Cellular and humoral immune responses of a patient with American cutaneous leishmaniasis and AIDS.
The lymphocyte responsiveness to leishmanial antigens and its influence on the course of cutaneous leishmaniasis was studied in a patient with AIDS-associated American cutaneous leishmaniasis caused by Leishmania braziliensis. The patient had cutaneous disseminated erythematous papules or nodules and mucosal lesions as well as moniliasis and weight loss. The patient had a poor delayed-type hypersensitivity to leishmanial antigens, showing 3 mm of induration. The cellular immune responses were studied in vitro by lymphocyte proliferative assays induced by leishmanial antigens and concanavalin A. The T cell phenotypes were analysed by flow cytometry. The peripheral blood mononuclear cells before proliferation showed an inversion of the CD4/CD8 ratio (0.28:1). The lymphoproliferative responses to antigen and mitogen were very low (indices < 2.5). The blast-like cell phenotypes after antigen stimulation in culture were: CD3+ 44.8%, CD4+ 7.53% and CD8+ 17.45%. In AIDS patients the decrease in the pool of CD4+ cells, and consequent diminution of the CD4/CD8 ratio, produced by HIV infection provokes a generalized immune depression. The patient's disseminated clinical picture was probably related to the inability of his T cell-mediated immune responses to control the spread of Leishmania infection.
Da-Cruz
A M
AM
Instituto Oswaldo Cruz, Rio de Janeiro, Brazil.
Machado
E S
ES
Menezes
J A
JA
Rutowitsch
M S
MS
Coutinho
S G
SG
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000276:immunology*; D000328:Adult; D000818:Animals; D000953:Antigens, Protozoan / Q000276:immunology*; D016516:CD4-CD8 Ratio; D005455:Fluorescent Antibody Technique; D006801:Humans; D007111:Immunity, Cellular; D007892:Leishmania braziliensis / Q000276:immunology*; D016773:Leishmaniasis, Cutaneous / Q000150:complications / Q000276:immunology*; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male
D000953:Antigens, Protozoan