Análisis del comportamiento epidemiológico de Leishmaniasis cutánea en Perú 2016-2021 / Analysis of the epidemiological behavior of cutaneous leishmaniasis in Peru 2016-2021

La leishmaniasis cutánea (LC) es una patología cutánea inmunomediada causada principalmente por Leishmania (L.) major, Leishmania tropica, Leishmania braziliensis, L. mexicana y L. amazonensis. La carga de la LC en términos de morbilidad y estigmas sociales se concentra en ciertos países en desarrollo de Asia, África y Sudamérica. Las personas con LC asintomática representan una gran proporción de los individuos infectados en las zonas endémicas que no presentan ninguna lesión y pueden controlar la infección mediante mecanismos aún no del todo conocidos. En la actualidad, no existe ninguna medida profiláctica de control aprobada para la LC. Este reporte epidemiológico reveló que la LC prevalecía en las áreas geográficas de Selva y Sierra de Perú, mientras que departamentos como Ancash y La Libertad, áreas de la Costa, también estuvieron involucradas en el reporte de casos en los últimos años. El patrón de casos de LC reportados en los distintos departamentos del país tuvo un comportamiento muy parecido en el periodo comprendido entre 2016 y 2021, predominando en las primeras 4 o 5 semanas epidemiológicas la mayor frecuencia de pacientes enfermos con lesiones dérmicas compatibles y corroboradas con LC. La enfermedad es endémica en muchas partes del país, por eso se necesitan más esfuerzos y enfoques integrados para combatir esta patología(AU)

Cutaneous leishmaniasis (CL) is an immune-mediated skin pathology caused mainly by Leishmania (L.) major, Leishmania tropica, Leishmania braziliensis, L. mexicana and L. amazonensis. The burden of CL in terms of disease and social stigma is concentrated in certain developing countries in Asia, Africa, and South America. People with asymptomatic CL represent a large proportion of infected individuals in endemic areas who do not have any lesions and can control the infection through mechanisms that are not fully understood. Currently, there is no approved prophylactic control measure for CL. This epidemiological report revealed that CL was prevalent in the Selva and Sierra geographic areas of Peru, while departments such as Ancash and La Libertad, coastal areas, were also involved in the reporting of cases in recent years. The pattern of CL cases reported in the different departments of the country had a very similar behavior in the period between 2016 and 2021, with the highest frequency of sick patients with skin lesions compatible and corroborated with CL predominating in the first 4 or 5 epidemiological weeks. The disease is endemic in many parts of the country, so more efforts and integrated approaches are needed to combat this pathology(AU)

Predominance of Leishmania major and rare occurrence of Leishmania tropica with haplotype variability at the center of Iran

ABSTRACT Background Leishmania major is a causative agent of zoonotic cutaneous leishmaniasis in the center of Iran, Abarkouh district. Molecular characterization and precise incrimination of Leishmania species was carried out to perform controlling measurements and to design treatment programs for zoonotic cutaneous leishmaniasis. Methods All smears isolated from ulcers of suspected patients were examined under a light microscope and graded for amastigotes frequency. Extraction of DNA, PCR, RFLP and sequencing of ITS-rDNA genotype were done to increase the efficacy of Leishmania parasites identification at their species-specific level and to detect any Leishmania infections within. Results Humans were found to be infected with L. major with high infection frequency and also Leishmania tropica was identified with low occurrence for the first time as non-native species using molecular analyses. The rates of infections was considerable with microscopic observation (n= 65, 73%) out of 89 smears prepared from suspected patients. Molecular analyses showed that the density of L. major was significantly higher (n= 48, 53.93%) than L. tropica (n= 4, 4.49%) (Mann-Whitney U test: p< 0.05) and two samples (2.25%) remained ambiguous after several sequencing. L. major did not have diversity with two common haplotypes but L. tropica were found to exhibit high diversity with three novel haplotypes. Conclusion L. major was considered the causative agent of leishmaniasis in the region, but the identification of a non-native L. tropica revealed the importance of further isolation of Leishmania parasites following molecular analyses and confirmation, and also revealed the importance of further isolation of Leishmania parasites from patients of the field areas who do not have easily access to health care centers for specialized treatment strategies.

