High levels of anti-Leishmania IgG3 and low CD4+ T cells count were associated with relapses in visceral leishmaniasis
Abstract Background Visceral leishmaniasis (VL) is severe and potentially fatal. Brazil is one of the countries with the greatest endemicity for the disease in the world. The reduction of CD4+ T lymphocytes, B cells activation and high levels of inflammatory cytokines (IL-6/IL-8/TNF/IL-1β), plasma L...
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doaj-1aad9340a83b402fbe660998328afb112021-04-25T11:08:38ZengBMCBMC Infectious Diseases1471-23342021-04-0121111410.1186/s12879-021-06051-5High levels of anti-Leishmania IgG3 and low CD4+ T cells count were associated with relapses in visceral leishmaniasisRenata Caetano Kuschnir0Leonardo Soares Pereira1Maria Rita Teixeira Dutra2Ludmila de Paula3Maria Luciana Silva-Freitas4Gabriela Corrêa-Castro5Simone da Costa Cruz Silva6Glaucia Cota7Joanna Reis Santos-Oliveira8Alda Maria Da-Cruz9Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZHospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas GeraisHospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas GeraisHospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas GeraisLaboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZLaboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZInstituto Nacional de Infectologia Evandro Chagas, FIOCRUZInstituto René Rachou, FIOCRUZLaboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZLaboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZAbstract Background Visceral leishmaniasis (VL) is severe and potentially fatal. Brazil is one of the countries with the greatest endemicity for the disease in the world. The reduction of CD4+ T lymphocytes, B cells activation and high levels of inflammatory cytokines (IL-6/IL-8/TNF/IL-1β), plasma LPS, soluble CD14, anti-Leishmania IgG3 and low leptin levels are involved in the immunopathogenesis of VL, most associated with severe VL. Despite relapses occurring in about 4–5% of patients with VL not associated with HIV infection, the factors underlying relapses are little known. Our aim was to identify clinical, laboratory and immunological parameters that may be associated with recurrences in VL. Methods Fifteen VL patients recruited from Hospital Eduardo de Menezes (BH-MG) were grouped into relapsing (R-VL, n = 5) and non-relapsing (NR-VL, n = 10) and evaluated during active disease, immediately after treatment (post-treatment) and 6 months post-treatment (6mpt). Clinical and laboratory data obtained from medical records were correlated with CD4+ and CD8+ T cell counts and anti-Leishmania Igs and IL-6 plasma levels and compared to those parameters of ten healthy controls. Results During the active phase of VL, despite similarity in the clinical symptoms, the rates of thrombocytopenia, elevated transaminases (AST and ALT) and hyperbilirubinemia were higher in the NR-VL group compared to R-VL (p < 0.05), a profile reversed during the post-treatment phase. All patients had low CD4+ T counts in active phase, however, NR-VL patients had a higher gain of this cell type than R-VL in the post-treatment (p < 0.05). There was a significant reduction in IgG3 levels during the follow-up in the NR-VL group compared to the R-VL, especially at 6mpt (p < 0.05). In addition, IgG3 levels were negatively correlated with CD4+ T counts in the R-VL group (r = − 0.52). Elevated levels of IL-6 were observed in active VL and correlated with clinical markers of severity. Conclusions During active phase of VL, the NR-VL patients presented more severe laboratorial abnormalities compared to R-VL, probably because the latter had already received previous treatment. On the other hand, R-VL exhibited greater impairment of immune reconstitution and a high degree of B lymphocyte activation, which must be a factor that favored relapses.https://doi.org/10.1186/s12879-021-06051-5Visceral leishmaniasisRelapsesClinical follow-upImmune response |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Renata Caetano Kuschnir Leonardo Soares Pereira Maria Rita Teixeira Dutra Ludmila de Paula Maria Luciana Silva-Freitas Gabriela Corrêa-Castro Simone da Costa Cruz Silva Glaucia Cota Joanna Reis Santos-Oliveira Alda Maria Da-Cruz |
