Immunopathology of leishmaniasis: an update.
Leishmaniasis represents a severe, increasing, public health problem. The perspective of its control is highly dependent on research progress, on therapeutic manipulations of the immune system, and on vaccine development. There is a correlation between the clinical outcome of Leishmania infection and the cytokine response profile. While a protective immune response against Leishmania has been clearly identified to be related to the influence of a type-1 response and IFN-gamma production, the precise role of T helper (TH) 2 cytokines in non-healing infections requires further exploration. IL-4 and IL-13 (TH2 cytokines) can promote disease progression in cutaneous leishmaniasis, whereas IL-4 would appear to enhance protective type-1 responses in visceral leishmaniasis. Thus, the TH1/TH2 paradigm of resistance/susceptibility to intracellular parasites is probably an oversimplification of a more complicated network of regulatory/counter regulatory interactions. Moreover, the presence of antigen specific regulatory T cell subsets may provide an environment that contributes to the balance between TH1 and TH2 cells. Finally, the involvement of CD8 positive T cells has been described, but the modality of their function in this kind of infection has not been so far elucidated.
Mansueto
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P
Dipartimento di Medicina Clinica e delle Patologie Emergenti, University of Palermo, Palermo, Italy.
Vitale
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Di Lorenzo
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Rini
G B
GB
Mansueto
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S
Cillari
E
E
D000818:Animals; D017209:Apoptosis / Q000276:immunology; D006801:Humans; D007896:Leishmaniasis / Q000276:immunology* / Q000473:pathology*; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology