Severe visceral leishmaniasis in children: the relationship between cytokine patterns and clinical features

被引:19
作者
Alves Gama, Monica Elinor [1 ]
de Castro Gomes, Claudia Maria [2 ]
Silveira, Fernando Tobias [3 ,4 ]
Laurenti, Marcia Dalastra [2 ]
Goncalves, Eloisa da Graca [5 ]
da Silva, Antonio Rafael [5 ]
Pereira Corbett, Carlos Eduardo [2 ]
机构
[1] Univ Fed Maranhao, Ctr Ciencias Saude, Dept Med 3, Sao Luis, MA, Brazil
[2] Univ Sao Paulo, Fac Med, Dept Patol, Sao Paulo, Brazil
[3] Inst Evandro Chagas, Belem, Para, Brazil
[4] Fed Univ Para, Nucleo Med Trop, BR-66059 Belem, Para, Brazil
[5] Univ Fed Maranhao, Ctr Ciencias Saude, Dept Patol, Sao Luis, MA, Brazil
基金
巴西圣保罗研究基金会;
关键词
Visceral leishmaniasis; Kala-azar; Systemic inflammatory response syndrome; Cytokine production; REGULATORY T-CELLS; SUBCLINICAL FORM; INTERFERON-GAMMA; INTERLEUKIN-10; IMMUNOSUPPRESSION; IMMUNITY; DEATH;
D O I
10.1590/0037-8682-0203-2013
中图分类号
R38 [医学寄生虫学]; Q [生物科学];
学科分类号
07 ; 0710 ; 09 ; 100103 ;
摘要
Introduction: The relationship between severe clinical manifestations of visceral leishmaniasis (VL) and immune response profiles has not yet been clarified, despite numerous studies on the subject. This study aimed to investigate the relationship between cytokine profiles and the presence of immunological markers associated with clinical manifestations and, particularly, signs of severity, as defined in a protocol drafted by the Ministry of Health ( Brazil). Methods: We conducted a prospective, descriptive study between May 2008 and December 2009. This study was based on an assessment of all pediatric patients with VL who were observed in a reference hospital in Maranhao. Results: Among 27 children, 55.5% presented with more than one sign of severity or warning sign. Patients without signs of severity or warning signs and patients with only one warning sign had the highest interferon-gamma (IFN-gamma) levels, although their interleukin 10 (IL-10) levels were also elevated. In contrast, patients with the features of severe disease had the lowest IFN-gamma levels. Three patients who presented with more than two signs of severe disease died; these patients had undetectable interleukin 2 (IL-2) and IFN-gamma levels and low IL-10 levels, which varied between 0 and 36.8pg/mL. Conclusions: Our results showed that disease severity was associated with low IFN-gamma levels and elevated IL-10 levels. However, further studies with larger samples are needed to better characterize the relationship between disease severity and cytokine levels, with the aim of identifying immunological markers of active-disease severity.
引用
收藏
页码:741 / 745
页数:5
相关论文
共 39 条
[1]  
Alvarenga Daniel Gomes de, 2010, Rev. Soc. Bras. Med. Trop., V43, P194
[2]   Risk Factors for Death in Children with Visceral Leishmaniasis [J].
Alves de Queiroz Sampaio, Marcia Jaqueline ;
Cavalcanti, Nara Vasconcelos ;
Bezerra Alves, Joao Guilherme ;
Costa Fernandes Filho, Mario Jorge ;
Correia, Jailson B. .
PLOS NEGLECTED TROPICAL DISEASES, 2010, 4 (11)
[3]  
Alves JGB, 1996, PEDIAT I MATERNO INF, P320
[4]   An essential role for interleukin 10 in the function of regulatory T cells that inhibit intestinal inflammation [J].
Asseman, C ;
Mauze, S ;
Leach, MW ;
Coffman, RL ;
Powrie, F .
JOURNAL OF EXPERIMENTAL MEDICINE, 1999, 190 (07) :995-1003
[5]   NEW PERSPECTIVES ON A SUBCLINICAL FORM OF VISCERAL LEISHMANIASIS [J].
BADARO, R ;
JONES, TC ;
CARVALHO, EM ;
SAMPAIO, D ;
REED, SG ;
BARRAL, A ;
TEIXEIRA, R ;
JOHNSON, WD .
JOURNAL OF INFECTIOUS DISEASES, 1986, 154 (06) :1003-1011
[6]   Reactive oxygen and reactive nitrogen intermediates in innate and specific immunity [J].
Bogdan, C ;
Röllinghoff, M ;
Diefenbach, A .
CURRENT OPINION IN IMMUNOLOGY, 2000, 12 (01) :64-76
[7]  
Braga AS, 2007, THESIS U FEDERAL MIN
[8]   IMMUNOLOGICAL MARKERS OF CLINICAL EVOLUTION IN CHILDREN RECENTLY INFECTED WITH LEISHMANIA-DONOVANI-CHAGASI [J].
CARVALHO, EM ;
BARRAL, A ;
PEDRALSAMPAIO, D ;
BARRALNETTO, M ;
BADARO, R ;
ROCHA, H ;
JOHNSON, WD .
JOURNAL OF INFECTIOUS DISEASES, 1992, 165 (03) :535-540
[9]  
CARVALHO EM, 1994, J IMMUNOL, V152, P5949
[10]  
CARVALHO EM, 1985, J IMMUNOL, V135, P4144