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. 2012 Feb 8;7(2):e31551. doi: 10.1371/journal.pone.0031551

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Rai et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.

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A) High Levels of IL-4 in BM among VL patients: Scatter plot shows increased level of IL-4 in serum of VL patients (n = 11) than that of HCs (n = 10; p = 0.0005, Unpaired t test). Its level was further increased in BMA of VL patients (n = 9; p = 0.0005, Paired t test). After successful therapy (post), the IL-4 declined to undetectable levels in serum (n = 8) and BMA (n = 9) of cured VL cases. B) Elevated levels of IFN-γ among VL patients: Scatter plot depicting higher levels of IFN-γ (pg/ml) in the serum of untreated VL patients (n = 21) than that of HCs (n = 17; p = 0.064, unpaired t test). Level of IFN-γ is further increased in BMA (n = 19) as compared to that of autologous serum (n = 21, p = 0.001, Paired t test). After successful therapy (post), levels of serum IFN-γ is reduced in cured cases (n = 8) below their level at 0 day (pre). However, its level in BMA of cured cases (n = 9) remained high even after therapy, even though reduced to some extent after successful treatment (p = 0.043, Paired t test). C) Ratio of IL-4 and IFN-γ shows dominance of IL-4 over IFN-γ in serum as well as BMA before therapy. Post therapy, IFN-γ dominates over IL-4 quantitatively. D) High levels of IL-10 in untreated patients and its persistence after successful therapy with AmB: Increased levels of IL-10 was observed in the serum as well as BMA of untreated VL patients (n = 12) as compared to serum of HCs (n = 14; p = 0.0005, Unpaired t test). After therapy with AmB, IL-10 levels are maintained at high level in BMA (n = 12). E) IL-10 in SAG responsive and unresponsive patients: Pre treatment levels of IL-10 in the serum and BMA of VL patients could segregate SAG unresponsive patients from the responsive group. IL-10 levels were significantly higher in serum (p = 0.004, Mann Whitney test) and BMA (p = 0.007, Mann Whitney test) of patients who did not respond to SAG therapy. Horizontal line in dot plot depicts median value.