Immunochemotherapy in American cutaneous leishmaniasis: immunological aspects before and after treatment

• Published in: Memórias do Instituto Oswaldo Cruz Vol. 96; no. 1; pp. 89 - 98
• Main Authors: Toledo, V P, Mayrink, W, Gollob, K J, Oliveira, M A, Costa, C A, Genaro, O, Pinto, J A, Afonso, L C
• Format: Journal Article
• Language: English
• Published: Brazil Fundação Oswaldo Cruz, Fiocruz 01-01-2001; Instituto Oswaldo Cruz, Ministério da Saúde; Fundação Oswaldo Cruz (FIOCRUZ)
• Subjects: Adult; Animals; Antigens, Protozoan - immunology; Antimony - therapeutic use; Antiprotozoal Agents - therapeutic use; Cytokines - biosynthesis; Double-Blind Method; Enzyme-Linked Immunosorbent Assay; Female; human; Humans; Immunity, Cellular; immunochemotherapy; interferon-gamma; Interferon-gamma - biosynthesis; Interleukin-10 - biosynthesis; Leishmania; Leishmania - immunology; leishmaniasis; Leishmaniasis, Cutaneous - immunology; Leishmaniasis, Cutaneous - therapy; leishmaniasis, immunochemotherapy, human, interferon-y; Male; Meglumine - therapeutic use; Meglumine Antimoniate; Organometallic Compounds - therapeutic use; PARASITOLOGY; Protozoan Vaccines - therapeutic use; TROPICAL MEDICINE; leishmaniasis; human; interferon-gamma; immunochemotherapy
• ISSN: 1678-8060; 0074-0276; 0074-0276; 1678-8060
• DOI: 10.1590/S0074-02762001000100010

In this study, we evaluated the immune response of patients suffering
from cutaneous leishmaniasis treated with two distinct protocols. One
group was treated with conventional chemotherapy using pentavalent
antimonium salts and the other with immunochemotherapy where a vaccine
against cutaneous leishmaniasis was combined with the antimonium salt.
Our results show that, although no differences were observed in the
necessary time for complete healing of the lesions between the two
treatments, peripheral blood mononuclear cells from patients treated by
chemotherapy showed smaller lymphoproliferative responses at the end of
the treatment than those from patients in the immunochemotherapy group.
Furthermore, IFN-γ production was also different between the two
groups. While cells from patients in the chemotherapy group produced
more IFN-γ at the end of treatment, a significant decrease in this
cytokine production was associated with healing in the
immunochemotherapy group. In addition, IL-10 production was also less
intense in this latter group. Finally, an increase in CD8+ -IFN-γ
producing cells was detected in the chemotherapy group. Together these
results point to an alternative treatment protocol where healing can be
induced with a decreased production of a potentially toxic cytokine