Estudo morfológico e morfométrico comparativo de espécies de flebotomíneos (diptera: psychodidae: phlebotominae) dos gêneros nyssomyia barretto, 1962, bichromomyia artemiev, 1991 e migonemyia galati, 1995, vetores de leishmânias dermotrópicas, no Brasil / Comparative morphological and morphometric study of species of sand flies (diptera: Psychodidae: Phlebotominae) gender Nyssomyia Barretto, 1962, Bichromomyia Artemiev, 1991 and Migonemyia galati, 1995, vectors of Leishmania dermotropic in Brazil

Phlebotominae representa um dos grupos de insetos de grande importância médica, especialmente para o Brasil, estando associado à transmissão de agentes das leishmanioses tegumentar e visceral. A geração de conhecimentos sobre a morfologia e morfometria de ambos, machos e fêmeas de flebotomíneos vetores de leishmaniose tegumentar americana (LTA), poderão indicar estruturas diagnósticas importantes como subsídios para estudos filogenéticos que permitam avaliar a relação vetor -patógeno no processo de coevolução. Com isso o trabalho teve como objetivo analisar comparativamente as seguintes espécies de flebotomíneos: Nyssomyia intermedia, Ny. neivai, Ny. whitmani, Migonemyia migonei e Bichromomyia flaviscutellata, importantes vetores de Leishmania spp., causadores da LTA no Brasil. As análises morfométricas foram capazes de separar os gêneros. A análise comparativa dos flebotomíneos por morfometria geométrica e clássica, permitiu aprofundar a discussão sobre a posição taxonômica de Ny. intermedia e Ny. neivai, consideradas por alguns autores como espécies crípticas, onde houve diferença significativa em várias das estruturas analisadas, como no tamanho do centroide das asas e a razão entre os filamentos genitais e a ponta dos filamentos genitais. Através das análises de morfometria clássica e do tamanho dos centróides e as formas médias das asas, as espécies de Nyssomyia se apresentam mais próximas feneticamente de Mg. migonei, vetores de Leishmania (Viannia) braziliensis, do que de Bi. flaviscutellata, vetora de Leishmania (Leishmania) amazonensis, o que também corrobora com a separação dos gêneros Nyssomyia e Bichromomyia.

An overview of a diagnostic and epidemiologic reappraisal of cutaneous leishmaniasis in Iran

Cutaneous leishmaniasis (CL) is a widespread tropical infection which has a high incidence rate in Iran. Leishmania tropica, the causative agent of anthroponotic cutaneous leishmaniasis (ACL), and Leishmania major, which causes zoonotic cutaneous leishmaniasis (ZCL), are endemic in various parts of Iran with a high incidence rate. The aim of this study was to evaluate the reappraisal of the diagnosis and epidemiology of CL in Iran, by different clinical, parasitological and molecular assays among patients suspected of CL referred to the Department of Parasitology, at the Pasteur Institute of Iran during 2006-2009. Two hundred samples from patients with ulcerative skin lesions were collected, clinical analyses were applied, data questionnaire was completed and samples were examined for CL by using both direct microscopic and culture methods. Moreover, PCR assay was applied for detection of Leishmania species in CL isolates resulting from parasitological assay. Clinical observation revealed that the majority (58 percent) of lesions was single; double lesions were observed in 22 percent of patients, and only 20 percent of CL had multiple lesions. Out of 200 patients, Leishman body was observed in 77 samples (38.5 percent) by direct smear and 40 percent by cultivation assay. Most patients (21.3 percent) had a travel history to the Isfahan province, one of the most important endemic areas of CL located in center of Iran. PCR assay by kDNA indicated 32 and 18 out of 50 isolates respectively had similar patterns with standard L. major and L. tropica. In conclusion, clinical manifestations and an appropriate diagnostic assay with a parallel molecular characterization of CL may lead to a screening evaluation of disease, prognosis, treatment and control strategies.

