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Journal of Tropical Medicine
Volume 2012 (2012), Article ID 650874, 6 pages
http://dx.doi.org/10.1155/2012/650874
Review Article

Adenosine and Immune Imbalance in Visceral Leishmaniasis: The Possible Role of Ectonucleotidases

1Instituto de Bioquímica Médica, Universidade Federal do Rio de Janeiro, CCS, Bloco H, Cidade Universitária, Ilha do Fundão, 21941-590 Rio de Janeiro, RJ, Brazil
2Instituto Nacional de Ciência e Tecnologia de Biologia Estrutural e Bioimagem (INCTBEB), CCS, Bloco H, Cidade Universitária, Ilha do Fundão, 21941-590 Rio de Janeiro, RJ, Brazil
3Laboratório de Bioquímica Celular, Instituto de Bioquímica Médica, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro (UFRJ), Cidade Universitária, Ilha do Fundão, 21941-590 Rio de Janeiro, RJ, Brazil

Received 28 April 2011; Revised 31 July 2011; Accepted 10 August 2011

Academic Editor: Asrat Hailu Mekuria

Copyright © 2012 Rafael Paletta-Silva and José Roberto Meyer-Fernandes. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Visceral leishmaniasis (VL) is the most severe form of leishmaniasis and is responsible for most Leishmania-associated deaths. VL represents a serious public health problem that affects many countries. The immune response in leishmaniasis is very complex and is poorly understood. The Th1 versus Th2 paradigm does not appear to be so clear in visceral leishmaniasis, suggesting that other immunosuppressive or immune-evasion mechanisms contribute to the pathogenesis of VL. It has been demonstrated that generation of adenosine, a potent endogenous immunosuppressant, by extracellular enzymes capable to hydrolyze adenosine tri-nucleotide (ATP) at the site of infection, can lead to immune impairment and contribute to leishmaniasis progression. In this regard, this paper discusses the unique features in VL immunopathogenesis, including a possible role for ectonucleotidases in leishmaniasis.