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Because the adaptive immune response does not fully explain the outcome of Leishmania infection and considering that the initial events are crucial in the establishment of the infection, we investigated one of the growth factors, the insulin-like growth factor-I (IGF-I), found in circulation and produced by different cells including macrophages and present in the skin where the parasite is inoculated. Here, we review the role of IGF-I in leishmaniasis experimental models and human patients. IGF-I induces the growth of different Leishmania species in vitro and alters the disease outcome increasing the parasite load and lesion size, especially in L. major- and L. amazonensis-infected mouse leishmaniasis. IGF-I affects the parasite interacting with the IGF-I receptor present on Leishmania. During Leishmania-macrophage interaction, IGF-I acts on the arginine metabolic pathway, resulting in polyamine production both in macrophages and Leishmania. IGF-I and cytokines interact with reciprocal influences on their expression. IL-4 is a hallmark of susceptibility to L. major in murine leishmaniasis, but we observed that IGF-I operates astoundingly as an effector element of the IL-4. Approaching human leishmaniasis, patients with mucosal, disseminated, and visceral diseases presented surprisingly low IGF-I serum levels, suggesting diverse effects than parasite growth. We observed that low IGF-I levels might contribute to the inflammatory response persistence and delayed lesion healing in human cutaneous leishmaniasis and the anemia development in visceral leishmaniasis. We must highlight the complexity of infection revealed depending on the Leishmania species and the parasite\u2019s developmental stages. Because IGF-I exerts pleiotropic effects on the biology of interaction and disease pathogenesis, IGF-I turns up as an attractive tool to explore biological and pathogenic processes underlying infection development. IGF-I pleiotropic effects open further the possibility of approaching IGF-I as a therapeutical target.<\/jats:p>","DOI":"10.1155\/2021\/6614475","type":"journal-article","created":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T19:21:46Z","timestamp":1620242506000},"page":"1-17","source":"Crossref","is-referenced-by-count":3,"title":["Pleiotropic Effect of Hormone Insulin-Like Growth Factor-I in Immune Response and Pathogenesis in Leishmaniases"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5412-4066","authenticated-orcid":true,"given":"Luiza C.","family":"Reis","sequence":"first","affiliation":[{"name":"Instituto de Medicina Tropical de S\u00e3o Paulo, Faculdade de Medicina, Universidade de S\u00e3o Paulo (IMTSP-USP), S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8700-5469","authenticated-orcid":true,"given":"Eduardo Milton","family":"Ramos-Sanchez","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Tropical de S\u00e3o Paulo, Faculdade de Medicina, Universidade de S\u00e3o Paulo (IMTSP-USP), S\u00e3o Paulo, Brazil"},{"name":"Departamento de Salud Publica, Facultad de Ciencias de La Salud, Universidad Nacional Toribio Rodriguez de Mendoza de Amazonas, Chachapoyas, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6080-4532","authenticated-orcid":true,"given":"Fernanda N.","family":"Araujo","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Tropical de S\u00e3o Paulo, Faculdade de Medicina, Universidade de S\u00e3o Paulo (IMTSP-USP), S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariane F.","family":"Leal","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Tropical de S\u00e3o Paulo, Faculdade de Medicina, Universidade de S\u00e3o Paulo (IMTSP-USP), S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9234-8378","authenticated-orcid":true,"given":"Christiane Y.","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Tropical de S\u00e3o Paulo, Faculdade de Medicina, Universidade de S\u00e3o Paulo (IMTSP-USP), S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7845-6126","authenticated-orcid":true,"given":"Orlando R.","family":"Sevillano","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Tropical de S\u00e3o Paulo, Faculdade de Medicina, Universidade de S\u00e3o Paulo (IMTSP-USP), S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4140-5915","authenticated-orcid":true,"given":"Bernardina A.","family":"Uscata","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Tropical de S\u00e3o Paulo, Faculdade de Medicina, Universidade de S\u00e3o Paulo (IMTSP-USP), S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7048-562X","authenticated-orcid":true,"given":"Hiro","family":"Goto","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Tropical de S\u00e3o Paulo, Faculdade de Medicina, Universidade de S\u00e3o Paulo (IMTSP-USP), S\u00e3o Paulo, Brazil"},{"name":"Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31204-2"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-6968.2002.tb11101.x"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpara.2003.11.021"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1038\/nri933"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/j.imlet.2013.12.022"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2012.00083"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.174.5.2934"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.172.8.4672"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.4103\/0974-777X.62876"},{"issue":"7","key":"10","doi-asserted-by":"crossref","first-page":"3317","DOI":"10.4049\/jimmunol.158.7.3317","article-title":"Early production of IL-4 in susceptible mice infected with Leishmania major rapidly induces IL-12 unresponsiveness","volume":"158","author":"P. 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