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1.
Exp Parasitol ; 207: 107773, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31605671

RESUMEN

Studies of the primers that were designed to detect New World Leishmania were systematically reviewed to report the characteristics of each target, detection limit, specificity of the primers designed and diagnostic sensibility. The papers identified in the databases PubMed and Web of Science involved 50 studies. Minicircle is the most applied target in molecular research for diagnosis, due to its high sensitivity in detecting Leishmania in different clinical samples, a characteristic that can be partially attributed to the higher number of copies of the minicircle per cell. The other molecular targets shown in this review were less sensitive to diagnostic use because of the lower number of copies of the target gene per cell, but more specific for identification of the subgenus and/or species. The choice of the best target is an important step towards the result of the research. The target allows the design of primers that are specific to the genus, subgenus or a particular species and also imparts sensitivity to the method for diagnosis. The findings of this systematic review provide the advantages and disadvantages of the main molecular targets and primers designed for New World Leishmania, offering information so that the researcher can choose the PCR system best suited to their research need. This is a timely and extremely thorough review of the primers designed for New World Leishmania.


Asunto(s)
Cartilla de ADN/análisis , ADN Protozoario/análisis , Leishmania/genética , Leishmaniasis Cutánea/parasitología , Reacción en Cadena de la Polimerasa/métodos , Humanos , Leishmania/aislamiento & purificación , Límite de Detección , Sensibilidad y Especificidad
2.
Parasitol Res ; 117(2): 501-511, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29280072

RESUMEN

Leishmaniasis is caused by protozoa of the Leishmania genus, which is divided into subgenus Viannia and Leishmania. In humans, the course of infection largely depends on the host-parasite relationship and primarily of the infective species. The objective of the present study was to design specific primers to the identification of Leishmania species using multiplex PCR. Four primers were designed, based on the GenBank sequences of the kDNA minicircle, amplifying 127 bp for subgenus Viannia, 100 bp for L. amazonensis, and 60 bp for Leishmania donovani complex and L. major. None of the primers amplified Trypanosoma cruzi or L. mexicana. The limit of detection of multiplex PCR was 2 × 10-5 parasites for L. braziliensis, 2 x 10-3 parasites for L. amazonensis, and 1.4 × 10-3 parasites for L. infantum. The high sensitivity of multiplex PCR was confirmed by the detection of parasites in different biological samples, including lesion scrapings, spleen imprinting of a hamster, sandflies, and blood. The multiplex PCR that was developed herein presented good performance with regard to detecting and identifying the parasite in different biological samples and may thus be useful for diagnosis, decision making with regard to the proper therapeutic approach, and determining the geographic distribution of Leishmania species.


Asunto(s)
Cartilla de ADN/genética , ADN de Cinetoplasto/genética , Leishmania/clasificación , Leishmania/genética , Leishmaniasis/diagnóstico , Reacción en Cadena de la Polimerasa Multiplex/métodos , Animales , Secuencia de Bases , Cricetinae , Interacciones Huésped-Parásitos , Humanos , Leishmania/aislamiento & purificación , Leishmaniasis/parasitología , Psychodidae/parasitología , Sensibilidad y Especificidad , Bazo , Trypanosoma cruzi/genética
3.
Parasitology ; 144(8): 995-1004, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28367792

RESUMEN

Studies of topical treatments for leishmaniasis were systematically reviewed, to evaluate the therapeutic efficacy, safety and any adverse effects of these treatments. The papers identified in the databases PubMed and Web of Knowledge involved eight studies with a total of 1744 patients. The majority of trials was from Iran (4/8), covered a period of 8 years (2003-2011), and included patients 4-85 years of age. The most frequent Leishmania species in the studies were L. tropica (4/8) and L. major (2/8). The treatments administered were thermotherapy, paromomycin and combinations, CO2 laser, 5-aminolevulinic acid hydrochloride (10%) plus visible red light (633 nm) and cryotherapy. Six articles reported cure rates over 80·0%. Six studies reported on failure rates, three of them reporting rates lower than 10%. Four studies did not report relapses or recurrences, while the other studies reported low rates (1·8-6·3%). The most common adverse effects of the topical treatments were redness/erythema, pain, pruritus burning, oedema, vesicles and hyper- or hypopigmentation. The results provide strong evidence that the treatments topical evaluated showed high cure rates, safety and effectiveness, with low side-effects, relapse and recurrence rates, except for cryotherapy, which showed a moderate cure rate.


