American Cutaneous Leishmaniasis, Lepromatous Leprosy, and Pulmonary Tuberculosis Coinfection with Downregulation of the T-helper 1 Cell Response.
Delobel, Pierre 1; Launois, Pascal 2; Djossou, Felix 3,4; Sainte-Marie, Dominique 3,4; Pradinaud, Roger 3,4
[Article] Clinical Infectious Diseases. 37(5):628-633, September 1, 2003.

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: Cutaneous leishmaniasis, leprosy, and tuberculosis are caused by intracellular pathogens whose development depends on impaired cell-mediated immunity. We report an exceptional triple association of American cutaneous leishmaniasis, lepromatous leprosy, and pulmonary tuberculosis in a man with no recognized immunodeficiency. Normal immunological assessment of the interferon-[gamma] pathway does not support the hypothesis of a genetic defect in any of the genes involved in the T helper (Th)-1 cytokine cascade in this patient. Unresponsiveness to interleukin (IL)-12 of his T cells after stimulation with Leishmania guyanensis, Mycobacterium bovis bacille Calmette-Guerin, and Mycobacterium leprae antigens suggested the inability to mount an appropriate Th cell response to upregulate the IL-12 receptor expression.

(C) Copyright Oxford University Press 2003.