The absence of eosinophils is associated with early metastatic lesions in Leishmania amazonensis-infected mice

BACKGROUND Eosinophils are granulocytes that rapidly increase frequency in the bloodstream during helminthic infections and allergic responses. They are found in tissue infected by Leishmania during early disease, but their role during infection is not entirely understood. OBJECTIVES We aim to compare the disease due to Leishmania amazonensis in BALB/c and Δdbl-GATA1 mice, which lack eosinophils. METHODS BALB/c and Δdbl-GATA1 mice infected with L. amazonensis were observed for several weeks. The parasite load and dissemination pattern were assessed. FINDINGS The Δdbl-GATA1 mice developed an anticipated dissemination of L. amazonensis and a worsening disease. No differences were found in the lesion development or the parasite load in the footpad among Δdbl-GATA1 mice and BALB/c eight weeks after infection. However, nine weeks after infection, massive growth of metastatic lesions appeared in several parts of the skin in Δdbl-GATA1 mice, weeks earlier than BALB/c. We observed increased parasites in the bloodstream, probably an essential dissemination route. Thirteen weeks after infection, metastatic lesions were found in all Δdbl-GATA1 mice. MAIN CONCLUSION These results suggest a protective role of eosinophils in delaying the disease caused by L. amazonensis, although several limitations of this mice strain must be considered.

Comparative analysis of the tissue inflammatory response in human cutaneous and disseminated leishmaniasis

Cutaneous leishmaniasis (CL) is the most frequent clinical form of tegumentary leishmaniasis and is characterised by a single or a few ulcerated skin lesions that may disseminate into multiple ulcers and papules, which characterise disseminated leishmaniasis (DL). In this study, cells were quantified using immunohistochemistry and haematoxylin and eosin staining (CD4+, CD68+, CD20+, plasma cells and neutrophils) and histopathology was used to determine the level of inflammation in biopsies from patients with early CL, late CL and DL (ulcers and papules). The histopathology showed differences in the epidermis between the papules and ulcers from DL. An analysis of the cells present in the tissues showed similarities between the ulcers from localised CL (LCL) and DL. The papules had fewer CD4+ T cells than the DL ulcers. Although both CD4+ cells and macrophages contribute to inflammation in early CL, macrophages are the primary cell type associated with inflammation intensity in late ulcers. The higher frequency of CD20+ cells and plasma cells in lesions demonstrates the importance of B cells in the pathogenesis of leishmaniasis. The number of neutrophils was the same in all of the analysed groups. A comparison between the ulcers from LCL and DL and the early ulcers and papules shows that few differences between these two clinical forms can be distinguished by observing only the tissue.

Inflammation in disseminated lesions: an analysis of CD4+, CD20+, CD68+, CD31+ and vW+ cells in non-ulcerated lesions of disseminated leishmaniasis

Disseminated leishmaniasis (DL) differs from other clinical forms of the disease due to the presence of many non-ulcerated lesions (papules and nodules) in non-contiguous areas of the body. We describe the histopathology of DL non-ulcerated lesions and the presence of CD4-, CD20-, CD68-, CD31- and von Willebrand factor (vW)-positive cells in the inflamed area. We analysed eighteen biopsies from non-ulcerated lesions and quantified the inflamed areas and the expression of CD4, CD20, CD68, CD31 and vW using Image-Pro software (Media Cybernetics). Diffuse lymphoplasmacytic perivascular infiltrates were found in dermal skin. Inflammation was observed in 3-73% of the total biopsy area and showed a significant linear correlation with the number of vW+ vessels. The most common cells were CD68+ macrophages, CD20+ B-cells and CD4+ T-cells. A significant linear correlation between CD4+ and CD20+ cells and the size of the inflamed area was also found. Our findings show chronic inflammation in all DL non-ulcerated lesions predominantly formed by macrophages, plasmacytes and T and B-cells. As the inflamed area expanded, the number of granulomas and extent of the vascular framework increased. Thus, we demonstrate that vessels may have an important role in the clinical evolution of DL lesions.

Estudo clínico-molecular na leishmaniose mucocutânea: diagnóstico e rastreamento de subpopulações de leishmania (Viannia) braziliensis nos níveis inter e intrapacientes / Clinical and molecular study in mucocutaneous leishmaniasis: Diagnoses and screening of subpopulation of leishmania (Viannia) braziliensis in the inter and intrapatient levels

O presente estudo teve como principal objetivo avaliar a diversidade genética de Leishmania (Viannia) braziliensis nos níveis inter e intrapacientes, diretamente em lesões cutâneas e mucosas de indivíduos com leishmanioses mucocutânea (LMC), disseminada (LD) e mucosa (LM), incluindo indivíduos coinfectados pelo vírus da imunodeficiência humana (HIV). Um total de 61 amostras procedentes de 38 pacientes foi analisado pelas técnicas da reação em cadeia da polimerase (PCR), da reação em cadeia da polimerase com primer único em condições de baixa estringência (LSSP-PCR) e da análise fenética, tendo como alvo molecular a região variável do minicírculo do DNA do cinetoplasto (kDNA). Neste estudo, predominaram indivíduos do sexo masculino e com acometimento mucoso nasal. A presença de DNA do parasita foi evidenciada pela banda diagnóstica de 750 pb, em todas as amostras analisadas, possibilitando o diagnóstico específico. Na investigação do perfil genotípico de subpopulações de L. (V.) braziliensis, através da LSSP-PCR, foi revelado o polimorfismo genético intrafragmento traduzido como uma assinatura do kDNA do parasito para cada amostra. Assinaturas de kDNAs similares em amostras de paciente coletadas ao mesmo tempo (mucosa oral e nasal), e a divergência nos perfis genéticos em amostras coletadas em tempos diferentes na mesma localização (mucosa nasal) sugerem a clonalidade do inóculo inicial, como consequência da estrutura populacional clonal de Leishmania. No estudo da variabilidade genética de L. (V.) braziliensis nos níveis inter e intrapacientes foram evidenciadas similaridades genotípicas entre as amostras de lesões cutânea e mucosa intrapacientes. As análises fenética e estatística possibilitaram afirmar que a diversidade genética no nível intrapacientes é menor do que a observada entre os pacientes...

The present study has as its main objective to evaluate the genetic diversity of Leishmania(Viannia) braziliensis in the inter and intrapatient levels, directly from cutaneous and mucosallesions of individuals with mucocutaneous (MCL), disseminated (DL) and mucosal (ML)leishmaniasis, including individuals with the human immunodeficiency virus (HIV) infection.A total of 61 samples recovered from 38 patients was analyzed by the techniques ofpolymerase chain reaction (PCR), low-stringency single-specific-primer PCR (LSSP-PCR)and phenetic analysis, directed to the variable region of the kinetoplast DNA (kDNA)minicircles. In this study, male individuals with nasal mucosa involvement predominated. Thepresence of the parasite’s DNA was revealed by the diagnosis band of 750 bp, in all analyzedsamples, making the specific diagnosis possible. In the investigation of the genotypic profileof the subpopulations of L. (V.) braziliensis, through LSSP-PCR, it was revealed theintrafragment genetic polymorphism translated as a kDNA signature for each sample. SimilarkDNAs signatures in patient’s samples collected simultaneously (oral and nasal mucosa), andthe divergence in the genetic profiles in samples collected at different times on the samelocation (nasal mucosa) suggest the clonality of the initial inoculum, as a consequence of theclonal population structure of Leishmania. In the study of the genetic variability of L. (V.)braziliensis in the inter and intrapatient levels, genotypic similarities were observed amongthe cutaneous and mucosal lesions intrapatients...