title: Administration of recombinant interleukin-2 reduces the local parasite load of patients with disseminated cutaneous leishmaniasis.
abstract: Three patients with disseminated cutaneous leishmaniasis received three intranodular injections of 10 micrograms of recombinant interleukin 2 (rIL-2) at 48-h intervals. After 7 and 14 days, 4-mm punch biopsies were taken of control and injected nodules and processed for histology, electron microscopy, immunocytochemistry, and parasite culture. Control sites exhibited loose infiltrates of parasitized macrophages and T cells predominantly of the CD8+ phenotype. Amastigotes were present in large numbers and were found distributed within tightly apposed endosomes and larger vacuoles. After the administration of rIL-2, there was a prominent influx of T cells, predominantly of the CD4+ phenotype, and an increased number of plasma cells. At 7 days, leishmanial amastigotes were present in either the same or somewhat reduced numbers but predominantly within large, lucent vacuoles. By 14 days the number of amastigotes was strikingly lower. Lymphokine-treated skin sites became sterile in two patients, as evaluated by parasite culture after rIL-2 injection. The results suggest that the local administration of rIL-2 induces a beneficial enhancement of the cellular immunity with a consequent disposal of parasites in the cutaneous site.
authors.affiliation: Department of Infectious Diseases, Karolinska Institute, Stockholm, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Akuffo
authors.forename: G
authors.initials: G
authors.lastname: Kaplan
authors.forename: R
authors.initials: R
authors.lastname: Kiessling
authors.forename: S
authors.initials: S
authors.lastname: Teklemariam
authors.forename: M
authors.initials: M
authors.lastname: Dietz
authors.forename: J
authors.initials: J
authors.lastname: McElrath
authors.forename: Z A
authors.initials: ZA
authors.lastname: Cohn
mesh_terms: D000293:Adolescent; D000818:Animals; D006801:Humans; D007111:Immunity, Cellular; D007376:Interleukin-2 / Q000627:therapeutic use*; D007891:Leishmania / Q000276:immunology / Q000648:ultrastructure; D007896:Leishmaniasis / Q000628:therapy*; D008264:Macrophages / Q000469:parasitology / Q000648:ultrastructure; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use; D012867:Skin / Q000469:parasitology
chemical_list: D007376:Interleukin-2; D011994:Recombinant Proteins