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cutanous leishmaniasis treatment

John R David
The present gold standard of the treatment of cutaneous leishmaniasis (CL) is pentavalent antimonials either sodium stibogluconate (Pentostam) or meglumine antimoniate (Glucantime), These drugs are quite toxic. They are given by injection and usually administered intramuscularly or intravenously for three weeks or intralesionally for seven or more weeks. That is why the successful introduction of radiofrequency-induced heat therapy using a Thermomed™ 1.8 instrument administered in a single application, with minimal toxic effects, is so important for the treatment of CL...
March 14, 2018: Parasitology
Nicole Zimara, Menberework Chanyalew, Abraham Aseffa, Ger van Zandbergen, Bernd Lepenies, Maximilian Schmid, Richard Weiss, Anne Rascle, Anja Kathrin Wege, Jonathan Jantsch, Valentin Schatz, Gordon D Brown, Uwe Ritter
Resistant mouse strains mount a protective T cell-mediated immune response upon infection with Leishmania (L.) parasites. Healing correlates with a T helper (Th) cell-type 1 response characterized by a pronounced IFN-γ production, while susceptibility is associated with an IL-4-dependent Th2-type response. It has been shown that dermal dendritic cells are crucial for inducing protective Th1-mediated immunity. Additionally, there is growing evidence that C-type lectin receptor (CLR)-mediated signaling is involved in directing adaptive immunity against pathogens...
2018: Frontiers in Immunology
Suelen S da Silva, Sandra S Mizokami, Jacqueline R Fanti, Idessania N Costa, Juliano Bordignon, Ionice Felipe, Wander R Pavanelli, Waldiceu A Verri, Ivete Conchon Costa
OBJECTIVES: To evaluate the analgesic effect of Glucantime (antimoniate N-methylglucamine) in Leishmania amazonensis infection and complete Freund's adjuvant (CFA), chronic paw inflammation model, in BALB/c mice. METHODS: Two models of chronic inflammatory pain in BALB/c mice paw were used: infection with L. amazonensis and CFA stimulation. Both animals models received daily treatment with Glucantime (10 mg/kg, i.p.) and during the treatment was measured the mechanical hyperalgesia with electronic version of von Frey filaments...
March 12, 2018: Journal of Pharmacy and Pharmacology
Letícia Sayuri Murase, João Vítor Perez de Souza, Quirino Alves de Lima Neto, Tatiane França Perles de Mello, Bruna Muller Cardoso, Daniele Stéfanie Sara Lopes Lera-Nonose, Jorge Juarez Vieira Teixeira, Maria Valdrinez Campana Lonardoni, Izabel Galhardo Demarchi
This is a systematic review on the role of metalloproteases in the pathogenicity of the American tegumentary leishmaniasis (ATL) caused by New World Leishmania species. The review followed the PRISMA method, searching for articles in PubMed, EMBASE, LILACS and ISI Web of Science, by employing the following terms: 'leishmaniasis', 'cutaneous leishmaniasis', 'mucocutaneous leishmaniasis', 'diffuse cutaneous leishmaniasis', 'Leishmania' and 'metalloproteases'. GP63 of New World Leishmania species is a parasite metalloproteases involved in the degradation and cleavage of many biological molecules as kappa-B nuclear factor, fibronectin, tyrosine phosphatases...
March 13, 2018: Parasitology
Doroodgar Moein, Doroodgar Masoud, Mahboobi Saeed, Doroodgar Abbas
Cutaneous leishmaniasis (CL) can be seen in 2 forms, zoonotic and anthroponotic, in Iran. In this study, epidemiological aspects of CL were studied during an 8-year period (2009-2016) in city of Kashan, central Iran. The demographic and epidemiological data, including age, sex, occupation, number and site of the lesions, treatment regimen, past history of CL, and season of all patients were gathered from the health centers. Descriptive statistics were used to describe features of the study data. Total 2,676 people with CL were identified...
