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Rogerio LA, Takahashi TY, Cardoso L, Takamiya NT, de Melo EV, de Jesus AR, de Oliveira FA, Forrester S, Jeffares DC, da Silva JS, Ribeiro JM, Almeida RP, Maruyama SR. Co-infection of Leishmania infantum and a Crithidia-related species in a case of refractory relapsed visceral leishmaniasis with non-ulcerated cutaneous manifestation in Brazil. Int J Infect Dis 2023; 133:85-88. [PMID: 37182549 PMCID: PMC10330508 DOI: 10.1016/j.ijid.2023.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 05/16/2023] Open
Abstract
We report a refractory and relapsed visceral leishmaniasis case in a male child patient followed from 2016 to 2020, whose clinical isolates from multiple relapses were analyzed at the genome level. To the best of our knowledge, it is the first report that both visceral leishmaniasis and non-ulcerated cutaneous leishmaniasis have concomitantly manifested in the same patient. Importantly, sequence analysis revealed that the patient was co-infected with Leishmania infantum and a Crithidia-related parasite, which was previously found in a fatal case of visceral leishmaniasis from the same endemic region.
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Affiliation(s)
- Luana Aparecida Rogerio
- Department of Genetics and Evolution, Centre for Biological Sciences and Health, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Talita Yuri Takahashi
- Department of Genetics and Evolution, Centre for Biological Sciences and Health, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Luria Cardoso
- Department of Medicine, Centre for Biology and Health Sciences, Federal University of Sergipe (UFS), Aracaju, Sergipe, Brazil
| | - Nayore Tamie Takamiya
- Department of Genetics and Evolution, Centre for Biological Sciences and Health, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Enaldo Vieira de Melo
- Department of Medicine, Centre for Biology and Health Sciences, Federal University of Sergipe (UFS), Aracaju, Sergipe, Brazil
| | - Amelia Ribeiro de Jesus
- Department of Medicine, Centre for Biology and Health Sciences, Federal University of Sergipe (UFS), Aracaju, Sergipe, Brazil
| | - Fabricia Alvisi de Oliveira
- Laboratory of Molecular Biology, University Hospital (HU-UFS), Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Sarah Forrester
- Department of Biology and York Biomedical Research Institute, University of York, York, UK
| | - Daniel C Jeffares
- Department of Biology and York Biomedical Research Institute, University of York, York, UK
| | - João Santana da Silva
- Fiocruz - Bi-Institutional Translational Medicine Project, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | | | - Roque Pacheco Almeida
- Department of Medicine, Centre for Biology and Health Sciences, Federal University of Sergipe (UFS), Aracaju, Sergipe, Brazil
| | - Sandra Regina Maruyama
- Department of Genetics and Evolution, Centre for Biological Sciences and Health, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil.
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de Oliveira Rekowsky LL, de Oliveira DT, Cazzaniga RA, Magalhães LS, Albuquerque LF, Araujo JMS, Tenório MDL, Machado TC, Lipscomb MW, Dos Santos PL, Ribeiro de Jesus A, Bezerra-Santos M, da Silva RLL. Influence of Testosterone in Neglected Tropical Diseases: Clinical Aspects in Leprosy and In Vitro Experiments in Leishmaniasis. Trop Med Infect Dis 2023; 8:357. [PMID: 37505653 PMCID: PMC10385189 DOI: 10.3390/tropicalmed8070357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 07/29/2023] Open
Abstract
Neglected tropical diseases encompass a group of chronic and debilitating infectious diseases that primarily affect marginalized populations. Among these diseases, leprosy and leishmaniasis are endemic in numerous countries and can result in severe and disfiguring manifestations. Although there have been reports indicating a higher incidence of leprosy and leishmaniasis in males, the underlying factors contributing to this observation remain unclear. Therefore, the objective of this study was to examine both clinical and experimental evidence regarding the role of testosterone in leprosy and leishmaniasis. A prospective clinical study was conducted to compare the clinical forms of leprosy and assess circulating testosterone levels. Additionally, the impact of testosterone on Leishmania amazonensis-infected macrophages was evaluated in vitro. The findings demonstrated that serum testosterone levels were higher in women with leprosy than in the control group, irrespective of the multi- or pauci-bacillary form of the disease. However, no differences in testosterone levels were observed in men when comparing leprosy patients and controls. Interestingly, increasing doses of testosterone in macrophages infected with L. amazonensis resulted in a higher proportion of infected cells, decreased CD40 expression on the cell surface, elevated expression of SOCS1, and decreased expression of IRF5. These findings provide biological evidence to support the influence of testosterone on intracellular infections, though the interpretation of clinical evidence remains limited.
