Association of Testosterone and Cholesterol Level in Modulation of Immunity and Severity of Disease in Visceral Leishmaniasis Patients-a Preliminary Study

Males are more prone to Visceral Leishmaniasis (VL) as compared to females. The role of androgens in host defence against Leishmania and other pathogens is of considerable interest. This study was aimed to understand a baseline mechanistic understanding of the pathogenesis of visceral leishmaniasis with respect to testosterone. We examined the relationship between serum testosterone and cholesterol levels, antigen induced Interleukin-10 (IL-10) and Interferon-gamma (IFN-γ) and production by Peripheral Blood Mono Nuclear Cells (PBMCs) and parasite burden as determined by microscopic examination on male patients (n = 18) with VL and gender-and age-matched controls (n = 10). Testosterone plasma levels were found to be up regulated in VL patients as compared to healthy controls. In severely infected patients, the mean testosterone concentration was observed to be increased compared with other VL patients (p<0.001). Further, serum cholesterol level was found much down regulated during severe infection of VL (p<0.005) as compared to healthy control. Further an in-vitro stimulation of PBMCs of VL patients with exogenous testosterone resulted in an increase IL-10 production with a subsequent decline in host protective IFN-γ response. This study suggests that testosterone level might be linked to immuno-pathogenicity of VL infection. Whether testosterone level is probably a marker of severe VL infection with an immunosuppressive effect needs to be validated further.