Evaluation of medullary cytokine expression and clinical and laboratory aspects in severe human visceral leishmaniasis

Evaluation of medullary cytokine expression and clinical and laboratory aspects in severe human visceral leishmaniasis

Background Visceral leishmaniasis (VL) is a serious public health problem. The factors that can determine whether VL develops and progresses to severe form have not been fully identified, but a specific cellular immune response appears to play a key role. Therefore, understanding immunopathogenesis...

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Published in:Parasite immunology Vol. 43; no. 12; pp. e12880 - n/a
Main Authors: Teles, Leandro de Freitas, Viana, Agostinho Gonçalves, Cardoso, Mariana Santos, Pinheiro, Guilherme Rafael Gomide, Bento, Gabriele Ariadine, Lula, Jamille Fernandes, Soares, Tânia de Cássia Moreira, Fujiwara, Ricardo Toshio, Carvalho, Silvio Fernando Guimarães de
Format: Journal Article
Language:English
Published: England Wiley Subscription Services, Inc 01-12-2021
Subjects:
Alanine
Alanine transaminase
Bone marrow
Cytokines
Cytokines - metabolism
Humans
Immune response
Immune response (cell-mediated)
Immunopathogenesis
Immunoregulation
Inflammation
Interferon
Interferon-gamma
Leishmaniasis, Visceral
Lymphocytes T
Parasite Load
Parasitic diseases
parasitic load
Patients
Public health
Statistical analysis
Transaminase
Tumor necrosis factor
Tumor Necrosis Factor-alpha - metabolism
Visceral leishmaniasis
parasitic load
cytokines
Visceral leishmaniasis
bone marrow
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Summary:Background Visceral leishmaniasis (VL) is a serious public health problem. The factors that can determine whether VL develops and progresses to severe form have not been fully identified, but a specific cellular immune response appears to play a key role. Therefore, understanding immunopathogenesis can be useful in preventing a serious clinical outcome. Materials and Methods Bone marrow samples were collected from patients with severe VL (SVL) or non‐severe VL (NSVL). Cytokine levels and parasitic load were analysed by RT‐qPCR. There is a statistically significant difference in the leukocyte parameter in patients with SVL and NSVL compared with the control patients (p = .006 and p = .014, respectively). Results Urea, alanine transaminase and albumin parameters had a significant difference p = .036, p = .039 and p = .017, respectively, between SVL and NSVL. Although high levels of IFN‐γ, IL‐10, IL‐6 and TNF‐α were present in all groups of individuals with VL, they were not statistically associated with severity. In patients with active VL, IFN‐γ and IL‐10 were associated, respectively, with a reduction and increase in the parasite load, strong and significant positive association between IFN‐γ and IL‐10 (rho = .627 and p = .003). Conclusion This study demonstrates that VL stimulates an non‐dichotomized inflammatory response between Th1/Th2 and that bone marrow is an important tissue for immune regulation.
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ISSN:0141-9838
1365-3024
DOI:10.1111/pim.12880