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Infect Immun, June 1998, p. 2698-2704, Vol. 66, No. 6
0019-9567/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Indications of the Protective Role of Natural Killer Cells in Human Cutaneous Leishmaniasis in an Area of Endemicity

Kerima Maasho,1 Fabio Sanchez,2 Erwin Schurr,2 Asrat Hailu,3 and Hannah Akuffo1,*

Microbiology and Tumour Biology Centre, Karolinska Institutet and Swedish Institute for Infectious Disease Control, Stockholm, Sweden1; McGill Centre for the Study of Host Resistance, McGill University, Montreal General Hospital, Montreal, Quebec, Canada2; and Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia3

Received 3 September 1997/Returned for modification 13 November 1997/Accepted 12 February 1998

The role of natural versus acquired immunity to Leishmania aethiopica infection in humans is the focus of our studies. We found in previous studies that mononuclear cells from nonexposed healthy Swedish donors responded to Leishmania antigen stimulation by proliferation and gamma interferon production. The main cell type responding was CD3- CD16/56+ natural killer (NK) cells. These findings led us to suggest that the potential to produce a rapid, nonacquired NK cell response may be a protective phenotype. In order to test this hypothesis, an area in Ethiopia where Leishmania is endemic was selected, and peripheral blood mononuclear cells were obtained from individuals who had lived in the area most of their lives but had no evidence of past or present leishmaniasis. Their responses were compared with those of confirmed leishmaniasis patients from the same region with active lesions or cured leishmaniasis lesions. Cells from these donors were stimulated in vitro with L. aethiopica antigen. Responses were measured by proliferation, cytokine production, and phenotype analysis by fluorescence-activated cell sorting. The association of NRAMP1 alleles with the studied phenotype and susceptibility to L. aethiopica-induced leishmaniasis was also evaluated. The results show that Leishmania antigens can induce NK cell and CD8+-T-cell responses in vitro. This is clearly seen in proliferating cells from the cured (immune) individuals and the apparently protected controls from the area of endemicity. It contrasted with the reactivity of the patients, where some NK proliferation was coupled with enhanced CD4+-T-cell proliferation. We conclude from these observations that NK cells and CD8+ cells proliferating in response to Leishmania stimulation are involved in protection from and healing of (Ethiopian) cutaneous leishmaniasis; however, such mechanisms appear to be unrelated to the NRAMP1 host resistance gene.

* Corresponding author. Mailing address: Microbiology and Tumour Biology Centre, Karolinska Institutet, Box 280, 17177 Stockholm, Sweden. Phone: 46 8 728 7236. Fax: 46 8 33 15 47. E-mail: Hannah.Akuffo{at}mtc.ki.se.

Infect Immun, June 1998, p. 2698-2704, Vol. 66, No. 6
0019-9567/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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