February 2018: Korean Journal of Parasitology
Patrícia Flávia Quaresma, Cristiana Ferreira Alves de Brito, Jeronimo Marteleto Nunes Rugani, Janaína de Moura Freire, Rodrigo de Paula Baptista, Elizabeth Castro Moreno, Raquel Carvalho Gontijo, Felipe Dutra Rego, Joaquim Edemilson Diniz, Maria Norma Melo, Célia Maria Ferreira Gontijo
American tegumentary leishmaniasis (ATL) samples obtained from the lesions of patients with typical (n = 25, 29%), atypical (n = 60, 69%) or both (n = 2%) clinical manifestations were analysed by multilocus enzyme electrophoresis, hsp70 restriction-fragment length polymorphism (PCR-RFLP), hsp70 sequencing and phylogenetics methods. The hsp70 PCR-RFLP analysis revealed two different profiles whose the most samples differed from those expected for Leishmania braziliensis and the other Leishmania species tested: of 39 samples evaluated, two (5%) had a restriction profile corresponding to L...
March 12, 2018: Parasitology
Liliana López, Iván Vélez, María Patricia Arbeláez, Piero Olliaro
OBJECTIVE: To document the sources of heterogeneity in outcomes and shortcomings in trial designs reported by previous systematic reviews. METHODS: Systematic review of clinical trials of CL treatments published since 1991, to assess and compare eligibility criteria and outcome measures in trials (any type of treatment) of CL (any form) reported before and after the publication of the CONSORT statement. RESULTS: We identified 106 eligible trials published between 1991-2015, 74% after the 2001 CONSORT statement; 58% (n=63) were on Old World CL and 37% (n=40) in New World CL; overall 11,531 patients enrolled in 243 treatment groups on 30 different treatments...
March 9, 2018: Tropical Medicine & International Health: TM & IH
Devika Iddawela, Sanura Malinda Pallegoda Vithana, Dhilma Atapattu, Lanka Wijekoon
BACKGROUND: Leishmaniasis, a vector borne tropical/subtropical disease caused by the protozoan Leishmania is transmitted to humans by sandfly vectors Phlebotomus and Lutzomyia. The principal form found in Sri Lanka is cutaneous leishmaniasis (CL) and is caused by Leishmania donovani. A rising trend in disease prevalence has been observed recently in Sri Lanka and the island is in fact the newest endemic focus in South Asia. Determining the prevalence of smear positivity among clinically suspected CL patients, identifying risk factors and specific clinical presentations of CL in order to implement preventive and early treatment strategies were the objectives of this study...
March 6, 2018: BMC Infectious Diseases
Katrien Van Bocxlaer, Eric Gaukel, Deirdre Hauser, Seong Hee Park, Sara Schock, Vanessa Yardley, Ryan Randolph, Jacob J Plattner, Tejal Merchant, Simon L Croft, Robert T Jacobs, Stephen A Wring
Cutaneous leishmaniasis (CL) is caused by several species of the protozoan parasite Leishmania - affecting an estimated 10 million people worldwide. Previously reported strategies for the development of topical CL treatments have focussed primarily on drug permeation and formulation optimisation as the means to increase treatment efficacy.Our approach aims to identify compounds with anti-leishmanial activity and properties consistent with topical administration. Of the test compounds, five benzoxaboroles showed potent activity (EC50 < 5 μM) against intracellular amastigotes of at least one Leishmania species and acceptable activity (20 μM< EC50 <30 μM) against two more species...
March 5, 2018: Antimicrobial Agents and Chemotherapy
Dalila Y Martínez, Kristien Verdonck, Paul M Kaye, Vanessa Adaui, Katja Polman, Alejandro Llanos-Cuentas, Jean-Claude Dujardin, Marleen Boelaert
BACKGROUND: Tegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by Leishmania parasites. TL patients may concurrently carry other pathogens, which may influence the clinical outcome of TL. METHODOLOGY AND PRINCIPAL FINDINGS: This review focuses on the frequency of TL coinfections in human populations, interactions between Leishmania and other pathogens in animal models and human subjects, and implications of TL coinfections for clinical practice...
