Serum cytokine profile in the subclinical form of visceral leishmaniasis

The factors determining the development or not of visceral leishmaniasis (VL) have not been completely identified, but a Leishmania-specific cellular immune response seems to play a fundamental role in the final control of infection. Few studies are available regarding the production of cytokines in the subclinical form of VL, with only the production of IFN-g and TNF-a known. The aim of the present study was to identify immunological markers for the oligosymptomatic or subclinical form of VL. A prospective cohort study was conducted on 784 children aged 0 to 5 years from an endemic area in the State of Maranhão, Brazil, between January 1998 and December 2001. During 30 consecutive months of follow-up, 33 children developed the oligosymptomatic form of the disease and 12 the acute form. During the clinical manifestations, serum cytokine levels were determined in 27 oligosymptomatic children and in nine patients with the acute form using a quantitative sandwich enzyme immunoassay. In the subclinical form of VL, variable levels of IL-2 were detected in 52.3 percent of the children, IL-12 in 85.2 percent, IFN-g in 48.1 percent, IL-10 in 88.9 percent, and TNF-a in 100.0 percent, with the last two cytokines showing significantly lower levels than in the acute form. IL-4 was not detected in oligosymptomatic individuals. Multiple discriminant analysis used to determine the profile or combination of cytokines predominating in the subclinical form revealed both a Leishmania resistance (Th1) and susceptibility (Th2) profile. The detection of both Th1 and Th2 cytokine profiles explains the self-limited evolution accompanied by the discrete alterations observed for the subclinical form of VL.

Sandflies (Diptera: Psychodidae) of the Amazônia of Maranhão. V. Seasonal occurrence in ancient colonization area and endemic for cutaneous leishmaniasis

In this paper, the seasonal abundance of 25 sandfly species (1 of the Brumptomyia genus and 24 of the Lutzomyia genus) found at P1V5, municipal district of Buriticupu, Maranhão State, is discussed. The capture was carried out from 18:00 P.M. to 6:00 A.M., once a month, from January to December 1996. CDC light traps were set up in the forest, in the peri and intradomicile environments. Five species were only found in the rainy season (January to June), being represented by one or two individuals; eight species occurred only in the dry season (July to December) and eleven species appeared in both seasons. The most frequent species in the dry period were: L. whitmani (26.3 percent), L. serrana (23 percent), L. choti (22.8 percent), L. evandroi (7.5 percent), L. longipalpis (5.8 percent), L. termitophila (3.3 percent), L. shannoni (3 percent) and L. migonei (2.5 percent). In the rainy season, L. whitmani was the prevailing species (74 percent), followed by L. termitophila (4 percent), L. umbratilis (3.4 percent), L. serrana (2.8 percent), L. evandroi (2,8 percent) and L. claustrei (2.4 percent). L. whitmani was thought to be an annual species, occurring in the entire year of study. The others species, with exception to L. serrana and L. evandroi, showed a seasonal, punctual or peripheric pattern

An outbreak of human Leishmania (Viannia) braziliensis infection

The occurence of acute cutaneous leishmaniasis among inhabitants of 10 farms within 10 Km of the hamlet of Corte de Pedra, Bahia, Brazil was studied prospectively from 1984-l989. A mean population of 1,056 inhabitants living in 146 hourses were visited every 6 months and the numberof sKin ulcers recorded. A leishmanin skin test survey was done people with suggestive skin scars or active disease in l984. The incidence of skin ulcers due to Leishmania (Viannia) brasiliensis (Vlb) reached 83/1,000 inhabitants but declined sharply in the subsequent 2 years. Retrospective data shows that leishamiasis is a sporadic endemic disease. Although the reasons for this epidemic are unclear some possible aetiological factors are discussed