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Cellular Analysis of Cutaneous Leishmaniasis Lymphadenopathy: Insights into the Early Phases of Human Disease

Lymphadenopathy is an early clinical sign in cutaneous leishmaniasis (CL), caused by Viannia parasites, and may help to understand the initial host response to these species of Leishmania. We report on characteristics of cells obtained from lymph nodes from cutaneous leishmaniasis patients with lymphadenopathy without ulceration (early phase, N = 21) or lymphadenopathy and ulceration (late phase, N = 29). Early-phase patients exhibited a higher proportion of neutrophils, eosinophils, and CD8+ T cells. Conversely, CD19+ B lymphocytes and plasma cells were more frequently observed in late-phase patients. The signal for IL-10 was significantly higher in late-phase patients; signals for IFN- or IL-4 were similar in both groups. These data reinforce observations of an initial mixed Th1–Th2 profile as well as the early role of the CD8 T cell in cutaneous leishmaniasis. Additionally, there is a chronologic relationship between ulcer development and B-cell increase. IL-10 also increases at a late stage and may be important in limiting tissue damage.

Received April 11, 2007. Accepted for publication July 24, 2007.

Acknowledgments: The authors thank João Santana da Silva (Faculdade de Medicina de Ribeirão Preto-USP) for the primers sequences information, Ednaldo Lima Lago and his team for fieldwork support and Edgar Carvalho and Claudia Brodskyn for valuable suggestions.

Financial support: This study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico- Brazil (CNPq), Fundação de Amparo à Pesquisa do Estado da Bahia-Brazil (FAPESB), and FIOCRUZ. M. Barral-Netto and A. Barral are senior investigators from CNPq.

^* Address correspondence to Aldina Barral, Rua Waldemar Falcão, 121, Brotas, Salvador. E-mail: abarral{at}bahia.fiocruz.br

There are no commercial or other associations that might pose a conflict of interest.

Authors’ addresses: Glória Bomfim and Silvane Santos, Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Rua João das Botas, s/n, Salvador, Bahia, Brazil. Bruno B. Andrade, Jorge Clarêncio, Manoel Barral-Netto, and Aldina Barral, Centro de Pesquisas Gonçalo Moniz, FIOCRUZ, Rua Waldemar Falcão, 121, Candeal. Salvador, Bahia, Brazil.

Reprint requests: Aldina Barral, Laboratório de Imunoparasitologia, Centro de Pesquisas Gonçalo Moniz, FIOCRUZ, Rua Waldemar Falcão, 121, Candeal. CEP: 40295-001 Salvador, Bahia, Brazil. Phone: 55 71 3176-2259. Fax: 55 71 3176-2279. E-mail: abarral{at}bahia.fiocruz.br.