Mansueto P, Vitale G, Di Lorenzo G, Rini G B, Mansueto S, Cillari E
Dipartimento di Medicina Clinica e delle Patologie Emergenti, University of Palermo, Palermo, Italy.
Int J Immunopathol Pharmacol. 2007 Jul-Sep;20(3):435-45. doi: 10.1177/039463200702000302.
Leishmaniasis represents a severe, increasing, public health problem. The perspective of its control is highly dependent on research progress, on therapeutic manipulations of the immune system, and on vaccine development. There is a correlation between the clinical outcome of Leishmania infection and the cytokine response profile. While a protective immune response against Leishmania has been clearly identified to be related to the influence of a type-1 response and IFN-gamma production, the precise role of T helper (TH) 2 cytokines in non-healing infections requires further exploration. IL-4 and IL-13 (TH2 cytokines) can promote disease progression in cutaneous leishmaniasis, whereas IL-4 would appear to enhance protective type-1 responses in visceral leishmaniasis. Thus, the TH1/TH2 paradigm of resistance/susceptibility to intracellular parasites is probably an oversimplification of a more complicated network of regulatory/counter regulatory interactions. Moreover, the presence of antigen specific regulatory T cell subsets may provide an environment that contributes to the balance between TH1 and TH2 cells. Finally, the involvement of CD8 positive T cells has been described, but the modality of their function in this kind of infection has not been so far elucidated.
利什曼病是一个严重且日益严重的公共卫生问题。其控制前景高度依赖于研究进展、免疫系统的治疗性操作以及疫苗开发。利什曼原虫感染的临床结果与细胞因子反应谱之间存在关联。虽然已明确针对利什曼原虫的保护性免疫反应与1型反应和干扰素-γ产生的影响有关，但辅助性T（TH）2细胞因子在不愈合感染中的精确作用仍需进一步探索。白细胞介素-4和白细胞介素-13（TH2细胞因子）可促进皮肤利什曼病的疾病进展，而白细胞介素-4似乎可增强内脏利什曼病中的保护性1型反应。因此，对细胞内寄生虫抗性/易感性的TH1/TH2模式可能过于简化了一个更为复杂的调节/反调节相互作用网络。此外，抗原特异性调节性T细胞亚群的存在可能提供了一个有助于TH1和TH2细胞之间平衡的环境。最后，已描述了CD8阳性T细胞的参与，但迄今为止尚未阐明它们在这种感染中的功能方式。
