CD4+ and CD8+ T cell immune responses of immunocompetent and immunocompromised (AIDS) patients with american tegumentary leishmaniasis

Submitted by Sandra Infurna ([email protected]) on 2019-11-07T17:12:28Z No. of bitstreams: 1 AldaMCruz_Paula_Lucca_etal_IOC_1996.pdf: 67487 bytes, checksum: d21a1f4ad327f8eccea6d44b26edab3b (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2019-11-07T17:18:07Z (GMT) No. of bitstreams: 1 AldaMCruz_Paula_Lucca_etal_IOC_1996.pdf: 67487 bytes, checksum: d21a1f4ad327f8eccea6d44b26edab3b (MD5)Made available in DSpace on 2019-11-07T17:18:07Z (GMT). No. of bitstreams: 1 AldaMCruz_Paula_Lucca_etal_IOC_1996.pdf: 67487 bytes, checksum: d21a1f4ad327f8eccea6d44b26edab3b (MD5) Previous issue date: 1996Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Protozoologia. Laboratório Imunidade Celular e Humoral. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Protozoologia. Laboratório Imunidade Celular e Humoral. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Protozoologia. Laboratório Imunidade Celular e Humoral. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Protozoologia. Laboratório Imunidade Celular e Humoral. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Protozoologia. Laboratório Imunidade Celular e Humoral. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Protozoologia. Laboratório Imunidade Celular e Humoral. Rio de Janeiro, RJ, Brasil

Atypical Mucocutaneous Leishmaniasis Caused by Leishmania braziliensis in an Acquired Immunodeficiency Syndrome Patient: T-cell Responses and Remission of Lesions Associated with Antigen Immunotherapy

An atypical case of acquired immunodeficiency syndrome-associated mucocutaneous lesions due to Leishmania braziliensis is described. Many vacuolated macrophages laden with amastigote forms of the parasite were found in the lesions. Leishmanin skin test and serology for leishmaniasis were both negative. The patient was resistant to therapy with conventional drugs (antimonial and amphotericin B). Interestingly, remission of lesions was achieved after an alternative combined therapy of antimonial associated with immunotherapy (whole promastigote antigens). Peripheral blood mononuclear cells were separated and stimulated in vitro with Leishmania antigens to test the lymphoproliferative responses (LPR). Before the combined immunochemotherapy, the LPR to leishmanial antigens was negligible (stimulation index - SI=1.4). After the first course of combined therapy it became positive (SI=4.17). The antigen responding cells were predominantly T-cells (47.5%) most of them with CD8+ phenotype (33%). Very low CD4+ cells (2.2%) percentages were detected. The increased T-cell responsiveness to leishmanial antigens after combined therapy was accompanied by interferon-g (IFN-g) production as observed in the cell culture supernatants. In this patient, healing of the leishmaniasis lesions was associated with the induction of a specific T-cell immune response, characterized by the production of IFN-g and the predominance of the CD8+ phenotype among the Leishmania-reactive T-cells