Asunto(s)
Antiprotozoarios/administración & dosificación , Antiprotozoarios/efectos adversos , Hipertermia Inducida , Láseres de Gas , Leishmaniasis Cutánea/tratamiento farmacológico , Administración Tópica , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Humanos , Láseres de Gas/efectos adversos , Leishmania/efectos de los fármacos , Leishmania/efectos de la radiación , Persona de Mediana Edad , Adulto Joven
4.
Parasite Immunol ; 38(1): 64-77, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26615004

RESUMEN

Cutaneous leishmaniasis usually presents therapeutic resistance to antimonials, and the existing therapies for leishmaniasis have many adverse effects and toxicity. Natural products may be regarded as possible candidates for alternative leishmaniasis treatment. The plant Tetradenia riparia has shown promise for the treatment of infectious diseases in folk medicine. We evaluated the antileishmanial activity of an essential oil from T. riparia (TrEO) and the modulatory effects of TrEO on cytokine modulation by peritoneal fluid cells that were infected with L. (L.) amazonensis. Peritoneal fluid cells were infected with Leishmania and incubated with TrEO (30 ng/mL) for 3, 6, and 24 h. Cytokines were screened using semi-quantitative reverse-transcription polymerase chain reaction (RT-PCR) and flow cytometry. Antileishmanial activity was evaluated at 24 h by microscopic counting and quantitative PCR (qPCR). TrEO treatment induced the death of 50% of Leishmania amastigotes (indicated by microscopic counting) and 91% of the parasite load (indicated by qPCR). TrEO inhibited some of the most critical cytokines for parasite growth and the establishment of infection, including granulocyte-macrophage colony-stimulating factor, interleukin-4 (IL-4), IL-10, and tumour necrosis factor. The parasite inhibited interferon-γ and IL-12, and TrEO blocked this inhibition, indicating that these cytokines are critical for activating mechanisms associated with the death and elimination of the parasite. These results suggest that TrEO may be an alternative leishmaniasis therapy when considering its antileishmanial and immunomodulatory activity.


Asunto(s)
Líquido Ascítico/citología , Leishmania/efectos de los fármacos , Leishmaniasis Cutánea/tratamiento farmacológico , Aceites Volátiles/farmacología , Aceites de Plantas/farmacología , Animales , Células Cultivadas , Factor Estimulante de Colonias de Granulocitos y Macrófagos/antagonistas & inhibidores , Interferón gamma/antagonistas & inhibidores , Interleucina-10/antagonistas & inhibidores , Interleucina-12/antagonistas & inhibidores , Interleucina-4/antagonistas & inhibidores , Lamiaceae/metabolismo , Leishmania/inmunología , Medicina Tradicional , Ratones , Ratones Endogámicos BALB C , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores
5.
Exp Parasitol ; 167: 83-93, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27181585

RESUMEN

Leishmaniasis is a group of diseases that presents various clinical manifestations. Many studies have shown that the parasite plays an important role in the clinical manifestations and prognosis of this disease. The cutaneous and mucosal forms of American tegumentary leishmaniasis (ATL) are associated with Leishmania (Viannia) braziliensis, which exhibits intraspecific genetic polymorphisms and various clinical manifestations. The present study focused on four different L. braziliensis strains that were isolated from patients with distinct Glucantime(®) treatment responses. The isolates were described based on their molecular, biological, and infective characteristics. Growth patterns in culture medium and different grow phases were analyzed, MID-Logarithimic (Mid-LOG), Logarithimic (LOG) and Stationary (STAT) phases. Complement resistance was evaluated using guinea pig serum. Infection to murine peritoneal macrophages, cytokine and nitric oxide were analyzed. Ultrastructural features were determined by transmission electron microscopy, and molecular characteristics were determined based on random amplified polymorphic DNA (RAPD). All of the L. braziliensis isolates showed typical growth and similar complement sensitivity patterns. Markedly lower infectivity indexes were observed for all strains in the LOG phase, with different cytokine profiles. The ultrastructure analysis revealed distinct differences between the MID-LOG, LOG, and STAT phases. The RAPD results showed a divergence between the isolates of the L. braziliensis. The in vitro characterization of L. braziliensis isolates from humans with different treatment responses using various parameters enabled us to observe differences among the isolates. Molecular and in vivo characterizations are currently under study to improve understanding of the parasite-host interaction that can imply in the clinical manifestation differences.


