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首页> 外文期刊>Infection and immunity >Immunological Determinants of Clinical Outcome in Peruvian Patients with Tegumentary Leishmaniasis Treated with Pentavalent Antimonials
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Immunological Determinants of Clinical Outcome in Peruvian Patients with Tegumentary Leishmaniasis Treated with Pentavalent Antimonials

机译：五价锑治疗秘鲁皮肤性利什曼病的患者临床结局的免疫学决定因素。

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The mechanisms linking the immune response to cutaneous and mucosal leishmaniasis (CL and ML, respectively) lesions and the response to treatment are incompletely understood. Our aims were to prospectively assess, by quantitative reverse transcription-PCR, the levels of mRNA for gamma interferon, tumor necrosis factor alpha, interleukin-10 (IL-10), IL-4, and IL-13, as well as the presence of T cells (CD2) and macrophages (CD68), in CL and ML lesions and to follow their changes in response to treatment with pentavalent antimonials. The leishmanin skin test (LST) was performed on all CL and ML patients before treatment. The patient population included individuals living in areas of Peru where the disease is endemic, i.e., 129 with CL and 43 with ML. Compared to CL patients, the LST induration size was larger, the levels of all cytokine mRNAs but IL-10 were higher, T-cell mRNA was similar, and macrophage mRNA was lower in ML patients. The proportion of CL patients with an LST induration size of >8 mm was higher among responders to treatment. In CL, the pretreatment levels of cytokine mRNAs did not discriminate between responders and nonresponders; however, treatment was more often accompanied by a reduction in the levels of T-cell and cytokine mRNAs in responders than in nonresponders. Furthermore, the production of cytokines per T cell and macrophage decreased with treatment but IL-10 production remained high in nonresponders. Overall, these findings point to complex relationships among New World Leishmania parasites, skin and mucosal immune responses, and treatment outcome. The persistence of high levels of IL-10 in CL is characteristically associated with a poor response to treatment.
机译：对皮肤和粘膜利什曼病（分别为CL和ML）病变的免疫反应以及对治疗反应的免疫机制尚不完全清楚。我们的目标是通过定量逆转录PCR来前瞻性评估γ干扰素，肿瘤坏死因子α，白介素10（IL-10），IL-4和IL-13的mRNA水平以及是否存在CL和ML病变中T细胞（CD2）和巨噬细胞（CD68）的变化，并跟踪它们对五价锑治疗反应的变化。在治疗前，对所有CL和ML患者进行了利什曼宁皮肤试验（LST）。该患者人群包括居住在该病为地方病的秘鲁地区的个体，即，CL患129，ML患43。与CL患者相比，ML患者的LST硬结大小较大，所有细胞因子mRNA水平但IL-10较高，T细胞mRNA相似，巨噬细胞mRNA较低。在治疗反应者中，LST硬结大小> 8 mm的CL患者比例更高。在CL中，细胞因子mRNA的预处理水平不能区分反应者和非反应者。然而，与无反应者相比，反应者中的治疗通常伴随着T细胞和细胞因子mRNA水平的降低。此外，治疗后每个T细胞和巨噬细胞的细胞因子产生减少，但无反应者中IL-10产生仍然很高。总体而言，这些发现表明新世界的利什曼原虫寄生虫，皮肤和粘膜免疫反应以及治疗结果之间存在复杂的关系。 CL中高水平的IL-10持续存在与治疗反应不良相关。

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