Leishmania Donovani: An Opportunistic Microbe Associated With Progressive Disease in Three Immunocompromised Patients

Badaró, Roberto; Rocha, Heonir; Em, Carvalho; Queiroz, A.F.; Jones, T. C.

doi:10.1016/s0140-6736(86)91725-3

Cited by 141 publications

(70 citation statements)

References 22 publications

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“…1 This event has already been demonstrated in patients treated with steroids or other immunosuppressive agents. 15,16 Previous studies have indicated that Leishmania may be a putative cofactor in the progression of HIV-related disease. 17 Our goal was to investigate in vitro the mutual immunologic relationship between HIV and Leishmania.…”

Section: Discussionmentioning

confidence: 99%

In vitro production of type 1 and type 2 cytokines by peripheral blood mononuclear cells from subjects coinfected with human immunodeficiency virus and Leishmania infantum.

Nigro

Cacopardo²,

Preiser³

et al. 1999

Am J Trop Med Hyg

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Section: Discussionmentioning

confidence: 99%

In vitro production of type 1 and type 2 cytokines by peripheral blood mononuclear cells from subjects coinfected with human immunodeficiency virus and Leishmania infantum.

Nigro

Cacopardo²,

Preiser³

et al. 1999

Am J Trop Med Hyg

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“…This clinical spectrum of the disease is mostly related to different Leishmania species (1)(2)(3)(4)(5), but the immunological responses to the parasite are certainly an important determinant of the clinical outcome of Leishmania infection (6). For instance, it has been demonstrated that the prevalence of serological conversion in an endemic area of visceral leishmaniasis is higher than the prevalence of disease (7). This finding suggests that there are subjects that are infected and can control the disease.…”

mentioning

confidence: 99%

Cytokine profile and pathology in human leishmaniasis

Ribeiro-de-Jesus

Almeida

Lessa

et al. 1998

Braz J Med Biol Res

192

190

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The clinical spectrum of leishmaniasis and control of the infection are influenced by the parasite-host relationship. The role of cellular immune responses of the Th1 type in the protection against disease in experimental and human leishmaniasis is well established. In humans, production of IFN-γ is associated with the control of infection in children infected by Leishmania chagasi. In visceral leishmaniasis, an impairment in IFN-γ production and high IL-4 and IL-10 levels (Th2 cytokines) are observed in antigen-stimulated peripheral blood mononuclear cells (PBMC). Moreover, IL-12 restores IFN-γ production and enhances the cytotoxic response. IL-10 is the cytokine involved in down-regulation of IFN-γ production, since anti-IL-10 monoclonal antibody (mAb) restores in vitro IFN-γ production and lymphoproliferative responses, and IL-10 abrogates the effect of IL-12. In cutaneous and mucosal leishmaniasis, high levels of IFN-γ are found in L. amazonensis-stimulated PBMC. However, low or absent IFN-γ levels were observed in antigen-stimulated PBMC from 50% of subjects with less than 60 days of disease (24 ± 26 pg/ml). This response was restored by IL-12 (308 ± 342 pg/ml) and anti-IL-10 mAb (380 ± 245 pg/ml) (P<0.05). Later during the disease, high levels of IFN-γ and TNF-α are produced both in cutaneous and mucosal leishmaniasis. After treatment there is a decrease in TNF-α levels (366 ± 224 pg/ml before treatment vs 142 ± 107 pg/ml after treatment, P = 0.02). Although production of IFN-γ and TNF-α might be involved in the control of parasite multiplication in the early phases of Leishmania infection, these cytokines might also be involved in the tissue damage seen in tegumentary leishmaniasis.Correspondence

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“…However, the outcome of infection can be skewed to disease. There is an increased risk of developing symptomatic visceral leishmaniasis if immunosuppression occurs because of a neoplastic disorder (7) , HIV (8) , or malnutrition (9) . Risk of disease is also associated to host genetics (10) .…”

Section: Symptomatic Infectionmentioning

confidence: 99%