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Immunomodulation of Macrophages May Benefit Cutaneous Leishmaniasis Outcome

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Abstract

Purpose of Review

This review emerges from the necessity to gather information of quality on the possibility to directly modulate macrophages and its functions to improve cutaneous leishmaniasis treatment in order to improve the lesions of the infection without leaving a disfiguring scar.

Recent Findings

Cutaneous leishmaniasis often leaves disfiguring scars, a fact associated with improper infection resolution related to an inappropriate action of the macrophages. As these cells are the main target of Leishmania spp., these parasites subvert macrophages’ response to avoid a pro-inflammatory profile, with interferon-γ (IFN-γ) and tumoural necrosis factor-α (TNF-α), and induce an anti-inflammatory with the participation of IL-10. These are one of the many strategies that different species of Leishmania spp. used to escape the immune response, which also includes reducing oxidative stress and parasite killing. The use of immune mediators to induce pro-inflammatory macrophages has been showing success into eliminating the parasites and promoting a proper resolution of the infection.

Summary

The treatment of CL often eliminates the parasites; however, beyond its cytotoxicity, it takes time and still a disfiguring scar remain. Therefore, the treatment should be based on several aspects such as the clinical manifestation, localization of the lesions, and the possibility to integrate other medications beyond focusing only on parasite killing. Thus, the treatment aiming the modulation of the immune system together with traditional treatments, given that Leishmania can interfere in the pro-inflammatory pathway of the macrophages, could represent an alternative strategy to promote complete closure of the lesions without disfiguring scar.

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Acknowledgements

The authors thank Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).

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TSA receives a fellowship from CAPES.

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  1. Laboratory of Applied Immunology, Masters’ Program of Pharmaceutical Science, Center of Medical and Pharmaceutical Sciences, Western Parana State University (UNIOESTE), 2069 Universitaria St., Cascavel, PR, Brazil

    Lucas Bonatto de Souza Lima, Rafael Andrade Menolli & Thais Soprani Ayala

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  1. Lucas Bonatto de Souza Lima
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LBSL: Drafting the article, Acquisition of data; RAM: Acquisition of data, Analysis, and interpretation of data TSA: Conception and design of the study, Acquisition of data, Drafting the article, Final approval of the version to be submitted.

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Correspondence to Thais Soprani Ayala.

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The authors Rafael Andrade Menolli and Thais Soprani Ayala did contribute equally as corresponding author.

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de Souza Lima, L.B., Menolli, R.A. & Ayala, T.S. Immunomodulation of Macrophages May Benefit Cutaneous Leishmaniasis Outcome. Curr Trop Med Rep 10, 281–294 (2023). https://doi.org/10.1007/s40475-023-00303-x

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