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Sandoval Pacheco CM, Araujo Flores GV, Ferreira AF, da Matta VLR, de Castro Gomes CM, Sosa-Ochoa WH, Zúniga C, Silveira FT, Corbett CEP, Laurenti MD. Role of antigen-presenting cells in non-ulcerated skin lesions caused by Leishmania (Leishmania) infantum chagasi. Parasite Immunol 2023; 45:e12971. [PMID: 36695719 DOI: 10.1111/pim.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
In Central America, infection by Leishmania (Leishmania) infantum chagasi causes visceral leishmaniasis and non-ulcerated cutaneous leishmaniasis (NUCL). This work aimed to evaluate the participation of subpopulations of antigen-presenting cells in skin lesions of patients affected by NUCL through double-staining immunohistochemistry using cellular and intracellular markers. Twenty-three skin biopsies from patients affected by NUCL were used. Histological sections stained by HE were used for histopathological study. Immunohistochemical studies were performed using primary antibodies against Langerhans cells, dermal dendritic cells, T lymphocytes, and the cytokines IL-12, IFN-γ, TNF-α, iNOS, and IL-10. The histopathological lesions were characterized by an inflammatory infiltrate, predominantly lymphohistiocytic, of variable intensity, with a diffuse arrangement associated with epithelioid granulomas and discreet parasitism. Double-staining immunohistochemistry showed higher participation of dendritic cells producing the proinflammatory cytokine IL-12 in relation to the other evaluated cytokines. Activation of the cellular immune response was marked by a higher density of CD8 Tc1-lymphocytes followed by CD4 Th1-lymphocytes producing mainly IFN-γ. The data obtained in the present study suggest that antigen-presenting cells play an important role in the in situ immune response through the production of proinflammatory cytokines, directing the cellular immune response preferentially to the Th1 and Tc1 types in NUCL caused by L. (L.) infantum chagasi.
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Affiliation(s)
- Carmen M Sandoval Pacheco
- Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Gabriela V Araujo Flores
- Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Aurea F Ferreira
- Laboratorio de Investigação Médica, LIM50, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, HCFMUSP, São Paulo, SP, Brazil
| | - Vânia L R da Matta
- Laboratorio de Investigação Médica, LIM50, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, HCFMUSP, São Paulo, SP, Brazil
| | - Claudia M de Castro Gomes
- Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Wilfredo H Sosa-Ochoa
- Instituto de Investigaciones en Microbiologia, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Concepción Zúniga
- Departamento de Vigilancia de la Salud, Hospital Escuela, Tegucigalpa, Honduras
| | - Fernando T Silveira
- Instituto Evandro Chagas, Belém, PA, Brazil.,Universidade Federal do Pará, Belém, PA, Brazil
| | - Carlos E P Corbett
- Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Márcia D Laurenti
- Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Yadav P, Azam M, Ramesh V, Singh R. Unusual Observations in Leishmaniasis-An Overview. Pathogens 2023; 12:pathogens12020297. [PMID: 36839569 PMCID: PMC9964612 DOI: 10.3390/pathogens12020297] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/06/2023] [Accepted: 01/19/2023] [Indexed: 02/15/2023] Open
Abstract
Leishmaniasis significantly affects the population of the tropics and subtropics. Clinical features and infective species of Leishmania are the primary factors driving the direction of diagnosis. The rise in incidences of atypical presentations present a challenge in patient treatment. Knowledge of unusual/rare presentations can aid in having a broader perspective for including the different aspects during the examination and thus avoid misdiagnosis. A comprehensive literature survey was performed to present the array of atypical presentations confounding clinicians which have been seen in leishmaniasis. Case reports of unusual findings based on the localizations and morphology of lesions and infective species and the predominant geographical sites over almost five decades highlight such presentations in the population. Information regarding the clinical features recorded in the patient and the chosen treatment was extracted to put forward the preferred drug regimen in such cases. This comprehensive review presents various unusual observations seen in visceral leishmaniasis, post-kala-azar dermal leishmaniasis, cutaneous leishmaniasis, and mucocutaneous leishmaniasis. It highlights the need to consider such features in association with differential diagnosis to facilitate proper treatment of the patient.
