India and Sudan) and bulky lymph nodes, mainly in Sudan, whose aspiration is used for diagnosis, while the skin of patients in Americas reminds aged wax and the lymph nodes are little bulky. In the Indian subcontinent, there is no animal reservoir; the disease is transmitted from one individual to another (anthroponosis) through sand flies [3].…”

Systematic Review of Biomarkers To Monitor Therapeutic Response in Leishmaniasis

“…However, IL-6 was not correlated with spleen/liver size (73). Also IL-12 levels were found to drop significantly within 30 days of treatment (73) and was largely absent in cured and asymptomatic cases (67,69). In contrast, in Bangladesh and Brazil, IL-12 was shown to be elevated in asymptomatic VL cases (83,90).…”