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Cellular infiltrate in cutaneous leishmaniasis lesions and therapeutic outcome
Camila Sampaio Ribeiro1, Riam Rocha França2, Juliana Almeida Silva1
1Universidade Federal da Bahia, Salvador, BA, Brazil.
Background:
The treatment of cutaneous leishmaniasis is a challenge. A better understanding of the in situ mechanisms involved in the evolution and cure of the disease is essential for the development of new therapies.
Objective:
Correlate histopathological and immunological characteristics of cutaneous leishmaniasis lesions with clinical outcome after different treatment regimens.
Methods:
The authors analyzed cellular infiltration and immunohistochemistry staining for CD4, CD8 and IL-17 in biopsy samples from 33 patients with cutaneous leishmaniasis before treatment. All patients were recruited in a randomized clinical trial at Corte de Pedra (Bahia-Brazil) and assigned to receive Glucantime®, Glucantime® + Oral Tamoxifen or Glucantime® + Topical Tamoxifen. Patients were followed for 2 to 6 months to define disease outcome.
Results:
A similar expression of CD4, CD8 and IL-17 was observed in lesion samples regardless of clinical outcome. In general, a higher amount of CD8 cells were observed compared with CD4 cells. An important observation was that all patients whose cellular infiltrate did not contain plasma cells were cured after treatment.
Study Limitations:
Isolated quantification of TCD8 and IL-17 using immunohistochemistry is insufficient to analyze the role of these molecules in the immunopathogenesis of cutaneous leishmaniasis. In addition, the expansion of the immunohistochemistry panel would allow a more complete analysis of the immune response in situ.
Conclusions:
The absence of plasma cells in cutaneous leishmaniasis lesions was related to a favorable therapeutic outcome.
Insights
The absence of plasma cells in cutaneous leishmaniasis lesions indicates successful treatment outcomes. Further analysis of immune responses in situ is needed for better therapeutic strategies.
Area of Science:
- Immunology
- Dermatology
- Tropical Medicine
Background:
- Cutaneous leishmaniasis treatment presents significant challenges.
- Understanding in situ disease mechanisms is crucial for developing novel therapies.
Purpose of the Study:
- To correlate histopathological and immunological features of cutaneous leishmaniasis lesions with clinical outcomes following various treatment regimens.
Main Methods:
- Analysis of cellular infiltration and immunohistochemistry for CD4, CD8, and IL-17 in biopsy samples from 33 patients.
- Patients received Glucantime®, Glucantime® + Oral Tamoxifen, or Glucantime® + Topical Tamoxifen.
- Clinical outcomes were assessed over a 2 to 6-month follow-up period.
Main Results:
- CD4, CD8, and IL-17 expression levels did not significantly correlate with clinical outcomes.
- CD8 cell counts were generally higher than CD4 cell counts.
- Patients without plasma cells in their lesions achieved complete cure.
Conclusions:
- Quantifying TCD8 and IL-17 alone is insufficient for understanding cutaneous leishmaniasis immunopathogenesis.
- Expanding immunohistochemistry panels can provide a more comprehensive analysis of the immune response.
- Absence of plasma cells in lesions is linked to favorable treatment outcomes.
