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1.
J Clin Invest ; 92(6): 2626-32, 1993 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8254019

RESUMO

Patients with acute kala azar are generally nonreactive in a number of immunologic assays, including T cell proliferation and generation of macrophage-activating cytokines, principally IFN-gamma, in response to leishmania antigens in vitro. To test for potential immunosuppressive factors, a series of T cell lines and clones were established from patients with acute kala azar, from patients after chemotherapy for kala azar, and from skin test-positive adults from the same endemic region. Although CD4+ T cell lines and clones could be readily established from the skin test-positive adults, lines and clones from acute or treated patients were heavily biased in expression of CD8+. The CD8+ cells from acute patients did not themselves release cytokines in response to leishmania antigens in vitro, but markedly affected the cytokine profile of peripheral blood mononuclear cells isolated 1 yr later after recovery. Addition of the CD8+ cells caused inhibition of lymphoproliferation and IFN-gamma release, with augmentation of IL-6 and IL-10 release. The inhibitory effects of the CD8+ cells could be partially abrogated by antibodies to IL-10 but not by antibodies to IL-4. Analysis of four patients with acute kala azar demonstrated release of IL-10 that could not be demonstrated in supernatants from asymptomatic skin test-positive individuals. Generation of IL-10 may contribute to the profound suppression of IFN-gamma release that occurs during kala azar due to Leishmania chagasi.


Assuntos
Interleucina-10/biossíntese , Leishmaniose Visceral/imunologia , Subpopulações de Linfócitos T/imunologia , Linfócitos T/imunologia , Adolescente , Adulto , Anticorpos Monoclonais/farmacologia , Antígenos CD/sangue , Antígenos CD4/sangue , Antígenos CD8/sangue , Linhagem Celular , Células Clonais , Citotoxicidade Imunológica , Humanos , Interferon gama/biossíntese , Interferon gama/sangue , Interleucina-10/sangue , Interleucina-10/imunologia , Interleucina-4/biossíntese , Interleucina-4/imunologia , Interleucina-4/fisiologia , Interleucina-6/biossíntese , Interleucina-6/sangue , Células Matadoras Naturais/imunologia , Leishmaniose Visceral/tratamento farmacológico , Ativação Linfocitária , Ativação de Macrófagos , Masculino , Receptores de Antígenos de Linfócitos T alfa-beta/análise , Receptores de Antígenos de Linfócitos T gama-delta/análise , Testes Cutâneos , Subpopulações de Linfócitos T/efeitos dos fármacos , Linfócitos T/efeitos dos fármacos , Acetato de Tetradecanoilforbol/farmacologia
2.
J Infect Dis ; 166(5): 1124-32, 1992 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-1402024

RESUMO

Epidemiologic aspects of the relationship between infection with Leishmania chagasi and development of clinical visceral leishmaniasis (VL) were studied in all children < 11 years old in a defined, endemic, rural area of the state of Ceará in northeast Brazil. Antileishmanial antibodies were measured in the same subjects by ELISA on six occasions between May 1987 and August 1989. Seroconversion was documented during this period in 108 children, with a cumulative annual incidence of 4.6%. Twelve (11.1%) of these children developed VL. Age < 4 years, hematocrit < 33%, and living in the mountains predicted the development of clinically apparent VL after seroconversion. Despite a high percentage of dogs serologically positive in the region (38%), there was no increased risk of infection for children living in the same household with dogs. Since children in households with a prior case of VL had a threefold increased risk of infection, human-sandfly-human transmission might have been important.


Assuntos
Leishmaniose Visceral/epidemiologia , Anticorpos Antiprotozoários/sangue , Estatura , Peso Corporal , Brasil/epidemiologia , Criança , Pré-Escolar , Demografia , Ensaio de Imunoadsorção Enzimática , Feminino , Geografia , Humanos , Lactente , Leishmaniose Visceral/sangue , Leishmaniose Visceral/diagnóstico , Masculino , Estado Nutricional , Testes Cutâneos
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