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<i>Leishmania donovani</i>-Induced Immune Dysregulation among Sudanese Patients with Visceral and Post Kala-Azar Dermal Leishmaniases: Possible Roles in Pathogenesis

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Advances in Infectious Diseases 2020年第4期10卷 235-242页

作者： elsamani elmotwafig mohamed elsammani Brima Younis Musa Mona Elfaki Eltahir Elfaki Ahmed Mudawi Mudawi Eltahir Awad Gasim Khalil Institute of Endemic Diseases University of Khartoum Khartoum Sudan Department of Microbiology and Clinical Parasitology College of Medicine King Khalid University Abha KSA

L. donovani infections (visceral and post kala-azar dermal leishmaniases) are characterized by infection-induced reversible immune suppression. Autoimmunity is a well-documented phenomenon among patients with primary immune deficiencies. This study aimed to study auto-immune phenomena accompanying L. donovani infections. In a prospective case-controlled study and following informed consent, 155 individuals with visceral leishmaniasis (VL;n = 62), post kala-azar dermal leishmaniasis (PKDL;n = 31) and apparently healthy volunteers (n = 62) were recruited. Sera antinuclear (ANA), anti-dsDNA, anti-thyroid peroxidase (TPO), anti-smooth muscles (ASMA) and F-actin auto-antibodies were measured using ELISA and indirect immune-fluorescence assay. The mean ages of VL, PDKL patients and apparently healthy volunteers were: 17.5 ± 12.5, 15.0 ± 7.0 and 17.5 ± 9.5 years with Male:Female ratios of 2:0, 1:2 and 1:5 respectively. Significantly high frequencies of F-actin (74.2%;46/62) and ASMA (50%;31/62) auto-antibodies were seen among VL patients (p = 0.003, p = 0.001) compared to apparently healthy volunteers. Likewise, significantly high frequencies of F-actin (64.5%;20/31;p = 0.001), ASMA (42%;13/31;p = 0.003), ANA (36%;11/31;p = 0.001) and anti-dsDNA (16%;5/31;p = 0.01) auto-antibodies were seen among PKDL patients. Development of tissue-based autoantibodies in L. donovani infections probably indicates loss of peripheral tolerance with activation of circulating auto-reactive T and B cells probably contributing to disease pathogenesis (increased bilirubin/liver enzymes, prolonged QT interval/arrythmias and blood cytopenias). In conclusion, L. donovani infection-induced immune suppression with development of tissue-based auto-antibodies is prevalen

关键词： L. donovani-Induced Immune Suppression Tissue-Based Autoimmunity Pathogenesis

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Leishmania donovani -Induced Immune Dysregulation among Sudanese Patients with Visceral and Post Kala-Azar Dermal Leishmaniases: Possible Roles in Pathogenesis

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Advances in Infectious Diseases（传染病进展） 2020年第5期

作者： elsamani elmotwafig mohamed elsammani Brima Younis Musa Mona Elfaki Eltahir Elfaki Ahmed Mudawi Mudawi Eltahir Awad Gasim Khalil

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