Advances in Infectious Diseases, 2020, 10, 235-242 https://www.scirp.org/journal/aid ISSN Online: 2164-2656 ISSN Print: 2164-2648 DOI: 10.4236/aid.2020.105021 Nov. 25, 2020 235 Advances in Infectious Diseases Leishmania donovani-Induced Immune Dysregulation among Sudanese Patients with Visceral and Post Kala-Azar Dermal Leishmaniases: Possible Roles in Pathogenesis Elsamani Elmotwafig Mohamed Elsammani 1# , Brima Younis Musa 1 , Mona Elfaki Eltahir Elfaki 2 , Ahmed Mudawi Mudawi 1 , Eltahir Awad Gasim Khalil 1* 1 Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan 2 Department of Microbiology and Clinical Parasitology, College of Medicine, King Khalid University, Abha, KSA Abstract L. donovani infections (visceral and post kala-azar dermal leishmaniases) are characterized by infection-induced reversible immune suppression. Au- toimmunity is a well-documented phenomenon among patients with primary immune deficiencies. This study aimed to study auto-immune phenomena accompanying L. donovani infections. In a prospective case-controlled study and following informed consent, 155 individuals with visceral leishmaniasis (VL; n = 62), post kala-azar dermal leishmaniasis (PKDL; n = 31) and appar- ently healthy volunteers (n = 62) were recruited. Sera antinuclear (ANA), an- ti-dsDNA, anti-thyroid peroxidase (TPO), anti-smooth muscles (ASMA) and F-actin auto-antibodies were measured using ELISA and indirect im- mune-fluorescence assay. The mean ages of VL, PDKL patients and appar- ently healthy volunteers were: 17.5 ± 12.5, 15.0 ± 7.0 and 17.5 ± 9.5 years with Male:Female ratios of 2:0, 1:2 and 1:5 respectively. Significantly high frequen- cies of F-actin (74.2%; 46/62) and ASMA (50%; 31/62) auto-antibodies were seen among VL patients (p = 0.003, p = 0.001) compared to apparently healthy volunteers. Likewise, significantly high frequencies of F-actin (64.5%; 20/31; p = 0.001), ASMA (42%; 13/31; p = 0.003), ANA (36%; 11/31; p = 0.001) and anti-dsDNA (16%; 5/31; p = 0.01) auto-antibodies were seen among PKDL patients. Development of tissue-based autoantibodies in L. donovani infec- tions probably indicates loss of peripheral tolerance with activation of circu- lating auto-reactive T and B cells probably contributing to disease pathogene- sis (increased bilirubin/liver enzymes, prolonged QT interval/arrythmias and blood cytopenias). In conclusion, L. donovani infection-induced immune # Deceased. How to cite this paper: Elsammani, E.E.M., Musa, B.Y., Elfaki, M.E.E., Mudawi, A.M. and Khalil, E.A.G. (2020) Leishmania donovani-Induced Immune Dysregulation among Sudanese Patients with Visceral and Post Kala-Azar Dermal Leishmaniases: Possi- ble Roles in Pathogenesis. Advances in Infec- tious Diseases, 10, 235-242. https://doi.org/10.4236/aid.2020.105021 Received: October 20, 2020 Accepted: November 22, 2020 Published: November 25, 2020 Copyright © 2020 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access