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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Post-Kala-azar dermal leishmaniasis: A paradigm of paradoxical immune reconstitution syndrome in non-HIV/AIDS patients
Journal of Tropical Medicine, Article 275253, Year 2013
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Description
Visceral leishmaniasis (VL) is a parasitic disease characterized by immune suppression. Successful treatment is usually followed by immune reconstitution and a dermatosis called post-Kala-azar dermal leishmaniasis (PKDL). Recently, PKDL was described as one of the immune reconstitution syndromes (IRISs) in HIV/VL patients on HAART. This study aimed to present PKDL as a typical example of paradoxical IRIS in non-HIV/AIDS individuals. Published and new data on the pathogenesis and healing of PKDL was reviewed and presented. The data suggested that PKDL is a typical example of paradoxical IRIS, being a new disease entity that follows VL successful treatment and immune recovery. PKDL lesions are immune inflammatory in nature with granuloma, adequate response to immunochemotherapy, and an ensuing hypersensitivity reaction, the leishmanin skin test (LST). The data also suggested that the cytokine patterns of PKDL pathogenesis and healing are probably as follows: an active disease state dominated by IL-10 followed by spontaneous/treatment-induced IL-12 priming, IL-2 stimulation, and INF-γ production. INF-γ-activated macrophages eliminate the Leishmania parasites/antigen to be followed by LST conversion and healing. In conclusion, PKDL is a typical example of paradoxical IRIS in non-HIV/AIDS individuals with anti-inflammatory cytokine patterns that are superseded by treatment-induced proinflammatory cytokines and lesions healing. © 2013 Eltahir Awad Gasim Khalil et al.
Authors & Co-Authors
Khalil, Eltahir Awad Gasim
Sudan, Khartoum
Leishmaniasis Research Group
Sudan, Khartoum
Institute of Endemic Diseases Sudan
Sudan, Khartoum
Ministry of Science and Technology
Khidir, Selma Abdelmoneim
Sudan, Khartoum
Leishmaniasis Research Group
Sudan, Khartoum
Institute of Endemic Diseases Sudan
Musa, Ahmed Mudawi
Sudan, Khartoum
Leishmaniasis Research Group
Sudan, Khartoum
Institute of Endemic Diseases Sudan
Musa, Brima Younis
Sudan, Khartoum
Leishmaniasis Research Group
Sudan, Khartoum
Institute of Endemic Diseases Sudan
Elfaki, Mona Eltahir
Sudan, Khartoum
Leishmaniasis Research Group
Sudan, Khartoum
Institute of Endemic Diseases Sudan
Elkadaru, Abd Elgadir Mohamed Yousif
Sudan, Khartoum
Leishmaniasis Research Group
Sudan
Tropical Diseases Hospital
Zijlstra, Eduard Evert
Sudan, Khartoum
Leishmaniasis Research Group
Sudan, Khartoum
Institute of Endemic Diseases Sudan
el-Hassan, Ahmed Mohamed A.
Sudan, Khartoum
Leishmaniasis Research Group
Sudan, Khartoum
Institute of Endemic Diseases Sudan
Statistics
Citations: 22
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1155/2013/275253
ISSN:
16879686
e-ISSN:
16879694
Research Areas
Infectious Diseases