Cytokine Responses to Novel Antigens in a Peri-Urban Population in Brazil Exposed to Leishmania infantum chagasi

Carmel B. Stober Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom; Department of Biochemistry, Bioscience Center, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Instituto de Ciência e Tecnologia de Doenças Tropicais, Natal, Rio Grande do Norte, Brazil; Cambridge Institute for Medical Research, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia

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Selma M. B. Jeronimo Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom; Department of Biochemistry, Bioscience Center, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Instituto de Ciência e Tecnologia de Doenças Tropicais, Natal, Rio Grande do Norte, Brazil; Cambridge Institute for Medical Research, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia

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Nubia N. Pontes Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom; Department of Biochemistry, Bioscience Center, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Instituto de Ciência e Tecnologia de Doenças Tropicais, Natal, Rio Grande do Norte, Brazil; Cambridge Institute for Medical Research, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia

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E. Nancy Miller Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom; Department of Biochemistry, Bioscience Center, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Instituto de Ciência e Tecnologia de Doenças Tropicais, Natal, Rio Grande do Norte, Brazil; Cambridge Institute for Medical Research, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia

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Jenefer M. Blackwell Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom; Department of Biochemistry, Bioscience Center, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Instituto de Ciência e Tecnologia de Doenças Tropicais, Natal, Rio Grande do Norte, Brazil; Cambridge Institute for Medical Research, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom; Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia

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Visceral leishmaniasis (VL) is fatal if untreated, and there are no vaccines for this disease. High levels of CD4-derived interferon-γ (IFN-γ) in the presence of low levels of interleukin-10 (IL-10) predicts vaccine success. Tumor necrosis factor-α (TNF-α) is also important in this process. We characterized human immune responses in three groups exposed to Leishmania infantum chagasi in Brazil: 1) drug-cured VL patients (recovered VL); 2) asymptomatic persons with positive Leishmania-specific delayed-type hypersensitivity skin reactions (DTH+); and 3) DTH-negative household contacts. Magnitude of DTH correlated with crude Leishmania antigen–driven IFN-γ, TNF-α, and IL-5, but not IL-10. DTH+ persons showed equivalent levels of IFN-γ, but higher levels of IL-10, to tryparedoxin peroxidase and Leishmania homolog of receptor for activated C kinase compared with recovered VL patients. The IFN-γ:IL-10 and TNF-α:IL-10 ratios were higher in recovered VL patients than in DTH+ persons. Seven of 11 novel candidates (R71, L37, N52, L302.06, M18, J41, and M22) elicited cytokine responses (36–71% of responders) in recovered VL patients and DTH+ persons. This result confirmed their putative status as cross-species vaccine/immunotherapeutic candidates.

Author Notes

* Address correspondence to Jenefer M. Blackwell, Telethon Institute for Child Health Research, University of Western Australia, PO Box 855, Subiaco, Western Australia 6872, Australia. E-mail: jblackwell@ichr.uwa.edu.au
† Deceased.

Financial support: This study was supported by grants from the National Institutes of Health to Jenefer M. Blackwell (R01AI067874-01) and Selma M. B. Jeronimo (P50 AI-30639).

Authors' addresses: Carmel B. Stober, Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, CB2 2QQ, United Kingdom, E-mail: c.stober@doctors.org.uk. Selma M. B. Jeronimo and Nubia N. Pontes, Department of Biochemistry, Bioscience Center, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, 59078-970, Brazil; and Instituto de Ciência e Tecnologia de Doenças Tropicais, Natal, Rio Grande do Norte, Brazil, E-mails: smbj@cb.ufrn.br and nnatalir@yahoo.com.br. Jenefer M. Blackwell, Cambridge Institute for Medical Research, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge CB2 0XY, United Kingdom; and Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia 6008, Australia, E-mail: jblackwell@ichr.uwa.edu.au.

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