Selective Suppression of Cellular Immunity and Increased Cytotoxicity in Skin Lesions of Disseminated Leishmaniasis Uncovered by Transcriptome-Wide Analysis

Abstract

Disseminated leishmaniasis (DL) is an emerging form of cutaneous leishmaniasis (CL) where multiple acneiform or papular lesions occur at ≥2 noncontiguous anatomical regions affecting various body segments (Costa et al., 1986). With increasing incidence in endemic areas of Leishmania braziliensis transmission, DL is a difficult-to-treat disease owing to the elevated number of lesions, the frequent mucosal involvement, and the low cure rate (Machado et al., 2019). Lack of lymph node enlargement and the rapid spread of lesions to many parts of the skin and mucosa suggest that the parasites disseminate through the bloodstream (Costa et al., 1986), and both host and parasite factors have been implicated in this manifestation.