Moafi Mohammad, Rezvan Hossein, Sherkat Roya, Taleban Roya, Asilian Ali, Zarkesh Esfahani Seyed Hamid, Nilforoushzadeh Mohammad Ali, Jaffary Fariba, Feizi Awat
Faculty of Veterinary Science, Department of Pathobiology, Bu-Ali Sina University, Hamedan, Iran.
Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
BMJ Open. 2017 Jan 27;7(1):e013006. doi: 10.1136/bmjopen-2016-013006.
Seldom cutaneous leishmaniasis (CL) may present as a lasting and active lesion(s), known as a non-healing form of CL (NHCL). Non-functional type 1 T helper (Th1) cells are assumed the most important factor in the outcome of the disease. The present study aims to assess some molecular defects that potentially contribute to Th1 impairment in NHCL.
This prospective observational study will be implemented among five groups. The first and second groups comprise patients afflicted with non-healing and healing forms of CL, respectively. The third group consists of those recovered participants who have scars as a result of CL. Those participants who have never lived or travelled to endemic areas of leishmaniasis will comprise the fourth group. The fifth group comprises participants living in hyperendemic areas for leishmaniasis, although none of them have been afflicted by CL. The aim is to recruit 10 NHCL cases and 30 participants in each of the other groups. A leishmanin skin test (LST) will be performed to assess in vivo immunity against the Leishmania infection. The cytokine profile (interleukin (IL)-12p70, interferon (IFN)-γ, C-X-C motif chemokine ligand (CXCL)-11 and IL-17a) of the isolated peripheral blood mononuclear cells (PBMCs) will be evaluated through ELISA. Real-time PCR will determine the C-X-C motif chemokine receptor (CXCR)-3 and IL-17a gene expression and expression of IL-12Rβ1 will be assessed by flow cytometry. Furthermore, IL-12B and IL-12RB1 mutation analysis will be performed.
It is anticipated that the outcome of the current study will identify IL-12B and IL-12RB1 mutations, which lead to persistent lesions of CL. Furthermore, our expected results will reveal an association between NHCL and pro-inflammatory cytokines (IL-12p70, IFN-γ IL-17a and CXCL-11), as well as CXCR-3 expression.
This study has been approved by a local ethical committee. The final results will be disseminated through peer-reviewed journals and scientific conferences.
皮肤利什曼病(CL)很少会表现为持久且活跃的病变,即所谓的非愈合型皮肤利什曼病(NHCL)。无功能的1型辅助性T细胞(Th1)被认为是影响该病转归的最重要因素。本研究旨在评估一些可能导致NHCL中Th1功能受损的分子缺陷。
本前瞻性观察性研究将在五组人群中开展。第一组和第二组分别为患有非愈合型和愈合型CL的患者。第三组由那些因CL而留有疤痕的康复参与者组成。第四组为从未在利什曼病流行地区生活或旅行过的参与者。第五组为生活在利什曼病高度流行地区但均未患CL的参与者。目标是每组招募10例NHCL病例和30名参与者。将进行利什曼原虫皮肤试验(LST)以评估针对利什曼原虫感染的体内免疫力。通过酶联免疫吸附测定(ELISA)评估分离的外周血单个核细胞(PBMC)的细胞因子谱(白细胞介素(IL)-12p70、干扰素(IFN)-γ、C-X-C基序趋化因子配体(CXCL)-11和IL-17a)。实时聚合酶链反应(PCR)将测定C-X-C基序趋化因子受体(CXCR)-3和IL-17a基因表达,通过流式细胞术评估IL-12Rβ1的表达。此外,将进行IL-12B和IL-12RB1突变分析。
预计本研究结果将鉴定出导致CL持续性病变的IL-12B和IL-12RB1突变。此外,我们预期的结果将揭示NHCL与促炎细胞因子(IL-12p70、IFN-γ、IL-17a和CXCL-11)以及CXCR-3表达之间的关联。
本研究已获当地伦理委员会批准。最终结果将通过同行评审期刊和科学会议进行传播。