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Conundrums in leishmaniasis.

Baibaswata Saha1, Surajit Bhattacharjee2, Arup Sarkar3

  • 1Centre of Advanced Study, Department of Zoology, Savitribai Phule Pune University, Pune 411007, India.

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Summary

Leishmaniasis presents paradoxes, from sandfly saliva

Keywords:
Immune responseLeishmaniasisPKDLParadoxT-cells

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Area of Science:

  • Immunology and Parasitology
  • Infectious Diseases

Background:

  • Leishmaniasis, caused by Leishmania parasites, presents complex immunological challenges.
  • The transmission by sandfly vectors and the host's immune response create unresolved paradoxes in disease progression and resolution.

Purpose of the Study:

  • To explore the immunological paradoxes in leishmaniasis, from initial skin infection to visceralization and post-treatment recurrence.
  • To understand the roles of neutrophils, macrophages, and T-helper cells in disease outcome and the pathogenesis of post-kala azar dermal leishmaniasis (PKDL).

Main Methods:

  • Review and synthesis of existing knowledge on the host-parasite interactions in leishmaniasis.
  • Analysis of immune cell dynamics, including neutrophils, macrophages, and T-cell subsets, during different stages of the disease.

Main Results:

  • Neutrophils can act as 'Trojan Horses,' facilitating parasite spread.
  • Granuloma formation serves dual roles in containment and immunopathogenesis.
  • T-helper cell differentiation paradoxically influences cure or non-cure outcomes in visceral leishmaniasis.

Conclusions:

  • Leishmaniasis pathogenesis is characterized by intricate immune responses and paradoxes.
  • Understanding these paradoxes is crucial for developing effective therapeutic strategies and managing disease recurrence like PKDL.