Immunology study and the Assessment of parameters in difference Age, Sex of stage resistance infection leishmaniasis in Dayla

The Leishmania parasite belonged to trypanosomatidae family,. Cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) are endemic in Iraq as one of the neglected tropical diseases. The current drugs which are used as antileishaminial treatment characterized by enormous side effects including their toxicity to human, long term treatment, liver problems, hugely cost. Therefore, there is a necessity to find an alternative treatment marked as low cost, more specific against parasite’s stages, Tumor necrosis factor-alpha (TNF-α), a cytokine that generated by the innate immune response to CL infection, can influence disease clearance in the human host. The effect of this pro-inflammatory cytokine in CL ulcer development during the infection is not well established. The current study was conducted on 88 individaul of both sexes, they were from Diyala province and the capital Baghdad, during the period from October 2020 to February 2021. All suspected cutaneous or visceral patients involved in this study were prediagnosed in the laboratory before processing Tumor Necrosis Factor-alpha (TNF-α) and Adenosine Deaminase Enzyme (ADA) by ELISA colorimetric detection. Total number of confirmed leishmaniasis patients were (n=57) cutaneous patients and (n=16) visceral patients, collected from different hospitals in Diyala province and Baghdad. Positive CL or VL samples were confirmed by microscopic Giemsa staining, In this study, the level of circulating tumor necrosis factor alpha and adenosine deaminase enzyme levels were detected in CL patients of newly diagnosed infection and in patients undergoing different doses of treatment, 2nd and 3rd Pentostam trail-treatment, in addition, VL patients of newly diagnosed infection with no treatment; in comparison to control subjects. Regardless the type of leishmaniasis and according to age, the results showed that TNF-α concentration was higher in patients less than 15 years old, in comparison with other age group over 15 years (15-60) years old, which was 1169.899 ng/ml and 961.206 ng/ml respectively. While according to sex, the higher concentration of TNF-α was recorded in female rather than male, 1030.243 ng/ml and 996.458 ng/ml Regarding ADA enzyme, the highest enzyme activity also recorded in the age group of 1-14 years old, which was 4.749 nanomol/minute/µg, in comparison of patients between 15-60 years old, which was 3.706 nanomol/minute/µg. While according to sex, the maximum enzyme activity was seen in male rather than female (4.296, 4.483) nanomol/minute/µg, respectively. The perceived rise of TNF-α and ADA serum levels may give insights into this pro-inflammatory cytokine as a biomarker in prognosis and tracking disease progression.