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In this study, we compare the clinical, immunologic, and histopathologic features between Leishmania skin test-positive (LST+) and Leishmania skin test-negative (LST-) in CL. Compared to LST+ patients, LST- patients had larger lesions and had been sicker for longer, presented with more instances of therapeutic failure with meglumine antimonate, (MA) and the healing times were higher than LST+. While granulomas were less frequent and the parasite load was higher in LST-, there were more CD8+ T cells and an enhanced production of Granzyme B in the supernatants of biopsies from LST- subjects. This study shows that in LST-, an impairment in Th1 immune response is associated with a high parasite burden, and the pathology is mediated by CD8+ T cells and the enhanced production of Granzyme B. The abnormalities in the immunologic response in LST- patients lead to a more severe disease with a high rate of failure to therapy.<\/jats:p>","DOI":"10.3390\/pathogens13111018","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T09:30:25Z","timestamp":1732008625000},"page":"1018","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Leishmania Skin Test Predicts Clinic-Immunologic and Therapeutic Outcomes in Cutaneous Leishmaniasis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0202-5661","authenticated-orcid":false,"given":"Luiz H.","family":"Guimar\u00e3es","sequence":"first","affiliation":[{"name":"Immunology Service, University Hospital Professor Edgar Santos, Federal University of Bahia, Salvador 40110-160, Bahia, Brazil"},{"name":"Health Sciences Center, Santo Antonio de Jesus campus, Federal University of Rec\u00f4ncavo da Bahia, Santo Ant\u00f4nio de Jesus 44574-490, Bahia, Brazil"},{"name":"National Institute of Science and Technology of Tropical Diseases (INCT-DT), MCTI CNPq, Salvador 40110-160, Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2339-9046","authenticated-orcid":false,"given":"Evelyn","family":"Zacarias","sequence":"additional","affiliation":[{"name":"Instituto Gon\u00e7alo Moniz, Funda\u00e7\u00e3o Oswaldo Cruz, Salvador 40296-710, Bahia, Brazil"},{"name":"Faculty of Pharmacy, Ondina Campus, Federal University of Bahia, Salvador 40170-115, Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra T.","family":"Nolasco","sequence":"additional","affiliation":[{"name":"Immunology Service, University Hospital Professor Edgar Santos, Federal University of Bahia, Salvador 40110-160, Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alm\u00e9rio N.","family":"Filho","sequence":"additional","affiliation":[{"name":"Instituto Gon\u00e7alo Moniz, Funda\u00e7\u00e3o Oswaldo Cruz, Salvador 40296-710, Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamile","family":"Lago","sequence":"additional","affiliation":[{"name":"Immunology Service, University Hospital Professor Edgar Santos, Federal University of Bahia, Salvador 40110-160, Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo R. L.","family":"Machado","sequence":"additional","affiliation":[{"name":"Immunology Service, University Hospital Professor Edgar Santos, Federal University of Bahia, Salvador 40110-160, Bahia, Brazil"},{"name":"National Institute of Science and Technology of Tropical Diseases (INCT-DT), MCTI CNPq, Salvador 40110-160, Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Instituto Gon\u00e7alo Moniz, Funda\u00e7\u00e3o Oswaldo Cruz, Salvador 40296-710, Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5033-1666","authenticated-orcid":false,"given":"Lucas P.","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Immunology Service, University Hospital Professor Edgar Santos, Federal University of Bahia, Salvador 40110-160, Bahia, Brazil"},{"name":"National Institute of Science and Technology of Tropical Diseases (INCT-DT), MCTI CNPq, Salvador 40110-160, Bahia, Brazil"},{"name":"Instituto Gon\u00e7alo Moniz, Funda\u00e7\u00e3o Oswaldo Cruz, Salvador 40296-710, Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Augusto","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Immunology Service, University Hospital Professor Edgar Santos, Federal University of Bahia, Salvador 40110-160, Bahia, Brazil"},{"name":"National Institute of Science and Technology of Tropical Diseases (INCT-DT), MCTI CNPq, Salvador 