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首页> 外文期刊>Clinical and diagnostic laboratory immunology >T-Cell-Mediated Immune Responses in Patients with Cutaneous or Mucosal Leishmaniasis: Long-Term Evaluation after Therapy
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T-Cell-Mediated Immune Responses in Patients with Cutaneous or Mucosal Leishmaniasis: Long-Term Evaluation after Therapy

机译：皮肤或粘膜利什曼病患者的T细胞介导的免疫反应：治疗后的长期评估。

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T-cell immune responses in patients with cutaneous leishmaniasis (CL) and mucosal leishmaniasis (ML) were studied during the active disease, at the end of therapy, and 1 to 17 years posttherapy (long-term follow-up). Lymphocyte proliferative responses, phenotypic characterization of CD4+ and CD8+ Leishmania-reactive T cells, and cytokine production were assayed. Patients with active ML and CL showed higher proportions of CD4+ than CD8+ T cells. In CL, the healing process was associated with a decrease of CD4+ and an increase of CD8+, leading to similar CD4+ and CD8+ proportions. This pattern was only seen in ML after long-term therapy. Long-term follow-up of patients with CL showed a positive CD4+/CD8+ ratio as observed during the active disease, although the percentages of these T cell subsets were significantly lower. Patients with CL did not show significant differences between gamma interferon (IFN-γ) and interleukin-5 (IL-5) production during the period of study. Patients with active ML presented higher IFN-γ and IL-5 levels compared to patients with active CL. IL-4 was only detected during active disease. Patients long term after cure from ML showed increasing production of IFN-γ, significant decrease of IL-5, and no IL-4 production. Two apparently beneficial immunological parameters were detected in tegumentary leishmaniasis: (i) decreasing proportions of CD4+ Leishmania-reactive T cells in the absence of IL-4 production associated with cure of CL and ML and (ii) decreasing levels of IL-5 long after cure, better detected in patients with ML. The observed T-cell responses maintained for a long period in healed patients could be relevant for immunoprotection against reinfection and used as a parameter for determining the prognosis of patients and selecting future vaccine preparations.
机译：在活动性疾病期间，治疗结束时和治疗后1至17年（长期随访）研究了皮肤利什曼病（CL）和粘膜利什曼病（ML）患者的T细胞免疫反应。检测淋巴细胞增殖反应，CD4 + 和CD8 + 利什曼原虫反应性T细胞的表型特征以及细胞因子的产生。活跃的ML和CL患者的CD4 + 比例高于CD8 + T细胞。在CL中，愈合过程与CD4 + 的减少和CD8 + 的增加相关，导致相似的CD4 + 和CD8 < sup> + 比例。这种模式仅在长期治疗后的ML中可见。对CL患者的长期随访显示，在活动性疾病期间观察到CD4 + / CD8 + 阳性，尽管这些T细胞亚群的百分比显着降低。在研究期间，CL患者在γ干扰素（IFN-γ）和白介素5（IL-5）产生之间没有显着差异。与活动性CL患者相比，活动性ML患者表现出更高的IFN-γ和IL-5水平。仅在活动性疾病期间检测到IL-4。 ML长期治愈后的患者显示IFN-γ产生增加，IL-5显着降低，并且没有IL-4产生。在皮下利什曼病中检测到两个明显有益的免疫学参数：（i）在没有IL-4产生而治愈甲状旁腺的情况下，CD4 + 利什曼原虫反应性T细胞的比例降低CL和ML，以及（ii）治愈后很长一段时间内IL-5水平降低，在ML患者中更好地检测到。观察到的在治愈的患者中长期维持的T细胞反应可能与针对再感染的免疫保护有关，并可用作确定患者预后和选择未来疫苗制剂的参数。

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