Subpopulations of T lymphocytes in the peripheral blood and lymph nodes of Indian kala-azar patients

Distribution of T cells in the peripheral blood and lymph nodes of Indian kala-azar (KA) patients was studied by using appropriate phenotypic markers for CD2+, CD4+ and CD8+ cells. Significant reduction in the CD2+, CD4+ cell numbers as well as CD4+/CD8+ cell ratio was noted in the peripheral blood of active KA cases. Such alteration in the T cell population appeared to be a manifestation of the disease process as it showed a tendency to return close to normalcy several months after successful chemotherapy. Histopathological studies of KA patients with lymphadenopathy demonstrated gradual destruction of lymph node follicular architecture which correlated well with the severity and duration of illness. Massive infiltration of CD2+ cells in the cortical region of lymph node was evident. The observed preponderance of CD4+ cells over CD8+ ones in these infiltrates was in sharp contrast to the distribution pattern of these cells in the periphery. Significance of these findings is discussed in relation to the current concepts on the immunology of leishmaniasis and related diseases.