Zinc sulphate in the treatment of cutaneous leishmaniasis: in vitro and animal study

This study was designed to evaluate the effectiveness of zinc sulphate both in vitro and in an animal model against both strains of old world cutaneous leshmaniasis. The in vitro sensitivities of promastigotes and axenic amastigotes of both Leishmania major and L. tropica to zinc suphate was determined, the LD50 calculated and compared to the standard treatment for cutaneous leishmaniais pentavalent antimony compounds. The results show that the two forms of both strains were sensitive to zinc sulphate and their respective LD50 were lower compared to the pentavalent antinomy compound. Furthermore the sensitivities of the forms of both strains were tested using a simple slide method and compared to results of the standard method. To confirm this result, zinc sulphate was administered orally to mice infected with cutaneous leishmaniasis both therapeutically and prophylactically. Results showed that oral zinc sulphate was effective in both treatment and prophylaxis for cutaneous leishmaniasis. These results encourage the use of oral zinc sulphate in the treatment of cutaneous leishmaniasis clinically.

GPI phospholipase C from Trypanosoma brucei causes a GPI-negative phenotype in Leishmania major: I. Implications for GPI-negative mammalian cells; II. Compartmentalization of two GPI biosynthetic pathways

The major surface macromolecules of the protozoan parasite Leishmania major, gp63 (a metalloprotease), and lipophosphoglycan (a polysaccharide) are glycosylphosphatidylinositol (GPI)-anchored. We expressed a cytoplasmic glycosylphosphatidylinositol phospholipase C (GPIPLC) in L. major in order to examine the topography of the protein-GPI and polysaccharide-GPI pathways. In L. major cells expressing GPIPLC cell-associated gp63 could not be detected in immunoblots, gp63 was secreted into the culture medium without ever receiving a GPI anchor. Putative protein-GPI intermediates LP-1 and LP-2 decreased about 10-fold. In striking contrast, lipophosphoglycan levels were unaltered. We conclude that reactions specific to the polysaccharide-GPI pathway are compartmentalalized within the endoplasmic reticulum, thereby sequestering those intermediates from GPIPLC cleavage. Protein-GPI synthesis, at least up to production of Man (1Ó6)Man(1Ó4)GlcN(1Ó6)-myo-inositol-1-phospholipid, is cystolic. To our knowledge, this represents the first use of a catabolic enzyme, in vivo, to elucidate the topography of biosynthetic pathways. Intriguingly, the phenotype of GPIPLC-expressing L. major, secretion of proteins with GPI addition signals, and depletion of protein-GPI anchor precursors, is similar to that of some protein-GPI mutants in higher eukaryotes. These findings have implications for paroxysmal nocturnal hemoglobinuria and Thy-1-negative T-lymphoma

Leishmaniasis cutánea (Botón de Oriente) / Cutaneous leishmaniasis

Se presenta un paciente de 65 años de edad, con una lesión nodular de aproximadamente 1,5 cm de diámetro, eritematosa y asintomática, ubicada en tercio superior, cara anterior de pierna derecha. Como antecedente de importancia, refiere haber viajado a Italia donde permaneció hasta 3 meses antes de la aparición de la afección. Los estudios efectuados demostraron que se trataba de una leishmaniasis cutánea (Botón de Oriente). Se analizan las formas clínicas, métodos diagnósticos y terapéuticos, y se efectúa una revisión de la literatura de esta inusual enfermedad en nuestro medio

Heterogeneity of cysteine proteinases in Leishmania braziliensis and Leishmania major

Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) with acrylamide copolymerized with gelatin (substrate-SDS-PAGE) was used to compare promastigote proteinases from two Leishmania species (L. braziliensis and L. major-like). Substrate-SDS-PAGE resolved at least 6 distinct proteinase activities with relative molecular masses between 20 and 65 kDa. The profile of proteinase activity was the same for both species, although qualitative differences were observed. L. major-like expressed a low molecular weight (20 kDa) proteinase with maximum activity at pH 7.0, which was demonstrable from pH 5.0 to pH 8.0. The 20-kDa protease was recovered in the detergent phase of TX-114 and was inhibited by the sulfhydryl group-blocking reagent E-64 (2.5 mM) and the non-specific inhibitor iodoacetic acid (1 mM). Pepstatin (1 microM) and PMSF (2.5 mM) did not inhibit the 20-kDa enzyme. The present study suggests that both Leishmania species studied express hydrophobic cysteine proteases of different molecular weights, since about 2 x 10(7) parasites were analyzed in each lane and the proteolytic activity developed at 37 degrees C for 16 h