Asunto(s)
Antiprotozoarios/uso terapéutico , Leishmania braziliensis/fisiología , Leishmaniasis Cutánea/parasitología , Meglumina/uso terapéutico , Compuestos Organometálicos/uso terapéutico , Adulto , Anciano , Animales , Brasil , Proteínas del Sistema Complemento/farmacología , Citocinas/metabolismo , ADN Protozoario/química , ADN Protozoario/aislamiento & purificación , Femenino , Cobayas , Humanos , Leishmania braziliensis/genética , Leishmania braziliensis/inmunología , Leishmania braziliensis/ultraestructura , Leishmaniasis Cutánea/tratamiento farmacológico , Macrófagos Peritoneales/parasitología , Masculino , Antimoniato de Meglumina , Ratones , Ratones Endogámicos BALB C , Microscopía Electrónica de Transmisión , Persona de Mediana Edad , Óxido Nítrico/metabolismo , Técnica del ADN Polimorfo Amplificado Aleatorio
6.
Exp Parasitol ; 157: 128-37, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26116864

RESUMEN

Tetradenia riparia plant is used as a traditional medicine in Africa for the treatment of inflammatory and infectious diseases as like parasitic. Therapy for leishmaniasis caused by Leishmania (Leishmania) amazonensis specie often fails, and the conventional drugs are toxic, expensive, require a long period of treatment, and adverse effects are common. The alternative therapies using natural products are inexpensive and have few or any adverse reaction. These reasons are sufficient to investigate the new natural therapeutic for leishmaniasis. We evaluated the potential of the essential oil (TrEO) and 6,7-dehydroroyleanone (TrROY) isolated from T. riparia on L. (L.) amazonensis promastigote and amastigote forms, cytotoxicity on human erythrocytes and murine macrophages, nitric production and inducible nitric oxide synthase (iNOS) mRNA expression. TrEO was the most effective to promote the Leishmania promastigote death. After 72 h incubation, the lethal dose of TrEO and TrROY that promoted 50% Leishmania death (LD50) were 0.8 µg/mL and 3 µg/mL, respectively. TrEO and TrROY were not cytotoxic to human erythrocytes, but TrROY was toxic to murine macrophages resulting in a low selectivity index. The transmission electronic microscopy showed that TrEO (0.03 µg/mL) was able to modify the promastigote ultrastructures suggesting autophagy as chromatin condensation, blebbing, membranous profiles and nuclear fragmentation. Infected-macrophages treated with TrEO (0.03 µg/mL) or TrROY (10 µg/mL) had an infection index decreased in 65 and 48%. TrEO did not induce iNOS mRNA expression or nitrite production in macrophages infected with Leishmania. TrROY and mainly TrEO promoted the Leishmania death, and TrROY showed loss toxicity to erythrocytes cells. Other compounds derived from T. riparia and the essential oil could be explored to develop a new alternative treatment for leishmaniasis.


Asunto(s)
Abietanos/farmacología , Lamiaceae/química , Leishmania mexicana/efectos de los fármacos , Aceites Volátiles/farmacología , Abietanos/química , Abietanos/aislamiento & purificación , Animales , Eritrocitos/efectos de los fármacos , Hemólisis/efectos de los fármacos , Humanos , Leishmania mexicana/ultraestructura , Dosificación Letal Mediana , Macrófagos Peritoneales/efectos de los fármacos , Ratones , Ratones Endogámicos BALB C , Microscopía Electrónica de Transmisión , Óxido Nítrico Sintasa de Tipo II/genética , Aceites Volátiles/química , Aceites Volátiles/aislamiento & purificación , Extractos Vegetales/aislamiento & purificación , Extractos Vegetales/farmacología , Hojas de la Planta/química , ARN Mensajero/metabolismo
7.
Mem Inst Oswaldo Cruz ; 110(8): 1024-34, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26602873

