title: Is the in situ inflammatory reaction an important tool to understand the cellular immune response in American tegumentary leishmaniasis?
abstract: BACKGROUND
  The study of American tegumentary leishmaniasis (ATL) lesions might contribute to the understanding of the dynamics of the infection.
  
  
  OBJECTIVE
  To examine the cellular infiltrate of cutaneous ATL lesions and to compare these results with the detection of the parasites and clinical data.
  
  
  METHODS
  Lesions of 19 patients with ATL were evaluated through immunohistochemical analysis.
  
  
  RESULTS
  The lesions presented an inflammatory reaction mainly consisting of T cells and macrophages. Analysis of the expression of nitric oxide synthase type 2 (NOS2) showed that its intensity was directly correlated with the number of CD3+ T cells. We also observed an association between high NOS2 expression and low quantity of parasites, highlighting the importance of NOS2 in the elimination of parasites.
  
  
  CONCLUSIONS
  The present results suggest that (i) the inflammatory process is intense in cutaneous ATL lesions and maintains a similar activity for several months; (ii) the dynamics of cell infiltration change during this period, with a gradual decrease in CD8+ T cells, probably correlated with a reduction in the parasite number; (iii) neutrophils may participate in the inflammatory process even during later stages of infection; (iv) the relative increase in the number of CD4+ T cells associated with the onset of fibrosis may suggest a participation of these cells in the control of the inflammatory process; and (v) late lesions with tendency for healing usually show focal inflammation. The study of healing lesions might contribute to the understanding of the late steps of the control of the inflammatory process in ATL lesions.
authors.affiliation: Laboratory of Immunoparasitology, Department of Immunology, Oswaldo Cruz Institute, IOC/FIOCRUZ, Pavilhão 26, 4o andar sala 406C, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, RJ, Brazil.
authors.forename: F N
authors.initials: FN
authors.lastname: Morgado
authors.forename: A
authors.initials: A
authors.lastname: Schubach
authors.forename: C M V
authors.initials: CM
authors.lastname: Rosalino
authors.forename: L P
authors.initials: LP
authors.lastname: Quintella
authors.forename: G
authors.initials: G
authors.lastname: Santos
authors.forename: M
authors.initials: M
authors.lastname: Salgueiro
authors.forename: F
authors.initials: F
authors.lastname: Conceição-Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D003713:Dendritic Cells / Q000276:immunology; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D007124:Immunoenzyme Techniques; D007249:Inflammation / Q000201:enzymology / Q000276:immunology* / Q000469:parasitology; D007801:Langerhans Cells / Q000276:immunology; D007892:Leishmania braziliensis / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000201:enzymology / Q000276:immunology* / Q000469:parasitology / Q000473:pathology; D008264:Macrophages / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology; D052247:Nitric Oxide Synthase Type II / Q000378:metabolism; D016176:T-Lymphocyte Subsets / Q000276:immunology
chemical_list: D052247:Nitric Oxide Synthase Type II