Is There Any Difference in the In Situ Immune Response in Active Localized Cutaneous Leishmaniasis That Respond Well or Poorly to Meglumine Antimoniate Treatment or Spontaneously Heal?

Localized cutaneous leishmaniasis caused by Leishmania braziliensis can either respond well or poorly to the treatment heal spontaneously; It seems be dependent on parasite and/or host factors, but mechanisms are not fully understood. We evaluated in situ immune response eighty-two active lesions from fifty-eight patients prior classified as early spontaneous regression (SRL-n = 14); responders (GRL-n 20); and non-responders (before first treatment/relapse, PRL1/PRL2-n 24 each). Immunohistochemistry was used identify cell/functional markers which were correlated with clinical characteristics. PRL showed significant differences lesion number/size, evolution, positive parasitological examinations when compared other groups. SRL presented a more efficient than GRL PRL, higher IFN-γ/NOS2 lower percentage of macrophages, neutrophils, NK, B cells, Ki-67+ cells. Compared SRL, had fewer CD4+ Tcells CD163+ macrophages. PRL1 CD68+ macrophages cells less IFN-γ GRL. present profile, could explain poor response, while balanced profile for healing. Altogether, these evaluations suggest differentiated organization inflammatory process different tegumentary evolution.