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This study examined transcriptional markers expressed by CD4\n                      <jats:sup>+<\/jats:sup>\n                      T cells that could distinguish asymptomatic individuals from endemic controls and visceral leishmaniasis (VL) patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      CD4\n                      <jats:sup>+<\/jats:sup>\n                      T cells were isolated from individuals with asymptomatic\n                      <jats:italic>L<\/jats:italic>\n                      .\u2009\n                      <jats:italic>donovani<\/jats:italic>\n                      infection, endemic controls and VL patients. RNA was extracted and RNAseq employed to identify differentially expressed genes. The expression of one gene and its protein product during asymptomatic infection were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Amphiregulin (AREG) was identified as a distinguishing gene product in CD4\n                      <jats:sup>+<\/jats:sup>\n                      T cells from individuals with asymptomatic\n                      <jats:italic>L.\u2009donovani<\/jats:italic>\n                      infection, compared to VL patients and healthy endemic control individuals. AREG levels in plasma and antigen\u2010stimulated whole\u2010blood assay cell culture supernatants were significantly elevated in asymptomatic individuals, compared to endemic controls and VL patients. Regulatory T (Treg) cells were identified as an important source of AREG amongst CD4\n                      <jats:sup>+<\/jats:sup>\n                      T\u2010cell subsets in asymptomatic individuals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Increased Treg cell\n                      <jats:italic>AREG<\/jats:italic>\n                      expression was identified in individuals with asymptomatic\n                      <jats:italic>L.\u2009donovani<\/jats:italic>\n                      infection, suggesting the presence of an ongoing inflammatory response in these individuals required for controlling infection and that AREG may play an important role in preventing inflammation\u2010induced tissue damage and subsequent disease in asymptomatic individuals.\n                    <\/jats:p>\n                  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