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BACKGROUND: Cutaneous leishmaniasis (CL) is a vector borne disease predominantly found in tropical and subtropical countries, including Iran. For more than 6 decades, pentavalent antimonials have been used successfully worldwide for the treatment of leishmaniasis, but over the past few years, clinical resistance to these medications has increased. In this study, we evaluated CL patients who did not show any desirable responses to the anti-leishmanial treatment within a 10-year period (2008 to 2017). METHODS: All patients from different parts of Iran suspected of having cutaneous leishmaniasis, who were referred to the laboratory of leishmaniosis in Tehran University of Medical Sciences from 2008-2017 were parasitological examined. RESULTS: During this period, a total of 1480 suspected CL patients were referred to the laboratory of leishmaniosis. Samples from 655 patients (70.8%) suspected of having CL were positive microscopically. The failure rate in patients treated with anti-leishmaniasis medications for a minimum of three complete treatment periods was 1.83% (12 cases). There was no association between the number and size of skin lesions and patient characteristics. Also, the route of drug administration had no significant effect on the number and size of lesions. CONCLUSION: In the present study, treatment failure was found in some confirmed CL patients treated with meglumine antimoniate. Over the past few years, it seems that had been increased in resistance to these medications. So, a review of the correct implementation of the treatment protocol and/or a combination therapy may be helpful in preventing an increase in the rate of treatment failure.
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BACKGROUND: Cutaneous leishmaniasis (CL) is described as a major health problem in many countries of the world. Regulatory T cells (Tregs) are characterized as one of immunologic indexes. One of the best methods to determine of Tregs percentage is flow cytometry. The aim of this study was determination of the role of Tregs profile among acute and chronic forms of human CL using flow cytometry analysis. METHODS: This study was conducted on 24 patients referred to Laboratory of Leishmaniasis, Tehran University of Medical Sciences, Tehran, Iran with acute and 14 patients with chronic phases of CL as well as 15 healthy individuals as control group in 2015-2016. After microscopic examination, 2 ml of peripheral blood samples were collected for determining percentage of CD4 + CD25 + CD127 low Tregs by using flow cytometry method. RESULTS: Using flow cytometry analysis, the average percentage of Tregs were calculated 5.73, 6.71 and 6.61 for acute, chronic and healthy individuals, respectively. With SPSS software and Scheffe multiple comparison tests, the differences within in these groups are statistically significant (P=0.04) and between the acute and chronic group, there was marginally significant with approximately 91% of confidence level (P=0.088). CONCLUSION: Marginally differences were found significantly among averages of Regulatory T cells, acute and chronic phases of CL. Further comprehensive studies can be needed to verify the role of Tregs in both phases of CL cases.
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BACKGROUND: Visceral leishmaniasis is systematic serous parasitic disease with public health importance. Zoonotic form of visceral leishmaniasis is wide spread in Mediterranean basin and South America regions. Direct agglutination test (DAT) is an accurate, reliable and non-expensive serological test for the diagnosis of visceral leishmaniasis in human and canines but the antigen preparation involves some limitations. This study aimed to compare the conventional production of DAT antigen with our modified DAT antigen and then assessed on human and dog pooled sera. METHODS: Conventional DAT antigen has been prepared at the School of Public Health, Tehran University of Medical Sciences and some modifications were carried out on it, which named as modified DAT antigen. Three positive and one negative human and dog pooled serum were separately used for the comparison of modified DAT with conventional DAT antigen batches with one-month interval for a period of 9 months. RESULTS: A good concordance was observed between modified DAT compared to conventional DAT antigens for the detection of visceral leishmaniasis on human (100%) and dog (94.4%) pooled sera, respectively. CONCLUSION: Since the modified DAT antigen could be reduced the preparation time from 3 days to several hours and a good degree of agreement was found between modified DAT and convention DAT antigen batches, it can be used as a simple and easy tool for screening and serodiagnosis of human and canine L. infantum infection.
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BACKGROUND: Current research findings demonstrate that acupuncture, a traditional Chinese medicine, has beneficial effects on several acute and chronic infectious and inflammatory diseases. Acupuncture promotes tissue healing and regulates immune response in various disease conditions. Cutaneous leishmaniasis (CL) is a parasitic disease caused by protozoan from genus Leishmania. Acupuncture is supposed to accelerate healing of CL because of common mechanisms involved in the cure of the CL lesions. MATERIALS AND METHODS: 60 BALB/c mice were experimentally infected with L. major strain MRHO/IR/75/ER and divided into three groups: (1) Treatment group received acupuncture 2 times a week for 5 weeks (10 sessions) with intraperitoneal diazepam as a sedative agent. (2) Diazepam control group only received diazepam the same as the treatment group. (3) Control group did not receive any intervention. Size of the lesions was measured before the experiment, on session 5 and 10 and 4 weeks after the experiment. Parasite burden was evaluated by microscopic assay as well as quantitative real-time polymerase chain reaction technique. RESULTS: Size of the lesions decreased significantly on session 5 in treated group in comparison with session 0 (P = 0.02) while the size of the lesions increased significantly in two control groups on session 5 and 4 weeks after treatment (P = 0.04 and P = 0.01 respectively). Mean parasite burden did not show a significant difference between or within groups on session 0 and 10 by any methods. CONCLUSIONS: This investigation showed that acupuncture decreased size of the CL lesions by session 5 in the BALB/c mice model, but did not cause a significant reduction in parasite burden.
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BACKGROUND: In the northeast and central parts of Iran, Rhombomys opimus (great gerbil) is the primary reservoir host of zoonotic cutaneous leishmaniasis (ZCL). This study used both parasitological and molecular methods to identify Leishmania spp. and their different haplotypes that were circulating in the great gerbil populations in ZCL foci from northeastern Iran. METHODS: A cross-sectional study using microscopy, culturing and molecular methods was conducted to detect Leishmania parasites in 194 live R. opimus in ZCL foci from northeastern Iran during 2010-2011. RESULTS: Leishmania spp. were found in 38.1% (74/194) of the samples by microscopy and in 41.2% (80/194) by culturing. Small papules and skin thickening on the upper edge of the ears were observed in 25 (12. 9%) of the R. opimus. PCR-RFLP and PCR direct sequencing of internal transcribed spacer 1 (ITS1) rRNA showed similar infection rates for L. major and L. turanica in 60 eligible R. opimus, only one mixed infection containing both L. major and L. turanica was found. Phylogenetic analysis was conducted using the ITS1 sequences of 32 isolates that were successfully aligned by comparison of their base sequences with the ITS1 DNA sequence database using ClustalW and MEGA5. The samples were classified into monophyletic clusters (>97% bootstrap). Six haplotypes were observed for L. major and seven for L. turanica. CONCLUSION: In northeast Iran, L. major, and L. turanica naturally circulate in R. opimus, and L. major/L. turanica co-infections also exist. Phylogenetic analysis suggested that Leishmania spp. isolated from R. opimus are not a monophyletic group.