Immunological determinants of clinical outcome in Peruvian patients with tegumentary leishmaniasis treated with pentavalent antimonials

Article Article scientifique Article Immunological determinants of clinical outcome in Peruvian patients with tegumentary leishmaniasis treated with pentavalent antimonials eng 2009 author Maurer-Cecchini Anne 635612 author Decuypere Saskia author Chappuis François 34709 author Alexandrenne Coralie author De Doncker Simonne author Boelaert Marleen author Dujardin Jean-Claude author Loutan Louis 22904 author Dayer Jean-Michel 25468 author Tulliano Gianfranco author Arevalo Jorge author Llanos-Cuentas Alexandro author Chizzolini Carlo 93910 2022-2029 10.1128/IAI.01513-08 19237520 0019-9567 http://iai.asm.org/content/77/5/2022.full.pdf The mechanisms linking the immune response to cutaneous and mucosal leishmaniasis (CL and ML, respectively) lesions and the response to treatment are incompletely understood. Our aims were to prospectively assess, by quantitative reverse transcription-PCR, the levels of mRNA for gamma interferon, tumor necrosis factor alpha, interleukin-10 (IL-10), IL-4, and IL-13, as well as the presence of T cells (CD2) and macrophages (CD68), in CL and ML lesions and to follow their changes in response to treatment with pentavalent antimonials. The leishmanin skin test (LST) was performed on all CL and ML patients before treatment. The patient population included individuals living in areas of Peru where the disease is endemic, i.e., 129 with CL and 43 with ML. Compared to CL patients, the LST induration size was larger, the levels of all cytokine mRNAs but IL-10 were higher, T-cell mRNA was similar, and macrophage mRNA was lower in ML patients. The proportion of CL patients with an LST induration size of >8 mm was higher among responders to treatment. In CL, the pretreatment levels of cytokine mRNAs did not discriminate between responders and nonresponders; however, treatment was more often accompanied by a reduction in the levels of T-cell and cytokine mRNAs in responders than in nonresponders. Furthermore, the production of cytokines per T cell and macrophage decreased with treatment but IL-10 production remained high in nonresponders. Overall, these findings point to complex relationships among New World Leishmania parasites, skin and mucosal immune responses, and treatment outcome. The persistence of high levels of IL-10 in CL is characteristically associated with a poor response to treatment. Adolescent Adult Aged Aged, 80 and over Animals Antimony/therapeutic use Antiprotozoal Agents/therapeutic use Child Child, Preschool Cytokines/biosynthesis Female Gene Expression Profiling Humans Infant Leishmaniasis, Cutaneous/drug therapy/immunology Macrophages/immunology Male Middle Aged Peru Prospective Studies Skin/pathology T-Lymphocytes/immunology Treatment Outcome Young Adult Dewey 613 Dewey 616 56 Département de médecine 221 64 Département de santé et médecine communautaires 22A false 16 Groupe Jean-Michel Gaspoz 23 95 Groupe Louis Loutan (médecine des Voyages et des Migrations, Médecine Tropicale, Santé Internationale) 122 385 La matrice extracellulaire 651 Infection and immunity 77 5 e0edcb96-e454-4488-bcd6-32df80498efd Article (Published version) Restricted Maurer-Cecchini-2009-Immunological_determ1.pdf 682321 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires

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Immunological determinants of clinical outcome in Peruvian patients with tegumentary leishmaniasis treated with pentavalent antimonials	Infection and immunity			2009	644	0

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Maurer-Cecchini, Anne