40110-160, Bahia, Brazil"},{"name":"Instituto Gon\u00e7alo Moniz, Funda\u00e7\u00e3o Oswaldo Cruz, Salvador 40296-710, Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2697-8002","authenticated-orcid":false,"given":"Edgar M.","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Immunology Service, University Hospital Professor Edgar Santos, Federal University of Bahia, Salvador 40110-160, Bahia, Brazil"},{"name":"National Institute of Science and Technology of Tropical Diseases (INCT-DT), MCTI CNPq, Salvador 40110-160, Bahia, Brazil"},{"name":"Instituto Gon\u00e7alo Moniz, Funda\u00e7\u00e3o Oswaldo Cruz, Salvador 40296-710, Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3071-6339","authenticated-orcid":false,"given":"S\u00e9rgio","family":"Arruda","sequence":"additional","affiliation":[{"name":"National Institute of Science and Technology of Tropical Diseases (INCT-DT), MCTI CNPq, Salvador 40110-160, Bahia, Brazil"},{"name":"Instituto Gon\u00e7alo Moniz, Funda\u00e7\u00e3o Oswaldo Cruz, Salvador 40296-710, Bahia, Brazil"},{"name":"Department of Life Sciences, School of Medicine, Salvador Campus, State University of Bahia, Salvador 41200-105, Bahia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Alvar, J., V\u00e9lez, I.D., Bern, C., Herrero, M., Desjeux, P., Cano, J., Jannin, J., den Boer, M., and WHO Leishmaniasis Control Team (2012). Leishmaniasis worldwide and global estimates of its incidence. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0035671"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1016\/S0140-6736(18)31204-2","article-title":"Leishmaniasis","volume":"392","author":"Burza","year":"2018","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/S1413-8670(11)70133-7","article-title":"Epidemiological and clinical characteristics of cutaneous leishmaniasis and their relationship with the laboratory data, south of Brazil","volume":"15","author":"Curti","year":"2011","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1111\/j.1600-065X.1989.tb00557.x","article-title":"Role of cytokines and CD4+ T-cell subsets in the regulation of parasite immunity and disease","volume":"112","author":"Scott","year":"1989","journal-title":"Immunol Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1034\/j.1600-065X.2000.917307.x","article-title":"The role of nitric oxide in innate immunity","volume":"173","author":"Bogdan","year":"2000","journal-title":"Immunol. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1046\/j.1365-3024.2002.00467.x","article-title":"Divergent expression of inflammatory dermal chemokines in cutaneous leishmaniasis","volume":"24","author":"Ritter","year":"2002","journal-title":"Parasite Immunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"6734","DOI":"10.1128\/IAI.70.12.6734-6740.2002","article-title":"Up-regulation of Th1- type responses in mucosal leishmaniasis patients","volume":"70","author":"Bacellar","year":"2002","journal-title":"Infect. Immun."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1038\/jid.2013.4","article-title":"CD8(+) granzyme B(+)-mediated tissue injury vs. CD4(+)IFN\u03b3(+)-mediated parasite killing in human cutaneous leishmaniasis","volume":"133","author":"Boaventura","year":"2013","journal-title":"J. Investig. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Carvalho, A.M., Costa, R.S., Lago, A., Bacellar, O., Beiting, D.P., Scott, P., Carvalho, L.P., and Carvalho, E.M. (2024). In Situ versus Systemic Immune Response in the Pathogenesis of Cutaneous Leishmaniasis. Pathogens, 13.","DOI":"10.3390\/pathogens13030199"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1111\/j.1365-3024.2009.01116.x","article-title":"Immunopathogenic competences of Leishmania (V.) braziliensis and L. (L.) amazonensis in American cutaneous leishmaniasis","volume":"31","author":"Silveira","year":"2009","journal-title":"Parasite Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1001\/archderm.1926.02370140053003","article-title":"Cutaneous Reaction in Leishmaniasis","volume":"13","author":"Montenegro","year":"1926","journal-title":"Arch. Derm. Syphilol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"79","DOI":"10.4269\/ajtmh.1986.35.79","article-title":"Selection of a skin test antigen for American visceral leishmaniasis","volume":"35","author":"Reed","year":"1986","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Carstens-Kass, J., Paulini, K., Lypaczewski, P., and Matlashewski, G. (2021). A review of the leishmanin skin test: A neglected test for a neglected disease. