Serological profiles in Indian post kala-azar dermal leishmaniasis.

TLDR: Analysis of the data suggests an over-all difference between the serological profiles of PKADL and KA patients and reasonably good correlation between the severity of dermal lesions and IgG-ELISA titres was obtained.

Abstract: Post kala-azar dermal leishmaniasis (PKADL) is sequal to some of the visceral leishmaniasis (kala-azar) patients. More than 10% of Indian kala-azar (KA) patients develop this nonulcerative skin lesions, containing Leishmania donovani, within one to two years after recovery from visceral infection by the parasite (Brahmachari, 1922). The apparent change in the viscerotropic properties of L. donovani to dermatotropism is believed to be induced by the immunoregulatory mechanisms operating in these treated KA patients (Adler, 1964). Presence of antileishmanial antibodies were demonstrated in the sera of PKADL patients with active dermal lesions (Mukherjee et al., 1968, Haldar et al., 1981). Attention has been focussed on the cell-mediated immune (CMI) response (Haldar et al, 1983) as CMI plays a major role in protection against leishmaniasis (Mauel and Behin, 1982). In the present study, we have attempted to look into both the cellular and humoral immune profiles of 14 Indian PKADL patients, followed up longitudinally before and after the period of treatment. For this, lymphocyte transformation tests have been carried out in vitro in the presence of Leishmania antigen and the results are correlated with those of skin test experiments in vivo. Furthermore, alterations in the serum IgG and IgM class specific antileishmanial antibody titers have been determined by standardized ELISA method. All these results are discussed with respect to our knowledge on the immunology of clinical leishmaniasis.