Differential expression of chemokines in patients with localized and diffuse cutaneous American leishmaniasis

The abundance of macrophages in localized cutaneous leishmaniasis (LCL) and diffuse cutaneous leishmaniasis (DCL) lesions and differences in the composition ofT cell subsets indicate involvement of cell-specific chemotaxis processes. The expression of macrophage chemoattractant protein (MCP)-I, macrophage inflammatory protein (MIP)-IO ' and-lfJ, RANTES (regulated on activa-tion, normal T cell expressed and secreted), 1-309, and interleukin-8 were investigated in lesions of patients with LCL or DCL. In LCL, high levels of MCP-I and moderate levels of MIP-IO ' were detected. In DCL, MCP-I expression was significantly lower and MIP-IO ' expression was predomi-nant. All other chemokines investigated were minimally expressed or absent. These findings suggest that MCP-I and MIP-IO ' are responsible for the recruitment of macrophages and T cells in cutaneous leishmaniasis. The results show that self-healing LCL is associated with higher levels of MCP-I, which may stimulate macrophage microbicidal mechanisms, and nonhealing DCL is associated with higher levels of MIP-IO'. Cutaneous leishmaniasis is initiated by the bite of an infected sandfly and deposition of protozoan Leishmania parasites in the skin. In the mammalian host, the organisms are obligat