Role of toll-like receptors 2 and 4 and the nutritional status, and genotoxic changes in patients with visceral leishmaniasis

Abstract

Visceral leishmaniasis (VL) is an emerging public health problem, being one of the major neglected diseases in Brazil and the world, where 88 countries are affected with 500,000 new cases annually. In Brazil the prevalence in the last five years was 3,500 cases, and the region of Bauru, regarded as endemic, has increased cases every year. In the Old World is caused by the etiological agent L. donovani and the New World by L. chagasi / infantum, is a lethal disease if not treated. Resistance to infection is associated with production of Th1 cytokines and susceptibility to Th2 cytokine profile. Moreover, toll-like receptors (TLRs) of innate immunity, in antigen presenting cells, plays an important role in microbial recognition and development of adaptive immune response. Moreover, it has been observed association between infectious diseases and genotoxic changes, which may be due to the effector mechanisms of the immune response, increasing susceptibility to malignant transformation. Considering the lack of studies in patients pre-and post-treatment on the role of TLRs in the production of pro-and anti-inflammatory mediators, knowledge of the nutritional profile, which has great impact on the immune response, and the presence of genotoxic changes, this project intend to evaluate the involvement of TLR-2 and TLR-4 in the production of cytokines and NO, correlating these with clinical and nutritional status, and verify the presence of genotoxic changes in patients with visceral leishmaniasis pre-and post-treatment. (AU)