lmmune cell response in American cutaneous leishmaniasis

Abstract

In leishmaniasis, macrophages can act as antigen presenting cells, activating T cells which participate in parasite elimination. Activated T-cells induce the production of the cytokines which mediate the disease's resolution (Thl response) or exacerbation (Th2 response). Some cytokines, such as IFN?, help to control the disease, whilst IL-4 and IL-10 promote disease progression. The mouse model has shown a clear dichotomy in immune response associated with the development and progression or resolution of the disease. By contrast, a mixed response involving Thl and Th2 cytokines is obsetved in humans. The disease is the result of the interaction of different factors, such as the Leishmania specie and its virulence, combined with the host's immune response, leading to the presentation of different clinical types, such as cutaneous, mucocutaneous, diffuse and visceral leishmaniasis, al1 being associated with particular species. Yet, under special circumstances, a single species may cause any of these disease forms. Antimonial pentavalent compounds (SbV) are the first-line treatment for leishmaniasis, although immunotherapy is considered as an alternative for treatment of the disease. Furthermore, the development of vaccines against leishmaniasis could become an important means of controlling the disease in endemic areas. Therefore, an understanding of the immune response in the pathogenesis and resolution of leishmaniasis is fundamental for its clinical management and prevention.