RESUMEN

The herbaceous shrub Tetradenia riparia has been traditionally used to treat inflammatory and infectious diseases. Recently, a study showed that T. riparia essential oil (TrEO) obtained in summer has antileishmanial effects, although these results could be influenced by seasonal variation. This study evaluated the activity of the TrEO obtained in different seasons against Leishmania (Leishmania) amazonensis, in vitro and in vivo. The compounds in the TrEO were analysed by gas chromatography-mass spectrometry; terpenoids were present and oxygenated sesquiterpenes were the majority compounds (55.28%). The cytotoxicity and nitric oxide (NO) production were also tested after TrEO treatment. The TrEO from all seasons showed a 50% growth inhibitory concentration for promastigotes of about 15 ng/mL; at 30 ng/mL and 3 ng/mL, the TrEO reduced intracellular amastigote infection, independently of season. The TrEO from plants harvested in summer had the highest 50% cytotoxic concentration, 1,476 ng/mL for J774.A1 macrophages, and in spring (90.94 ng/mL) for murine macrophages. NO production did not change in samples of the TrEO from different seasons. The antileishmanial effect in vivo consisted of a reduction of the parasite load in the spleen. These results suggest that the TrEO has potential effects on L. (L.) amazonensis, consonant with its traditional use to treat parasitic diseases.


Asunto(s)
Antiprotozoarios/farmacología , Lamiaceae/química , Leishmania/efectos de los fármacos , Aceites Volátiles/farmacología , Extractos Vegetales/farmacología , Animales , Antiprotozoarios/aislamiento & purificación , Citotoxinas/farmacología , Femenino , Cromatografía de Gases y Espectrometría de Masas , Inhibidores de Crecimiento/farmacología , Técnicas In Vitro , Concentración 50 Inhibidora , Leishmania/clasificación , Ganglios Linfáticos/parasitología , Macrófagos Peritoneales/efectos de los fármacos , Macrófagos Peritoneales/parasitología , Ratones Endogámicos BALB C , Óxido Nítrico/análisis , Aceites Volátiles/química , Carga de Parásitos , Extractos Vegetales/química , Hojas de la Planta/química , Estaciones del Año , Sesquiterpenos/análisis , Bazo/parasitología , Factores de Tiempo
8.
Exp Parasitol ; 128(4): 353-6, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21575635

RESUMEN

The aim of this study was to investigate the effectiveness of Photodynamic Therapy (PDT) using Methylene Blue (MB) as the photosensitizing compound and a Light-Emitting Diode (LED) in American cutaneous leishmaniasis (ACL). Hamsters were experimentally infected with Leishmania (Leishmania) amazonensis. After the development of the lesions in the footpad, the animals were treated with MB three times a week for 3 months. Ten minutes after each application of MB, the lesions were irradiated with LED for 1 h. The lesions were evaluated weekly by the measurement of the hamster footpad thickness. At the end of the treatment the parasitic load was quantified in the regional lymph node of the hamsters. The treatment promoted a decrease in the thickness of infected footpad (P=0.0001) and reduction in the parasitic load in the regional lymph node (P=0.0007) of the animals from group treated with MB+LED. PDT using MB+LED in ACL caused by L. amazonensis shows a strong photodynamic effect. This therapy is very promising, once it is an inexpensive system and the own patient can apply it in their wound and in their house without the need of technical assistance.


Asunto(s)
Inhibidores Enzimáticos/uso terapéutico , Leishmania mexicana/efectos de los fármacos , Leishmaniasis Cutánea/tratamiento farmacológico , Azul de Metileno/uso terapéutico , Fotoquimioterapia/métodos , Animales , Cricetinae , Inhibidores Enzimáticos/normas , Ganglios Linfáticos/parasitología , Masculino , Mesocricetus , Azul de Metileno/normas , Fotoquimioterapia/normas , Bazo/parasitología
9.
Iran J Parasitol ; 16(4): 567-575, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-35082885

