Antileishmania and immunomodulatory potential of cashew nut shell liquid and cardanol.

Conventional treatments for leishmaniasis have caused serious adverse effects, poor tolerance, development of resistant strains. Natural products have been investigated as potential therapeutic alternatives. The cashew nut shell liquid (CNSL) is a natural source of phenolic compounds with several biological activities, where cardanol (CN) is considered one of the most important and promising compounds. This study aimed to evaluate antileishmanial, cytotoxic and immunomodulatory activities of CNSL and CN. Both showed antileishmanial potential, with IC50 for CNSL and CN against Leishmania infantum: 148.12 and 56.74 µg/mL; against Leishmania braziliensis: 85.71 and 64.28 µg/mL; against Leishmania major: 153.56 and 122.31 µg/mL, respectively. The mean cytotoxic concentrations (CC50) of CNSL and CN were 37.51 and 31.44 µg/mL, respectively. CNSL and CN significantly reduced the percentage of infected macrophages, with a selectivity index (SI) >20 for CN. CNSL and cardanol caused an increase in phagocytic capacity and lysosomal volume. Survival rates of Zophobas morio larvae at doses of 3; 30 and 300 mg/kg were: 85%, 75% and 60% in contact with CNSL and 85%, 60% and 40% in contact with CN, respectively. There was a significant difference between the survival curves of larvae when treated with CN, demonstrating a significant acute toxicity for this substance. Additional investigations are needed to evaluate these substances in the in vivo experimental infection model.

Isopropyl Gallate, a Gallic Acid Derivative: In Silico and In Vitro Investigation of Its Effects on Leishmania major.

Isopropyl gallate (IPG) is a polyphenol obtained from alterations in the gallic acid molecule via acid catalysis with previously reported leishmanicidal and trypanocidal activities. The present study aims to evaluate in silico binding activity towards some targets for antileishmanial chemotherapy against Leishmania major species, and ADMET parameters for IPG, as well as in vitro antileishmanial and cytotoxic effects. Molecular docking was performed using AutoDockVina and BIOVIA Discovery Studio software, whereas in silico analysis used SwissADME, PreADMET and admetSAR software. In vitro antileishmanial activity on promastigotes and amastigotes of Leishmania major, cytotoxicity and macrophages activation were assessed. IPG exhibited affinity for pteridine reductase (PTR1; -8.2 kcal/mol) and oligopeptidase B (OPB; -8.0 kcal/mol) enzymes. ADMET assays demonstrated good lipophilicity, oral bioavailability, and skin permeability, as well as non-mutagenic, non-carcinogenic properties and low risk of cardiac toxicity for IPG. Moreover, IPG inhibited the in vitro growth of promastigotes (IC50 = 90.813 µM), presented significant activity against amastigotes (IC50 = 13.45 µM), promoted low cytotoxicity in macrophages (CC50 = 1260 µM), and increased phagocytic capacity. These results suggest IPG is more selectively toxic to the parasite than to mammalian cells. IPG demonstrated acceptable in silico pharmacokinetics parameters, and reduced infection and infectivity in parasitized macrophages, possibly involving macrophage activation pathways and inhibition of leishmania enzymes.

Limonene-carvacrol: A combination of monoterpenes with enhanced antileishmanial activity.

BACKGROUND: Leishmaniasis is a parasitosis with a wide incidence in developing countries. The drugs which are indicated for the treatment of this infection usually are able to promote high toxicity. PURPOSE: A combination of limonene and carvacrol, monoterpenes present in plants with antiparasitic activity may constitute an alternative for the treatment of these diseases. METHODS: In this study, the antileishmania activity against Leishmania major, cytotoxicity tests, assessment of synergism, parasite membrane damage tests as well as molecular docking and immunomodulatory activity of limonene-carvacrol (Lim-Car) combination were evaluated. RESULTS: The Lim-Car combination (5:0; 1:1; 1:4; 2:3; 3:2; 4:1 and 0:5) showed potential antileishmania activity, with mean inhibitory concentration (IC50) ranging from 5.8 to 19.0 µg.mL-1. They demonstrated mean cytotoxic concentration (CC50) ranging from 94.1 to 176.0 µg.mL-1, and did not show significant hemolytic effect. In the investigation of synergistic interaction, the 4:1 Lim-Car combination showed better fractional inhibitory concentration (FIC) index as well as better activity on amastigotes and IS. The samples caused considerable damage to the parasite membrane this monoterpene activity seems to be more related to Trypanothione Reductase (TryR) enzyme interaction, demonstrated in the molecular docking assay. In addition, the 4:1 Lim-Car combination stimulated macrophage activation, and showed at was the best association, with reduction of infection and infectivity of parasitized macrophages. CONCLUSION: The 4:1 Lim-Car combination appears to be a promising candidate as a monotherapeutic antileishmania agent.

