Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/44024
Title: Atypical Mucocutaneous Leishmaniasis Caused by Leishmania braziliensis in an Acquired Immunodeficiency Syndrome Patient: T-cell Responses and Remission of Lesions Associated with Antigen Immunotherapy
Authors: Cruz, Alda Maria da
Figueiras, Danilo V.
Coutinho, Ziadir
Mayrink, Wilson
Grimaldi Jr, Gabriel
Luca, Paula M. de
Mendonça, Sergio C. F.
Coutinho, Sergio G.
Affilliation: Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Protozoologia. Laboratório de Imunidade Celular e Humoral. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Estado do Rio de Janeiro. Hospital Universitário Gaffrée-Guinle. Serviço de Dermatologia. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Estado do Rio de Janeiro. Hospital Universitário Gaffrée-Guinle. Serviço de Dermatologia. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Minas Gerais. Departamento de Parasitologia. Belo Horizonte, MG, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Imunologia. Laboratório de Pesquisa em Leishmanioses. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Abstract: An atypical case of acquired immunodeficiency syndrome-associated mucocutaneous lesions due to Leishmania braziliensis is described. Many vacuolated macrophages laden with amastigote forms of the parasite were found in the lesions. Leishmanin skin test and serology for leishmaniasis were both negative. The patient was resistant to therapy with conventional drugs (antimonial and amphotericin B). Interestingly, remission of lesions was achieved after an alternative combined therapy of antimonial associated with immunotherapy (whole promastigote antigens). Peripheral blood mononuclear cells were separated and stimulated in vitro with Leishmania antigens to test the lymphoproliferative responses (LPR). Before the combined immunochemotherapy, the LPR to leishmanial antigens was negligible (stimulation index - SI=1.4). After the first course of combined therapy it became positive (SI=4.17). The antigen responding cells were predominantly T-cells (47.5%) most of them with CD8+ phenotype (33%). Very low CD4+ cells (2.2%) percentages were detected. The increased T-cell responsiveness to leishmanial antigens after combined therapy was accompanied by interferon-γ (IFN-γ) production as observed in the cell culture supernatants. In this patient, healing of the leishmaniasis lesions was associated with the induction of a specific T-cell immune response, characterized by the production of IFN-γ and the predominance of the CD8+ phenotype among the Leishmania-reactive T-cells.
Keywords: Human mucocutaneous leishmaniasis
Acquired immunodeficiency syndrome
CD8+ cells
Interferon-γ
Immunotherapy
keywords: Leishmaniose mucocutânea humana
Síndrome da Imunodeficiência Adquirida
Células CD8 +
Interferon-γ
Imunoterapia
Issue Date: 1999
Publisher: Fundação Oswaldo Cruz. Instituto Oswaldo Cruz.
Citation: CRUZ, Alda M. da et al. Atypical Mucocutaneous Leishmaniasis Caused by Leishmania braziliensis in an Acquired Immunodeficiency Syndrome Patient: T-cell Responses and Remission of Lesions Associated with Antigen Immunotherapy. Memórias do Instituto Oswaldo Cruz, Rio de Janeiro, v. 94, n. 4, p. 537-542, July/Aug. 1999.
DOI: 10.1590/S0074-02761999000400020
ISSN: 0074-0276
Copyright: open access
Appears in Collections:IOC - Artigos de Periódicos
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