RESUMEN

BACKGROUND: We aimed to determine the cellular recruitment (leukocyte rolling and adhesion) by which the Leishmania (Viannia) braziliensis, L. (Leishmania) amazonensis, and L. (Leishmania) major species in the mesenteric microcirculation of BALB/c mice. METHODS: Five experimental groups were considered: group 1 (L. braziliensis); group 2 (L. amazonensis); group 3 (L. major); group 4 (control group with PBS); group 5 (negative control group), analyzed 3, 6, 12, and 24 h after parasite inoculation. RESULTS: Infections by the different Leishmania species caused an increase in the number of rolling leukocytes: L. braziliensis a peak at 6 h; L. amazonensis and L. major a peak at 3 h. The Leishmania infections induced leukocyte adhesion: L. major and L. amazonensis showed an increase after 3 and 6 h, respectively. CONCLUSION: The kinetics of cellular recruitment in Leishmania infections, leading to infection susceptibility or resistance, indicates that distinct mechanisms regulate the initial response to Leishmania infection and determine its course.

10.
Rev Soc Bras Med Trop ; 54: e00472020, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33338104

RESUMEN

INTRODUCTION: The objective of this study was to evaluate the performance of filter paper (FP) for lesion scraping collection in a polymerase chain reaction (PCR) for cutaneous leishmaniasis (CL) diagnosis. METHODS: Lesion scrapings from 48 patients were collected and analyzed for PCR. RESULTS: PCR with FP detected up to three Leishmania braziliensis promastigotes. Considering the direct search by microscopy or PCR of samples collected in STE buffer as standards, the sensitivity of PCR with FP was 100%. CONCLUSIONS: FP can be useful for CL diagnosis in remote regions, allowing high sensitivity in the detection of the parasite by PCR.


Asunto(s)
Leishmania braziliensis , Leishmaniasis Cutánea , ADN Protozoario/genética , Humanos , Leishmania braziliensis/genética , Leishmaniasis Cutánea/diagnóstico , Microscopía , Reacción en Cadena de la Polimerasa , Sensibilidad y Especificidad
11.
Rev Soc Bras Med Trop ; 52: e20170415, 2019 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-30810648

RESUMEN

INTRODUCTION: Genetic polymorphisms define the cytokine production leading to susceptibility or resistance to diseases. We studied the cytokine polymorphism in the development of tegumentary leishmaniasis (TL). METHODS: Genotyping of TNF-α, TGF-ß1, IFN-γ, IL-6, and IL-10 were performed by polymerase chain reaction assay. RESULTS: G and C alleles of TGF- ß1 (codon 25) were the most common in controls and patients, respectively. G/G was the most frequent genotype in controls, and G/C and C/C in patients. CONCLUSIONS: G/G genotype of codon 25 in TGF-ß1 appeared to confer resistance, and G/C and C/C genotypes, susceptibility to TL in this population.


Asunto(s)
Predisposición Genética a la Enfermedad/genética , Leishmaniasis Cutánea/genética , Polimorfismo Genético/genética , Factor de Crecimiento Transformador beta1/genética , Adulto , Anciano , Alelos , Biomarcadores , Brasil , Estudios de Casos y Controles , Citocinas/genética , Femenino , Genotipo , Humanos , Interferón gamma/genética , Interleucina-10/genética , Interleucina-6/sangre , Interleucina-6/genética , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factor de Necrosis Tumoral alfa/genética
12.
Obstet Gynecol Surv ; 73(4): 219-230, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29701867

RESUMEN

IMPORTANCE: Hypothyroidism is one of the most prevalent diseases in pregnancy, but there is no consensus about its management in pregnant women. OBJECTIVE: In this systematic review, we evaluated the association between pregnancy complications and treated or untreated maternal hypothyroidism. EVIDENCE ACQUISITION: PubMed and reference lists were searched for the Medical Subject Headings terms "pregnancy complications" and "hypothyroidism." The eligibility criteria for inclusion in the study were an original study published between 2002 and 2013. Six reviewers independently selected the studies, and 3 extracted the data. Two reviewers assessed the risk of bias and quality of the studies. RESULTS: Eighteen studies were included in the systematic review. The most prevalent complications associated with maternal hypothyroidism were abortion, intrauterine fetal death, preterm delivery, and preeclampsia. The pregnancy outcome depended on the treatment that was received by the patient. CONCLUSIONS: Strong evidence indicates that maternal hypothyroidism is associated with maternal-fetal complications, but no consensus was found among the studies reviewed herein. The dose of levothyroxine that is required to maintain euthyroidism is still questioned, but studies have suggested that levothyroxine should be adjusted according to the gestational period and laboratory profile.


