Mechanisms of Immune Evasion, Dissemination, and Persistence in Leishmania amazonensis Infection

Leishmania amazonensis is one of the etiological agents of cutaneous leishmaniasis in its localised form. Moreover, this parasite can cause more severe disease conditions, such as diffuse and disseminated cutaneous leishmaniasis. The development of more severe clinical manifestations is associated with the parasite's ability to establish a chronic infection and disseminate to cutaneous tissues distal to the site of primary infection. This ability is dependent on host immune factors but is also influenced by intrinsic factors of the parasite related to pathogenicity and evasion of the immune system. This review discusses immunological and parasitological factors associated with the latency and dissemination of L. amazonensis infection and the consequent development of severe forms of cutaneous disease.