Treatment of two patients with diffuse cutaneous leishmaniasis caused by Leishmania mexicana modifies the immunohistological profile but not the disease outcome.

Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.

Treatment of two patients with diffuse cutaneous leishmaniasis caused by Leishmania mexicana modifies the immunohistological profile but not the disease outcome.

Trop Med Int Health. 1999 Dec;4(12):801-11. Unique Identifier : AIDSLINE MED/20098847
Salaiza-Suazo N; Volkow P; Tamayo R; Moll H; Gillitzer R; Perez-Torres A; Perez-Montfort R; Dominguez JD; Velasco-Castrejon O; Crippa M; Becker I; Departamento de Medicina Experimental, Faculdad de Medicina,; UNAM, Mexico.

Abstract: Two patients with diffuse cutaneous leishmaniasis caused by Leishmania mexicana were treated with two leishmanicidal drugs (pentamidine and allopurinol) combined with recombinant interferon-gamma restoring Th-1 favouring conditions in the patients. Parasites decreased dramatically in the lesions and macrophages diminished concomitantly, while IL-12-producing Langerhans cells and interferon-gamma- producing NK and CD8 + lymphocytes increased in a reciprocal manner. The CD4+/CD8 + ratio in the peripheral blood normalized. During exogenous administration of interferon-gamma the parasites' capacity to inhibit the oxidative burst of the patients' monocytes was abolished. Even though Th-1-favouring conditions were restored, both patients relapsed two months after therapy was discontinued. We conclude that the tendency to develop a disease-promoting Th-2 response in DCL patients is unaffected by, and independent of, parasite numbers. Even though intensive treatment in DCL patients induced Th-1 disease restricting conditions, the disease-promoting immunomodulation of few persistent Leishmania sufficed to revert the immune response.

Keywords: JOURNAL ARTICLE Allopurinol/THERAPEUTIC USE Animal Antimetabolites/THERAPEUTIC USE Antiprotozoal Agents/*THERAPEUTIC USE CD4-CD8 Ratio/DRUG EFFECTS Drug Therapy, Combination Human Interferon-gamma, Recombinant/*THERAPEUTIC USE Killer Cells, Natural/DRUG EFFECTS/IMMUNOLOGY Langerhans Cells/*DRUG EFFECTS/IMMUNOLOGY/PARASITOLOGY *Leishmania mexicana Leishmaniasis, Diffuse Cutaneous/*DRUG THERAPY/*IMMUNOLOGY/ PATHOLOGY Pentamidine/*THERAPEUTIC USE Respiratory Burst/DRUG EFFECTS/IMMUNOLOGY Support, Non-U.S. Gov't Treatment Outcome

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