This ATP6V0d2-mediated PV selectivity for ox-LDL-derived components could play an important role in vivo: Leishmania parasites developing large PVs are clinically associated with persistent diffuse granulomatous lesions in humans (diffuse cutaneous leishmaniasis), causing chronic damage to skin deep tissues despite only moderate inflammation in terms of NOS2 and IFN-γ expression compared to other disease manifestations [84, 85]. This evidence concerns the gene NOS2 and diffuse cutaneous Leishmaniasis.