Circulating immune complexes (IC) and IC-induced levels of GM-CSF are increased in sudanese patients with acute visceral Leishmania donovani infection undergoing sodium stibogluconate treatment: implications for disease pathogenesis

J Immunol. 2007 Apr 15;178(8):5383-9. doi: 10.4049/jimmunol.178.8.5383.

Abstract

Infection with Leishmania donovani is associated with IL-10 as well as with GM-CSF. Immune complexes (IC) exert important functions by stimulation of monocytes/macrophage-mediated production of pro- and anti-inflammatory cytokines in rheumatic diseases. In this investigation, we have explored IC-induced cytokine production during Leishmania infection. Sera from 43 patients with visceral leishmaniasis (VL), 17 patients with post-kala-azar dermal leishmaniasis, and 20 healthy Sudanese controls were precipitated with polyethylene glycol (PEG). The PEG precipitates were added to serum-free PBMC for 20 h,whereupon supernatant levels of IL-1beta, IL-6, IL-10, IL-1 receptor antagonist protein, TNF-alpha, TNF receptor p75, and GM-CSF were investigated using ELISA. Circulating levels of C1q-binding IC were also measured in the serum samples. PEG precipitates from Leishmania-infected patients induced significantly higher levels of GM-CSF (p = 0.0037) and IL-10 (p < 0.0001), as well as of IL-6 (p < 0.0001) and IL-1 receptor antagonist (p = 0.0238) as compared with PEG precipitates from controls. Patients with acute VL as well as VL patients receiving sodium stibogluconate treatment displayed significantly increased levels of PEG precipitate-induced GM-CSF. The induction of GM-CSF by circulating IC was especially prominent in acute VL patients receiving sodium stibogluconate treatment; ANOVA revealed significant interaction between disease activity and treatment for PEG precipitate-induced levels of GM-CSF (disease activity, p = 0.0006; treatment, p = 0.0005; interaction, p = 0.0046). Parallel associations were determined for C1q-binding immune complexes, but not for any cytokine other than GM-CSF. The importance of IC-induced GM-CSF in leishmaniasis warrants further study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antigen-Antibody Complex / blood*
  • Antimony Sodium Gluconate / therapeutic use*
  • Antiprotozoal Agents / therapeutic use*
  • Cytokines / biosynthesis
  • Granulocyte-Macrophage Colony-Stimulating Factor / blood*
  • Humans
  • Leishmania donovani*
  • Leishmaniasis, Visceral / drug therapy
  • Leishmaniasis, Visceral / etiology
  • Leishmaniasis, Visceral / immunology*
  • Polyethylene Glycols / pharmacology
  • Receptors, IgG / physiology

Substances

  • Antigen-Antibody Complex
  • Antiprotozoal Agents
  • Cytokines
  • Receptors, IgG
  • Polyethylene Glycols
  • Granulocyte-Macrophage Colony-Stimulating Factor
  • Antimony Sodium Gluconate