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Affiliation(s)
- Laís Lima de Oliveira Rekowsky
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju 49060676, Brazil
- Posgraduate Program of Health Science, Federal University of Sergipe, Aracaju 49060676, Brazil
| | - Daniela Teles de Oliveira
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju 49060676, Brazil
| | - Rodrigo Anselmo Cazzaniga
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju 49060676, Brazil
| | - Lucas Sousa Magalhães
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju 49060676, Brazil
- Posgraduate Program of Health Science, Federal University of Sergipe, Aracaju 49060676, Brazil
| | - Lenise Franco Albuquerque
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju 49060676, Brazil
- Dermatology Division of Medical Hospital, Federal University of Sergipe, Aracaju 49060676, Brazil
| | - Jonnia Maria Sherlock Araujo
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju 49060676, Brazil
- Dermatology Division of Medical Hospital, Federal University of Sergipe, Aracaju 49060676, Brazil
| | - Martha Débora Lira Tenório
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju 49060676, Brazil
- Dermatology Division of Medical Hospital, Federal University of Sergipe, Aracaju 49060676, Brazil
| | - Tiziane Cotta Machado
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju 49060676, Brazil
| | - Michael W Lipscomb
- Department of Pharmacology, Center for Immunology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Priscila Lima Dos Santos
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju 49060676, Brazil
- Posgraduate Program of Health Science, Federal University of Sergipe, Aracaju 49060676, Brazil
| | - Amelia Ribeiro de Jesus
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju 49060676, Brazil
- Posgraduate Program of Health Science, Federal University of Sergipe, Aracaju 49060676, Brazil
- Instituto de Investigação em Imunologia (iii), Institutos Nacionais de Ciência e Tecnologia (INCT), CNPq, São Paulo 05403-900, Brazil
| | - Márcio Bezerra-Santos
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju 49060676, Brazil
- Posgraduate Program of Health Science, Federal University of Sergipe, Aracaju 49060676, Brazil
| | - Ricardo Luís Louzada da Silva
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju 49060676, Brazil
- Health Education Department, Federal University of Sergipe, Lagarto 49400000, Brazil
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Fonseca ABDL, Simon MDV, Cazzaniga RA, de Moura TR, de Almeida RP, Duthie MS, Reed SG, de Jesus AR. The influence of innate and adaptative immune responses on the differential clinical outcomes of leprosy. Infect Dis Poverty 2017; 6:5. [PMID: 28162092 PMCID: PMC5292790 DOI: 10.1186/s40249-016-0229-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 12/20/2016] [Indexed: 12/22/2022] Open
Abstract
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. According to official reports from 121 countries across five WHO regions, there were 213 899 newly diagnosed cases in 2014. Although leprosy affects the skin and peripheral nerves, it can present across a spectrum of clinical and histopathological forms that are strongly influenced by the immune response of the infected individuals. These forms comprise the extremes of tuberculoid leprosy (TT), with a M. leprae-specific Th1, but also a Th17, response that limits M. leprae multiplication, through to lepromatous leprosy (LL), with M. leprae-specific Th2 and T regulatory responses that do not control M. leprae replication but rather allow bacterial dissemination. The interpolar borderline clinical forms present with similar, but less extreme, immune biases. Acute inflammatory episodes, known as leprosy reactions, are complications that may occur before, during or after treatment, and cause further neurological damages that can cause irreversible chronic disabilities. This review discusses the innate and adaptive immune responses, and their interactions, that are known to affect pathogenesis and influence the clinical outcome of leprosy.
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Affiliation(s)
- Adriana Barbosa de Lima Fonseca
- Department of Medicine, Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil
| | - Marise do Vale Simon
- Department of Medicine, Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil
| | - Rodrigo Anselmo Cazzaniga
- Department of Medicine, Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil
| | - Tatiana Rodrigues de Moura
- Department of Medicine, Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil
| | - Roque Pacheco de Almeida
- Department of Medicine, Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil.,Instituto de Investigação em Imunologia, Institutos Nacionais de Ciência e Tecnologia, CNPq, São Paulo, SP, Brazil
| | | | | | - Amelia Ribeiro de Jesus
- Department of Medicine, Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil. .,Instituto de Investigação em Imunologia, Institutos Nacionais de Ciência e Tecnologia, CNPq, São Paulo, SP, Brazil.
