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The immune response in Post-kala-azar dermal leishmaniasis (PKDL)
Záluská, Elisabeth ; Volf, Petr (advisor) ; Leštinová, Tereza (referee)
Visceral leishmaniasis (VL), also called kala-azar, is a life-threatening parasitic disease, most often caused by Leishmania donovani. After recovery from VL, parasites persisting in the skin can cause post kala-azar dermatitis (PKDL). PKDL is found mainly in the Indian subcontinent and East Africa. Patients with PKDL are a threat to public health and their surroundings because they can serve as a reservoir for the parasite and thus help in its further spread. PKDL has two main forms: in South Asia are mostly caused by papulonodular lesions (pimples and bumps on the skin surface). In East Africa are more common hypomelatonic lesions (hypopigmentation of the skin, characterized by light spots). In patients, there is a decrease in the expression of melanin-A and a gradual loss and degeneration of melanocytes. After an episode of VL, there is a different immune response in the skin and in the rest of the body. The immune response is somewhere between TH1 and TH2, and that gives an advantage to the remaining surviving parasites in the skin. The TH1 response is responsible for the inflammatory response and formation of skin lesions, which are typical for PKDL. On the other hand, the TH2 response promotes regeneration and healing process, and that helps the parasite persist in the skin. For the...
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