Cell-mediated immune response in cutaneous leishmaniasis patients

The aim of this study was to evaluate the cell-mediated immune response in cutaneous leishmaniasis (CL) patients, its usefulness as a diagnostic tool and to examine its variability in relation to chemotherapeutic treatment. Cell-mediated immunity was evaluated by a lymphocyte proliferation (LP) assay using whole blood specimens collected from 68, CL patients. Forty of them were treated topically with paromomycin plus methylbenzethonium chloride ointment ± systemic allopurinol, and tested before and after termination of treatment. The LP assay was positive in 86%-100% of the untreated patients at the time of referral. Treatment given at various intervals after infection neither altered, nor terminated the development of cellular immune response. A fluctuation of the immune response was observed in 4 patients during infection. Therefore, we conclude that the LP response becomes positive very early after infection, and can be used as an additional diagnostic tool for CL. No correlation was demonstrated between the level of LP and the result of treatment.