In situ cellular immune response in non-ulcerated skin lesions due to Leishmania (L) infantum chagasi infection

Skin lesions of patients affected by non-ulcerated cutaneous leishmaniasis (NUCL) caused by L. (L.) infantum chagasi are characterized by lymphohistiocytic inflammatory infiltrate associated with epithelioid granuloma and scarce parasitism. However, the in situ cellular immune response of these patients is unclear. Therefore, the aim of the present study was to characterize the cellular immune response in the skin lesions of patients affected by NUCL. Methods Twenty biopsies were processed by immunohistochemistry using primary antibodies to T lymphocytes (CD4, CD8), NK cells, B lymphocytes, macrophages, nitric oxide synthase and interferon-gamma. Results Immunohistochemistry revealed higher expression of all cellular types and molecules (IFN-γ, iNOS) in the dermis of diseased skin compared to the skin of healthy individuals (p < 0.05). Morphometric analysis performed in the skin lesions sections showed the predominance of CD8+ T lymphocytes in the mononuclear infiltrate, followed by macrophages, mostly iNOS+, a response that could be mediated by IFN-γ. Conclusion Our study improves knowledge of the cellular immune response in non-ulcerated or atypical cutaneous leishmaniasis caused by L. (L.) infantum chagasi in Central America and pointed to the pivotal participation of CD8+ T lymphocytes in the host defense mechanisms against the parasite in patients with NUCL.(AU)

Prevalencia de la infección por Leishmania spp. en un área periurbana de Altagracia de Orituco, estado Guárico, Venezuela / Prevalence of infection with Leishmania spp. in a suburban area of Altagracia de Orituco, Guarico State, Venezuela

Leishmania infantum es el agente etiológico de la leishmaniasis visceral (LV). Sin embargo, tanto en el Viejo Mundo como en el Nuevo Mundo(América Central), este protozoario ha sido involucrado en casos de leishmaniasis cutánea atípica (LCA). Evidencias clínicas, parasitológicas, moleculares y entomológicas han demostrado que una situación similar está ocurriendo en un área periurbana de Altagracia de Orituco (Guárico, Venezuela). Con la finalidad de contribuir al entendimiento de este nuevo escenario epidemiológico, se realizó un estudio transversal en el cual se determinó la reactividad a la prueba de leishmanina [Leishmanin skin test (LST)] y la seroprevalencia a antígenos crudos de Leishmania spp. y al antígeno específico rK39 mediante la prueba de ELISA en una muestra de ocho casos de LCA detectados en el periodo 1997-2000, en sus cohabitantes (n=15) y en una muestra de 233 de la comunidad igualmente expuestas a riesgo. La dermoprevalencia resultó ser de 31,6% (67/212). El 28,8% (67/233) resultó positivo a la prueba de ELISA usando promastigotas de L. infantum (=L. chagasi) y 13,3% (31/233) poseían anticuerpos anti-L. braziliensis. Así mismo, la prueba de ELISA usando el antígeno rK39 resultó positiva en uno de los ocho casos estudiados y en dos de sus cohabitantes; así como también en 13,7% (32/233) de los individuos residentes en la comunidad. Los resultados obtenidos indican la circulación de especies del subgénero Leishmania y del subgénero Viannia en el área en estudio y que la presencia de anticuerpos anti-Leishmania en general se encontró asociada a la edad y al tiempo de residencia en la zona

Leishmania infantum is the etiological agent of the visceral leishmaniasis (VL). However, in the OldWorld as well in the New World (Central America), thisprotozo an has also been involved in cases of atypicalcutaneous leishmaniasis (ACL). Clinical, molecularand entomological evidences have demonstrated thata similar situation is happening in a peri-urban areaof Altagracia de Orituco (Guárico state, Venezuela). With the purpose of contributing to the understandingof such an epidemiological scenario, a cross-sectionalstudy was carryed out using the leishmanin skin test(LST) and screening for the seroprevalence to crudeantigens of Leishmania spp. and rK39 by means ofthe ELISA test in cases of ACL reported in the period1997-2000 (n=8), among their co-inhabitants (n=15) and in a randomly selected sample of 233 people. Thedermoprevalence was 31.6% (67/212); 28.8% (67/233)were positive to the ELISA test using promastigotes of L. infantum (= L. chagasi) and 13.3% (31/233) hadantibodies anti-L. braziliensis. In addition, the test of ELISA using the antigen rK39 was positive in oneout of the eight cases studied and in two out of theirco-inhabitants; as well as in 13.7% (32/233) of theinhabitants of the community. The results obtained inthis epidemiological study indicate the circulation of species of the sub-genus Leishmania as well as of thesubgenus Viannia. The presence of antibodies anti-Leishmania in general was associated to the age andthe time of residence in the zone