Journal
PARASITE IMMUNOLOGY
Volume 31, Issue 8, Pages 423-431Publisher
WILEY
DOI: 10.1111/j.1365-3024.2009.01116.x
Keywords
American cutaneous leishmaniasis; immunopathogenic competences; Leishmania (V; ) braziliensis; L; (L; ) amazonensis
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Funding
- Instituto Evandro Chagas (Secretaria de Vigilancia em Saude, Ministerio da Saude, Brazil)
- Instituto de Medicina Tropical (Universidade Federal do Para, Brazil)
- Wellcome Trust (London, UK)
- Laboratorio de Investigacao Medica (LIM)-50 [Hospital de Clinicas (HC)-Faculdade de Medicina (FM)-Universidade de Sao Paulo (USP)
- Fundacao de Amparo a Pesquisa do Estado de Sao Paulo [06/56319-1]
- Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [06/56319-1] Funding Source: FAPESP
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P>The immunopathogenic competences of Leishmania (V.) braziliensis and L. (L.) amazonensis were reviewed in the light of more recent features found in the clinical and immunopathological spectrum of American cutaneous leishmaniasis. It was shown a dichotomy in the interaction between these Leishmania species and human T-cell immune response; while L. (V.) braziliensis shows a clear tendency to lead infection from the localized cutaneous leishmaniasis (LCL), a moderate T-cell hypersensitivity form at the centre of the spectrum, toward to the mucocutaneous leishmaniasis (MCL) at the T-cell hypersensitivity pole and with a prominent Th1-type immune response, L. (L.) amazonensis shows an opposite tendency, leading infection to the anergic diffuse cutaneous leishmaniasis (ADCL) at the T-cell hyposensitivity pole and with a marked Th2-type immune response. Between the central LCL and the two polar MCL and ADCL, the infection can present an intermediary form known as borderline disseminated cutaneous leishmaniasis, characterized by an incomplete inhibition of T-cell hypersensitivity but with a evident supremacy of Th1 over Th2 immune response (Th1 >= Th2). These are probably the main immunopathogenic competences of L. (V.) braziliensis and L. (L.) amazonensis regarding the immune response dichotomy that modulates human infection outcome by these Leishmania parasites.
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