Mechanisms and consequences of persistence of intracellular pathogens: leishmaniasis as an example

Lifelong persistence after clinical cure of the primary infection is a characteristic feature of many intracellular pathogens, including viruses, bacteria and protozoa. The underlying mechanisms are complex and range from the passive protection against toxic effector molecules of the host and the remodelling of intracellular compartments as safe niches to the active modulation of the immune response at multiple levels. Parasites of the genus Leishmania have been particular helpful in unravelling some of the basic processes and form therefore the centre of the discussion.