Manamperi N H, Oghumu S, Pathirana N, de Silva M V C, Abeyewickreme W, Satoskar A R, Karunaweera N D
Faculty of Medicine, Department of Parasitology, University of Kelaniya, Ragama, Sri Lanka.
Department of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH, USA.
Parasite Immunol. 2017 Mar;39(3). doi: 10.1111/pim.12413.
Cutaneous leishmaniasis in Sri Lanka is a newly established parasitic disease caused by the usually visceralizing Leishmania donovani. Skin lesions manifest as non-itchy, non-tender papules, nodules or ulcers. In situ cytokine expression provides clues for immunopathogenesis of this localized form of disease. Skin biopsies from 58 patients were analyzed for histological appearance and in situ cytokine expression of T-helper 1 (Th1) and T-helper 2 (Th2) cytokines, namely interferon (IFN)-γ, interleukin (IL)-12A, tumor necrosis factor (TNF)-α, IL-4 and IL-10 by real-time RT-PCR. Significant up-regulation of the Th1 cytokine IFN-γ and down-regulation of the Th2 cytokine IL-4 were seen in patients compared to healthy controls. Significantly elevated tissue expression of IFN-γ and TNF-α was seen in lesions that presented later than 6 months from the time of onset, while IL-4 expression was more prominent in lesions that responded poorly to antimony therapy. A prominent Th1 response appears to support resolving of lesions, whereas a Th2-biased milieu tends to favor poor responsiveness to antimony and delayed lesion healing in L. donovani infections in Sri Lanka.
斯里兰卡的皮肤利什曼病是一种新发现的寄生虫病，由通常会引起内脏病变的杜氏利什曼原虫引起。皮肤病变表现为无瘙痒、无压痛的丘疹、结节或溃疡。原位细胞因子表达为这种局部疾病的免疫发病机制提供了线索。对58例患者的皮肤活检组织进行分析，通过实时逆转录聚合酶链反应检测其组织学外观以及辅助性T细胞1（Th1）和辅助性T细胞2（Th2）细胞因子，即干扰素（IFN）-γ、白细胞介素（IL）-12A、肿瘤坏死因子（TNF）-α、IL-4和IL-10的原位细胞因子表达。与健康对照相比，患者体内Th1细胞因子IFN-γ显著上调，Th2细胞因子IL-4下调。在发病6个月后出现的病变中，IFN-γ和TNF-α的组织表达显著升高，而IL-4表达在对锑治疗反应较差的病变中更为突出。在斯里兰卡杜氏利什曼原虫感染中，突出的Th1反应似乎有助于病变的消退，而偏向Th2的环境往往导致对锑的反应较差以及病变愈合延迟。
