Abstract
Introduction: The Northeast region accounts for 55% of leprosy cases and nearly 50% of cases of visceral leishmaniasis in Brazil. Ceará, in particular the Fortaleza capital is responsible for a large number of new cases of these diseases. This fact is reinforced by the correlation in the distribution of cases of these diseases in the state of Ceará counties where according to the data of the State Health Departament (2013), we observed strong epidemiological correlation between cases of leprosy and visceral leishmaniasis in 184 counties mostly in Fortaleza. Objectives: Our objective was to analyze the production of anti-PGL1 IgM antibodies in patients with visceral leishmaniasis untreated. Materials and Methods: 28 patients with clinical and laboratory confirmation for visceral leishmaniasis followed at São José Hospital for Infectious Diseases. Results: As to gender, 21 were males and 7 females, with a median age of 20,5 years (var 3-76 years.), Of which 15 patients did not require hospitalization and 13 were hospitalized for an average 28 days (var. 5 to 28 days). The mean and standard deviation of the anti-IgM PGL1 index was 1.91 ± 0.69, and 78.6% considered seropositive. Conclusion: It was not observed any difference between gender, age, necessity or not hospitalization, or time treatment. The high frequency of positive IgM anti-PGL1,can be secondary to polyclonal activation occurring in kala-azar, hindering the possibility of detection of M. leprae infection by serologic evaluation in high endemicity area for visceral leishmaniasis.
References
2 Ezenwa OV, Jolles EA. From host immunity to pathogen invasion: the effects of helmint coinfection on the dynamics of microparasites. Integr Comp Biol. 2011;51(4):540-551. doi: 10.1093/icb/icr058
3 Lee NH, Embi CS, Vigeland KM, White CR Jr. Concomitant pulmonary tuberculosis and leprosy. J Am Acad Dermatol. 2003 Oct;49(4):755-7. doi:10.1067/S0190-9622(03)00456-0
4 Supali T, Verweij JJ, Wiria AE, Djuardi Y, Hamid F, Kaisar MMM, et al. Polyparasitismand its impact on the immune system. Int J Parasitol. 2010 Aug;40(10):1171-6. doi:10.1016/j.ijpara.2010.05.003
5 Wammes LJ, Hamid F, Wiria AE, Gier B, Sartono E, Maizels RM, et al. Regulatory T cells in human geohelminth infection suppress immune responses to BCG and Plasmodium falciparum. Eur J Immunol. 2010;40(2):437-42. doi:10.1002/eji.200939699
6 Delobel P,Launois P, Djossou F, Sainte-Marie D, Pradinaud R. American cutaneous leishmaniasis, lepromatous lepros and pulmonary tuberculosis coinfection with downregulation of the T-helper 1 cell response. Clin Infect Dis. 2003;37(5):628-33. doi: 10.1086/376632
7 Molina I, Fisa R, Riera C, Falcó V, Elizalde A, Salvador F, et al. Ultrasensitive Real-Time PCR for the clinical management of visceral lesihmaniasis in HIV-infected patients. Am J Trop Hyg. 2013;89(1):105-10. doi:10.4269/ajtmh.12-0527
8 Bogaart EVD, Talha AB, Straetemans M, Mens PF, Adams ER, Grobusch MP et al. Cytokine profiles amongst Sudanese patients with visceral leishmaniasis and malaria co-infections. BMC Immunol. 2014 May;15(16):1-10. doi: 10.1186/1471-21721516
9 Scollard DM, Stryjewska BM, Prestigiacomo JF, Gillis TP, Waguespack-Labiche J. Hansen’s disease (leprosy) complicated by secondary mycobacterial infection. J Am Acad Dermatol. 2011 Mar;64(3):593-6. doi: 10.1016/j.jaad.2009.10.004.
10 Rijal A, Rijal S, Bhandari S. Leprosy coinfection with kala-zar.Int J Dermatol. 2009 Jul;48(7):740-2. doi:10.1111/j.1365-4632.2009.04018.x.