Comparison on the performance of Leishmania major-like and Leishmania braziliensis braziliensis as antigen for new world leishmaniasis IgG-immunofluorescence test

O desempenho de um antigeno de promastigotas de L. major-like para o diagnostico sorologico de leishmaniose mucocutanea pelo teste de imunofluorescencia-IgG foi comparado com o desempenho de um antigeno de L. braziliensis braziliensis. Cada antigeno foi usado para testar 224 soros de etiologias como leishmaniose mucocutanea, micoses profundas, toxoplasmose, malaria, doenca de Chagas, leishmaniose visceral, fator anti-nucleo, esquistossomose mansonica, fator reumatoide e controles normais. A concordancia entre as respostas de cada antigeno foi grande: 77,2 por cento dos soros de leishmaniose mostraram resultado positivo para ambos os antigenos ou negativo, assim como 91,1 por cento dos soros controle negativos. Reacoes cruzadas ficaram restritas a doenca de Chagas, leishmaniose visceral, fator anti-nucleo e paracoccidioidomicose. A resposta quantitativa dos soros de leishmaniose e doenca de Chagas foi avaliada pelo metodo de regressao linear; embora a interseccao com o eixo y e o "slope" fossem diferentes para cada antigeno nenhum deles se mostrou melhor na evidenciacao de anticorpos anti-Leishmania. O antigeno de L. major-like mostrou-se melhor que o de L.b. braziliensis na evidenciacao de anticorpos em soros de doenca de Chagas.

Extracellular dephosphorylation in the parasite, leishmania major / Desfosforilacion extracelular en el parasito, leishmania major

Leishmania major promastigotes were analyzed for the presence of protein phosphatase activity in intact cells and membrane-enriched fractions. Parasite phosphoprorylated in live cells with {*-32P} adenosine 5'-triphosphate (ATP) and an edogemous leishmanial ectokinase, were dephosphorylated by endogenous protein phosphatase like activity in intact cells and membrane-rich fractions. An alkaline phosphatase-like activity was also identified using the artificial substrate, p-nitrophenyl phosphate (pNPP). This activity was localized on the extracellular membrane of intact parasite, as well as in the particulate fraction of lysed cells. The phosphatase activity measure using pNPP had inhibition properties and a pH profile between protein phosphatases and general alkaline phosphatase. This study supports the observation that there is extracellular protein phosphorylation/dephosphorylation in L.major which may play a significant role in host-cell-parasite recognition and infection

Botäo do oriente: relato de caso / Oriental sore: a case report

É relatado caso clínico de leishmaniose o qual, por suas características clínicas e epidemiológicas, foi identificado como botäo do oriente

Estudo sobre a relaçåo parasito-hospedeir e lectinas como instrumento de diferenciaçåo entre cepas de Leishmania no Novo Mundo / Study about relationship host/parasite and lectines with differencial instrument among Leishmania strains in new-world

Trata-se de estudo baseado em investigaçÆes científicas publicadas acerca de lectinas usadas para detectar grupos de carboidratos específicos presentes nas superfícies celulares, com fins taxonômicos em Leishmania, bem como pesquisa da relaçåo parasito-hospedeiro considerando os estágios evolutivos das cepas e condiçÆes de patogenicidade e nåo patogenicidade

Cultivo de leishmania em meio definido. Estudos de seus requerimentos nutricionais / Culture of leishmania in definite way. Studies of its nutricionais petitions