Asunto(s)
Hipotiroidismo/tratamiento farmacológico , Complicaciones del Embarazo/tratamiento farmacológico , Tiroxina/efectos adversos , Aborto Espontáneo , Femenino , Muerte Fetal , Humanos , Recién Nacido , Intercambio Materno-Fetal , Preeclampsia , Embarazo , Resultado del Embarazo , Nacimiento Prematuro , Tiroxina/administración & dosificación
13.
Photodiagnosis Photodyn Ther ; 21: 294-305, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29289704

RESUMEN

OBJECTIVE: We researched articles that used photodynamic therapy (PDT) for skin wound healing in humans. METHODS: The systematic review was conducted through scientific articles that investigated the action of PDT on wound healing in humans, published from July 2005 to March 2017, in the data bases PubMed and LILACS. RESULTS: The main types of wound described in selected articles in this review were chronic ulcer and non-melanoma skin cancer. For accomplishing the PDT, second generation of photosensitizing agents with laser or light emitting diode were used. The studies demonstrated that PDT contribute in several ways to the wound healing process: leading to cellular death; reducing or increasing inflammation; stimulating fibroblasts proliferation and, consequently, of collagen and elastin; raising transforming growth factor beta and metalloproteinases. Based on this, PDT provided good results in wound healing process, acting in several steps and accelerating tissue repair. CONCLUSIONS: PDT improved healing in many wound models in humans, revealing itself as a promising therapeutic modality for stimulating wound healing and remodelling.


Asunto(s)
Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Cicatrización de Heridas/efectos de la radiación , Muerte Celular/efectos de la radiación , Colágeno/biosíntesis , Elastina/biosíntesis , Fibroblastos/metabolismo , Humanos , Metaloproteasas/biosíntesis , Fotoquimioterapia/efectos adversos , Fotoquimioterapia/instrumentación , Neoplasias Cutáneas/radioterapia , Úlcera Cutánea/radioterapia , Factores de Crecimiento Transformadores/biosíntesis
14.
J Lasers Med Sci ; 9(4): 274-282, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-31119023

RESUMEN

Introduction: American tegumentary leishmaniasis (ATL) is a zoonotic disease caused by protozoan parasites of the genus Leishmania that affects the skin and mucous membrane. Currently, the available drugs for the treatment are injectable, with side effects, long-term treatment regimen and there is the possibility of drug resistance. Thus, alternative therapies have been tested, including photodynamic therapy (PDT). We evaluated the efficacy of PDT on its own and associated with the prescribed ATL treatment. Methods: BALB/c mice were infected with Leishmania (Leishmania) amazonensis and divided into 6 groups: Gluc+PDT, treated with Glucantime® and photodynamic therapy (PDT) with methylene blue (MB)/red LED (light-emitting diode); Gluc, treated with Glucantime®; PDT, treated with PDT with MB/red LED; Ampho+PDT, treated with amphotericin and PDT with MB/red LED; Ampho, treated with amphotericin; and control, which were infected but not treated. Two treatment cycles were performed. After 165 days of infection, the parasite load was determined. Results: Statistical differences were not found (P>0.05) between measures of volume and thickness of the infected footpads in the treated groups when compared with the control group. However, there was a significant reduction (P<0.05) in the parasitic load of the popliteal lymph nodes of the Gluc+PDT, Gluc, PDT and Ampho groups when compared to the control group. In the histological analysis of the infected footpads, the Gluc+PDT group presented a smaller amount of amastigote nests and lower intensity of the mononuclear infiltrate when compared to the Gluc and PDT groups. Conclusion: The results showed that although there is no significant difference in the evaluations of footpad size (thickness and volume), there is a downward measurement tendency in the Gluc+PDT group, as it can be observed by volume data and corroborated by parasite negative load.