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Oliveira DTD, Sherlock J, Melo EVD, Rollemberg KCV, Paixão TRSD, Abuawad YG, Simon MDV, Duthie M, Jesus ARD. Clinical variables associated with leprosy reactions and persistence of physical impairment. Rev Soc Bras Med Trop 2014; 46:600-4. [PMID: 24270251 DOI: 10.1590/0037-8682-0100-2013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Accepted: 10/04/2013] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Leprosy is a chronic disease that affects skin and peripheral nerves. Disease complications include reactional episodes and physical impairment. One World Health Organization (WHO) goal of leprosy programs is to decrease the number of grade 2 impairment diagnoses by 2015. This study aims to evaluate clinical factors associated with the occurrence of leprosy reactions and physical impairment in leprosy patients. METHODS We conducted a retrospective study of data from medical records of patients followed in two important centers for the treatment of leprosy in Aracaju, Sergipe, Brazil, from 2005 to 2011. We used the chi-square test to analyze associations between the following categorical variables: gender, age, operational classification, clinical forms, leprosy reactions, corticosteroid treatment, and physical impairment at the diagnosis and after cure. Clinical variables associated with multibacillary leprosy and/or reactional episodes and the presence of any grade of physical impairment after cure were evaluated using the logistic regression model. RESULTS We found that men were more affected by multibacillary forms, reactional episodes, and grade 2 physical impairment at diagnosis. Leprosy reactions were detected in a total of 40% of patients and all were treated with corticosteroids. However, physical impairment was observed in 29.8% of the patients analyzed at the end of the treatment and our multivariate analysis associated a low dose and short period of corticosteroid treatment with persistence of physical impairments. CONCLUSIONS Physical impairment should receive an increased attention before and after treatment, and adequate treatment should be emphasized.
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Passos Vázquez CM, Mendes Netto RS, Ferreira Barbosa KB, Rodrigues de Moura T, de Almeida RP, Duthie MS, Ribeiro de Jesus A. Micronutrients influencing the immune response in leprosy. NUTR HOSP 2014; 29:26-36. [PMID: 24483959 DOI: 10.3305/nh.2014.29.1.6988] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 09/19/2013] [Indexed: 12/01/2022] Open
Abstract
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an intracellular bacillus of airborne transmission. The disease affects the skin and peripheral nerves and can cause neurological sequelae. The bacillus multiplies slowly in the host and the disease probably occurs due to malfunctioning in host immune response. This review addresses the role of some specific micronutrients in the immune response, such as Vitamins A, D, E, C, Zinc and Selenium, detailing their mechanisms of actions in infectious diseases, and in leprosy. The immune response to pathogens releases harmful substances, which lead to tissue damage. This review discusses how a decreased level of antioxidants may contribute to an increased oxidative stress and complications of infectious diseases and leprosy. As the nutrients have a regulatory effect in the innate and adaptative immune responses, a perfect balance in their concentrations is important to improve the immune response against the pathogens.
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Affiliation(s)
- Cecília Maria Passos Vázquez
- Laboratório de Biologia Molecular. Hospital Universitário. Departamento de Medicine. Universidade Federal de Sergipe..
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de Oliveira DT, Bezerra MM, de Almeida JAP, Duthie M, Reed S, de Jesus AR. Neurological disability in leprosy: incidence and gender association in Sergipe, Brazil. Geospat Health 2012; 6:S125-S129. [PMID: 23032278 DOI: 10.4081/gh.2012.130] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The environmental impact assessment process is over 40 years old and has dramatically expanded. Topics, such as social, health and human rights impact are now included. The main body of an impact analysis is generally hundreds of pages long and supported by countless technical appendices. For large, oil/gas, mining and water resources projects both the volume and technical sophistication of the reports has far exceeded the processing ability of host communities. Instead of informing and empowering, the reports are abstruse and overwhelming. Reinvention is required. The development of a visual integrated impact assessment strategy that utilizes remote sensing and spatial analyses is described.
