Age modifies the immunologic response and clinical presentation of American tegumentary leishmaniasis.
Leishmania (Viannia) braziliensis is the main causal agent of American tegumentary leishmaniasis (ATL) that may present as cutaneous, mucosal, or disseminated cutaneous leishmaniasis. The disease is highly prevalent in young males and there is a lack of studies of ATL in the elderly. Herein, we compared clinical manifestations, immunologic response, and response to antimony therapy between patients > 60 years of age (N = 58) and patients who were 21-30 years of age (N = 187). The study was performed in Corte de Pedra, Bahia, Brazil, a well-known area of L. braziliensis transmission. Cytokine production by cultured peripheral blood mononuclear cells stimulated with soluble Leishmania antigen was performed. Elderly subjects more frequently had a previous history of cutaneous leishmaniasis, large lesions, or mucosal leishmaniasis, and they were less likely to have lymphadenopathy. There was no difference regarding gender and response to therapy. Peripheral blood mononuclear cells from elderly subjects produced a similar amount of tumor necrosis factor than young patients but they produced less interferon-gamma and more interleukin-10 than young subjects. We concluded that elderly patients with cutaneous leishmaniasis should be searched for mucosal or disseminated leishmaniasis. The decreased interferon-gamma production and increase in interleukin-10 observed in elderly patients may contribute to parasite persistence and L. braziliensis infection dissemination.
Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), CNPq/MCT, Salvador, Bahia, Brazil; Centro de Pesquisa Gonçalo Moniz, Fundação Oswaldo Cruz FIOCRUZ-Salvador, Bahia, Brazil.
Augusto M
AM
Carvalho
Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), CNPq/MCT, Salvador, Bahia, Brazil; Centro de Pesquisa Gonçalo Moniz, Fundação Oswaldo Cruz FIOCRUZ-Salvador, Bahia, Brazil.
Camila F
CF
Amorim
Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), CNPq/MCT, Salvador, Bahia, Brazil; Centro de Pesquisa Gonçalo Moniz, Fundação Oswaldo Cruz FIOCRUZ-Salvador, Bahia, Brazil.
Juliana L S
JL
Barbosa
Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), CNPq/MCT, Salvador, Bahia, Brazil; Centro de Pesquisa Gonçalo Moniz, Fundação Oswaldo Cruz FIOCRUZ-Salvador, Bahia, Brazil.
Alexsandro S
AS
Lago
Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), CNPq/MCT, Salvador, Bahia, Brazil; Centro de Pesquisa Gonçalo Moniz, Fundação Oswaldo Cruz FIOCRUZ-Salvador, Bahia, Brazil imuno@ufba.br.
Edgar M
EM
Carvalho
D000328:Adult; D000367:Age Factors; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D007892:Leishmania braziliensis; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007371:Interferon-gamma