Nogueira Marcia Ferraz, Goto Hiro, Sotto Mírian Nacagami, Cucé Luiz Carlos
Departamento de Dermatologia, Faculdade de Medicina, Universidade de Santo Amaro, São Paulo, Brasil.
Rev Inst Med Trop Sao Paulo. 2008 Nov-Dec;50(6):333-7. doi: 10.1590/s0036-46652008000600004.
American tegumentary leishmaniasis presents as two major clinical forms: localized cutaneous leishmaniasis (LCL) and mucocutaneous leishmaniasis (MCL). The immune response in leishmaniasis is efficiently evaluated by the response to Leishmania antigen through the Montenegro skin test (MST). Both LCL and MCL present positive response to MST, indicating that the patients present cell-mediated immunity against the parasite - Leishmania. In spite of the presence of immunity in MCL, this is not sufficient to stop disease progression and prevent resistance to treatment. In this study we demonstrated interleukin (IL) 2, 4, 5 and interferon (IFN) gamma expression in biopsies of MST of ten patients with American tegumentary leishmaniasis. The obtained results were compared between LCL (n = 5) and MCL (n = 5) patients. The MST of MCL patients displayed a higher expression of IL-2, IL-4 and IL-5, in comparison to LCL. There was no significant difference in IFN-gamma expression between groups. The obtained results suggest the role of IL-4 and IL-5 in the maintenance of the immunopathogenic mechanism of the destructive lesions that characterize MCL.
局限性皮肤利什曼病（LCL）和黏膜皮肤利什曼病（MCL）。通过黑热病皮肤试验（MST）对利什曼原虫抗原的反应可有效评估利什曼病中的免疫反应。LCL和MCL对MST均呈阳性反应，表明患者存在针对寄生虫利什曼原虫的细胞介导免疫。尽管MCL存在免疫力，但这不足以阻止疾病进展和防止对治疗产生耐药性。在本研究中，我们在10例美洲皮肤利什曼病患者的MST活检中检测到白细胞介素（IL）2、4、5和干扰素（IFN）γ的表达。将所得结果在LCL（n = 5）和MCL（n = 5）患者之间进行比较。与LCL相比，MCL患者的MST显示出更高的IL-2、IL-4和IL-5表达。两组之间IFN-γ表达无显著差异。所得结果提示IL-4和IL-5在维持以MCL为特征的破坏性病变的免疫致病机制中发挥作用。