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Affiliation(s)
- Daniela Teles de Oliveira
- Laboratório de Biologia Molecular, Hospital Universitário, Departamento de Medicina, Universidade Federal de Sergipe, Rua Claudio Batista s/n, Bairro Sanatório, Aracaju, Sergipe, Brazil, CEP 49060-100
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Ribeiro de Jesus A, Luna T, Pacheco de Almeida R, Machado PRL, Carvalho EM. Pentoxifylline down modulate in vitro T cell responses and attenuate pathology in Leishmania and HTLV-I infections. Int Immunopharmacol 2008; 8:1344-53. [PMID: 18687297 DOI: 10.1016/j.intimp.2008.03.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2007] [Revised: 03/27/2008] [Accepted: 03/31/2008] [Indexed: 01/13/2023]
Abstract
Tumor necrosis factor-alpha (TNF-alpha) is known to have numerous biological properties relating to inflammation. This cytokine participates in the tissue damage of chronic inflammatory, autoimmune and infectious diseases. Pentoxifylline is a methylxanthine that inhibits phosphodiesterase IV, which inhibits the degradation of the cAMP and prostanoids. The increased intracellular concentration of the cAMP leads to a negative regulation of NF-kappaB and NF-AT transcription factors and suppresses TNF-alpha production. This review describes studies that support evidences that TNF-alpha is involved in the pathogenesis of HTLV-1 associated myelopathy and of cutaneous and mucosal leishmaniasis. Additionally, it demonstrates the effect of pentoxifylline in vitro in inhibiting TNF-alpha and IFN-gamma spontaneous production in PBMC from HTLV-1-infected patients, as well as its in vivo effect in inhibiting TNF-alpha in sera from mucosal leishmaniasis patients. Moreover, we review the results of clinical studies from the last 10 years using pentoxifylline to treat HTLV-1 associated myelopathy and cutaneous and mucosal leishmaniasis.
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Affiliation(s)
- Amelia Ribeiro de Jesus
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil
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Giudice A, Camada I, Leopoldo PTG, Pereira JMB, Riley LW, Wilson ME, Ho JL, de Jesus AR, Carvalho EM, Almeida RP. Resistance of Leishmania (Leishmania) amazonensis and Leishmania (Viannia) braziliensis to nitric oxide correlates with disease severity in Tegumentary Leishmaniasis. BMC Infect Dis 2007; 7:7. [PMID: 17316450 PMCID: PMC1810296 DOI: 10.1186/1471-2334-7-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2006] [Accepted: 02/22/2007] [Indexed: 11/18/2022] Open
Abstract
Background Nitric oxide (NO•) plays a pivotal role as a leishmanicidal agent in mouse macrophages. NO• resistant Escherichia coli and Mycobacterium tuberculosis have been associated with a severe outcome of these diseases. Methods In this study we evaluated the in vitro toxicity of nitric oxide for the promastigote stages of Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis parasites, and the infectivity of the amastigote stage for human macrophages. Parasites were isolated from patients with cutaneous, mucosal or disseminated leishmaniasis, and NO• resistance was correlated with clinical presentation. Results Seventeen isolates of L. (L.) amazonensis or L. (V.) braziliensis promastigotes were killed by up to 8 mM of more of NaNO2 (pH 5.0) and therefore were defined as nitric oxide-susceptible. In contrast, eleven isolates that survived exposure to 16 mM NaNO2 were defined as nitric oxide-resistant. Patients infected with nitric oxide-resistant Leishmania had significantly larger lesions than patients infected with nitric oxide-susceptible isolates. Furthermore, nitric oxide-resistant L. (L.) amazonensis and L. (V.) braziliensis multiplied significantly better in human macrophages than nitric oxide-susceptible isolates. Conclusion These data suggest that nitric oxide-resistance of Leishmania isolates confers a survival benefit for the parasites inside the macrophage, and possibly exacerbates the clinical course of human leishmaniasis.