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Affiliation(s)
- Priya Yadav
- ICMR-National Institute of Pathology, New Delhi 110029, India
- Manipal Academy of Higher Education, Manipal 576104, India
| | - Mudsser Azam
- ICMR-National Institute of Pathology, New Delhi 110029, India
| | - V Ramesh
- Department of Dermatology, ESIC Hospital, Faridabad 1210026, India
| | - Ruchi Singh
- ICMR-National Institute of Pathology, New Delhi 110029, India
- Correspondence: or
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El mazini S, Ejghal R, Bekhti K, Lemrani M. The Sporadic cutaneous leishmaniasis due to Leishmania infantum in Morocco: A presumably trend towards endemicity. Acta Trop 2022; 227:106288. [PMID: 34933005 DOI: 10.1016/j.actatropica.2021.106288] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/01/2022]
Abstract
In Morocco, cutaneous leishmaniasis (CL) is an endemic disease; it is considered a major public health problem caused by three species Leishmaniamajor, Leishmaniatropica, and the dermotropic variant MON-24 of Leishmaniainfantum. This species has three incriminated vectors named; Phlebotomus ariasi, Phlebotomus longicuspis and Phlebotomus perniciosus, with the dog as reservoir.The main aim of this review is to elucidate the current epidemiological pattern of CL due to L.infantum and to investigate the factors facilitating its propagation throughout the country. Therefore, the number of CL cases due to L.infantum, their repartition; the distribution of L.infantum vectors, as well as the factors affecting their abundance and spread were investigated. We showed a wide extension of this form of CL, from the north of Morocco to the Saharan areas, as well as an increase of reported cases. This extension of the disease has been accompanied by a juxtaposed spread and a high abundance of confirmed vectors of L. infantum, which are present in almost all bioclimatic zones. In this review, we have highlighted the impact of climate: temperature, humidity, precipitation; vegetation and human activities on the geographical expansion of L. infantum vectors. These abiotic and biotic factors constitute favorable conditions for the increase of vector populations, and their introduction into areas where they did not exist before, and subsequently raise the risk of introduction of this form of cutaneous leishmaniasis into previously free areas. To conclude, CL by L.infantum, traditionally evolving as a sporadic form, is changing to an endemic mode, which seeks more epidemiological studies, and more attention from the health authorities when implementing control programs.
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Leishmaniasis: where are we and where are we heading? Parasitol Res 2021; 120:1541-1554. [PMID: 33825036 DOI: 10.1007/s00436-021-07139-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/24/2021] [Indexed: 01/19/2023]
Abstract
Leishmaniasis is a zoonotic disease in humans caused by the bite of a parasite-infected sandfly. The disease, widely referred to as "poor man's disease," affects millions of people worldwide. The clinical manifestation of the disease depends upon the species of the parasite and ranges from physical disfigurement to death if left untreated. Here, we review the past, present, and future of leishmaniasis in detail. The life cycle of Leishmania sp., along with its epidemiology, is discussed, and in addition, the line of therapeutics available for treatment currently is examined. The current status of the disease is critically evaluated, keeping emerging threats like human immunodeficiency virus (HIV) coinfection and post kala-azar dermal leishmaniasis (PKDL) into consideration. In summary, the review proposes a dire need for new therapeutics and reassessment of the measures and policies concerning emerging threats. New strategies are essential to achieve the goal of leishmaniasis eradication in the next few decades.
