ABSTRACT: Development of immunoprotection against visceral leishmaniasis (VL) focused on the identification of antigens capable of inducing a Th1 immune response. Alternatively, antigens targeting the CD8 and T-regulatory responses are also relevant in VL pathogenesis and worthy of being included in a preventive human vaccine. We assessed in active and cured patients and VL asymptomatic subjects the clinical signs and cytokine responses to the Leishmania donovani nucleoside hydrolase NH36 antigen and its N-(F1), central (F2) and C-terminal (F3) domains. As markers of VL resistance, the F2 induced the highest levels of IFN-?, IL-1?, and TNF-? and, together with F1, the strongest secretion of IL-17, IL-6, and IL-10 in DTH+ and cured subjects. F2 also promoted the highest frequencies of CD3+CD4+IL-2+TNF-?-IFN-?-, CD3+CD4+IL-2+TNF-?+IFN-?-, CD3+CD4+IL-2+TNF-?-IFN-?+, and CD3+CD4+IL-2+TNF-?+IFN-?+ T cells in cured and asymptomatic subjects. Consistent with this, the IFN-? increase was correlated with decreased spleen (R?=?-0.428, P?=?0.05) and liver sizes (R?=?-0.428, P?=?0.05) and with increased hematocrit counts (R?=?0.532, P?=?0.015) in response to F1 domain, and with increased hematocrit (R?=?0.512, P 0.02) and hemoglobin counts (R?=?0.434, P?=?0.05) in response to F2. Additionally, IL-17 increases were associated with decreased spleen and liver sizes in response to F1 (R?=?-0.595, P?=?0.005) and F2 (R?=?-0.462, P?=?0.04). Conversely, F1 and F3 increased the CD3+CD8+IL-2+TNF-?-IFN-?-, CD3+CD8+IL-2+TNF-?+IFN-?-, and CD3+CD8+IL-2+TNF-?+IFN-?+ T cell frequencies of VL patients correlated with increased spleen and liver sizes and decreased hemoglobin and hematocrit values. Therefore, cure and acquired resistance to VL correlate with the CD4+-Th1 and Th-17 T-cell responses to F2 and F1 domains. Clinical VL outcomes, by contrast, correlate with CD8+ T-cell responses against F3 and F1, potentially involved in control of the early infection. The in silico-predicted NH36 epitopes are conserved and bind to many HL-DR and HLA and B allotypes. No human vaccine against Leishmania is available thus far. In this investigation, we identified the NH36 domains and epitopes that induce CD4+ and CD8+ T cell responses, which could be used to potentiate a human universal T-epitope vaccine against leishmaniasis.
