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Abstract: Recovery from CL is usually accompanied with long-lasting protection and induction of strong immune response. The phenotypes, generation and maintenance of central (=TCM) and effector (=TEM) memory T cell subsets in human leishmaniasis are not well known. Profile of T cell subsets were analyzed on peripheral CD8+ T cells from volunteers with history of cutaneous leishmaniasis (HCL). In HCL and control groups, mean frequencies of CCR7+CD45RA+CD8+ naïve and CCR7−CD45RA−CD8+ TEM cells were higher than other subsets before culture, but after stimulation with soluble Leishmania antigen, the frequency of naïve T cells was significantly decreased and the frequency of TEM cells was significantly increased. TEM phenotype composed the highest portion of proliferating Carboxy Fluorescein diacetate Succinimidyl Ester (CFSE)-dim population which was significantly higher in HCL volunteers than in control group. Stimulation of isolated CD8+ memory T cells, but not naïve T cells, from HCL volunteers induced a significantly higher IFN-γ production compared with that of healthy controls. Intracellular IFN-γ staining provided the same result. Memory population is shown to be responsible for Leishmania-induced IFN-γ production. Leishmania-reactive proliferating TEM cells were identified as the most frequent subset which may play a role in recall immune response and protection against Leishmania infection. [Copyright &y& Elsevier]

Summary: Objectives: This study was performed to evaluate the epidemiological status of cutaneous leishmaniasis (CL) in the most important endemic foci of Qom Province, central Iran. The city of Qom is the largest center for Shi’a scholarship in the world and is a significant pilgrimage destination. Methods: During 2006–2011, all suspected CL patients with skin lesion(s) referred to regional health centers of Ghomrood and Ghanavat regions, and all actively detected cases, were examined clinically and parasitologically for CL. Patient information was recorded and patients were categorized based on the number and size of the lesions. Odds ratios (OR) of different risk factors were calculated. Results: A total of 849 (59.2% male, 40.8% female) confirmed cases of CL were enrolled; the average incidence rate of the disease was 14.9 per 100000 people. During the study period 2006–2011, the trend in CL incidence showed no sudden variations in the areas studied, except for an outbreak of CL in 2009. Leishmania major was identified as the causative agent based on internal transcribed spacer 1 (ITS1) ribosomal DNA PCR analysis. During the study period, the age distribution of CL cases was relatively stable, with the majority (50%) of patients aged 1–25 years. Most cases (n = 468; 55.1%) had a single lesion and 82 (9.6%) patients had four or more lesions (range 1–29). The risk of developing multiple lesions was significantly increased in patients with seasonal jobs (summer workers) (p = 0.023; OR 1.516) and significantly decreased in patients who were affected in winter (p = 0.010; OR 0.398). The risk of developing large-sized lesions (>1cm) was significantly increased in patients in the age groups >25 years (p = 0.001–0.015; OR 2.5–3.5) and decreased in patients with seasonal jobs (summer workers) (p = 0.005; OR 0.570). Conclusions: The present data show the importance of CL as a health problem in suburban areas of Qom Province. In order to identify other epidemiological aspects of leishmaniasis in this area, studies on vectors and reservoirs are recommended. Since leishmaniasis caused by L. major is typically zoonotic, control measures should focus on rodents as the main reservoirs and Phlebotomus papatasi as the main vector. Awareness should be raised in the high-risk populations comprising people with diabetes, young adults (<25 years old), and those who work outdoors during the summer. [Copyright &y& Elsevier]

Infection with Helicobacter pylori was assessed through serum H. pylori IgG antibody in children with intellectual disabilities (ID). The sero-status of cytotoxin-associated gene A (CagA) was determined as a risk determinant for severe H. pylori-associated diseases. In total, 210 children with ID were included who were permanent resident of three institutes in Tehran. Medical history and demographic data were collected by reviewing the medical file records. The anti H. pylori IgG antibody was detected in serum of 74.8% of children using ELISA. Significant correlations were found between the rate of infection and age (P =0.001) and duration of institutionalization (P =0.018). The likelihood of H. pylori IgG positive response increased with age with the highest response in 15–18 years age group (OR=6.66, 95% CI: 2.14–20.17; P =0.001). Similarly, the average titers of H. pylori IgG antibody were increased with age. The institutionalization duration of more than 49 months affected the likelihood of H. pylori IgG positive response (OR=2.437, 95% CI: 1.12–5.26; P =0.023). Anti-CagA titers were higher than 5arbU/ml in 92 (58.6%) children, indicating a positive response against CagA protein. The titer of H. pylori IgG was significantly higher in CagA-positive (mean±SE=51.04±3.41) than in CagA-negative children (38.07±4.18; P =0.017). In contrast to total H. pylori IgG titers, anti-CagA antibody had non-regular trend of alterations with age. The seropositivity rate of H. pylori infection in ID children was higher than other reports in healthy children from various regions of the country. The risk of H. pylori infection is increased with age and duration of institutionalization. The serostatus of CagA in children with IDs has not been reported so far. The regular monitoring of the CagA-positive carriers is recommended; since CagA positive cases carry the risk of progression of infection toward severe H. pylori associated sequels such as gastric cancer and duodenal ulcers. [Copyright &y& Elsevier]