Introduction. T-helper cells (Th)-1& -2 cytokines homeostasis control orpredict clinical outcome of infected persons, especially those with HIV /AIDS. This case-control study evaluated the leucocytes differentials, TNF-alpha, interleukin (IL)-2 and -10 levels among HIV infected persons with serological evidence of leishmaniasis attending University of Abuja Teaching Hospital, Nigeria
Material and Methods. Blood samples from 28 HIV infected persons who had Leishmania donovani rK39 and IgG positive (group 1), 30 age- & -sex matched HIV infected persons without Leishmania antibodies (group 2) and 30 apparently healthy persons without HIV and Leishmania antibodies (group 3). Full blood counts, TNF alpha, IL-2 and -10 levels were analyzed using automated hematology analyzer and ELISA, respectively. Structured questionnaires were used to collate biodata and clinical presentations of participants.
Results. Ten (35.7%) participants in group 1 were on ART, 15 (50%) in group 2 were on ART, while group 3 were ART naïve. There were significantly higher values in basophil (4.4 ± 2.5%) and eosinophil counts (12.9 ± 3.8%) in HIV/leishmania coinfected persons (p ˂ 0.005). However, other white cells subpopulation was significantly lower in HIV/leishmania co-infected participants (p ˂ 0.05). There was significantly reduced CD4+ T cell counts ([119 ± 26 versus 348 ± 63 versus 605 ± 116 cells/mm3]), TNF-alpha ([36.82 ± 8.21 versus 64.67 ± 12.54 versus 254.98 ± 65.59 pg/mL]) and IL-2 levels ([142.14 ± 20.91 versus 507.6 ± 84.42 versus 486.62 ± 167.87 pg/mL]) among HIV/Leishmania co-infected participants compared to group 2 and group 3 participants, respectively. However, higher IL-10 level (80.35 ± 14.57 pg/mL) was found in HIV/Leishmania co-infected participants as opposed to the HIV mono-infected (62.2 ± 10.43 pg/mL) and apparently healthy persons (23.97 ± 4.88 pg/mL) (p ˂ 0.001).
Conclusion. Eosinophil, basophil counts and serum IL-10 level were high in HIV/Leishmania coinfected persons, demonstrating parasite-induced hypersensitivity and immunosuppression.
- Adriaensen W, Dorlo TPC, Vanham G, Kestens L, Kaye PM and van Griensven J. Immunomodulatory Therapy of Visceral Leishmaniasis in Human Immunodeficiency Virus- Coinfected Patients. Front. Immunol. 2018. 8:1943. doi: 10.3389/fimmu.2017.01943
- Monge-Maillo B, Norman FF, Cruz I, Alvar J, Lo´pez-Ve´lez R. Visceral Leishmaniasis and HIV Coinfection in the Mediterranean Region. PLoS Negl Trop Dis. 2014. 8: e3021. doi:10.1371/journal.pntd.0003021
- Lindoso JA, Cota GF, da Cruz AM, Goto H, Maia-Elkhoury ANS. Visceral Leishmaniasis and HIV Coinfection in Latin America. PLoS Negl Trop Dis. 2014; 8(9): e3136. doi:10.1371/journal.pntd.0003136
- Ezra N, Ochoa MT, Craft N. Human immunodeficiency virus and leishmaniasis. J Global Infect Dis. 2010; 2:248–257
- de Vries HJC, Reedijk SH, Schallig HDFH. Cutaneous Leishmaniasis: Recent Developments in Diagnosis and Management. Am J Clin Dermatol. 2015; 16: 99–109
- WHO Report on Global Surveillance of Epidemic-prone Infectious Diseases – Leishmaniasis. 2019. https://www.who.int/csr/resources/publications/CSR_ISR_2000_1leish/en/ Last accessed 20th August, 2019.
- Shafiei R, Mohebali M, Akhoundi B, Galian MS, Kalantar F, Ashkan S, et al. Emergence of co-infection of visceral leishmaniasis in HIV-positive patients in northeast Iran: A preliminary study. Trav Med Infect Dis. 2014; 12: 73-178
- Forestier C, Gao Q, Boons G. Leishmania lipophosphoglycan: how to establish structure-activity relationships for this highly complex and multifunctional glycoconjugate? Front Cell Infect Microbiol. 2014; 4: 193.
