title: Circulating T helper 1 (Th1) cell- and Th2 cell-associated cytokines in Indian patients with visceral leishmaniasis.
abstract: Sera from 61 Indian patients with visceral leishmaniasis caused by infection with Leishmania donovani were tested for the presence of T helper 1 (Th1) cell-(interferon-gamma [IFN-gamma]) and Th2 cell-associated cytokines (interleukin-4 [IL-4] and IL-10). The IFN-gamma activity was detected in 53%. IL-4 in 84%, and IL-10 in 56% of patient samples. Sera from 10 healthy Indian controls showed detectable IFN-gamma in 90%. IL-4 in 10%, and IL-10 in 20%; corresponding percentages for sera from eight healthy American controls were 100%, 12%, and 0%, respectively. Quantitative data for the 61 patients compared with the 10 Indian controls indicated comparable mean levels of IFN-gamma, but three- and 13-fold increases in IL-10 and IL-4, respectively. Undetectable IFN-gamma activity, observed in 47% of patients, was associated with the presence IL-4 alone or in combination with IL-10 but not with IL-10 alone. In patients who had failed prior therapy (n = 29) compared with previously untreated patients (n = 32). IFN-gamma levels were 67% lower and IL-4 levels were two-fold higher, IL-10 activity was comparable. These results using peripheral blood support the presence of a suppressive Th2 cell-associated immune response in symptomatic Indian kala-azar and point to a possible role for IL-4.
authors.affiliation: Kala-Azar Medical Research Center, Department of Medicine, Banaras Hindu University, Varanasi, India.
authors.forename: S
authors.initials: S
authors.lastname: Sundar
authors.forename: S G
authors.initials: SG
authors.lastname: Reed
authors.forename: S
authors.initials: S
authors.lastname: Sharma
authors.forename: A
authors.initials: A
authors.lastname: Mehrotra
authors.forename: H W
authors.initials: HW
authors.lastname: Murray
mesh_terms: D000328:Adult; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D007898:Leishmaniasis, Visceral / Q000276:immunology* / Q000628:therapy; D008297:Male; D018417:Th1 Cells / Q000276:immunology*; D018418:Th2 Cells / Q000276:immunology*; D017211:Treatment Failure
chemical_list: D016207:Cytokines; D016753:Interleukin-10; D015847:Interleukin-4; D007371:Interferon-gamma