Abstract

Cutaneous leishmaniasis remains both a public health and a therapeutic challenge. To date, no ideal therapy for cutaneous leishmaniasis has been identified, and no universally accepted therapeutic regimen and approved vaccines are available. Due to the mesenchymal stromal cell (MSC) immunomodulatory capacity, they have been applied in a wide variety of disorders, including infectious, inflammatory, and allergic diseases. We evaluated the potential effects of bone marrow MSC therapy in a murine model of cutaneous leishmaniasis. In vitro, coculture of infected macrophages with MSC increased parasite load on macrophages in comparison with controls (macrophages without MSCs). In vivo, BALB/c mice were infected with 2 × 106 Leishmania amazonensis (Josefa strain) promastigotes in the footpad. 7 and 37 days after infection, animals were treated with 1 × 105 MSCs, either intralesional (i.l.), i.e., in the same site of infection, or intravenously (i.v.), through the external jugular vein. Control animals received the same volume (50 µL) of phosphate-buffered saline by i.l. or i.v. routes. The lesion progression was assessed by its thickness measured by pachymetry. Forty-two days after infection, animals were euthanized and parasite burden in the footpad and in the draining lymph nodes was quantified by the limiting dilution assay (LDA), and spleen cells were phenotyped by flow cytometry. No significant difference was observed in lesion progression, regardless of the MSC route of administration. However, animals treated with i.v. MSCs presented a significant increase in parasite load in comparison with controls. On the other hand, no harmful effect due to MSCs i.l. administered was observed. The spleen cellular profile analysis showed an increase of IL-10 producing T CD4+ and TCD8+ cells in the spleen only in mice treated with i.v. MSC. The excessive production of IL-10 could be associated with the disease-aggravating effects of MSC therapy when intravenously administered. As a conclusion, in the current murine model of L. amazonensis-induced cutaneous disease, MSCs did not control the damage of cutaneous disease and, depending on the administration route, it could result in deleterious effects.

Highlights

  • Leishmania (Leishmania) amazonensis is one of the etiological agents of the tegumentary leishmaniasis in Latin America [1] and occurs more frequently in the Amazon forest region [2]

  • Due to the susceptibility to infection with L. amazonensis, BALB/c mice have been used in several pre-clinical studies in order to understand the mechanisms of parasite’s evasion of the host immune defense system [5]

  • Mesenchymal stromal cells adhered to plastic under standard tissue culture conditions and were able to differentiate into mesenchymal lineages, including osteocytes, chondrocytes, and adipocytes under in vitro conditions

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Summary

Introduction

Leishmania (Leishmania) amazonensis is one of the etiological agents of the tegumentary leishmaniasis in Latin America [1] and occurs more frequently in the Amazon forest region [2]. L. amazonensis is the etiological agent of cutaneous diffuse leishmaniasis [2], and in some cases, the infection may result in visceral leishmaniasis [3]. No ideal therapy for cutaneous leishmaniasis has been identified, and no universally accepted therapeutic regimen and approved vaccines are available. These limitations regarding an effective therapy highlight the need to develop new therapeutic strategies against cutaneous leishmaniasis

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