Vaccinations against cutaneous Leishmania infection

Cutaneous leishmaniasis is an endemic disease with increasing incidence, even in Europe. Recently, it has attracted more attention due to reactivation in immunocompromised hosts, e.g. in the context of HIV. Therapeutic options range from topical treatment to systemic therapy for more complex cases. A vaccine does not exist at present. Despite of several attempts, vaccine generation has proven to be difficult even though protective immunity against this obligate intracellular protozoan parasite is dependent on the development of antigen-specific CD4+ and CD8+ T cells capable of releasing IFN?. IFN?, in turn, activates phagocytic host cells to generate oxidative radicals and to eliminate the parasite. This review will describe the basic immunology leading to the development of protective immunity in infected individuals. In addition, the authors will focus on highlighting the different approaches utilized for vaccine development and describe what a efficient vaccine may consist of. Combined intensive research in the fields of basic parasitology and immunology may allow for the generation of an efficacious vaccine against this important human pathogen in the near future.