Infectious Diseases and Immunology, Indian Institute of Chemical Biology, West Bengal, India.
Rev Soc Bras Med Trop. 2013 Mar-Apr;46(2):128-34. doi: 10.1590/0037-8682-0022-2012.
Visceral leishmaniasis (VL) or kala-azar, a disseminated infection of the lymphoreticular system of the body, is marked by severe defect in immune system of the host. Successful cure of VL depends on the immune status of the host in combination with the effects of the antileishmanial drugs. The rationale approach towards eradication of this disease would be to potentiate the immune functioning of the host in addition to parasite killing. This review deals with different aspects of adaptive and innate immune responses and explores their role in protection or pathogenesis of VL. IL-10 has emerged as the principal cytokine responsible for disease pathogenesis, although evidences regarding its source during active VL remain inconclusive. On the other hand, IFNγ,under the influence of IL-12, is mostly correlated with healing of the disease. Chemokines are important in mounting cell-mediated immune response as they can prevent parasite invasion in association with cytokines. Different types of T cells like CD4, CD8 and NK T cells also contribute to the immunology of this disease. In spite of conflicting reports, the role of regulatory T cells in VL pathogenesis is important. Recently discovered Th17 subset and its different members have been reported to perform diverse functions in the course of VL and leishmaniasis as a whole. Innate immune responses, depending on the cell types, are essential in early parasite detection and subsequent development of an efficient NK cell response. Immunotherapy targeting IL-10 could be looked upon as an interesting option for the treatment of VL.
内脏利什曼病（VL）或黑热病，是一种身体淋巴网状系统的弥散性感染，其特征是宿主免疫系统严重缺陷。VL 的成功治愈取决于宿主的免疫状态以及抗利什曼原虫药物的作用。消除这种疾病的合理方法是增强宿主的免疫功能，同时杀死寄生虫。这篇综述涉及适应性和固有免疫反应的不同方面，并探讨了它们在保护或 VL 发病机制中的作用。IL-10 已成为导致疾病发病机制的主要细胞因子，尽管关于其在活动性 VL 期间的来源的证据仍不确定。另一方面，IFNγ在 IL-12 的影响下，与疾病的治愈大多相关。趋化因子在引发细胞介导的免疫反应中很重要，因为它们可以与细胞因子一起防止寄生虫入侵。不同类型的 T 细胞，如 CD4、CD8 和 NK T 细胞，也有助于这种疾病的免疫学。尽管存在相互矛盾的报告，但调节性 T 细胞在 VL 发病机制中的作用很重要。最近发现的 Th17 亚群及其不同成员已被报道在 VL 及整个利什曼病的病程中发挥不同的功能。根据细胞类型，固有免疫反应对于早期寄生虫检测和随后发展有效的 NK 细胞反应至关重要。针对 IL-10 的免疫疗法可能被视为治疗 VL 的一种有趣选择。