15.
Dermatol Res Pract ; 2018: 9014726, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30675152

RESUMEN

The first choice drugs for the treatment of cutaneous and mucocutaneous leishmaniasis are pentavalent antimonials, sodium stibogluconate, or meglumine antimoniate. However, the treatment with these drugs is expensive, can cause serious adverse effects, and is not always effective. The combination of two drugs by different routes or the combination of an alternative therapy with systemic therapy can increase the efficacy and decrease the collateral effects caused by the reference drugs. In this systematic review we investigated publications that described a combination of nonconventional treatment for cutaneous and mucocutaneous with pentavalent antimonials. A literature review was performed in the databases Web of Knowledge and PubMed in the period from 01st of December 2004 to 01st of June 2017, according to Prisma statement. Only clinical trials involving the treatment for cutaneous or mucocutaneous leishmaniasis, in English, and with available abstract were added. Other types of publications, such as reviews, case reports, comments to the editor, letters, interviews, guidelines, and errata, were excluded. Sixteen articles were selected and the pentavalent antimonials were administered in combination with pentoxifylline, granulocyte macrophage colony-stimulating factor, imiquimod, intralesional sodium stibogluconate, ketoconazole, silver-containing polyester dressing, lyophilized LEISH-F1 protein, cryotherapy, topical honey, and omeprazole. In general, the combined therapy resulted in high rates of clinical cure and when relapse or recurrence was reported, it was higher in the groups treated with pentavalent antimonials alone. The majority of the articles included in this review showed that cure rate ranged from 70 to 100% in patients treated with the combinations. Serious adverse effects were not observed in patients treated with drugs combination. The combination of other drugs or treatment modalities with pentavalent antimonials has proved to be effective for cutaneous and mucocutaneous leishmaniasis and for most seemed to be safe. However, new randomized, controlled, and multicentric clinical trials with more robust samples should be performed, especially the combination with immunomodulators.

16.
J Lasers Med Sci ; 8(1): 46-50, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28912944

RESUMEN

Introduction: The treatment of cutaneous leishmaniasis (CL) is based primarily on the use of pentavalent antimonials, which may lead to many side effects limiting their use. Photodynamic therapy (PDT) is an alternative for the treatment of CL, and some xanthene dyes have the potential for use in PDT. Methods: The xanthenes rose bengal B (RB) and its derivatives rose bengal methyl ester (RBMET), and butyl ester (RBBUT) were analyzed for leishmanicidal activity against promastigotes and intracellular amastigotes of Leishmania amazonensis. Cytotoxicity was assessed in J774.A1 macrophages. Results: RB derivates RBMET (IC50 9.83 µM), and RBBUT (IC50 45.08 µM) showed leishmanicidal activity, however, were toxic to J774.A1 macrophages, resulting in low selectivity index. Conclusion: The RBMET and RBBUT showed to be effective against the L. amazonensis and the low selectivity index presented may not be a limitation for their use in PDT to CL treatment.

17.
Rev Inst Med Trop Sao Paulo ; 58: 67, 2016 Sep 22.
Artículo en Inglés | MEDLINE | ID: mdl-27680172

RESUMEN

Leishmaniases are infectious diseases caused by protozoa of the genus Leishmania. They are widely distributed worldwide and endemic in 88 countries in four continents. The present study analyzed the reported cases of American Tegumentary Leishmaniasis (ATL) in Paraná State (Brazil) from January 2007 to December 2013. The data were grouped according to Regional Health (RH) districts and macroregions, which allowed visualization of the reality in each region in the state. A total of 2,879 ATL cases were reported and distributed among the 22 RH districts, with an average detection rate of 3.9 cases per 100,000 inhabitants. The northwestern region accounted for 50.1% of the total cases, and the northern region accounted for 26.0-76.1% of the reported cases. The 6th RH district did not report any cases. The 7th, 9th, and 18th RH districts had a higher cure rate (> 80%), and lower cure rates were found in the 1st, 4th, and 12th RH districts. Reported unfavorable outcomes included treatment abandonment and death. Overall cure rates are based on the entire country, and unfavorable outcomes require greater attention of managers and health professionals to meet the goals of the Brazilian Ministry of Health.

