Immunochemotherapy in American cutaneous leishmaniasis: Immunological aspects before and after treatment

In this study, we evaluated the immune response of patients suffering from cutaneous leishmaniasis treated with two distinct protocols. one group was treated with conventional chemotherapy using pentavalent antimonium salts a nd the other with immunochemotherapy where a vaccine against cutaneous leis hmaniasis was combined with the antimonium salt. Our results show that, alt hough no differences were observed in the necessary time for complete heali ng of the lesions between the two treatments, peripheral blood mononuclear cells from patients treated by chemotherapy showed smaller lymphoproliferat ive responses at the end of the treatment than those from patients in the i mmunochemotherapy group. Furthermore, IFN-gamma production was also differe nt between the two groups. While cells from patients in the chemotherapy gr oup produced more IFN-gamma at the end of treatment, a significant decrease in this cytokine production was associated with healing in the immunochemo therapy group. In addition, IL-10 production was also less intense in this latter group. Finally, an increase in CD8+ -IFN-gamma producing cells was d etected in the chemotherapy group. Together these results point to an alter native treatment protocol where healing can be induced with a decreased pro duction of a potentially toxic cytokine.