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Sandoval C, Araujo G, Sosa W, Avalos S, Silveira F, Corbett C, Zúniga C, Laurenti M. In situ cellular immune response in non-ulcerated skin lesions due to Leishmania (L.) infantum chagasi infection. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20200149. [PMID: 33708246 PMCID: PMC7909480 DOI: 10.1590/1678-9199-jvatitd-2020-0149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/25/2021] [Indexed: 11/29/2022] Open
Abstract
Background Skin lesions of patients affected by non-ulcerated cutaneous leishmaniasis
(NUCL) caused by L. (L.) infantum chagasi are characterized
by lymphohistiocytic inflammatory infiltrate associated with epithelioid
granuloma and scarce parasitism. However, the in situ
cellular immune response of these patients is unclear. Therefore, the aim of
the present study was to characterize the cellular immune response in the
skin lesions of patients affected by NUCL. Methods Twenty biopsies were processed by immunohistochemistry using primary
antibodies to T lymphocytes (CD4, CD8), NK cells, B lymphocytes,
macrophages, nitric oxide synthase and interferon-gamma. Results Immunohistochemistry revealed higher expression of all cellular types and
molecules (IFN-γ, iNOS) in the dermis of diseased skin compared to the skin
of healthy individuals (p < 0.05). Morphometric analysis performed in the
skin lesions sections showed the predominance of CD8+ T
lymphocytes in the mononuclear infiltrate, followed by macrophages, mostly
iNOS+, a response that could be mediated by IFN-γ. Conclusion Our study improves knowledge of the cellular immune response in
non-ulcerated or atypical cutaneous leishmaniasis caused by L. (L.)
infantum chagasi in Central America and pointed to the pivotal
participation of CD8+ T lymphocytes in the host defense
mechanisms against the parasite in patients with NUCL.
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Affiliation(s)
- Carmen Sandoval
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil
| | - Gabriela Araujo
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil
| | - Wilfredo Sosa
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil.,Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Sara Avalos
- Master Program in Infectious and Zoonotic diseases, School of Microbiology, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Fernando Silveira
- Department of Parasitology, Evandro Chagas Institute, Secretariat of Health Surveillance, Ministry of Health, Belém, PA, Brazil.,Institute of Tropical Medicine, Federal University of Pará, Belém, PA, Brazil
| | - Carlos Corbett
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil
| | - Concepción Zúniga
- Department of Health Surveillance, School Hospital, Tegucigalpa, Honduras
| | - Marcia Laurenti
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil
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Gianchecchi E, Montomoli E. The enemy at home: leishmaniasis in the Mediterranean basin, Italy on the focus. Expert Rev Anti Infect Ther 2020; 18:563-577. [DOI: 10.1080/14787210.2020.1751611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
| | - Emanuele Montomoli
- VisMederi S.r.l, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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Beiter KJ, Wentlent ZJ, Hamouda AR, Thomas BN. Nonconventional opponents: a review of malaria and leishmaniasis among United States Armed Forces. PeerJ 2019; 7:e6313. [PMID: 30701136 PMCID: PMC6348955 DOI: 10.7717/peerj.6313] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/19/2018] [Indexed: 01/10/2023] Open
Abstract
As the United States military engage with different countries and cultures throughout the world, personnel become exposed to new biospheres as well. There are many infectious pathogens that are not endemic to the US, but two of particular importance are Plasmodium and Leishmania, which respectively cause malaria and leishmaniasis. These parasites are both known to cause significant disease burden in their endemic locales, and thus pose a threat to military travelers. This review introduces readers to basic life cycle and disease mechanisms for each. Local and military epidemiology are described, as are the specific actions taken by the US military for prevention and treatment purposes. Complications of such measures with regard to human health are also discussed, including possible chemical toxicities. Additionally, poor recognition of these diseases upon an individual's return leading to complications and treatment delays in the United States are examined. Information about canine leishmaniasis, poorly studied relative to its human manifestation, but of importance due to the utilization of dogs in military endeavors is presented. Future implications for the American healthcare system regarding malaria and leishmaniasis are also presented.
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Affiliation(s)
- Kaylin J Beiter
- Department of Biomedical Sciences, College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY, United States of America
| | - Zachariah J Wentlent
- Department of Biomedical Sciences, College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY, United States of America
| | - Adrian R Hamouda
- Department of Biomedical Sciences, College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY, United States of America
| | - Bolaji N Thomas
- Department of Biomedical Sciences, College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY, United States of America
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8
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Raja M, Gonzales Zamora JA. Visceral leishmaniasis with cutaneous involvement caused by Leishmania infantum-chagasi. IDCases 2017; 11:16-17. [PMID: 29255674 PMCID: PMC5725215 DOI: 10.1016/j.idcr.2017.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 11/14/2017] [Accepted: 11/14/2017] [Indexed: 11/28/2022] Open
Abstract
Leishmaniainfantum-chagasi is a species of Leishmania associated with visceral involvement. Cutaneous lesions are rarely seen in cases of visceral leishmaniasis. The diagnosis is achieved by skin biopsy and confirmed with molecular techniques such as polymerase chain reaction (PCR). Systemic therapy with amphotericin B is the treatment of choice for visceral leishmaniasis.
