title: Increased levels of interleukin-10 and IgG3 are hallmarks of Indian post-kala-azar dermal leishmaniasis.
abstract: BACKGROUND
  Post-kala-azar dermal leishmaniasis (PKDL), an established sequela of visceral leishmaniasis (VL), is proposed to facilitate anthroponotic transmission of VL, especially during interepidemic periods. Immunopathological mechanisms responsible for Indian PKDL are still poorly defined.
  
  
  METHODS
  Our study attempted to characterize the immune profiles of patients with PKDL or VL relative to that of healthy control subjects by immunophenotyping, intracellular cytokine staining of peripheral blood mononuclear cells, and enzyme-linked immunosorbent assay for serum cytokines and immunoglobulin G (IgG) subclasses.
  
  
  RESULTS
  Patients with PKDL had significantly raised percentages of peripheral CD3+CD8+ cells compared with control subjects, a difference that persisted after cure. Patients with PKDL showed an intact response to phytohemagglutinin, with the percentages of lymphocytes expressing interferon (IFN)-gamma, interleukin (IL)-2, IL-4, and IL-10 being comparable to those in control subjects. Patients with VL had decreased IFN-gamma and IL-2 expression, which was restored after cure, and increased IL-10 expression, which persisted after cure. In their response to Leishmania donovani antigen, patients with PKDL showed a 9.6-fold increase in the percentage of IL-10-expressing CD3+CD8+ lymphocytes compared with control subjects, and this percentage decreased with treatment. Patients with PKDL had raised levels of IgG3 and IgG1 (surrogate markers for IL-10), concomitant with increased serum levels of IL-10.
  
  
  CONCLUSIONS
  IL-10-producing CD3+CD8+ lymphocytes are important protagonists in the immunopathogenesis of Indian PKDL.
authors.affiliation: Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, India.
authors.forename: Sudipto
authors.initials: S
authors.lastname: Ganguly
authors.forename: Nilay Kanti
authors.initials: NK
authors.lastname: Das
authors.forename: Moumita
authors.initials: M
authors.lastname: Panja
authors.forename: Shekhar
authors.initials: S
authors.lastname: Pal
authors.forename: Dolanchampa
authors.initials: D
authors.lastname: Modak
authors.forename: Mehebubar
authors.initials: M
authors.lastname: Rahaman
authors.forename: Sudeshna
authors.initials: S
authors.lastname: Mallik
authors.forename: Subhashis Kamal
authors.initials: SK
authors.lastname: Guha
authors.forename: Netai
authors.initials: N
authors.lastname: Pramanik
authors.forename: Ramapada
authors.initials: R
authors.lastname: Goswami
authors.forename: Joyashree Nath
authors.initials: JN
authors.lastname: Barbhuiya
authors.forename: Bibhuti
authors.initials: B
authors.lastname: Saha
authors.forename: Mitali
authors.initials: M
authors.lastname: Chatterjee
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D017252:CD3 Complex / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002648:Child; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D007074:Immunoglobulin G / Q000097:blood*; D007194:India / Q000453:epidemiology; D016753:Interleukin-10 / Q000097:blood*; D016773:Leishmaniasis, Cutaneous / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000276:immunology*; D007898:Leishmaniasis, Visceral / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D017252:CD3 Complex; D007074:Immunoglobulin G; D016753:Interleukin-10