TUMOR-NECROSIS-FACTOR-ALPHA IN HUMAN AMERICAN TEGUMENTARY LEISHMANIASIS

Tumor necrosis factor-alpha (TNF-alpha) is a cytokine produced by acti vated macrophages and other cells. In order to verify whether the seru m levels of TNF-alpha in American tegumentary leishmaniasis patients a re associated with the process of cure or aggravation of the disease, 41 patients were studied: 26 cases of cutaneous leishmaniasis (CL) and 15 of mucocutaneous leishmaniasis (MCL). During active disease the se rum levels of TNF-alpha of MCL patients were significantly higher than those of CL patients and control subjects (healthy individuals and cu taneous lesions from other etiologies). The MCL patients had serum tit ers of TNF-alpha significantly lower at the end of antimonial therapy than before therapy After a six-month follow-up, the MCL patients had serum levels of TNF-alpha similar to those observed at the end of the therapy as well as to those of CL patients and control subjects. No si gnificant variation in the serum levels of TNF-alpha was observed in C L patients throughout the study period (before, at the end of therapy and after a six-month follow-up). The possible relationship between th e high TNF-alpha serum levels and severity of the disease is discussed .