We report the case of a 66 year-old woman who presented nodular skin lesions on her back and upper extremities. Biopsy revealed amastigotes that were identified as Leishmania infantum-chagasi by PCR. Evaluation also showed hepatomegaly and pulmonary nodules. Treatment with amphotericin B led to complete resolution of skin lesions.
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Affiliation(s)
- Mohammed Raja
- Division of Infectious Diseases, Department of Medicine, University of Miami, Miller School of Medicine, Miami 33136, FL, USA
| | - Jose Armando Gonzales Zamora
- Division of Infectious Diseases, Department of Medicine, University of Miami, Miller School of Medicine, Miami 33136, FL, USA
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10
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Abstract
Leishmanides have been rarely reported in the literature. In this study, the authors present a case of a 50-year-old HIV-positive man who developed a generalized cutaneous eruption of papules and plaques in which no microorganism was demonstrated by culture, microscopical examination, immunohistochemistry, or polymerase chain reaction. The patient was eventually diagnosed with laryngeal leishmaniasis, and when treated, the cutaneous lesions greatly improved.
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11
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Moafi M, Rezvan H, Sherkat R, Taleban R, Asilian A, Zarkesh Esfahani SH, Nilforoushzadeh MA, Jaffary F, Feizi A. Evaluation of IL-12RB1, IL-12B, CXCR-3 and IL-17a expression in cases affected by a non-healing form of cutaneous leishmaniasis: an observational study design. BMJ Open 2017; 7:e013006. [PMID: 28132002 PMCID: PMC5278291 DOI: 10.1136/bmjopen-2016-013006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Seldom cutaneous leishmaniasis (CL) may present as a lasting and active lesion(s), known as a non-healing form of CL (NHCL). Non-functional type 1 T helper (Th1) cells are assumed the most important factor in the outcome of the disease. The present study aims to assess some molecular defects that potentially contribute to Th1 impairment in NHCL. METHODS AND ANALYSIS This prospective observational study will be implemented among five groups. The first and second groups comprise patients afflicted with non-healing and healing forms of CL, respectively. The third group consists of those recovered participants who have scars as a result of CL. Those participants who have never lived or travelled to endemic areas of leishmaniasis will comprise the fourth group. The fifth group comprises participants living in hyperendemic areas for leishmaniasis, although none of them have been afflicted by CL. The aim is to recruit 10 NHCL cases and 30 participants in each of the other groups. A leishmanin skin test (LST) will be performed to assess in vivo immunity against the Leishmania infection. The cytokine profile (interleukin (IL)-12p70, interferon (IFN)-γ, C-X-C motif chemokine ligand (CXCL)-11 and IL-17a) of the isolated peripheral blood mononuclear cells (PBMCs) will be evaluated through ELISA. Real-time PCR will determine the C-X-C motif chemokine receptor (CXCR)-3 and IL-17a gene expression and expression of IL-12Rβ1 will be assessed by flow cytometry. Furthermore, IL-12B and IL-12RB1 mutation analysis will be performed. DISCUSSION It is anticipated that the outcome of the current study will identify IL-12B and IL-12RB1 mutations, which lead to persistent lesions of CL. Furthermore, our expected results will reveal an association between NHCL and pro-inflammatory cytokines (IL-12p70, IFN-γ IL-17a and CXCL-11), as well as CXCR-3 expression. ETHICS AND DISSEMINATION This study has been approved by a local ethical committee. The final results will be disseminated through peer-reviewed journals and scientific conferences.