18.
Artículo en Inglés | MEDLINE | ID: mdl-27007563

RESUMEN

The clinical manifestations and prognosis of cutaneous leishmaniasis (CL) can be influenced by the immune response of the patient and the species of the parasite. A case of atypical clinical presentation of CL, with development of non-characteristic lesions, poor response to therapy, and a long time to resolution is reported. Confirmatory laboratory tests included parasite detection, indirect immunofluorescence, Montenegro skin test, polymerase chain reaction, and parasite identification by multilocus enzyme electrophoresis. The parasite was identified as Leishmania braziliensis. The lesion was unresponsive to three complete courses of N-methylglucamine antimoniate intramuscular, and to treatment with pentamidine. The patient did not tolerate amphotericin B. The lesion finally receded after treatment with intravenous N-methylglucamine antimoniate. It is essential to ensure the accuracy of diagnosis and the appropriate treatment, which can include the use a second choice drug or a different route of administration.


Asunto(s)
Anfotericina B/uso terapéutico , Leishmania braziliensis , Leishmaniasis Cutánea/tratamiento farmacológico , Meglumina/uso terapéutico , Compuestos Organometálicos/uso terapéutico , Humanos , Leishmaniasis Cutánea/diagnóstico , Masculino , Antimoniato de Meglumina , Persona de Mediana Edad , Resultado del Tratamiento
19.
Rev. Soc. Bras. Med. Trop ; 54: e00472020, 2021. tab, graf
Artículo en Inglés | SES-SP, Coleciona SUS (Brasil), LILACS | ID: biblio-1143886

RESUMEN

Abstract INTRODUCTION: The objective of this study was to evaluate the performance of filter paper (FP) for lesion scraping collection in a polymerase chain reaction (PCR) for cutaneous leishmaniasis (CL) diagnosis. METHODS: Lesion scrapings from 48 patients were collected and analyzed for PCR. RESULTS: PCR with FP detected up to three Leishmania braziliensis promastigotes. Considering the direct search by microscopy or PCR of samples collected in STE buffer as standards, the sensitivity of PCR with FP was 100%. CONCLUSIONS: FP can be useful for CL diagnosis in remote regions, allowing high sensitivity in the detection of the parasite by PCR.


Asunto(s)
Humanos , Leishmania braziliensis/genética , Leishmaniasis Cutánea/diagnóstico , Reacción en Cadena de la Polimerasa , ADN Protozoario/genética , Sensibilidad y Especificidad , Microscopía
20.
Rev Soc Bras Med Trop ; 49(5): 593-601, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27812654

RESUMEN

INTRODUCTION: American tegumentary leishmaniasis (ATL) is an endemic disease in many regions of Brazil; however, only few reports on the actual epidemiological conditions are available. Here, we aimed to assess the clinical, epidemiological, and laboratory characteristics of ATL patients and their treatment in the 15th Regional Health Division of Paraná State, Maringá, Brazil. METHODS: This epidemiological study included patients diagnosed with ATL from January 2010 to September 2014, from the 15th Regional Health Division database. RESULTS: A total of 220 cases aged 3-84 years (85% male and 60.9% with up to 8 years of schooling) were included. The cases were classified as having the cutaneous form (n=183; 83.2%), mucosal form (n=26; 11.8%), mucocutaneous form (n=11; 5%), and relapses (n=21; 9.6%). Diagnosis was made via laboratory test results in 197 (89.5%) patients, and 172 (78.2%) completed the treatment within the study period. With regard to patients with the cutaneous form, 134 (95%) were cured, 131 (97.8%) were treated with Glucantime(r), and 47 (36.7%) received dosage of >15 and <20mg Sb5+/kg/day. Among the cases with mucosal involvement, 87.1% were cured and most were treated with <20mg Sb5+/kg/day. Thus, the cure rate was 93.6%. CONCLUSIONS: During the study period in the 15th Regional Health Division of Paraná State, ATL cases had a good response to treatment with a low rate of relapse or treatment failure, although a high percentage of mucosal or mucocutaneous form cases was also noted.


Asunto(s)
Leishmaniasis Cutánea/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Niño , Preescolar , Escolaridad , Enfermedades Endémicas , Femenino , Humanos , Leishmaniasis Cutánea/clasificación , Leishmaniasis Cutánea/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Adulto Joven
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