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Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/22261


Title: Atypical Mucocutaneous Leishmaniasis Caused by Leishmaniabraziliensis in an Acquired Immunodeficiency Syndrome Patient: T-cell Responses and Remission of Lesions Associated with Antigen Immunotherapy
Authors: Da-Cruz, Alda Maria
Filgueiras, Danilo V.
Coutinho, Ziadir
Mayrink, Wilson
Grimaldi Jr, Gabriel
De Luca, Paula M.
Mendonça, Sergio C. F.
Coutinho, Sérgio G.
Keywords: human mucocutaneous leishmaniasis - acquired immunodeficiency syndrome - CD8+ cells - interferon-y - immunotherapy
Issue Date: 31-Dec-1999
Publisher: Fundação Oswaldo Cruz, Fiocruz
Citation: Memórias do Instituto Oswaldo Cruz (ISSN: 1678-8060) Vol 94 Num 4
Abstract: An atypical case of acquired immunodeficiency syndrome-associated mucocutaneous lesions due to Leishmaniabraziliensis 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.
URI: http://hdl.handle.net/1807/22261
Other Identifiers: http://www.bioline.org.br/abstract?id=oc99099
Rights: Copyright 1999 Fundacao Oswaldo Cruz - Fiocruz
Appears in Collections:Bioline International Legacy Collection

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