Aline C Muniz1, Olívia Bacellar2, Ednaldo Lima Lago3, Augusto M Carvalho4, Pedro Paulo Carneiro1, Luiz Henrique Guimarães3, Paulo N Rocha5, Lucas P Carvalho6, Marshall Glesby7, Edgar M Carvalho6. 1. Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Federal University of Bahia Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine. 2. Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Federal University of Bahia Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais. 3. Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Federal University of Bahia. 4. Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador. 5. Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine Department of Medicine and Diagnostic Support, Federal University of Bahia School of Medicine, Brazil. 6. Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Federal University of Bahia Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador. 7. Weill Cornell Medical College, New York, New York.
Abstract
BACKGROUND: The control of Leishmania braziliensis by individuals with subclinical infection (SC) are unknown. METHODS: A cohort of 308 household contacts (HCs) of patients with cutaneous leishmaniasis (CL) was established in 2010 in an endemic area and followed up for 5 years. Whole-blood cultures stimulated with soluble Leishmania antigen and a Leishmania skin test (LST) were performed in years 0, 2, and 4. The identification of the lymphocyte subsets secreting interferon (IFN) γ and the ability of monocytes to control Leishmania were determined. RESULTS: During follow-up, 118 subjects (38.3%) had evidence of L. braziliensis infection. Of the HCs, CL was documented in 45 (14.6%), 101 (32.8%) had SC infection, and 162 (52.6%) did not have evidence of exposure to L. braziliensis The ratio of infection to disease was 3.2:1. IFN-γ production, mainly by natural killer cells, was associated with protection, and a positive LST result did not prevent development of disease. Moreover, monocytes from subjects with SC infection were less permissive to parasite penetration and had a greater ability to control L. braziliensis than cells from patients with CL. CONCLUSIONS: Protection against CL was associated with IFN-γ production, negative LST results, impaired ability of Leishmania to penetrate monocytes, and increased ability to control Leishmania growth.
BACKGROUND: The control of Leishmania braziliensis by individuals with subclinical infection (SC) are unknown. METHODS: A cohort of 308 household contacts (HCs) of patients with cutaneous leishmaniasis (CL) was established in 2010 in an endemic area and followed up for 5 years. Whole-blood cultures stimulated with soluble Leishmania antigen and a Leishmania skin test (LST) were performed in years 0, 2, and 4. The identification of the lymphocyte subsets secreting interferon (IFN) γ and the ability of monocytes to control Leishmania were determined. RESULTS: During follow-up, 118 subjects (38.3%) had evidence of L. braziliensisinfection. Of the HCs, CL was documented in 45 (14.6%), 101 (32.8%) had SC infection, and 162 (52.6%) did not have evidence of exposure to L. braziliensis The ratio of infection to disease was 3.2:1. IFN-γ production, mainly by natural killer cells, was associated with protection, and a positive LST result did not prevent development of disease. Moreover, monocytes from subjects with SC infection were less permissive to parasite penetration and had a greater ability to control L. braziliensis than cells from patients with CL. CONCLUSIONS: Protection against CL was associated with IFN-γ production, negative LST results, impaired ability of Leishmania to penetrate monocytes, and increased ability to control Leishmania growth.
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