Características clínicas e imunológicas da leishmaniose mucocutânea

Abstract

In Brazil, American Cutaneous Leishmaniasis is primarily caused by the parasite Leishmania Vianna braziliensis. Mucosal Leishmaniasis, which involves only mucosal tissue, occurs as a result of the metastatic spread from skin lesions. According to the World Health Organization, leishmaniasis is one of the six most significant tropical diseases in terms of public health. The aim of the present study was to use immunohistochemistry to investigate the anatomopathological aspects of Mucosal Leishmaniasis, including the determination of the phenotypic profile of the cell population and tissue cytokines before and after treatment. In recent years, immunohistochemistry has become a valuable tool in understanding the immunopathology of various infectious diseases, including leishmaniasis, as it enables the detection of the infectious agent and the characterization of the cell types and cytokines involved in the inflammatory response. The study was carried out through a retrospective analysis of medical records from 1301 patients treated at the leishmaniasis outpatient clinic of the Júlio Müller University Hospital of the Federal University of Mato Grosso from 2008 to 2017, as well as a crosssectional study with patients treated at the same clinic from 2019 to 2021. We analyzed the histopathology, immunophenotyping of lymphocytes, and parasitemia of patients with mucosal leishmaniasis before and after therapy, and correlated the results with cure or therapeutic failure. Our data showed that therapeutic failure was associated with high parasitemia and a Th2 and Treg lymphocyte profile. To maintain homeostasis in the inflamed tissue, several mediators, including annexin A1, play an important role in regulating inflammation. Our findings demonstrate that Th2 and Treg cells have higher expression levels of this protein. The data presented in this study, combined with previous literature, highlight the significance of annexin A1 dynamics in the regulation of the immune system during mucosal leishmaniasis. This is the first study to contribute to the understanding of the role of annexin A1 in the interaction with Th1, Th2, TH17, and Treg cells in mucosal leishmaniasis