Immunopathology of post kala-azar dermal leishmaniasis (PKDL): T-cell phenotypes and cytokine profile
Research output: Contribution to journal › Journal article › Research › peer-review
In Sudan, post kala-azar dermal leishmaniasis (PKDL) caused by Leishmania donovani develops in half of the patients treated for visceral leishmaniasis (kala-azar). In most patients lesions heal spontaneously, but in others symptoms are severe and persist for years. This study examined the immunological response in lesions of PKDL patients by immunohistochemistry and compared the findings with results obtained using peripheral blood mononuclear cells (PBMCs). In all lesions, parasites or parasite antigen were present and provoked the formation of an inflammatory infiltrate consisting of a mixture of macrophages, lymphocytes, and plasma cells. In patients who had high interferon-gamma (IFNgamma) responses to Leishmania antigen in vitro, compact epithelioid granulomas were formed. The inflammatory cells were mainly CD3(+) and interleukin-10 (IL10) was the most prominent cytokine in the lesions. However, IFNgamma was found in all and IL4 in most lesions, in varying amounts. PBMCs from all patients responded to Leishmania antigen by IFNgamma production or proliferation. The results indicate that PKDL develops as a result of an influx of immunocompetent cells into skin, which harbours parasites. The inflammatory response to the parasites is complex. It involves several cell types and cytokines, of which some are antagonistic. It is conceivable that the balance between these cytokines determines the outcome of the disease.
Original language | English |
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Journal | Journal of Pathology |
Volume | 189 |
Issue number | 4 |
Pages (from-to) | 615-22 |
Number of pages | 7 |
ISSN | 0022-3417 |
DOIs | |
Publication status | Published - 1999 |
Bibliographical note
Keywords: Adolescent; Adult; Animals; Antigens, Protozoan; Case-Control Studies; Cell Division; Cells, Cultured; Child; Cytokines; Female; Flow Cytometry; Humans; Immunohistochemistry; Interferon Type II; Interleukin-10; Interleukin-4; Leishmania donovani; Leishmaniasis, Cutaneous; Leishmaniasis, Visceral; Male; Statistics, Nonparametric; T-Lymphocytes
ID: 6765812