Lesion Size Correlates with Leishmania Antigen-Stimulated TNF-Levels in Human Cutaneous Leishmaniasis

Fabiano Oliveira Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia (iii-INCT), Bahia, Brazil

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Andre Bafica Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia (iii-INCT), Bahia, Brazil

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Andrea B. Rosato Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia (iii-INCT), Bahia, Brazil

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Cecilia B. F. Favali Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia (iii-INCT), Bahia, Brazil

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Jackson M. Costa Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia (iii-INCT), Bahia, Brazil

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Virginia Cafe Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia (iii-INCT), Bahia, Brazil

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Manoel Barral-Netto Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia (iii-INCT), Bahia, Brazil

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Aldina Barral Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia (iii-INCT), Bahia, Brazil

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Cutaneous leishmaniasis (CL) is a worldwide disease endemic in several regions of the globe. The hallmark of CL is skin ulcers likely driven by efforts of the immune system to control Leishmania growth. Cytokines, such as tumor necrosis factor (TNF) and interferon-gamma can control disease progression in animal models. Nevertheless, the impact of these cytokines in CL ulcer outcome is not well established in humans. In this study, 96 CL patients from an endemic area of Leishmania braziliensis were enrolled for a follow-up study that consisted of clinical and immunological evaluations in a 2-year period. Statistical analysis revealed that healing time (P = 0.029), age (P = 0.002), and TNF levels (P = 0.0002) positively correlate with ulcer size at the time of the first clinical evaluation. Our findings suggest that ulcer size correlates with healing time and TNF levels support the use of TNF inhibitors combined with standard therapy to improve healing in CL patients with severe lesions.

Author Notes

*Address correspondence to Aldina Barral, Laboratório de Imunoparasitologia (LIP), Centro de Pesquisas Gonçalo Moniz (CPqGM), Fundação Oswaldo Cruz – FIOCRUZ - Salvador, Bahia, Brazil. E-mail: abarral@bahia.fiocruz.br

Financial support: This work is supported by grants from CNPq, FAPESB, and PAPES/FIOCRUZ. ABafica, JC, ABarral and MB-N are investigators from the Brazilian National Council for Scientific and Technological Development (CNPq).

Authors' addresses: Fabiano Oliveira, Laboratory of Malaria and Vector Research, National Institutes of Health, Rockville, MD, E-mail: deepbahia@gmail.com. Andre Bafica, Universidade Federal de Santa Catarina, Departamento de Microbiologia, Imunologia e Parasitologia, Florianopolis, Santa Catarina, Brazil, E-mail: abafica@ccb.ufsc.br. Andrea B. Rosato, Laboratório de Imunoparasitologia (LIP), Centro de Pesquisas Gonçalo Moniz (CPqGM), Fundação Oswaldo Cruz – FIOCRUZ - Bahia, Salvador, Bahia, Brazil, E-mail: rosatoab@hotmail.com. Cecilia B. F. Favali, Universidade de Brasília, Instituto de Ciencias Biologicas, Departamento de Biologia Celular, Brasilia, Distrito Federal, Brazil, E-mail: cfavali@unb.br. Jackson M. Cost, Laboratório de Imunoparasitologia (LIP), Centro de Pesquisas Gonçalo Moniz (CPqGM), Fundação Oswaldo Cruz – FIOCRUZ - Bahia, Salvador, Bahia, Brazil, E-mail: jcosta@bahia.fiocruz.br. Virgina Cafe, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil, E-mail: Vcafe@ufba.br. Manoel Barral-Netto, Laboratório de Imuno-regulação (LIMI), Centro de Pesquisas Gonçalo Moniz (CPqGM), Fundação Oswaldo Cruz – FIOCRUZ - Bahia, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil; and Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia - iii - INCT, Salvador, Bahia, Brazil, E-mail: manoel.barral@gmail.com. Aldina Barral, Laboratório de Imunoparasitologia (LIP), Centro de Pesquisas Gonçalo Moniz (CPqGM), Fundação Oswaldo Cruz – FIOCRUZ - Bahia, Salvador, Bahia, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil; and Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia - iii - INCT, Salvador, Bahia, Brazil, E-mail: abarral@bahia.fiocruz.br.

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