title: American tegumentary leishmaniasis: T-cell differentiation profile of cutaneous and mucosal forms-co-infection with Trypanosoma cruzi.
abstract: American tegumentary leishmaniasis displays two main clinical forms: cutaneous (CL) and mucosal (ML). ML is more resistant to treatment and displays a more severe and longer evolution. Since both forms are caused by the same Leishmania species, the immunological response of the host may be an important factor determining the evolution of the disease. Herein, we analyzed the differentiation and memory profile of peripheral CD4(+) and CD8(+) T lymphocytes of patients with CL and ML and their Leishmania-T. cruzi co-infected counterparts. We measured the expression of CD27, CD28, CD45RO, CD127, PD-1 and CD57, together with interferon-γ and perforin. A highly differentiated phenotype was reflected on both T subsets in ML and preferentially on CD8(+) T cells in CL. A positive trend toward a higher T differentiation profile was found in T. cruzi-infected CL and ML patients as compared with Leishmania single infections. Association between CD8(+) T-cell differentiation and illness duration was found within the first year of infection, with progressive increase of highly differentiated markers over time. Follow-up of patients with good response to therapy showed predominance of early differentiated CD8(+) T cells and decrease of highly differentiated cells, while patients with frequent relapses presented the opposite pattern. CD8(+) T cells showed the most striking changes in their phenotype during leishmaniasis. Patients with long-term infections showed the highest differentiated degree implying a relation between T differentiation and parasite persistence. Distinct patterns of CD8(+) T differentiation during follow-up of different clinical outcomes suggest the usefulness of this analysis in the characterization of Leishmania-infected patients.
authors.affiliation: Instituto de Patología Experimental-CONICET, Universidad Nacional de Salta, Salta, Argentina. ceciliaparodi@conicet.gov.ar.|Laboratorio de Inmunología, Instituto de Medicina Experimental-CONICET, Academia Nacional de Medicina, Pacheco de Melo 3081, CP1425, Buenos Aires, Argentina. ceciliaparodi@conicet.gov.ar.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Parodi
authors.affiliation: Instituto de Patología Experimental-CONICET, Universidad Nacional de Salta, Salta, Argentina.
authors.forename: María F
authors.initials: MF
authors.lastname: García Bustos
authors.affiliation: Cátedra de Microbiología, Facultad de Ciencias de la Salud, Universidad Nacional de Salta, Salta, Argentina.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Barrio
authors.affiliation: Instituto de Patología Experimental-CONICET, Universidad Nacional de Salta, Salta, Argentina.
authors.forename: Federico
authors.initials: F
authors.lastname: Ramos
authors.affiliation: Cátedra de Microbiología, Facultad de Ciencias de la Salud, Universidad Nacional de Salta, Salta, Argentina.
authors.forename: Ana G
authors.initials: AG
authors.lastname: González Prieto
authors.affiliation: Instituto de Patología Experimental-CONICET, Universidad Nacional de Salta, Salta, Argentina.
authors.forename: María C
authors.initials: MC
authors.lastname: Mora
authors.affiliation: Laboratorio de Inmunología, Instituto de Medicina Experimental-CONICET, Academia Nacional de Medicina, Pacheco de Melo 3081, CP1425, Buenos Aires, Argentina.
authors.forename: Patricia
authors.initials: P
authors.lastname: Baré
authors.affiliation: Instituto de Patología Experimental-CONICET, Universidad Nacional de Salta, Salta, Argentina.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Basombrío
authors.affiliation: Laboratorio de Inmunología, Instituto de Medicina Experimental-CONICET, Academia Nacional de Medicina, Pacheco de Melo 3081, CP1425, Buenos Aires, Argentina.
authors.forename: María M
authors.initials: MM
authors.lastname: de Elizalde de Bracco
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000032:analysis; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D002454:Cell Differentiation; D014355:Chagas Disease / Q000473:pathology*; D002648:Child; D060085:Coinfection / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016130:Immunophenotyping; D007371:Interferon-gamma / Q000032:analysis; D007897:Leishmaniasis, Mucocutaneous / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D054353:Perforin / Q000032:analysis; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D055815:Young Adult
chemical_list: D015703:Antigens, CD; D054353:Perforin; D007371:Interferon-gamma
keywords: Cutaneous leishmaniasis; Differentiation and memory phenotype; Leishmania–T. cruzi co-infection; Mucosal leishmaniasis; Peripheral T lymphocytes