Sharma Umakant, Singh Sarman
Division of Clinical Microbiology, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi 110 029, India.
Indian J Exp Biol. 2009 Jun;47(6):412-23.
Leishmaniasis is a parasitic disease caused by various species of Leishmania, a unicellular kinetoplastid protozoan flagellate. It manifests mainly in 3 clinical forms; visceral leishmaniasis (VL), cutaneous leishmaniasis (CL) and mucocutaneous leishmaniasis (MCL), of which VL is the most severe form of the disease. VL is lethal if untreated and spontaneous cure is extremely rare. Cutaneous leishmaniasis usually has milder course and often results into a self-healing of ulcers. Resolution of leishmanial infection is dependent on the coordinated interactions between components of cell mediated immune response, specifically the activation of targeted T-cell populations for appropriate cytokine production and activation of macrophages. In murine model, the development of Thl response is associated with control of infection, and Th2 response is associated with disease progression. However, Th1 and Th2 dichotomy in the human system is not as distinct as in mice and the murine model does not strictly apply to human leishmaniasis. This review focuses the dichotomy of immune response against various clinical forms of the disease. An in-depth knowledge of sequences involved in the immune response to the parasite would help in designing prophylactic and therapeutic strategies against leishmaniasis.
利什曼病是由利什曼原虫属的各种物种引起的一种寄生虫病，利什曼原虫属是一种单细胞动基体原生动物鞭毛虫。它主要表现为三种临床形式：内脏利什曼病（VL）、皮肤利什曼病（CL）和黏膜皮肤利什曼病（MCL），其中VL是该病最严重的形式。未经治疗的VL是致命的，自然治愈极为罕见。皮肤利什曼病通常病程较轻，溃疡常可自愈。利什曼原虫感染的消退取决于细胞介导免疫反应各成分之间的协同相互作用，特别是靶向T细胞群体的激活，以产生适当的细胞因子并激活巨噬细胞。在小鼠模型中，Th1反应的发展与感染的控制有关，而Th2反应与疾病进展有关。然而，人类系统中的Th1和Th2二分法并不像小鼠那样明显，小鼠模型并不完全适用于人类利什曼病。本综述重点关注针对该疾病各种临床形式的免疫反应二分法。深入了解针对该寄生虫的免疫反应中涉及的序列，将有助于设计针对利什曼病的预防和治疗策略。