Foram desenvolvidos meios definidos para o cultivo para o cultivo de Leishmania.Estes meios,foram denominados "meios da série MD"e sua versão final é o meio MD-30.19 cepas de Leishmania cresceram nas 2 versões finais dos meios definidos de séria MD:meios MD-29 e MD-30.Quatorze foram isoladas no Novo Mundo,do homem,roedores e hospedeiro invertebrado,sendo 7 L.mexicana,4 Leishmania sp.,ainda sem classificação dentro dos modernos conceitos bioquímicos,2 L.hertigi,subespécies:L.hertigi deanei e L.hertigi e uma L.donovani.As 5 cepas restantes foram isiladas no Velho Mundo do homem e de lacertídeos,sendo uma L.tropica,uma L.aethiopica,uma L.donovani e duas espécies que parasitam lagartos:L.tarentolae e L.agamae.Todas as cepas cresceram em meio definido MD-29 com um rendimento da ordem de dez a sétima potência flagelados/ml alcançando,portanto,uma população suficiente para permitir estudos bioquímicos e imunológicos diversos.As duas últimas versões dos meios definidos elaborados permitiram a transformação de amastigotas,isoladas diretamente de lesões de animais experimentalmente infectados,em promastigotas e manutenção subsequente das mesmas.As cepas de Leishmania isoladas e mantidas em meio definido não perderam sua infectividade para animal de laboratório(hamster).Duas cepas foram estudadas quanto aos seus requerimentos nutricionais.A cepa BH 121 do complexo L.mexicana e a cepa BH46 L.donovani.Foram estudados os efeitos da temperatura,pressão osmótica e do pH no crescimento.Ambas as Leishmania cresceram em meio definido numa faixa de temperatura de 20 a 28 graus celcius,sendo a temperatura ótima 23graus celcius.O aumento da pressão osmótica do meio definido reduziu o crescimento e levou a modificações morfológicas dos flagelos,sendo que a L.donovani parece ter uma mais limitada resistência osmótica que a L.mexicana.Ambas as cepas cresceram numa faixa de pH compreendida ente 6,5 e 9,0,sendo o pH ótimo para o cultivo dos flagelados 7,5.Os flagelos apresentaram requerimento de heme,sendo que hemina na concentração de 0,01 g/1 proporcionou crescimento máximo.Os flagelados exigiram uma fonte de purina,sendo que qualquer uma das purinas testadas(adenina,guanina,xantina,hipoxantina,adenosina e guanosina,adenosina monofosfato e adenosina trifosfato)pode suprir este requerimento.Primidinas não foram necessárias ao crescimento das duas Leishmania...Os resultados foram discutidos com os dados já descritos na leitura.

Aspectos clínicos comparativos da leishmaniose tegumentar na Regiåo Amazônica e Regiåo Centro-Oeste / A comparative study of cutaneous leishmaniasis from the Amazon and Central West regions of Brazil

Foram estudados 245 casos de Leishmaniose Tegumentar, sendo 149 da Regiåo Amazônica e 96 da Regiåo Centro-Oeste. De cada caso foram analisadas 30 variáveis clínicas. Na Regiåo Amazônica há incidência significativamente maior da LT no grupo etário de 15 a 25 anos. Na Regiåo Centro-Oeste, a incidência maior é em casados. Quanto à profissåo, na Regiåo Centro-Oeste há incidência maior em agricultores e dométicas, em relaçåo a idênticas profissÆes da Regiåo Amazônica; nessa regiåo, as profissÆes de estudante, de militar e de trabalhador braçal, comparativamente com as mesmas profissÆes da Regiåo Centro-Oeste, têm maior significaçåo. Há incidência signifivamente maior de lesÆes sistematizadas (múltiplas) no caso da Regiåo Amazônica que da Regiåo Centro-Oeste, e o único caso de forma foi observado naquela regiåo. Há predominância significativamente maior do tempo de evoluçåo das lesÆes, inferior a 60 dias na Regiåo Amazônica, quando comparado com igual período da Regiåo Centro-Oeste. Nesta regiåo, o período de maior predominância é aquele superior a 240 dias. Há incidência significativamente maior de lesÆes ulceradas e em atividade na Regiåo Amazônica, quando comparadas com as lesÆes observadas na Regiåo Centro-Oeste. O inverso sucede com o comprometimento das mucosas e a presença de lesÆes cutâneas verrucosas que incidem mais na Regiåo Centro-Oeste. As leishmânides såo mais freqüentes na Regiåo Amazônica. É provável que essas diferenças observadas, entre as duas regiÆes, sejam devidas a diferentes espécies ou subespécies de parasitos envolvidos