March 2018: PLoS Neglected Tropical Diseases
Hamida Al-Dwibe, Ahmad Amro, Aisha Gashout, Ali El-Zurghany, Said El-Zubi, Mohamed El-Hashme, Omar Hamarsheh, Mokhtar Maree
BACKGROUND: Several case reports describe diseases presenting with skin ulcerations, which resemble pyoderma gangrenosum especially in immune-compromised patients, often proven on further workup, to have an infective or malignant etiology. However, treatment of pyoderma gangrenosum by systemic steroids or other immunosuppressive agents may worsen the condition. CASE PRESENTATION: We report here, a 45 year-old Libyan woman with rheumatoid arthritis on low dose steroids with pyoderma gangrenosum-like skin lesions and positive pathergy...
March 1, 2018: BMC Research Notes
Jacques-Robert Christen, Eliane Bourreau, Magalie Demar, Edward Lightburn, Pierre Couppié, Marine Ginouvès, Ghislaine Prévot, Jean-Pierre Gangneux, Hélène Savini, Frank de Laval, Vincent Pommier de Santi, Sébastien Briolant
BACKGROUND: New world cutaneous leishmaniasis (NWCL) can be found in French Guiana as well as in several other parts of Central and South America. Leishmania guyanensis accounts for nearly 90% of cases in French Guiana and is treated with pentamidine isethionate, given by either intramuscular or intravenous injection. The military population is particularly exposed due to repeated missions in the rainforest. The purpose of the present study was to identify the factors associated with pentamidine isethionate treatment failure in a series of service members with L...
February 23, 2018: Travel Medicine and Infectious Disease
Valeska Albuquerque Francesconi, Fabio Francesconi, Rajendranath Ramasawmy, Gustavo Adolfo Sierra Romero, Maria das Graças Costa Alecrim
BACKGROUND: The treatment of Leishmaniasis caused by Leishmania (Viannia) guyanensis is based on a weak strength of evidence from very few clinical trials and some case series reports. Current treatment guidelines recommend pentamidine isethionate or meglumine antimoniate (Glucantime) as the first-line choices. Both are parenteral drugs with a low therapeutic indexes leading to a high risk of undesired effects. Imidazole derivatives interfere with the production of leishmanial ergosterol, an essential component of their membrane structure...
February 26, 2018: PLoS Neglected Tropical Diseases
A P Isaac-Márquez, P Talamás-Rohana, N Galindo-Sevilla, S E Gaitan-Puch, N A Díaz-Díaz, G A Hernández-Ballina, C M Lezama-Dávila
We evaluated, for the first time, the leishmanicidal potential of decanethiol functionalized silver nanoparticles (AgNps-SCH) on promastigotes and amastigotes of different strains and species of Leishmania: L. mexicana and L. major isolated from different patients suffering from localized cutaneous leishmaniasis (CL) and L. mexicana isolated from a patient suffering from diffuse cutaneous leishmaniasis (DCL). We recorded the kinetics of promastigote growth by daily parasite counting for 5 days, promastigote mobility, parasite reproduction by CFSE staining's protocol and promastigote killing using the propidium iodide assay...
February 19, 2018: World Journal of Microbiology & Biotechnology
Hans-Christian Stahl, Faridullah Ahmadi, Sami Mohammad Nahzat, Heng-Jin Dong, Kurt-Wilhelm Stahl, Rainer Sauerborn
BACKGROUND: The present health economic evaluation in Afghanistan aims to support public health decision makers and health care managers to allocate resources efficiently to appropriate treatments for cutaneous leishmaniasis (CL) elicited by Leishmania tropica or Leishmania major. METHODS: A decision tree was used to analyse the cost and the effectiveness of two wound care regimens versus intra-lesional antimony in CL patients in Afghanistan. Costs were collected from a societal perspective...
