title: In situ immune responses to interstitial pneumonitis in human visceral leishmaniasis.
abstract: Lung disease during active human visceral leishmaniasis is frequently reported. As such, studies have associated pulmonary symptoms to interstitial pneumonitis with a mononuclear infiltrate. However, the immune response in this condition has never been described before. The aim of this study was to determine the immunophenotypic pattern and cytokine profile of lung involvement (IPL) in human visceral leishmaniasis. Quantitative methods of analysis were performed using immunohistochemistry, and were compared with a control group of normal lung. Interstitial macrophages and cd8 cells were increased in IPL, and IL-4 as well as TNF-alpha displayed increased expression when compared to the control group. This inflammatory process with a Th2 pattern, as suggested by increased IL-4 and low IFN-gamma expression, is consistent with the immune response in other organs of visceral leishmaniasis. The microenvironment of the immune response in this condition is associated with lung disease in patients with interstitial pneumonitis related to visceral leishmaniasis, increasing the chance of bacterial infection.
authors.affiliation: Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: F F
authors.initials: FF
authors.lastname: Tuon
authors.forename: F
authors.initials: F
authors.lastname: Guedes
authors.forename: E R
authors.initials: ER
authors.lastname: Fernandes
authors.forename: C
authors.initials: C
authors.lastname: Pagliari
authors.forename: V S
authors.initials: VS
authors.lastname: Amato
authors.forename: M I
authors.initials: MI
authors.lastname: Seixas Duarte
mesh_terms: D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D049109:Cell Proliferation; D006801:Humans; D007150:Immunohistochemistry; D007371:Interferon-gamma / Q000096:biosynthesis; D015847:Interleukin-4 / Q000096:biosynthesis; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000276:immunology*; D017563:Lung Diseases, Interstitial / Q000276:immunology* / Q000469:parasitology; D008174:Lung Diseases, Parasitic / Q000209:etiology / Q000276:immunology*; D008264:Macrophages / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis
chemical_list: D014409:Tumor Necrosis Factor-alpha; D015847:Interleukin-4; D007371:Interferon-gamma