Development of in Vitro Parameters of Cell-Mediated Immunity in the Course of Human Cutaneous Leishmaniasis Infection

Frankenburg, Shoshana; Jonas, Flory; Gross, Anat; Klaus, Sidney N.

doi:10.4269/ajtmh.1993.48.512

Cited by 5 publications

(6 citation statements)

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“…Although antigen-specific T-cell clones probably develop relatively early after infection with parasites, 10 there may be stages in the course of the disease when the balance between the large array of cytokines and other mediators elicited by the infection may have opposing effects on the immune response. Although we have not noted a worsening of lesions when the TLP became negative in the course of the disease in most otherwise healthy patients, 9 there have been exceptions to this rule, 8,11 including the present patient. A state of partial immunosuppression, as in the present case, may contribute to the spread of the disease during the TLP-negative stage of the disease.…”

Section: Discussioncontrasting

confidence: 71%

“…In another study, in a group of 17 patients followed‐up during the normal course of the disease, we found that five (29%) showed an early positive response to Leishmania antigen that became negative in the course of the disease, but that all the patients eventually became TLP‐positive after the lesions had healed. 9 Taken together, it appears from these data that the development of immunity in CL, even in otherwise healthy individuals, is not a straightforward process that proceeds from lack of to presence of acquired immunity.…”

Section: Discussionmentioning

confidence: 85%

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Relapse of cutaneous leishmaniasis in a patient with an infected subcutaneous rheumatoid nodule

et al. 1999

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Cutaneous leishmaniasis is a protozoal infection generally considered to be limited to the skin. In Israel, the disease is common in geographically defined areas and is caused predominantly by Leishmania major. Sporotrichoid subcutaneous spread has been reported but is uncommon. We describe a patient with rheumatoid arthritis, treated with methotrexate and prednisone, in whom numerous rheumatoid nodules concomitant with cutaneous leishmaniasis were found, mimicking sporotrichoid spread of the disease. In a rheumatoid nodule that was examined by electron microscopy, Leishmania parasites were found at intracellular and extracellular locations. This observation supports the hypothesis that cutaneous leishmaniasis parasites persist after clinical cure of the disease and may re-emerge as a result of immunosuppression.

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 85%

Relapse of cutaneous leishmaniasis in a patient with an infected subcutaneous rheumatoid nodule

et al. 1999

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“…[28] and Frankenburg etal. [29], who reported on Leishmania antigen-specific proliferative response in patients with mild CL caused by L. major, and the findings of Castes et al, and Caceres-Dittmar et al, who found that Leishmania antigen-induced PBMC proliferative response correlated with disease severity in South American patients suffering from CL [30][31][32]. The Danish controls did not respond to LDA and gp63 antigen, whereas LMP as reported previously [33,34] activated the PBMC of some non-exposed donors.…”

Section: Discussionsupporting

confidence: 52%

Dichotomy of the T cell response to Leishmania antigens in patients suffering from cutaneous leishmaniasis; absence or scarcity of Th1 activity is associated with severe infections

Gaafar

Kharazmi

Ismail

et al. 1995

Clinical and Experimental Immunology

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SUMMARYThe T cell response was studied in 25 patients suffering from cutaneous leishmaniasis caused by Leishmania major with severe (« = 10) and mild (« = 15) disease manifestations. Peripheral blood mononuclear cells (PBMC) from the patients were activated by sonicates of Leishmania promastigotes (LMP) and amastigotes (LDA), and the surface protease gp63. The proliferative responses to Leishmania antigens were lower in patients with severe disease than in patients with mild disease {P = 0 01-0 05), and such a difference was not observed in the response to purified protein derivative of tuberculin (PPD) or tetanus toxoid (TT). LMP-induced interferon-gamma (IFN-7) production was lower in patients with severe than in patients with mild disease (P < 0 05). When the IL-4 and IFN-7 responses of each patient were considered, two response patterns were observed in the cultures activated by the Leishmania sonicates. One response pattern was characterized by high production of IFN-7 without production of IL-4 (a Thl-like pattern), the other was characterized by low IFN-7 levels which in most cases were associated with IL-4 production (not a Thl-like pattern). These patterns could not be distinguished when the cells from the same donors were stimulated by TT and PPD. The percentages of patients with a Thl-like response pattern after stimulation by LMP in patients with severe and mild disease manifestations were 30% and 80%, respectively. This difference was statistically significant {P = 0-034).

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“…Overall, 50% of the CL cases were found to be BT-positive in the present study. When Frankenburg et al (1993a) used a conventional [H 3 ]-thymidine-uptake assay to investigate cellular immunity in early cases of CL (who had had lesions for no more than 3 months), they also found that only about one in every two cases showed lymphoproliferative responses to L. major antigens. In the present study, interestingly, the cases with parasitologically confirmed disease were much more likely to be BT-positive than the cases that had only been identified from their clinical signs and symptoms (67% v. 37%).…”

Section: Discussionmentioning

confidence: 99%

“…The peripheral blood lymphocytes from only about 50% of the CL patients investigated by Frankenburg and Klaus (1989), for example, showed a proliferative response to L. major antigens in vitro (even though none of the patients had had their cutaneous lesions for more than 3 months). In another, related study, 30% of such patients displayed a transient down-regulation of lymphoproliferative response that was restored, in 50% of these cases, upon healing of the lesions (Frankenburg et al, 1993a). The transient inhibition of Th1 reactions has also been demonstrated in patients who had been infected, for no more than 2 months, with L. braziliensis (Rocha et al, 1999).…”

mentioning

confidence: 85%

The flow-cytometry-based evaluation of cellular immunity in cases of cutaneous leishmaniasis and healthy controls from the endemic area in southern Israel

Fishman¹,

Bazarsky²,

Sneir³

et al. 2006

Annals of Tropical Medicine & Parasitology

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Only limited data are available on the early immunological events associated with human cutaneous leishmaniasis (CL). In this study, peripheral-blood mononuclear cells were obtained from 66 individuals (34 patients with cutaneous lesions and 32 apparently healthy controls) who had each spent no more than 3 months in the endemic region of Qetzioth, in southern Israel. These cells' responses to Leishmania major antigen were then explored, by the flow-cytometry-based evaluation of blast transformation (BT). The lymphocytes from 17 (50%) of the patients but only one (3%) of the controls displayed BT. When, in an ELISA, most (52) of the subjects were checked for anti-L. major antibodies, none of the 22 controls investigated but 19 (63%) of the 30 patients were found seropositive. Although 14 (47%) of the 30 patients who were checked for antibodies were BT-positive, the seropositive patients were not significantly more or less likely to be BT-positive than the seronegative patients (P<0.919). These data indicate that, in CL, the hosts' cellular and humoral responses develop independently within the first 3 months post-infection, but further investigation is required to confirm this hypothesis.

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Development of in Vitro Parameters of Cell-Mediated Immunity in the Course of Human Cutaneous Leishmaniasis Infection

Cited by 5 publications

References 0 publications

Relapse of cutaneous leishmaniasis in a patient with an infected subcutaneous rheumatoid nodule

Relapse of cutaneous leishmaniasis in a patient with an infected subcutaneous rheumatoid nodule

Dichotomy of the T cell response to Leishmania antigens in patients suffering from cutaneous leishmaniasis; absence or scarcity of Th1 activity is associated with severe infections

The flow-cytometry-based evaluation of cellular immunity in cases of cutaneous leishmaniasis and healthy controls from the endemic area in southern Israel

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