SERIAL STUDY OF THE IMMUNE-RESPONSE OF AN INDIVIDUAL WITH EXACERBATEDSIMPLE CUTANEOUS LEISHMANIASIS

The immunological responses of a patient with exacerbated cutaneous le ishmaniasis, measured during the course of the disease, are described. Except for skin lesions the patient was healthy and showed no signs o f immunosuppression. Three immunological parameters were measured: spe cific lymphocyte proliferation (LPA), monocyte effector activity (MEA) , and antibody levels. LPA was positive early in the course of the dis ease, became negative as the lesions enlarged, and was positive again as the lesions healed 28 weeks after initiation of the study. In the M EA test, in which the mononuclear cells of the patient were incubated in the presence of Leishmania major promastigotes in a 3-day assay, th e number of amastigotes per 100 monocytes remained constant until week 28 and then decreased significantly. Antibody levels remained elevate d until week 28 and then decreased to background levels. The results i ndicate that the cell-mediated immune response parallels the course of the disease while circulating antibodies show an inverse relationship .