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009531"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1086\/498042","article-title":"The predictive validity of naturally acquired delayed-type hypersensitivity to leishmanin in resistance to Leishmania major-associated cutaneous leishmaniasis","volume":"192","author":"Louzir","year":"2005","journal-title":"J. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1590\/0037-8682-0343-2016","article-title":"The challenges on developing vaccine against visceral leishmaniasis","volume":"49","author":"Pearson","year":"2016","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1590\/S0074-02762004000300001","article-title":"Clinical and immunopathological spectrum of American cutaneous leishmaniasis with special reference to the disease in Amazonian Brazil: A review","volume":"99","author":"Silveira","year":"2004","journal-title":"Mem\u00f3rias Inst. Oswaldo Cruz"},{"key":"ref_17","first-page":"CD004834","article-title":"Interventions for American cutaneous and mucocutaneous leishmaniasis","volume":"8","author":"Pinart","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1086\/345772","article-title":"Disseminated leishmaniasis: A new and emerging form of leishmaniasis observed in northeastern Brazil","volume":"186","author":"Turetz","year":"2002","journal-title":"J. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Oliveira, W.N., D\u00f3rea, A.S., Carneiro, P.P., Nascimento, M.T., Carvalho, L.P., Machado, P.R.L., Schriefer, A., Bacellar, O., and Carvalho, E.M. (2021). The influence of infection by different Leishmania (Viannia) braziliensis isolates on the pathogenesis of disseminated leishmaniasis. Front. Cell. Infect. Microbiol., 11.","DOI":"10.3389\/fcimb.2021.740278"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Novais, F.O., Carvalho, A.M., Clark, M.L., Carvalho, L.P., Beiting, D.P., Brodsky, I.E., Carvalho, E.M., and Scott, P. (2017). CD8+ T cell cytotoxicity mediates pathology in the skin by inflammasome activation and IL-1\u03b2 production. PLoS Pathog., 13.","DOI":"10.1371\/journal.ppat.1006196"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1093\/infdis\/jiz538","article-title":"Granzyme B Produced by Natural Killer Cells Enhances Inflammatory Response and Contributes to the Immunopathology of Cutaneous Leishmaniasis","volume":"221","author":"Campos","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.jid.2019.05.025","article-title":"Glyburide, a NLRP3 Inhibitor, Decreases Inflammatory Response and Is a Candidate to Reduce Pathology in Leishmania braziliensis Infection","volume":"140","author":"Carvalho","year":"2020","journal-title":"J. Investig. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1093\/infdis\/jiaa374","article-title":"Impaired Th1 Response Is Associated With Therapeutic Failure in Patients With Cutaneous Leishmaniasis Caused by Leishmania braziliensis","volume":"223","author":"Carvalho","year":"2021","journal-title":"J. Infect. Dis."},{"key":"ref_24","first-page":"968","article-title":"American cutaneous leishmaniasis: Use of a skin test as a predictor of relapse after treatment","volume":"78","author":"Passos","year":"2000","journal-title":"Bull. World Health Organ."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Schnorr, D., Muniz, A.C., Passos, S., Guimaraes, L.H., Lago, E.L., Bacellar, O., Glesby, M.J., and Carvalho, E.M. (2012). IFN-\u03b3 production to leishmania antigen supplements the leishmania skin test in identifying exposure to L. braziliensis infection. PLoS Negl. Trop. Dis., 6.","DOI":"10.1371\/journal.pntd.0001947"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.actatropica.2011.02.007","article-title":"Systematic review of the adverse effects of cutaneous leishmaniasis treatment in the New World","volume":"118","author":"Oliveira","year":"2011","journal-title":"Acta Trop."