Analysis of the cellular parameters of the immune responses contributing to resistance and susceptibility of mice to infection with the intracellular parasite, Leishmania major.

Although the course of infection induced by L.major in mice is influenced by several factors, including the parasite virulence, the macrophage permissiveness to this parasite and response to T cell-produced lymphokines, this review has been restricted to summarizing, the recent data concerning the T-cell responses generated during infection and their effect on the disease process. Experimental evidence strongly suggests that T-cell responses play a fundamental role in resistance and susceptibility of mice to infection with L.major. It appears that resolution of lesion and exacerbation of disease result from the activity of distinct specific CD4+ T cells. There is a consensus of opinion that CD4+ T cells from the TH1 functional phenotype are generally endowed with protective function through their secreted lymphokines (e.g. IFN-gamma). However, some evidence exists that other lymphokines (e.g. TNF) might be involved in resolution of lesions. Results exist which indicate that some TH1 CD4+ T cells also contribute to susceptibility to infection. Their specificity differs from that of protective TH1 cells in the sense that these T cells might recognize parasite antigens not appropriately presented by parasitized macrophages and therefore, although releasing IFN-gamma, would not be able to concentrate this lymphokine on the surface of macrophages containing multiplying L.major. It appears that parasite-specific TH2 cells play an important role, through the IL-4 that they produce, in the severe disease seen in BALB/c mice. Determining the mechanisms responsible for the expansion of TH2 cells in genetically susceptible mice as well as assessing whether or not some parasite antigens are preferentially recognized by TH1 and TH2 cells are areas of investigation of prime importance for the rational design of a vaccine against leishmaniasis. Several observations indicate that CD8+ T cells have a role in the resolution of lesions induced by this parasite. Precise investigation of the mechanism(s) accounting for their beneficial effect might depend upon our ability to derive and maintain in vitro homogenous populations and clones of L.major-specific CD8+ T cells.