Laboratory of Transmission, Control and Immunobiology of Infections, Pasteur Institute of Tunis, Tunis, Tunisia.
Université de Tunis El Manar, Tunis, Tunisia.
Front Cell Infect Microbiol. 2018 Nov 13;8:397. doi: 10.3389/fcimb.2018.00397. eCollection 2018.
Zoonotic cutaneous leishmaniasis (ZCL) caused by infection is characterized by different clinical presentations which depend in part on the host factors. In attempt to investigate the impact of the host's immune response in the outcome of the disease, we conducted a prospective study of 453 individuals living in endemic foci of transmission in Central Tunisia. Several factors were assessed at the baseline including (i) the presence of typical scars of ZCL, (ii) hypersensitivity reaction to leishmanin, and (iii) the release of granzyme B (Grz B) by peripheral blood mononuclear cells (PBMC) in response to stimulation with live promastigotes. After one season of parasite's transmission, repeated clinical examinations allowed us to diagnose the new emerging ZCL cases. Heterogeneity was observed in terms of number of lesions developed by each individual as well as their size and spontaneous outcome, which led us to establish the parameter "severity of the disease." The efficacy of the presence of typical ZCL scar, the leishmanin skin test (LST) positive reactivity and the high levels of Grz B (≥2 ng/ml), in the protection against the development of ZCL were 29, 15, and 22%, respectively. However, these factors were more efficient against development of intermediate or severe forms of ZCL. Levels of Grz B >2 ng/ml showed the best efficacy of protection (equals to 72.8%) against development of these forms of ZCL. The association of such parameter with the positivity of the LST exhibited a better efficacy (equals to 83.6%). In conclusion, our results support the involvement of -specific cytotoxic cellular immune response in host protection against -infection. This factor could be of great interest in monitoring the success of vaccination against human leishmaniasis.
人源感染导致的动物源皮肤病（ZCL）具有不同的临床表现，部分取决于宿主因素。为了研究宿主免疫反应对疾病结果的影响，我们对生活在突尼斯中部 传播疫区的 453 名个体进行了前瞻性研究。在基线时评估了几种因素，包括：（i）是否存在 ZCL 的典型疤痕；（ii）对利什曼菌素的超敏反应；以及（iii）外周血单核细胞（PBMC）对活 前鞭毛体刺激后释放颗粒酶 B（Grz B）。在寄生虫传播的一个季节后，反复的临床检查使我们能够诊断出新出现的 ZCL 病例。每个个体发展的病变数量、大小和自发结果存在异质性，这使我们建立了“疾病严重程度”这一参数。存在典型 ZCL 疤痕、利什曼菌素皮肤试验（LST）阳性反应和高水平的 Grz B（≥2ng/ml）对预防 ZCL 的效果分别为 29%、15%和 22%。然而，这些因素对预防中度或重度 ZCL 更为有效。Grz B 水平>2ng/ml 对预防这些类型的 ZCL 显示出最佳的保护效果（相当于 72.8%）。将该参数与 LST 的阳性结果结合起来，表现出更好的保护效果（相当于 83.6%）。总之，我们的结果支持 - 特异性细胞毒性细胞免疫反应在宿主对 - 感染的保护中发挥作用。该因素可能对监测针对人类利什曼病的疫苗接种成功具有重要意义。