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1590\/S0036-46652008000300005","article-title":"Failure of both azithromycin and antimony to treat cutaneous leishmaniasis in Manaus, AM, Brazil","volume":"50","author":"Teixeira","year":"2008","journal-title":"Rev. Inst. Med. Trop. S\u00e3o Paulo"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"574","DOI":"10.4269\/ajtmh.2009.80.574","article-title":"Association of treatment of American cutaneous leishmaniasis prior to ulcer development with high rate of failure in northeastern Brazil","volume":"80","author":"Unger","year":"2009","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"E69","DOI":"10.1086\/340526","article-title":"Failure of early treatment of cutaneous leishmaniasis in preventing the development of an ulcer","volume":"34","author":"Machado","year":"2002","journal-title":"Clin. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Saheki, M.N., Lyra, M.R., Bedoya-Pacheco, S.J., Ant\u00f4nio, L.F., Pimentel, M.I.F., Salgueiro, M.M., Vasconcellos, \u00c9.C.F.E., Passos, S.R.L., Santos, G.P.L.D., and Ribeiro, M.N. (2017). Low versus high dose of antimony for American cutaneous leishmaniasis: A randomized controlled blind non-inferiority trial in Rio de Janeiro, Brazil. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0178592"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1002\/path.1711590406","article-title":"Histological analysis and the pathogenesis of mucocutaneous leishmaniasis","volume":"159","author":"Ridley","year":"1989","journal-title":"J. Pathol."},{"key":"ref_32","first-page":"51","article-title":"Recent advances in the pathophysiology and treatment of human cutaneous leishmaniasis","volume":"4","author":"Machado","year":"1997","journal-title":"Curr. Opin. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.imlet.2005.06.004","article-title":"Activated inflammatory T cells correlate with lesion size in human cutaneous leishmaniasis","volume":"101","author":"Antonelli","year":"2005","journal-title":"Immunol. Lett."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1111\/j.1365-3024.2009.01125.x","article-title":"Recruitment of CD8(+) T cells expressing granzyme A is associated with lesion progression in human cutaneous leishmaniasis","volume":"31","author":"Faria","year":"2009","journal-title":"Parasite Immunol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Carvalho, A.M., Bacellar, O., and Carvalho, E.M. (2022). Protection and Pathology in Leishmania braziliensis Infection. Pathogens, 11.","DOI":"10.3390\/pathogens11040466"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1128\/IAI.02404-14","article-title":"Protective and pathological functions of CD8+ T cells in Leishmania braziliensis infection","volume":"83","author":"Cardoso","year":"2015","journal-title":"Infect. Immun."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1038\/nri2711","article-title":"The regulation of IL-10 production by immune cells","volume":"10","author":"Saraiva","year":"2010","journal-title":"Nat. Rev. Immunol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1146\/annurev-immunol-031210-101312","article-title":"Regulation and functions of the IL-10 family of cytokines in inflammation and disease","volume":"29","author":"Ouyang","year":"2011","journal-title":"Annu. Rev. Immunol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s00281-015-0475-7","article-title":"CD8+ T cells in cutaneous leishmaniasis: The good, the bad, and the ugly","volume":"37","author":"Novais","year":"2015","journal-title":"Semin. Immunopathol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2830","DOI":"10.1002\/eji.200940115","article-title":"Human mucosal leishmaniasis: Neutrophils infiltrate areas of tissue damage that express high levels of Th17-related cytokines","volume":"40","author":"Boaventura","year":"2010","journal-title":"Eur. J. Immunol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1038\/nri.2016.72","article-title":"Cutaneous leishmaniasis: Immune responses in protection and pathogenesis","volume":"16","author":"Scott","year":"2016","journal-title":"Nat. Rev. Immunol."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/13\/11\/1018\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:35:21Z","timestamp":1760114121000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/13\/11\/1018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,19]]},"references-count":41,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["pathogens13111018"],"URL":"https:\/\/doi.org\/10.3390\/pathogens13111018","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,19]]}}}