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Treatment of two patients with diffuse cutaneous leishmaniasis caused by Leishmania mexicana modifies the immunohistological profile but not the disease outcome
Author(s) -
SalaizaSuazo Norma,
Volkow Patricia,
Tamayo Ruy,
Moll Heidrun,
Gillitzer Reinhard,
PérezTorres Armando,
PérezMontfort Ruy,
Domínguez Jose Delgado,
VelascoCastrejón Oscar,
Crippa Marco,
Becker Ingeborg
Publication year - 1999
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1046/j.1365-3156.1999.00491.x
Subject(s) - cutaneous leishmaniasis , leishmania mexicana , immunology , leishmaniasis , medicine , leishmania , cd8 , interferon , allopurinol , disease , parasite load , immune system , parasite hosting , world wide web , computer science
Summary Two patients with diffuse cutaneous leishmaniasis caused by Leishmania mexicana were treated with two leishmanicidal drugs (pentamidine and allopurinol) combined with recombinant interferon‐γ restoring Th‐1 favouring conditions in the patients. Parasites decreased dramatically in the lesions and macrophages diminished concomitantly, while IL‐12‐producing Langerhans cells and interferon‐γ– producing NK and CD8 + lymphocytes increased in a reciprocal manner. The CD4+/CD8 + ratio in the peripheral blood normalized. During exogenous administration of interferon‐γ the parasites' capacity to inhibit the oxidative burst of the patients' monocytes was abolished. Even though Th‐1‐favouring conditions were restored, both patients relapsed two months after therapy was discontinued. We conclude that the tendency to develop a disease‐promoting Th‐2 response in DCL patients is unaffected by, and independent of, parasite numbers. Even though intensive treatment in DCL patients induced Th‐1 disease restricting conditions, the disease‐promoting immunomodulation of few persistent Leishmania sufficed to revert the immune response.