{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:18:18Z","timestamp":1790713098348,"version":"4.1.0"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["AI 136032"],"award-info":[{"award-number":["AI 136032"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,13]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Leishmania skin test (LST) evaluates the delayed type hypersensitivity to Leishmania antigens (LA) and has been used for diagnosis of cutaneous leishmaniasis (CL). In CL patients LST is usually positive but a small percentage have negative LST. The aim of this study was to determine the clinical and immunologic features and response to antimony therapy in LST-negative CL patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compare the clinical presentation, response to therapy, and immune response of CL patients with negative vs positive LST.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The clinical presentation was similar in both groups but LST-negative patients had a lower cure rate. In the lesions, LST-negative patients displayed less inflammation and necrosis, and higher frequency of CD8+ T cells. Mononuclear cells from LST-negative patients had a poor T helper 1 cell (Th1) response but levels of interleukin-1\u03b2 (IL-1\u03b2), IL-6, IL-17, granzyme B, and metalloproteinase-9 (MMP-9) were similar to the LST-positive group upon stimulation with LA. Leishmania internalization and killing by macrophages were similar in both groups. Cure of disease was associated with restoration of Th1 response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In LST-negative patients, impaired Th1 response is associated with therapeutic failure. Increased frequency of CD8+ T cells and high production of inflammatory cytokines, granzyme B, and MMP-9 contributes to immunopathology.<\/jats:p><\/jats:sec>","DOI":"10.1093\/infdis\/jiaa374","type":"journal-article","created":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T19:09:08Z","timestamp":1593630548000},"page":"527-535","source":"Crossref","is-referenced-by-count":18,"title":["Impaired Th1 Response Is Associated With Therapeutic Failure in Patients With Cutaneous Leishmaniasis Caused by<i>Leishmania braziliensis<\/i>"],"prefix":"10.1093","volume":"223","author":[{"given":"Augusto M","family":"Carvalho","sequence":"first","affiliation":[{"name":"Instituto Gon\u00e7alo Moniz, Funda\u00e7\u00e3o Oswaldo Cruz, Salvador, Bahia, Brazil"},{"name":"Servi\u00e7o de Imunologia, Hospital Universit\u00e1rio Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz H","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Universidade Federal do Sul da Bahia, Teixeira de Freitas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fabia","family":"Costa","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ci\u00eancia e Tecnologia me Doen\u00e7as Tropicais, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u00edra G","family":"Saldanha","sequence":"additional","affiliation":[{"name":"Instituto Gon\u00e7alo Moniz, Funda\u00e7\u00e3o Oswaldo Cruz, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iana","family":"Prates","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunologia, Hospital Universit\u00e1rio Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas 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