title: Comparison of immune regulatory factors in acute and chronic lesions of cutaneous leishmaniasis due to Leishmania major.
abstract: BACKGROUND
  Adaptive immune response is an important factor in the healing process and development of protection in cutaneous leishmaniasis (CL). Little information is available in human CL about the importance of the balance between effector and regulatory immune responses. Therefore, the aim of this study was to asses messenger ribonucleic acid (mRNA) expression of interleukin-10 (IL-10), IL-4, transforming growth factor-β1 (TGF-β1), interferon-g (IFN-γ), and forkhead box P3 (Foxp3) (as a marker of regulatory T cells) in acute and chronic CL lesions caused by Leishmania major compared with normal skin samples.
  
  
  METHODS
  Thirty biopsies were obtained from CL patients with acute lesions (AL, n = 13), chronic lesions (CH, n = 11) and healthy volunteers (n = 6). Relative expressions of target genes were determined by means of reverse transcription real time polymerase chain reaction and were compared with the controls.
  
  
  RESULTS
  Expression of Foxp3, IL-4, and IFN-γ were significantly more in CH than AL group of patients (Foxp3: Median 0.48, inter-quartile range 0.32-0.76 [arbitrary units] for AL, and 0.97 (0.75-1.30) for CH, P = 0.006; IFN-γ: 45.98 (33.39-173.48) for AL, and 200.53 (97.49-361.76) for CH, P = 0.023; IL-4: 0.49 (0.34-2.16) for AL, and 2.14 (1.30-7.11) for CH, P = 0.021). Expression of TGF-β was not significantly different between groups.
  
  
  CONCLUSIONS
  The results indicate that IL-4 secretion at the site of L. major infection rather than low IFN-γ production might have a role in prolongation of disease. Despite a moderate increase of Foxp3 expression in chronic lesions, function of Tregs in persistent infection is not clear.
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Shervin Ghaffari
authors.initials: SG
authors.lastname: Hoseini
authors.affiliation: Department of Physiology, Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Shaghayegh Haghjooy
authors.initials: SH
authors.lastname: Javanmard
authors.affiliation: Department of Parasitology & Mycology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Seyed Hossein
authors.initials: SH
authors.lastname: Hejazi
authors.affiliation: Department of Physiology, Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Laleh
authors.initials: L
authors.lastname: Rafiei
authors.affiliation: Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Sayyed Hamid
authors.initials: SH
authors.lastname: Zarkesh
authors.affiliation: Royan Institute for Animal Biotechnology, ACECR, Isfahan, Iran.
authors.forename: Khadije
authors.initials: K
authors.lastname: Karbalaii
authors.affiliation: Center for Research in Skin Disease and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Khamesipour
keywords: Cutaneous leishmaniasis; Leishmania major; cytokines; gene expression; regulatory T cells