Maryam Shahi - Ghazvin University of Medical Sciences, Ghazvin, Iran
Masoud Mohajery - Parasitology & Medical Mycology Department, Mashhad University of Medical Sciences Mashhad, Iran
Seyyed Ali Akbar Shamsian - Parasitology & Medical Mycology Department, Mashhad University of Medical Sciences Mashhad, Iran
Hossein Nahrevanian - Parasitology Departmen, Pasteur Institute of Iran, Tehran, Iran.
Seyyed Mohammad Javad Yazdanpanah - Parasitology & Medical Mycology Department, Mashhad University of Medical Sciences Mashhad, Iran

Background: Cutaneous leishmaniasis is an endemic disease in many regions of Iran, including the city of Mashhad. In recent years, some cases have not responded to Glucantime, the usual treatment for this disease. The cellular immune response caused by T-helper type ۱ (Th۱) cells has an important role in protection against leishmaniasis, and activation of the T-helper type ۲ (Th۲) response causes progression of the disease. By analyzing these responses we hope to find a more effective treatment than that currently in use for leishmaniasis patients. Methods: The cellular immune responses in ۶۰ cases of non-healing and healing cutaneous leishmaniasis, and individuals in a control group, were analyzed by measuring cytokines released by peripheral blood mononuclear cells (PBMCs) when stimulated with Leishmania major antigens by Enzyme Linked Immuno Sorbent Assay (ELISA). Results: Subjects from the healing group secreted more interleukin-۱۲ (IL-۱۲) and interferon gamma (IFN-γ) (p<۰.۰۵) and less interleukins -۴, -۵, -۱۰ (IL-۴, IL-۵, and IL-۱۰) (p<۰.۰۰۵) and -۱۸ (IL-۱۸) (p=۰.۰۰۳) than the non-healing group. Conclusions: The results demonstrate that secretion of cytokines that activate Th۲ response including IL-۴, IL-۵ and IL-۱۰ in non-healing subjects was higher than healing subjects and secretion of cytokines that activate Th۱ response including IL-۱۲ and IFN-γ in healing subjects was higher relative to the non-healing subjects. In this study it has been shown that the level of IL-۱۸ progresses disease in non-healing patients when the level of IL-۱۲ gets decreased.

Cutaneous leishmaniasis, Cytokines, Glucantime