Atypical Manifestations of Cutaneous Leishmaniasis in a Region Endemic for Leishmania braziliensis: Clinical, Immunological and Parasitological Aspects

Luiz Henrique Guimarães; Adriano Queiroz; Juliana A Silva; Silvana C Silva; Viviane Magalhães; Ednaldo L Lago; Paulo Roberto L Machado; Olívia Bacellar; Mary E Wilson; Stephen M Beverley; Edgar M Carvalho; Albert Schriefer

doi:10.1371/journal.pntd.0005100

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Atypical Manifestations of Cutaneous Leishmaniasis in a Region Endemic for Leishmania braziliensis: Clinical, Immunological and Parasitological Aspects

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Atypical Manifestations of Cutaneous Leishmaniasis in a Region Endemic for Leishmania braziliensis: Clinical, Immunological and Parasitological Aspects

Luiz Henrique Guimarães, Adriano Queiroz, Juliana A Silva, Silvana C Silva, Viviane Magalhães, Ednaldo L Lago, Paulo Roberto L Machado, Olívia Bacellar, Mary E Wilson, Stephen M Beverley, …

PLoS neglected tropical diseases, Vol.10(12), pp.e0005100-e0005100

12/2016

DOI: 10.1371/journal.pntd.0005100

PMCID: PMC5131895

PMID: 27906988

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Abstract

Atypical cutaneous leishmaniasis (ACL) has become progressively more frequent in Corte de Pedra, Northeast Brazil. Herein we characterize clinical presentation, antimony response, cytokine production and parasite strains prevailing in ACL. Between 2005 and 2012, 51 ACL (cases) and 51 temporally matched cutaneous leishmaniasis (CL) subjects (controls) were enrolled and followed over time in Corte de Pedra. Clinical and therapeutic data were recorded for all subjects. Cytokine secretion by patients' peripheral blood mononuclear cells (PBMC) stimulated with soluble parasite antigen in vitro, and genotypes in a 600 base-pair locus in chromosome 28 (CHR28/425451) of the infecting L. (V.) braziliensis were compared between the two groups. ACL presented significantly more lesions in head and neck, and higher rate of antimony failure than CL. Cytosine-Adenine substitutions at CHR28/425451 positions 254 and 321 were highly associated with ACL (p<0.0001). In vitro stimulated ACL PBMCs produced lower levels of IFN-γ (p = 0.0002) and TNF (p <0.0001), and higher levels of IL-10 (p = 0.0006) and IL-17 (p = 0.0008) than CL PBMCs. ACL found in Northeast Brazil is caused by distinct genotypes of L. (V.) braziliensis and presents a cytokine profile that departs from that in classical CL patients. We think that differences in antigenic contents among parasites may be in part responsible for the variation in cytokine responses and possibly immunopathology between CL and ACL.

Leishmania braziliensis - physiology

Humans

Middle Aged

Tumor Necrosis Factor-alpha - genetics

Interleukin-17 - immunology

Interleukin-17 - genetics

Leukocytes, Mononuclear - parasitology

Male

Leishmaniasis, Cutaneous - immunology

Leishmania braziliensis - genetics

Endemic Diseases

Young Adult

Leishmaniasis, Cutaneous - parasitology

Interferon-gamma - immunology

Leukocytes, Mononuclear - immunology

Adolescent

Tumor Necrosis Factor-alpha - immunology

Leishmaniasis, Cutaneous - epidemiology

Adult

Female

Leishmania braziliensis - isolation & purification

Polymorphism, Single Nucleotide

Interferon-gamma - genetics

Brazil - epidemiology

Details

Title: Subtitle: Atypical Manifestations of Cutaneous Leishmaniasis in a Region Endemic for Leishmania braziliensis: Clinical, Immunological and Parasitological Aspects
Creators: Luiz Henrique Guimarães - Centro de Formação em Saúde, Universidade Federal do Sul da Bahia, Teixeira de Freitas, Brazil
Adriano Queiroz - Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
Juliana A Silva - Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
Silvana C Silva - Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
Viviane Magalhães - Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
Ednaldo L Lago - Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Salvador, Brazil
Paulo Roberto L Machado - Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Salvador, Brazil
Olívia Bacellar - Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Salvador, Brazil
Mary E Wilson - VA Medical Center, Iowa City, Iowa, United States of America
Stephen M Beverley - Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
Edgar M Carvalho - Centro de Pesquisas Gonçalo Moniz, Salvador, Brazil
Albert Schriefer - Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
Resource Type: Journal article
Publication Details: PLoS neglected tropical diseases, Vol.10(12), pp.e0005100-e0005100
DOI: 10.1371/journal.pntd.0005100
PMID: 27906988
PMCID: PMC5131895
NLM abbreviation: PLoS Negl Trop Dis
ISSN: 1935-2735
eISSN: 1935-2735
Publisher: United States
Grant note: R03 AI067663 / NIAID NIH HHS R56 AI099364 / NIAID NIH HHS P50 AI030639 / NIAID NIH HHS
Language: English
Date published: 12/2016
Academic Unit: Microbiology and Immunology; International Programs; Epidemiology; Internal Medicine
Record Identifier: 9984001134102771

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