title: Immunopathological characterization of human cutaneous leishmaniasis lesions caused by Leishmania (Viannia) spp. in Amazonian Brazil.
abstract: American cutaneous leishmaniasis (ACL) is a chronic infectious disease caused by different protozoan species of Leishmania, and it is endemic in both tropical and subtropical countries. Using immunohistochemistry, we investigate the density of CD68+, lysozyme+, CD1a+, factor XIIIa+, CD4+, CD8+, CD56+, interferon (IFN)-γ+, and inducible NO synthase (iNOS+) cells. These cells were analyzed from 22 biopsy samples obtained from the lesions of ACL patients, whose infection was caused by Leishmania (Viannia) spp. Histopathological analysis showed dense mononuclear inflammatory infiltration in the dermis, which was composed of lymphocytes, macrophages, plasma cells, and discrete tissue parasitism. Granulomatous reactions were also present in the majority of cases. The density of the activated macrophages was higher than that of inactivated macrophages in the lesions. The density of Langerhans cells (CD1a+) was lower than that of dermal dendrocytes (factor XIIIa+). The density of CD8+T lymphocytes was higher than that of CD4+T lymphocytes. The cellular density of these immunological markers in relation to the species of Leishmania demonstrated that L. (Viannia) sp. lesions had higher IFN-γ expression than that Leishmania (Viania) braziliensis lesions. The evaluation of these markers, according to disease progression, did not reveal any significant differences. L. (Viannia) sp. infection leads to a favorable immune response in the host, as predominantly represented by lysozyme+, factor XIIIa+, CD8+T cells, and the expression of (IFN)-γ+at the lesion site.
authors.affiliation: Pathology Department, Medical School of São Paulo University, São Paulo, São Paulo, Brazil. gomescla@usp.br.
authors.forename: Cláudia Maria
authors.initials: CM
authors.lastname: Castro Gomes
authors.affiliation: Pathology Department, Medical School of São Paulo University, São Paulo, São Paulo, Brazil.
authors.forename: Maria Gloria Teixeira
authors.initials: MGT
authors.lastname: Sousa
authors.affiliation: Pathology Department, Medical School of São Paulo University, São Paulo, São Paulo, Brazil.
authors.forename: Joyce Prieto Bezerra
authors.initials: JPB
authors.lastname: Menezes
authors.affiliation: Parasitology Department, Evandro Chagas Institute (Surveillance Secretary of Health, Ministry of Health), Belém, Pará, Brazil.
authors.forename: Marliane Campos
authors.initials: MC
authors.lastname: Batista
authors.affiliation: Pathology Department, Medical School of São Paulo University, São Paulo, São Paulo, Brazil.
authors.forename: Ana Carolina Stocco
authors.initials: ACS
authors.lastname: Lima
authors.affiliation: Dermatology Department, Medical School of São Paulo University, São Paulo, São Paulo, Brazil.
authors.forename: Walter
authors.initials: W
authors.lastname: Belda
authors.affiliation: Chelsea and Westminster Hospital London, London, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bradshaw
authors.affiliation: Pediatric Department, Federal University of Maranhão, São Luis, Maranhão, Brazil.
authors.forename: Monica Elinor Alves
authors.initials: MEA
authors.lastname: Gama
authors.affiliation: Pathology Department, Medical School of São Paulo University, São Paulo, São Paulo, Brazil.
authors.forename: Márcia Dalastra
authors.initials: MD
authors.lastname: Laurenti
authors.affiliation: Parasitology Department, Evandro Chagas Institute (Surveillance Secretary of Health, Ministry of Health), Belém, Pará, Brazil.|Tropical Medicine Institute, Federal University of Pará, Belém, Pará, Brazil.
authors.forename: Fernando Tobias
authors.initials: FT
authors.lastname: Silveira
authors.affiliation: Pathology Department, Medical School of São Paulo University, São Paulo, São Paulo, Brazil.
authors.forename: Carlos Eduardo Pereira
authors.initials: CEP
authors.lastname: Corbett
mesh_terms: D000293:Adolescent; D000328:Adult; D018949:Antigens, CD1; D001938:Brazil; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000166:cytology / Q000276:immunology*; D020405:Dermis / Q000469:parasitology / Q000473:pathology; D018450:Disease Progression; D026122:Factor XIIIa / Q000378:metabolism; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D007801:Langerhans Cells / Q000166:cytology / Q000276:immunology*; D007891:Leishmania / Q000276:immunology*; D007892:Leishmania braziliensis / Q000276:immunology*; D016773:Leishmaniasis, Cutaneous / Q000276:immunology* / Q000469:parasitology; D008262:Macrophage Activation / Q000276:immunology; D008264:Macrophages / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009113:Muramidase / Q000378:metabolism; D055815:Young Adult
chemical_list: D018949:Antigens, CD1; C419393:CD1a antigen; D007371:Interferon-gamma; D026122:Factor XIIIa; D009113:Muramidase
keywords: Activated macrophage; American cutaneous leishmaniasis; CD8 T cells; Dendritic cells; IFN-γ; Immunohistochemistry; Immunopathological characterization; Leishmania (Viannia) sp.