The major circulating immunosuppressive activity in American visceral leishmaniasis patients is associated with a high-molecular weight fraction and is not mediated by IgG, IgG immune complexes or lipoproteins

Opportunistic infections, due to disease-related immunosuppression, constitute the major cause of death in American visceral leishmaniasis (AVL). Sera from these patients (AVL sera) non-specifically inhibit the in vitro proliferative response of normal human lymphocytes to lectins or antigens. In the present work, the mediation of this inhibition by IgG, immune complexes and low- or very low-density lipoproteins was studied. AVL serum fractions containing proteins with the molecular weight of IgG, and IgG, purified from AVL sera by anion exchange chromatography, did not suppress the lymphoproliferation. Most of the suppressive activity of AVL sera was associated with a fraction containing molecules with molecular weights above 430 kDa. This would be compatible with it being due to immune complexes and/or lipoproteins, and not to soluble IL-2 receptors as reported previously. However, neither of the two possibilities seem to be the case, as (1) depletion of immune complexes by protein-A followed by protein-G chromatographies did not affect the serum suppressive activity, (2) no correlation between immune complex contents and suppressive activities in individual sera was observed, and (3) plasma lipoproteins (VLDL and LDL), purified from AVL patients and from healthy individuals, had the same degree of immunosuppressive activity.