Mucosal leishmaniasis ("espundia" Escomel, 1911)

Identification of antigens recognized by T cells in human leishmaniasis: analysis of T-cell clones by immunoblotting

Immunity in human leishmaniasis is mediated by sensitized T lymphocytes; however, the antigens involved in eliciting this immunity have not been defined. We describe the generation of human T-lymphocyte clones derived from two patients with healed leishmaniasis. By use of one- and two-dimensional cellular immunoblotting techniques, we directly identified the parasite antigens recognized by these clones. To our knowledge, these are the first leishmanial antigens identified to which CD4+, gamma interferon-producing T cells from immune individuals have been shown to respond, the strategy may be of general use for the identification of antigens involved in immunity in this disease.

Profile of human T cell response to leishmanial antigens. Analysis by immunoblotting

Control and resolution of leishmanial infection depends primarily on T cell-mediated immune mechanisms. The nature of the leishmanial antigens involved in eliciting T cell immunity is unknown. We have examined the pattern of peripheral blood lymphocyte responses in patients with active, healed, or subclinical leishmanial infection to fractionated leishmanial antigens using a T cell immunoblotting method in which nitrocellulose-bound leishmanial antigen, resolved by one or two dimensional electrophoresis, are incorporated into lymphocyte cultures. The proliferative and IFN-gamma responses of cells from patients with healed mucosal or cutaneous leishmaniasis were remarkably heterogeneous and occurred to as many as 50-70 distinct antigens. In contrast, responses from subjects with active, nonhealing, diffuse cutaneous leishmaniasis were either absent or present to only a small number of antigens. Control and resolution of leishmaniasis, and resistance to reinfection, is therefore associated with a T cell response to a large and diverse pool of parasite antigens. The method of T cell immunoblotting appears to offer a powerful, rapid, and relatively simple approach to the identification of antigens involved in eliciting a T cell response in human leishmaniasis.

Experiences with vaccines against cutaneous leishmaniasis: of men and mice

The need for a vaccine(s) against cutaneous leishmaniasis and the populations at risk for whom such vaccines should be developed are briefly discussed. The current human vaccine studies are reviewed, as are some experimental mouse studies with emphasis on Leishmania major infection relevant to vaccine development. Based on the information available from the mouse model and those data which are being sought in human studies, the benign nature of the cutaneous disease, the ease with which L. major can be manipulated to yield the required material, and the ongoing practice of leishmanization which allows rapid evaluation of candidate vaccine(s), it is suggested that a vaccine, at least against L. major, is imminent in the not too distant future.