title: Inflammation in disseminated lesions: an analysis of CD4+, CD20+, CD68+, CD31+ and vW+ cells in non-ulcerated lesions of disseminated leishmaniasis.
abstract: Disseminated leishmaniasis (DL) differs from other clinical forms of the disease due to the presence of many non-ulcerated lesions (papules and nodules) in non-contiguous areas of the body. We describe the histopathology of DL non-ulcerated lesions and the presence of CD4-, CD20-, CD68-, CD31- and von Willebrand factor (vW)-positive cells in the inflamed area. We analysed eighteen biopsies from non-ulcerated lesions and quantified the inflamed areas and the expression of CD4, CD20, CD68, CD31 and vW using Image-Pro software (Media Cybernetics). Diffuse lymphoplasmacytic perivascular infiltrates were found in dermal skin. Inflammation was observed in 3-73% of the total biopsy area and showed a significant linear correlation with the number of vW+ vessels. The most common cells were CD68+ macrophages, CD20+ B-cells and CD4+ T-cells. A significant linear correlation between CD4+ and CD20+ cells and the size of the inflamed area was also found. Our findings show chronic inflammation in all DL non-ulcerated lesions predominantly formed by macrophages, plasmacytes and T and B-cells. As the inflamed area expanded, the number of granulomas and extent of the vascular framework increased. Thus, we demonstrate that vessels may have an important role in the clinical evolution of DL lesions.
authors: Laboratório Avançado de Saúde Pública, Centro de Pesquisas Gonçalo Moniz, Fiocruz, Salvador, BA, Brasil. dayanasantosmendes@gmail.com
authors: Dayana Santos
authors: DS
authors: Mendes
authors: Marina Loyola
authors: ML
authors: Dantas
authors: Juliana Menezes
authors: JM
authors: Gomes
authors: Washington Luis Conrado dos
authors: WL
authors: Santos
authors: Adriano Queiroz
authors: AQ
authors: Silva
authors: Luiz Henrique
authors: LH
authors: Guimarães
authors: Paulo R
authors: PR
authors: Machado
authors: Edgar Marcelino de
authors: EM
authors: Carvalho
authors: Sérgio
authors: S
authors: Arruda
mesh_terms: D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000276:immunology; D018951:Antigens, CD20 / Q000276:immunology; D015214:Antigens, Differentiation, Myelomonocytic / Q000276:immunology; D001402:B-Lymphocytes / Q000276:immunology / Q000473:pathology; D001706:Biopsy; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D006801:Humans; D007249:Inflammation / Q000276:immunology* / Q000473:pathology; D016773:Leishmaniasis, Cutaneous / Q000276:immunology* / Q000473:pathology; D008264:Macrophages / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D014841:von Willebrand Factor / Q000276:immunology; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D018951:Antigens, CD20; D015214:Antigens, Differentiation, Myelomonocytic; D014841:von Willebrand Factor; C067980:CD68 antigen, human; D000097382:CD68 Molecule