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Cutaneous Leishmaniasis: The Complexity of Host's Effective Immune Response against a Polymorphic Parasitic Disease
Áurea Gabriel1, Ana Valério-Bolas1, Joana Palma-Marques1
1Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Rua da Junqueira 100, 1349-008 Lisboa, Portugal.
Insights
Cutaneous leishmaniasis (CL) is a neglected tropical disease causing disfiguring skin lesions. Understanding the immune response is crucial for controlling this widespread parasitic infection.
Area of Science:
- Immunology
- Tropical Medicine
- Parasitology
Background:
- Cutaneous leishmaniasis (CL) is a zoonotic infection caused by *Leishmania* parasites, presenting polymorphic clinical manifestations.
- CL lesions can lead to permanent disfigurement and significant psychosocial and economic burdens.
- Leishmaniasis is a neglected tropical disease with 1.0-1.5 million new cases annually and substantial disability-adjusted life years (DALYs) lost.
Purpose of the Study:
- To provide a comprehensive review of the immune responses against *Leishmania* parasites in CL.
- To outline the current understanding of host innate and acquired immunity in CL.
- To highlight the importance of accurate diagnosis and patient management for CL control.
Main Methods:
- Review of existing literature on host-parasite interactions in CL.
- Analysis of data from animal models and in vitro studies.
- Synthesis of knowledge on immune mechanisms involved in cutaneous leishmaniasis.
Main Results:
- The immune response to *Leishmania* is complex, involving both innate and acquired immunity.
- Animal models and in vitro studies have advanced the understanding of parasite-host interplay.
- Accurate diagnosis and effective patient management are critical for reducing CL incidence.
Conclusions:
- Effective control strategies for CL are challenging due to complex epizoology and lack of vaccines or preventive drugs.
- Further research into immune mechanisms is needed to develop better interventions.
- Integrated approaches focusing on diagnosis, management, and understanding host immunity are essential for CL control.
Abstract:
This review is aimed at providing a comprehensive outline of the immune response displayed against cutaneous leishmaniasis (CL), the more common zoonotic infection caused by protozoan parasites of the genus Leishmania. Although of polymorphic clinical presentation, classically CL is characterized by leishmaniotic lesions on the face and extremities of the patients, which can be ulcerative, and even after healing can lead to permanent injuries and disfigurement, affecting significantly their psychological, social, and economic well-being. According a report released by the World Health Organization, the disability-adjusted life years (DALYs) lost due to leishmaniasis are close to 2.4 million, annually there are 1.0-1.5 million new cases of CL, and a numerous population is at risk in the endemic areas. Despite its increasing worldwide incidence, it is one of the so-called neglected tropical diseases. Furthermore, this review provides an overview of the existing knowledge of the host innate and acquired immune response to cutaneous species of Leishmania. The use of animal models and of in vitro studies has improved the understanding of parasite-host interplay and the complexity of immune mechanisms involved. The importance of diagnosis accuracy associated with effective patient management in CL reduction is highlighted. However, the multiple factors involved in CL epizoology associated with the unavailability of vaccines or drugs to prevent infection make difficult to formulate an effective strategy for CL control.
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