A case of conventional treatment failure in visceral leishmaniasis: leukocyte distribution and cytokine expression in splenic compartments

BMC Infectious Diseases

Carlos HN Costa²  Luiz AR de Freitas¹  Maria IS Duarte³  Tulio Souza⁴  João de J Coutinho Jr²  Thiago LV e Silva²  Valter A Almeida¹  Lina G Santos²  Carla Pagliari³  Washington LC dos-Santos¹ 

[1] Fundação Oswaldo Cruz, Centro de Pesquisas Gonçalo Moniz, Salvador, BA, Brazil;Universidade Federal do Piauí, Instituto de Doenças Tropicais Natan Portela, Teresina, PI, Brazil;Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil;Hospital Aliança, Salvador, BA, Brazil

关键词: Leishmania chagasi;    Leishmania infantum;    Leukocyte populations;    Cytokines;    Spleen;    Visceral leishmaniasis;   

Others  :  1125598
DOI  :  10.1186/1471-2334-14-491

 received in 2014-05-15, accepted in 2014-09-02,  发布年份 2014

【 摘 要 】

Background

In this paper we study the distribution of leukocyte populations and of cytokine-producing cells in the spleen of a patient with visceral leishmaniasis resistant to clinical treatment. It is the first attempt to compare the distribution of leukocyte populations and cytokine-producing cells in the splenic compartments of a patient with visceral leishmaniasis with those observed in patients without the disease.

Case presentation

A 25-year-old male, farmer, was hospitalized on several occasions with diagnosis of visceral leishmaniasis and received all recommended treatments for the disease with only transient improvement followed by relapse. He was eventually subjected to splenectomy in order to control the effects of hypersplenism and to potentially overcome infection. After surgery and combined chemotherapy, the disease evolved to cure. In comparison with the spleens of the other two patients without visceral leishmaniasis, an increase was observed in the CD4/CD8 ratio and in the number of IL-10- and FoxP3-producing cells, while the number of IL-17-producing cells was lower in the spleen of the patient with visceral leishmaniasis.

Conclusion

This report confirms previous data on changes in the CD4/CD8 ratio in the spleens of patients with visceral leishmaniasis. Additionally the data presented herein suggests that splenic FoxP3- and IL-17-producing cells are involved in the chronicity of visceral leishmaniasis.

【 授权许可】

   
2014 dos-Santos et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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