February 14, 2018: Infectious Diseases of Poverty
Seyedeh Sedigheh Hamzavi, Anahita Sanaei Dashti, Mohammad Rahim Kadivar, Gholamreza Pouladfar, Bahman Pourabbas
This case report presents an 8-year-old girl, from Fars province in Iran, diagnosed with cutaneous leishmaniasis in the form of multiple nodular, ulcerative and crusted lesions disseminated on the face, trunk and extremities. The result of direct smear of ulcers was positive for Leishmania parasite. The patient had no immunodeficiency or relevant family history making her susceptible for disseminated cutaneous leishmaniasis. The skin lesions failed to respond to multiple treatment courses of meglumine antimoniate or amphotericin B but were successfully treated with simultaneous miltefosine and liposomal amphotericin B...
March 2018: Pediatric Infectious Disease Journal
Mehdi Bamorovat, Iraj Sharifi, Mohammad Reza Aflatoonian, Hamid Sharifi, Ali Karamoozian, Fatemeh Sharifi, Ahmad Khosravi, Saeid Hassanzadeh
Cutaneous leishmaniasis (CL) is a serious health challenge at the global level due to Leishmania tropica. This study was conducted to evaluate the risk factors associated with anthroponotic CL (ACL) in unresponsive (patient who does not heal and remains with an active lesion, despite receiving two courses of intra-lesional Glucantime along with cryotherapy and one cycle of systemic Glucantime) and responsive patients in a major focus in southeastern Iran. A case-control study was conducted from April 2015 to October 2016 in the southeast of Iran...
2018: PloS One
Nicolas Barros, Nestor Vasquez, Fernando Woll, Cesar Sanchez, Braulio Valencia, Alejandro Llanos-Cuentas, A Clinton White, Martin Montes
To evaluate the dynamics of regulatory T cells (Tregs) during tegumentary leishmaniasis, we assessed peripheral blood and biopsies from 54 patients. Patients with cutaneous leishmaniasis (CL) had a decreased proportion of Tregs in the peripheral blood, but the proportion was higher in the biopsies of lesions. During treatment of CL, circulating Tregs increased reaching normal proportions, whereas antigen-specific interferon-γ responses diminished. By contrast, circulating Tregs from mucosal leishmaniasis patients failed to normalize during treatment...
February 5, 2018: American Journal of Tropical Medicine and Hygiene
Masoud Maleki, Mahdi Yousefi, Sayyed Mojtaba Mousavi Bazzaz, Sayyed Abolghasem Sajadi Tabassi, Hasan Rakhshandeh, Shokouh Sadat Hamedi, Gholamreza Haghighi
Background: Cutaneous Leishmaniasis (CL) which is prevalent in all continents and is classified by the WHO as one of the neglected tropical diseases, existed in the past also, and discovered ancient works confirm this issue. The lack of adaptation of diseases between Persian Medicine (PM) and Modern medicine, led to no usage of effective therapeutic experiences of prior physicians. Objective: The purpose of this study is finding skin lesions adapted to CL in PM for usage of same disease treatment in the next clinical trials, and the use of approved therapies in CL...
November 2017: Electronic Physician
Jaiberth Antonio Cardona-Arias, Liliana López-Carvajal, Mery Patricia Tamayo-Plata, Iván Darío Vélez
BACKGROUND: Cutaneous leishmaniasis causes a high disease burden in Colombia, and available treatments present systemic toxicity, low patient compliance, contraindications, and high costs. The purpose of this study was to estimate the cost-effectiveness of thermotherapy versus Glucantime in patients with cutaneous leishmaniasis in Colombia. METHODS: Cost-effectiveness study from an institutional perspective in 8133 incident cases. Data on therapeutic efficacy and safety were included, calculating standard costs; the outcomes were disability adjusted life years (DALYs) and the number of patients cured...
January 29, 2018: BMC Public Health
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