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Comparative cellular immune host response in acute vs healed lesions of cutaneous leishmaniasis
Simeen Ber Rahman1, Arfan ul Bari
1Dermatology Department, Military Hospital, Rawalpindi.
Insights
Cellular immune responses, particularly Natural Killer (NK) cells and gamma delta T cells, are crucial in controlling cutaneous leishmaniasis (CL). These cells appear vital for limiting disease progression and parasite elimination in active CL cases.
Area of Science:
- Immunology
- Dermatology
- Infectious Diseases
Background:
- Cutaneous leishmaniasis (CL) poses a significant public health challenge in Pakistan.
- Research is focusing on understanding the host immune response, clinical correlations, and management implications of CL.
- This study aimed to evaluate the cellular immune response in active and healed CL patients.
Purpose of the Study:
- To characterize the cellular immune response in patients with active and healed cutaneous leishmaniasis.
- To explore the role of specific immune cells in disease limitation and parasite elimination.
- To identify potential implications for preventing leishmaniasis in susceptible individuals.
Main Methods:
- A cross-sectional, comparative study was conducted involving biopsies from active and healed CL lesions.
- Immunophenotyping of cells using monoclonal antibodies was performed on processed skin biopsies.
- Total and differential T cell counts were analyzed, with statistical comparisons using the Kruskal-Wallis Test.
Main Results:
- Significant differences in total cell counts, CD3+ T cells, and CD57+ (NK) cells were observed between active CL, healed lesions, and normal skin (p < 0.001).
- Healed lesions showed no significant difference from normal skin, except for CD3+ cells (p < 0.05).
- CD4+, CD8+, and CD19+ (plasma cell) counts did not show significant differences across groups.
Conclusions:
- Natural Killer (NK) cells and gamma delta T cells are implicated in limiting CL and eliminating the parasite.
- These specific immune cells appear to play a key role in the resolution of acute cutaneous leishmaniasis.
Background:
Cutaneous leishmaniasis (CL) has become a major public health problem in Pakistan and research is now focused to characterize the host's immune response, its clinical correlation and subsequent implications in management in this disease. This study was done to evaluate cellular immune host response in patients with active and healed CL and its possible implications in prevention of disease in susceptibles.
Methods:
This cross sectional and comparative study was conducted in Armed Forces Institute of Pathology (AFIP) and Military Hospital (MH) Rawalpindi (1998-2000). 30 biopsies of active skin lesions and 15 biopsies from healed lesions, after processing, were studied for various immunophenotype cells by using monoclonal antibodies. Total and differential T cell counts were recorded in these skin tissues. Non parametric Kruskal-Wallis Test for one way ANOVA was used to compare the median cell counts between active, healed and normal skin and p-value < 0.05 was considered significant.
Results:
The total cell counts, CD3+ cells and CD57+ (NK) cells were found statistically different (p = < 0.001) when active forms of the disease were compared with healed lesions and normal skin tissue. The difference was not significant (p = > 0.05) on comparing healed lesions with normal skin tissue biopsies except in case of CD3+ cell counts (p = < 0.05). However, CD4+, CD8+ and CD19+ (Plasma cells) counts were never seen significant (p = > 0.05) on comparison.
Conclusion:
NK cells and gamma delta cells seem to be responsible for limitation of the disease and elimination of the parasite from the lesion in cases of acute cutaneous leishmaniasis.
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