Silva Renata V S, Uliana Silvia R B, Yasunaka Jenicer K U Y, Veloso Cláudio S, Sousa Emille, Ferreira Maria M L, Carvalho Vivianne S, Ferreira Gabriel R, Costa Dorcas L, Costa Carlos H N
Laboratório de Leishmanioses, Departamento de Medicina Comunitária, Universidade Federal do Piauí, Teresina 64002-510, PI, Brazil.
Laboratório de Leishmanioses, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo 05508-090, SP, Brazil.
Pathogens. 2024 May 25;13(6):450. doi: 10.3390/pathogens13060450.
Visceral leishmaniasis (VL) results from protozoa and infection. This study investigated whether host factors would explain the relapses. First, susceptibility to amphotericin B of isolates was evaluated in vitro. Then, clinical data and the lipid profile of patients with relapsing and non-relapsing VL were assessed. Susceptibility to amphotericin B was similar between the isolates. CD4+ lymphocytes were reduced in both groups of patients in the first episode and with relapsing VL. Still, the strongest blood cell indicator associated with relapses was low total lymphocyte counts. Total plasma cholesterol, high-density lipoprotein, low-density lipoprotein, and, uniquely, triglycerides of the six individuals in the first episode and twenty-three with relapsing VL were lower in relapsing patients than those in the first episode. Deceased patients had extremely low low-density lipoprotein. After CD4+ decreases, lymphocyte CD8+ reduction is the final stage of immunological failure. The lower lipid concentrations appear to be secondary to the depletion of fat stores by inflammation-induced cachexia and fat exhaustion provoked by the co-occurrence of both diseases, which can finally lead to death.
内脏利什曼病（VL）由原生动物感染所致。本研究调查了宿主因素是否能解释复发情况。首先，在体外评估分离株对两性霉素B的敏感性。然后，评估复发型和非复发型VL患者的临床数据及血脂情况。分离株对两性霉素B的敏感性相似。在首次发作和复发型VL患者中，两组患者的CD4 + 淋巴细胞均减少。不过，与复发相关的最强血细胞指标是总淋巴细胞计数低。首次发作的6例患者和复发型VL的23例患者中，复发患者的总血浆胆固醇、高密度脂蛋白、低密度脂蛋白，以及独特的甘油三酯水平均低于首次发作患者。死亡患者的低密度脂蛋白极低。CD4 + 减少后，淋巴细胞CD8 + 减少是免疫功能衰竭的最后阶段。较低的脂质浓度似乎继发于炎症引起的恶病质导致的脂肪储备消耗以及两种疾病共同发生引起的脂肪耗竭，最终可能导致死亡。