- Rodrigues MZA, Grassi MFR, Mehta S, Zhang X, Gois LL, Schooley RT, et al. Th1/Th2 Cytokine Profile in Patients Coinfected with HIV and Leishmania in Brazil. Clin Vacc Immunol, 2011; p. 1765–1769
- Gois LL, Mehta S, Rodrigues MZ, Schooley RT, Badaro R, Grassi MF. Decreased memory T-cell response and function in human immunodeficiency virus-infected patients with tegumentary leishmaniasis. Mem Inst Oswaldo Cruz 2014; 109:9–14. doi:10.1590/0074-0276130174
- Andargie TE, Ejara ED. Pro- and Anti-inflammatory Cytokines in Visceral Leishmaniasis. J Cell Sci Therap, 2015; 6:1-8. DOI: 10.4172/2157-7013.1000206.
- Abbas AK, Lichtman AH, Pillai S. Cellular and Molecular Immunology. (7thedn) Elsivier Inc, Philadelphia. 2012
- Costa AS, Costa GC, Aquino DM, Mendonça VR, Barral-Netto M, Caldas Ade J. Cytokines and visceral leishmaniasis: a comparison of plasma cytokine profiles between the clinical forms of visceral leishmaniasis. Mem Inst Oswaldo Cruz. 2012;107:735-739.
- Dayakar A, Chandrasekaran S, Kuchipudi SV, Kalangi SK. Cytokines: Key Determinants of Resistance or Disease Progression in Visceral Leishmaniasis: Opportunities for Novel Diagnostics and Immunotherapy. Frontiers Immunol 2019; 10:670. doi: 10.3389/fimmu.2019.00670.
- Murray HW, Jungbluth A, Ritter E, Montelibano C, Marino MW. Visceral leishmaniasis in mice devoid of tumor necrosis factor and response to treatment. Infect Immun., 2000. 68:6289–93.
- Stegall T. Cytokines, Clinical Immunology & Serology. (4th edn) F.A. Davis Company, Philadelphia. 2010.
- Nylen S, Sacks D. Interleukin-10 and the pathogenesis of human visceral leishmaniasis. Trends Immunol., 2007; 28:378–84. doi: 10.1016/j.it.2007.07.004.
- Mesquita I, Ferreira C, Barbosa AM, Ferreira CM, Moreira D, Carvalho A, et al. The impact of IL-10 dynamic modulation on host immune response against visceral leishmaniasis. Cytokine, 2018; 112:16–20. doi: 10.1016/j.cyto.2018.07.001
- Botana L, Ibarra-Meneses AV, Sánchez C, Castro A, San Martin JV, Molina L, et al. Asymptomatic immune responders to Leishmania among HIV positive patients. PLoS Negl Trop Dis. 2019; 13: e0007461. https://doi.org/10.1371/journal. pntd.0007461.
- Okwor I, Uzonna JE. The immunology of Leishmania/HIV co-infection. Immunol Res. 2013; 56:163– 71. Epub 2013/03/19. https://doi.org/10.1007/s12026-013-8389-8 PMID: 23504228.
- van Griensven J, Carrillo E, Lopez-Velez R, Lynen L, Moreno J. Leishmaniasis in immunosuppressed individuals. Clin Microbiol Infect. 2014; 20:286–99. Epub 2014/01/24. https://doi.org/10.1111/1469- 0691.12556 PMID: 24450618.
- Henn GAL, Júnior ANR, Colares JKB, Mendes LP, Silveria JGC, Lima AAF, et al. Is Visceral Leishmaniasis the same in HIV-co-infected adults? Braz J Infect Dis. 2018; 22:92–98.
- Smelt S, Cotterell SJ, Engwerda C, Kaye P. B cell-deficient mice are highly resistant to Leishmania donovani infection, but develop neutrophil-mediated tissue pathology. J Immunol. 2000. 164: 3681–3688.
- McFarlane E, Perez C, Charmoy M, Allenbach C, Carter K, Alexander J, et al. Neutrophils Contribute to Development of a Protective Immune Response during Onset of Infection with Leishmania donovani. Infect Immun. 2008; 76: 532–541.
- Laskay T, van Zandbergen G, Solbach W. Neutrophil granulocytes as host cells and transport vehicles for intracellular pathogens: apoptosis as infection-promoting factor. Immunobiol, 2008; 213:183–91.
- Sheel M, Engwerda C. The diverse roles of monocytes in inflammation caused by protozoan parasitic diseases. Trends Parasitol. 2012; 28: 408–416.
- Leon B, Lopez-Bravo M, Ardavin C. Monocyte-derived dendritic cells formed at the infection site control the induction of protective T helper 1 responses against Leishmania. Immun. 2007; 26:519–31