Polyclonal B cell activation, circulating immune complexes and autoimmunity in human american visceral leishmaniasis

In a prospective study, serum and plasma samples from 17 patients with kala-azar were collected in Rio de Janeiro. High levels of immune complexes (IC) were detected in serum by means of 125I-Clq and conglutinin binding assays. The Clq binding material had a sedimentation coefficient of 19-25S, as determined by ultracentrifugation on sucrose gradient. Plasma levels of C3 and C3 breakdown products were measured and the C3d levels were increased in six out of 11 patients. The occurrence of polyclonal B cell activation was suggested by (a) a marked increase of serum IgG and IgM levels and (b) of the presence of antibodies against various proteins and haptens (SRBC, DNP-BSA, FITC-BSA,KLH). There was a close association between the presence of IC and anti-immunoglobulin antibodies. Anti-smooth muscle antibodies were also observed. These data are consistent with a major role of polyclonal B cell activation in the induction of IC during visceral leishmaniasis.