spellingShingle |
Renata Caetano Kuschnir Leonardo Soares Pereira Maria Rita Teixeira Dutra Ludmila de Paula Maria Luciana Silva-Freitas Gabriela Corrêa-Castro Simone da Costa Cruz Silva Glaucia Cota Joanna Reis Santos-Oliveira Alda Maria Da-Cruz High levels of anti-Leishmania IgG3 and low CD4+ T cells count were associated with relapses in visceral leishmaniasis BMC Infectious Diseases Visceral leishmaniasis Relapses Clinical follow-up Immune response |
author_facet |
Renata Caetano Kuschnir Leonardo Soares Pereira Maria Rita Teixeira Dutra Ludmila de Paula Maria Luciana Silva-Freitas Gabriela Corrêa-Castro Simone da Costa Cruz Silva Glaucia Cota Joanna Reis Santos-Oliveira Alda Maria Da-Cruz |
author_sort |
Renata Caetano Kuschnir |
title |
High levels of anti-Leishmania IgG3 and low CD4+ T cells count were associated with relapses in visceral leishmaniasis |
title_short |
High levels of anti-Leishmania IgG3 and low CD4+ T cells count were associated with relapses in visceral leishmaniasis |
title_full |
High levels of anti-Leishmania IgG3 and low CD4+ T cells count were associated with relapses in visceral leishmaniasis |
title_fullStr |
High levels of anti-Leishmania IgG3 and low CD4+ T cells count were associated with relapses in visceral leishmaniasis |
title_full_unstemmed |
High levels of anti-Leishmania IgG3 and low CD4+ T cells count were associated with relapses in visceral leishmaniasis |
title_sort |
high levels of anti-leishmania igg3 and low cd4+ t cells count were associated with relapses in visceral leishmaniasis |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2021-04-01 |
description |
Abstract Background Visceral leishmaniasis (VL) is severe and potentially fatal. Brazil is one of the countries with the greatest endemicity for the disease in the world. The reduction of CD4+ T lymphocytes, B cells activation and high levels of inflammatory cytokines (IL-6/IL-8/TNF/IL-1β), plasma LPS, soluble CD14, anti-Leishmania IgG3 and low leptin levels are involved in the immunopathogenesis of VL, most associated with severe VL. Despite relapses occurring in about 4–5% of patients with VL not associated with HIV infection, the factors underlying relapses are little known. Our aim was to identify clinical, laboratory and immunological parameters that may be associated with recurrences in VL. Methods Fifteen VL patients recruited from Hospital Eduardo de Menezes (BH-MG) were grouped into relapsing (R-VL, n = 5) and non-relapsing (NR-VL, n = 10) and evaluated during active disease, immediately after treatment (post-treatment) and 6 months post-treatment (6mpt). Clinical and laboratory data obtained from medical records were correlated with CD4+ and CD8+ T cell counts and anti-Leishmania Igs and IL-6 plasma levels and compared to those parameters of ten healthy controls. Results During the active phase of VL, despite similarity in the clinical symptoms, the rates of thrombocytopenia, elevated transaminases (AST and ALT) and hyperbilirubinemia were higher in the NR-VL group compared to R-VL (p < 0.05), a profile reversed during the post-treatment phase. All patients had low CD4+ T counts in active phase, however, NR-VL patients had a higher gain of this cell type than R-VL in the post-treatment (p < 0.05). There was a significant reduction in IgG3 levels during the follow-up in the NR-VL group compared to the R-VL, especially at 6mpt (p < 0.05). In addition, IgG3 levels were negatively correlated with CD4+ T counts in the R-VL group (r = − 0.52). Elevated levels of IL-6 were observed in active VL and correlated with clinical markers of severity. Conclusions During active phase of VL, the NR-VL patients presented more severe laboratorial abnormalities compared to R-VL, probably because the latter had already received previous treatment. On the other hand, R-VL exhibited greater impairment of immune reconstitution and a high degree of B lymphocyte activation, which must be a factor that favored relapses. |
topic |
Visceral leishmaniasis Relapses Clinical follow-up Immune response |
url |
https://doi.org/10.1186/s12879-021-06051-5 |
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