11 Azeredo-Coutinho RBG, Matos DCS, Nery JAC, Valete-RosalinoVM, Mendonça SCF. Interleikin-10 dependent down regulation of inteferon-gamma response to Leishmania by Mycobacterium leprae antigens during the clinical course of a coinfection. Braz J Med Biol Res 2012 July;45(7):632-6. doi:10.1590/S0100-879X2012007500073
12 Cecílio P, Pérez-Cabezas B, Santarém N, Maciel J, Rodrigues V, Cordeiro da Silva A. Deception and manipulation: the arms of Leishmania, a successful parasite. Front Immunol. 2014 Oct 20;5:480. doi: 10.3389/fimmu.2014.00480
13 Zofou D, Nyasa RB, Nsagha DS, Ntie-Kang F, Meriki HD, Assob JC, et al. Control of malaria and other vector-borne protozoan diseases in the tropics: enduring challenges despite considerable progress and achievements. Infect Dis Poverty. 2014 Jan 8;3(1):1. doi: 10.1186/2049-9957-3-1
14 Clem A. A current perspective on leishmaniasis. J Glob Infect Dis. 2010 May;2(2):124-6. doi: 10.4103/0974-777X.62863.
15 Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J, et al. Leishmaniasis worldwide and global estimates of its incidence. PLoS One. 2012;7(5):e35671. doi: 10.1371/journal.pone.0035671.
16 Gross TJ1, Kremens K, Powers LS, Brink B, Knutson T, Domann FE et al. Epigenetic silencing of the human NOS2 gene: rethinking the role of nitric oxide in human macrophage inflammatory responses. J Immunol. 2014 Mar 1;192(5):2326-38. doi: 10.4049/jimmunol.1301758
17 Olivier M, Atayde VD, Isnard A, Hassani K, Shio MT. Leishmania virulence factors: focus on the metalloprotease GP63. Microbes Infect. 2012 Dec;14(15):1377-89. doi: 10.1016/j.micinf.2012.05.014
18 Stromme EM, Bærøe K, Norheim OF. Disease control priorities for neglected tropical diseases: lessons form priority ranking based on the quality of evidence, cost effectiveness, severity of disease, catastrophic health expenditures, and loss of productivity. Dev World Bioeth. 2014;14(3):132-41. doi:10.1111/dewb.12016
19 Boer MC, Joosten SA, Ottenhoff TH. Regulatory T-cells at the interface between human host and pathogens in infectious diseases and vaccination.Front Immunol. 2015 May 11;6:217. doi: 10.3389/fimmu.2015.00217.
20 Roy S, Mukhopadhyay D, Mukherjee S, Ghosh S, Kumar S, Sarkar K, et al. A defective oxidative burst and impaired antigen presentation are hallmarks of human visceral leishmaniasis. J Clin Immunol. 2015 Jan;35(1):56-67. doi: 10.1007/s10875-014-0115-3.
21 Nagao-dias AT, Almeida TLP, Oliveira MF, Santos RC, Lima ALP, Brasil M. Salivary anti-PGL IgM and IgA titers and serum antibody IgG titers and avidities in leprosy patients and their correlation with time of infection and antigen exposure. Braz J Infect Dis. 2007 Apr;11(2):215-9. doi:101590/S1413-86702007000200009
22 Foss NT, Callera F, Alberto FL. Anti-PGL1 levels in leprosy patients and their contacts. Braz J Med Biol. 1993 [cited 2015 Nov 20];26(1):43-51 Available from: http://www.ncbi.nlm.nih.gov/pubmed/8220267
23 Frota CC, Freitas MV, Foss NT, Lima LN, Rodrigues LC, Barreto ML, et al. Seropositivity to anti-phenolic glycolipid-I in leprosy cases, contacts and no known contacts od leprosy in an endemic and a non-endemic area in Northeast Brazil. Trans R Soc Trop Med Hyg. 2010 Jul;104(7):490-5. doi: 10.1016/j.trstmh.2010.03.006.
24 Bazan-furini R, Motta ACF, Simão JCL, Tarquinio DC, Marques W Junior, Barbosa MHN et al. Early detection of leprosy by examination of household contects, determination of serun anti-PGL1 antibodies and consanguinity. Mem Ins Oswaldo Cruz. 2011;106(5):536-40. doi: 10.1590/S0074-02762011000500003
25 Amezcua Vesely MC, Bermejo DA, Montes CL, Acosta-Rodríguez EV, Gruppi A. B-cell response during protozoan parasite infections. J Parasitol Res. 2012;2012:362131. doi: 10.1155/2012/362131.
This work is licensed under a Creative Commons Attribution 4.0 International License.