Parasite Immunol. 2021 Sep 24:e12880. doi: 10.1111/pim.12880. Online ahead of print.
ABSTRACT
BACKGROUND: Visceral leishmaniasis (VL) is a serious public health problem. The factors that can determine whether VL develops and progresses to severe form have not been fully identified, but a specific cellular immune response appears to play a key role. Therefore, understanding immunopathogenesis can be useful in preventing a serious clinical outcome.
MATERIALS AND METHODS: Bone marrow samples were collected from patients with severe (SVL) or non-severe VL (NSVL). Cytokine levels and parasitic load were analyzed by RT-qPCR. There is a statistically significant difference in the leukocyte parameter in patients with SVL and NSVL compared to the control patients (p=0.006 and p=0.014, respectively).
RESULTS: Urea, alanine transaminase and albumin parameters had a significant difference p=0.036, p=0.039 and p=0.017, respectively, between SVL and NSVL. Although high levels of IFN-γ, IL-10, IL-6 and TNF-α were present in all groups of individuals with VL, they were not statistically associated with severity. In patients with active VL, IFN-γ and IL-10 were associated, respectively, with a reduction and increase in the parasite load, strong and significant positive association between IFN-γ and IL-10 (rho=0.627 and p=0.003).
CONCLUSION: This study demonstrates that VL stimulates an non-dichotomized inflammatory response between Th1/Th2 and that bone marrow is an important tissue for immune regulation.
PMID:34558674 | DOI:10.1111/pim.12880