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Affiliation(s)
- Mohammad Moafi
- Faculty of Veterinary Science, Department of Pathobiology, Bu-Ali Sina University, Hamedan, Iran
| | - Hossein Rezvan
- Faculty of Veterinary Science, Department of Pathobiology, Bu-Ali Sina University, Hamedan, Iran
| | - Roya Sherkat
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Taleban
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Asilian
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | - Fariba Jaffary
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Borghi SM, Fattori V, Conchon-Costa I, Pinge-Filho P, Pavanelli WR, Verri WA. Leishmania infection: painful or painless? Parasitol Res 2016; 116:465-475. [PMID: 27933392 DOI: 10.1007/s00436-016-5340-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 11/28/2016] [Indexed: 11/25/2022]
Abstract
The complex life cycle and immunopathological features underpinning the interaction of Leishmania parasites and their mammalian hosts poses frequent poorly explored and inconclusively resolved questions. The altered nociceptive signals over the course of leishmaniasis remain an intriguing issue for nociceptive and parasitology researchers. Experimental investigations have utilized behavioral, morphological, and neuro-immune approaches in the study of experimental cutaneous leishmaniasis (CL). The data generated indicates new venues for the study of the pathological characteristics of nociceptive processing in this parasitic disease. Leishmania-induced pain may be easily observed in mice and rats. However, nociceptive data is more complex in human investigations, including the occurrence of painless lesions in mucocutaneous and cutaneous leishmaniasis. Data from recent decades indicate that humans can also be affected by pain-related symptoms, often distinct from the region of body infection. The molecular and cellular mechanisms underlying such variable nociceptive states in humans during the course of leishmaniasis are an active area of research. The present article reviews nociception in leishmaniasis, including in experimental models of CL and clinical reports.
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Affiliation(s)
- Sergio M Borghi
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Victor Fattori
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Ivete Conchon-Costa
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Phileno Pinge-Filho
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Wander R Pavanelli
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil
| | - Waldiceu A Verri
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Rod. Celso Garcia Cid PR445 KM380, Londrina, Paraná, 86057-970, Brazil.
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Cecílio P, Pérez-Cabezas B, Santarém N, Maciel J, Rodrigues V, Cordeiro da Silva A. Deception and manipulation: the arms of leishmania, a successful parasite. Front Immunol 2014; 5:480. [PMID: 25368612 PMCID: PMC4202772 DOI: 10.3389/fimmu.2014.00480] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 09/19/2014] [Indexed: 12/12/2022] Open
Abstract
Leishmania spp. are intracellular parasitic protozoa responsible for a group of neglected tropical diseases, endemic in 98 countries around the world, called leishmaniasis. These parasites have a complex digenetic life cycle requiring a susceptible vertebrate host and a permissive insect vector, which allow their transmission. The clinical manifestations associated with leishmaniasis depend on complex interactions between the parasite and the host immune system. Consequently, leishmaniasis can be manifested as a self-healing cutaneous affliction or a visceral pathology, being the last one fatal in 85–90% of untreated cases. As a result of a long host–parasite co-evolutionary process, Leishmania spp. developed different immunomodulatory strategies that are essential for the establishment of infection. Only through deception and manipulation of the immune system, Leishmania spp. can complete its life cycle and survive. The understanding of the mechanisms associated with immune evasion and disease progression is essential for the development of novel therapies and vaccine approaches. Here, we revise how the parasite manipulates cell death and immune responses to survive and thrive in the shadow of the immune system.
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Affiliation(s)
- Pedro Cecílio
- Parasite Disease Group, Institute for Molecular and Cell Biology (IBMC), University of Porto , Porto , Portugal
| | - Begoña Pérez-Cabezas
- Parasite Disease Group, Institute for Molecular and Cell Biology (IBMC), University of Porto , Porto , Portugal
| | - Nuno Santarém
- Parasite Disease Group, Institute for Molecular and Cell Biology (IBMC), University of Porto , Porto , Portugal
| | - Joana Maciel
- Parasite Disease Group, Institute for Molecular and Cell Biology (IBMC), University of Porto , Porto , Portugal
| | - Vasco Rodrigues
- Parasite Disease Group, Institute for Molecular and Cell Biology (IBMC), University of Porto , Porto , Portugal
| | - Anabela Cordeiro da Silva
- Parasite Disease Group, Institute for Molecular and Cell Biology (IBMC), University of Porto , Porto , Portugal ; Department of Biological Sciences, Faculty of Pharmacy, University of Porto , Porto , Portugal
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