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Affiliation(s)
- Angela Giudice
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Instituto de Investigação em Imunologia (iii), Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Ilza Camada
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Instituto de Investigação em Imunologia (iii), Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Paulo TG Leopoldo
- Departamento de Fisiologia, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil
| | - Júlia MB Pereira
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Instituto de Investigação em Imunologia (iii), Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Lee W Riley
- Division of Infectious Diseases, School of Public Health, University of California, Berkeley, CA, USA
| | - Mary E Wilson
- Department of Internal Medicine, Microbiology, University of Iowa College of Medicine, Iowa City, IA, USA
| | - John L Ho
- Department of Medicine, Division of International Medicine and Infectious Diseases, Weill Medical College of Cornell University, New York, NY, USA
| | - Amelia Ribeiro de Jesus
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Instituto de Investigação em Imunologia (iii), Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Edgar M Carvalho
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Instituto de Investigação em Imunologia (iii), Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Roque P Almeida
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Instituto de Investigação em Imunologia (iii), Universidade Federal da Bahia, Salvador, Bahia, Brazil
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Castellucci L, Menezes E, Oliveira J, Magalhaes A, Guimaraes LH, Lessa M, Ribeiro S, Reale J, Noronha EF, Wilson ME, Duggal P, Beaty TH, Jeronimo S, Jamieson SE, Bales A, Blackwell JM, de Jesus AR, Carvalho EM. IL6−174 G/C Promoter Polymorphism Influences Susceptibility to Mucosal but Not Localized Cutaneous Leishmaniasis in Brazil. J Infect Dis 2006; 194:519-27. [PMID: 16845637 DOI: 10.1086/505504] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2006] [Accepted: 03/09/2006] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Mucosal leishmaniasis (ML) is associated with exaggerated tumor necrosis factor- alpha and interferon- gamma responses and tissue destruction. ML follows localized cutaneous leishmaniasis (CL) caused by Leishmania braziliensis infection. Interleukin (IL)-6 down-regulates T helper (Th) cell type 1 differentiation and drives Th2 cell differentiation. The IL6 -174 G/C polymorphism is associated with proinflammatory diseases and IL-6 regulation. METHODS The -174 G/C polymorphism was genotyped in population samples and families with CL and ML from Brazil. Genotype frequencies were compared among patients with ML, patients with CL, and 2 control groups by logistic regression and family-based association test (FBAT) analysis. IL-6 levels were measured in macrophages. RESULTS The C allele was more common in patients with ML than in patients with CL (odds ratio [OR], 2.55 [95% confidence interval {CI}, 1.32-4.91]; P=.005), than in patients who were leishmanin skin-test positive (OR, 2.23 [95% CI, 1.23-4.05]; P=.009), and than in neighborhood control subjects (OR, 2.47 [95% CI, 1.24-4.90]; P=.01). FBAT analysis confirmed an association between allele C and ML under both additive (z=4.295; P=.000017) and dominant (z=4.325; P=.000015) models. Significantly lower levels of IL-6 were measured in unstimulated macrophages from CC individuals than from GG individuals (P=.003) as well as after stimulation with soluble leishmania antigen (P=.009). CONCLUSIONS IL-6 may regulate type 1 proinflammatory responses, putting individuals with low macrophage IL-6 levels at increased risk for ML.
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Affiliation(s)
- Lea Castellucci
- Servico de Imunologia, Hospital Universitario Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil
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de Jesus AR, Silva A, Santana LB, Magalhães A, de Jesus AA, de Almeida RP, Rêgo MAV, Burattini MN, Pearce EJ, Carvalho EM. Clinical and immunologic evaluation of 31 patients with acute schistosomiasis mansoni. J Infect Dis 2002; 185:98-105. [PMID: 11756987 DOI: 10.1086/324668] [Citation(s) in RCA: 135] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2001] [Revised: 08/27/2001] [Indexed: 11/03/2022] Open
Abstract
Thirty-one patients with acute schistosomiasis were evaluated clinically and immunologically. Cytokine levels were determined in peripheral blood mononuclear cell (PBMC) supernatants. Levels of total and antigen-specific IgE, tumor necrosis factor (TNF)-alpha, and immune complexes were measured in serum samples. Clinical findings included general symptoms, liver damage, pulmonary involvement, and pericarditis. All patients had eosinophilia. Immune complexes were detected in 55% of the patients (mean+/-SD, 7.8+/-7.6 microg Eq/mL) and were associated with cough, dyspnea, and abnormal chest radiographic findings. Levels (mean +/- SD) of TNF-alpha (1349.3+/-767.6 pg/mL), interleukin (IL)-1 (2683+/-1270 pg/mL), and IL-6 (382 +/- 52.3 pg/mL) were elevated in PBMC. Serum TNF-alpha levels were elevated in 87% of the patients and were associated with abdominal pain. Higher interferon-gamma levels were detected in PBMC of patients with acute disease than in those of patients with chronic schistosomiasis; IL-5 levels were higher in those with chronic disease. Low IL-5 levels were associated with weight loss. Proinflammatory cytokines and immune complexes with low Th2 responses might explain the immunopathogenesis of acute schistosomiasis.
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Affiliation(s)
- Amelia Ribeiro de Jesus
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Bahia, Brazil
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