title: Histopathological and immunohistochemical aspects of American cutaneous leishmaniasis before and after different treatments.
abstract: BACKGROUND
  The histopathology and immune responses of the healing process of leishmaniasis are still poorly studied.
  
  
  OBJECTIVE
  This study aimed to examine the histopathological and immunological aspects of lesions of patients with cutaneous leishmaniasis before and after different therapeutic methods.
  
  
  METHODS
  We studied 23 individuals grouped according to the treatments: Glucantime, Glucantime + Leishvacin and Glucantime + Leishvacin associated with Bacillus Calmette-Guerin. For analysis of the histopathological changes present in the dermis and epidermis, histological sections were stained with hematoxylin and eosin. The samples were immunostained before and after treatment to analyze the expression of interferon (IFN)-γ, interleukin (IL) 12, IL-10 and IL-4.
  
  
  RESULTS
  Before treatment the presence of intense infiltrates of mononuclear cells was noticed and after treatment, even with a diagnosis of clinical cure, the subjects still showed a moderate inflammatory process. In the immunohistochemical analyses, we noticed a difference between the cytokines, with increased expression of cytokines IFN-γ and IL-12 compared to IL 10 and IL-4, both before and after treatment and, comparatively, the difference in this expression was more intense before treatment. However, the cytokine expression analyzed by treatment group showed no statistically significant difference.
  
  
  CONCLUSIONS
  We conclude that a clinical cure does not always coincide with the histopathological one, and that before treatment there is a predominance of Th1 cytokines. In terms of treatment type, there was no difference in the progression of healing for all the three types of treatment, indicating their clinical equivalence.
authors.affiliation: Universidade Estadual de Montes Claros(UNIMONTES), Montes Claros, MG, Brazil.
authors.forename: Agostinho Gonçalves
authors.initials: AG
authors.lastname: Viana
authors.forename: Wilson
authors.initials: W
authors.lastname: Mayrink
authors.forename: Carlos Alberto de Carvalho
authors.initials: CA
authors.lastname: Fraga
authors.forename: Luciana Maria
authors.initials: LM
authors.lastname: Silva
authors.forename: Patrícia Luciana Batista
authors.initials: PL
authors.lastname: Domingos
authors.forename: Paulo Rogério Ferreti
authors.initials: PR
authors.lastname: Bonan
authors.forename: Alfredo Maurício Batista de
authors.initials: AM
authors.lastname: Paula
authors.forename: Ana Cristina de Carvalho
authors.initials: AC
authors.lastname: Botelho
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D001500:BCG Vaccine / Q000627:therapeutic use; D002648:Child; D016207:Cytokines / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016233:Immunotherapy, Active / Q000379:methods*; D007891:Leishmania / Q000276:immunology; D007896:Leishmaniasis / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D054332:Leishmaniasis Vaccines / Q000627:therapeutic use; D008297:Male; D008536:Meglumine / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects; D055815:Young Adult
chemical_list: D000276:Adjuvants, Immunologic; D000981:Antiprotozoal Agents; D001500:BCG Vaccine; D016207:Cytokines; D054332:Leishmaniasis Vaccines; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate
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