Caracterização dos aspectos imunológicos na Leishmaniose Recidiva Cútis

Abstract

INTRODUCTION: Considered a rare condition of Cutaneous Leishmaniasis, Cutaneous Recurrent Leishmaniasis (LCR) is characterized by nodular lesions around or within the scar of an ulcer previously produced by Leishmania spp., with late onset and long lasting. OBJECTIVE: To characterize cytokines, chemokines and immune memory T cells in patients with LRC and LCL. MATERIALS AND METHODS: The sample group is represented by 36 patients with LRC and 36 with LCL, diagnosed as positive by the parasitological test and the Montenegro test. Cytokines from the “inflammatory” (IL-1β, IL-8, IL-10, and IL-12p40), “Th1/ Th2/ IL 17” (IL2, IL-4, IL-6, TNF, IFN and IL17) and "chemokines" (Rantes, MIG, MCP-1 and IP-10) using plasma and in vitro Cytometric Bead Array (CBA) kits. For extracellular labeling of memory cells specific fluorescence-conjugated monoclonal antibodies were used for cell characterization molecules (CD4+ or CD8+). For the panel was inserted the marking for memory cells CD45RO+ and CCR7+ (naive, effector memory (TME), central memory (TMC) and effector cells); cell activation molecules (CD25, CD69 and HLA-DR) and adhesion molecules (CD62Llow and CD62high). Samples were purchased from FACS Fortessa (BD) and analyzed on GraphPad. RESULTS: The plasma cytokines dosed in the “inflammatory” and “Th1/ Th2/IL-17” kits in LRC and LCL were higher among active or healed individuals than healthy controls. In LRC IL-8 and IL-12p40 presented significance only of the cured in relation to healthy controls. In vitro, in the “Th1/Th2/ IL-17” kit, no differences were evidenced when analyzing the clinical forms alone (active versus cured) and neither (LRC versus LCL). IL-8 levels in LRC and LCL were higher among active and cured after stimulation with Leishmania braziliensis. Comparing LRC versus LCL MIG (CXCL9) and IP-10 (CXCL10), responsible for cellular recruitment to the site of infection, were decreased in the plasma of individuals with active lesion. No difference was detected between clinical forms in CD45RO+ expression in immune memory T lymphocytes (CD4+ and CD8+). The markers of CD25 activation (intermediate activation) and HLA-DR (late activation) showed lower expression in patients with LRC compared to those active by LCL, and CD4+ and CD8+ T cells of patients with LRC compared to patients. LCL showed lower CD62Llow expression, higher amount of CD62Lrigh and lower number of TME cells in peripheral blood. CONCLUSÕES: Our data suggest that in LRC, the decrease in IP-10 could be characterized as a biomarker for early identification of this clinical form and may be related to other cellular response events (activation, migration and effector memory), associated with difficult therapeutic response. and resistance to treatment.