Abstract

BackgroundCutaneous leishmaniasis (CL) is caused by Leishmania (Viannia) braziliensis, which infects dermal macrophages and dendritic cells, causing an intense immune-mediated-tissue inflammation and a skin ulcer with elevated borders that can heal spontaneously or after antimonial therapy. The resolution of lesions depends on an adaptive immune response, and cytotoxic cells seem to have a fundamental role in this process. The aim of this study is to better understand the role of cytotoxicity mediated mechanisms that occur during the immune response in the CL lesion milieu, considering distinct cytotoxic-related CD107a+ cells, such as CD8+, CD4+, CD4neg CD8neg (double-negative, DN) and CD4+CD8+ (double-positive, DP) T lymphocytes, as well as NK and NKT cells.MethodsLesion derived cells were assessed for T cell subpopulations and NK cells, as well as CD107a expression by flow cytometry. In addition, cytometric bead array (CBA) was used to quantify cytokines and granzyme B concentrations in supernatants from macerated lesions.ResultsFlow cytometry analyses revealed that NKT cells are the major CD107a-expressing cell population committed to cytotoxicity in CL lesion, although we also observed high frequencies of CD4+ and DN T cells expressing CD107a. Analysing the pool of CD107a+-cell populations, we found a higher distribution of DN T cells (44%), followed by approximately 25% of NKT cells. Interestingly, NK and CD8+ T cells represented only 3 and 4% of the total-CD107a+-cell pool, respectively.ConclusionsThe cytotoxicity activity that occurs in the lesion milieu of CL patients seems to be dominated by DN T and NKT cells. These findings suggest the need for a reevaluation of the role of classical-cytotoxic NK and CD8+ T cells in the pathogenesis of CL, implicating an important role for other T cell subpopulations.

Highlights

  • Cutaneous leishmaniasis (CL) is caused by Leishmania (Viannia) braziliensis, which infects dermal macrophages and dendritic cells, causing an intense immune-mediated-tissue inflammation and a skin ulcer with elevated borders that can heal spontaneously or after antimonial therapy

  • Frequencies of cell subsets in lesions of cutaneous leishmaniasis patients We focused on determining the cytotoxic profile of cellular populations obtained directly from active cutaneous leishmaniasis lesions

  • Results observed in our current study revealed that NKT cells were distributed as the fourth cell population found in CL lesions and they are the most committed to cytotoxicity, representing the second most cytotoxic-cell population in the CL lesion environment, pointing to them as an important component of the localised immune response

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Summary

Introduction

Cutaneous leishmaniasis (CL) is caused by Leishmania (Viannia) braziliensis, which infects dermal macrophages and dendritic cells, causing an intense immune-mediated-tissue inflammation and a skin ulcer with elevated borders that can heal spontaneously or after antimonial therapy. CL is the most frequent clinical form of ATL and is characterised by the parasitic infection of derma, which results in an intense immunemediated tissue inflammation and a skin ulcer with elevated borders that can heal spontaneously or after antimonial therapy. Several authors have demonstrated that the pathogenesis of ATL is dependent on the cellular immune response and it seems to affect the clinical outcome of the disease by T-lymphocyte effector functions and cytokine profiles [3,4,5]. Studying the cellular immune response in ATL lesions allows us to propose mechanism involved in the formation, persistence or healing of leishmaniasis lesions

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