Methods of macrophages activation and their modulation for the prospection of new antileishmania drugs: a review

Leishmaniasis are a group of parasitic zoonoses provoked by protozoa from Leishmania genus and belonging to the group of neglected tropical diseases. The search and development for new drugs is necessary not only to investigate the activity against only the parasite, but also to investigate the possible synergistic effect of new drugs with the immune response of the host. In the present review, macrophages are pointed out as potential targets of the investigation of new antileishmanial drugs, and some methodologies in order to assess their activation as response to Leishmania-infected cells are presented. Macrophages are an important role in the cellular immune response, since they are cells from mononuclear phagocytic system, the first line of defense of the host, against parasites from Leishmania genus. Phagocytic capacity, lysosomal activity, increase of nitric oxide and intracellular calcium levels are parameters regarding assessment of macrophages activation which allow them to be more hostile in order to solve the infection and lead the patient to cure. In this context, we bring 19 substances already investigated and that activate macrophages, what makes them promising in the antileishmanial treatment. Therefore, assessment of macrophages activation, are important tools for discovery of immunomodulatory compounds which have potential to act in synergism with host immune response. Such compounds might be promising as monotherapy in the treatment of leishmaniasis, as well as being used as adjuvants in vaccines and/or in combination with conventional drugs.

Antileishmanial activity of cordiaquinone E towards Leishmania (Leishmania) amazonensis.

Leishmaniasis is caused by several protozoan species of Leishmania, and being endemically present in 98 countries around the world, it is also a severe public-health problem. The available antileishmanial drugs are toxic and yet present risks of recurrent infection. Efforts to find new, effective, and safe oral agents for the treatment of leishmaniasis are continuing throughout the world. This work aimed to evaluate the antileishmania activity of cordiaquinone E (CORe), isolated from the roots of Cordia polycephala (Lam.) I. M. Johnston. Cytotoxicity, and possible mechanisms of action against promastigote and amastigote forms of Leishmania amazonensis were examined. CORe was effective in inhibiting promastigote (IC50 4.5 ± 0.3 µM) and axenic amastigote (IC50 2.89 ± 0.11 µM) growth in concentrations found non-toxic for the host cell (CC50 246.81 ± 14.5 µM). Our results revealed that CORe presents direct activity against the parasite, inducing cell death by apoptosis. CORe present greater activity against intracellular amastigotes (EC50 1.92 ± 0.2 µM), yet with much higher selectivity indexes than the reference drugs, being respectively more benign towards RAW 264.7 macrophages than meglumine antimoniate and amphotericin B, (respectively by 4.68 and 42.84 fold). The antiamastigote activity was associated with increased TNF-α, IL-12, NO, and ROS levels, as well as decreased IL-10 levels. These results encourage the progression of studies on this compound for the development of new leishmanicidal agents.

Methyl gallate: Selective antileishmanial activity correlates with host-cell directed effects.

Leishmaniasis is a widespread tropical infection caused by different species of Leishmania protozoa. Many of the available drugs against the disease are toxic and in certain cases parasite drug resistance is developed. The discovery of drugs for the treatment of leishmaniasis is a pressing concern. In the present work, we describe in vitro studies of the phenolic compound methyl gallate (MG) against Leishmania (Leishmania) amazonensis and its possible mechanisms of action. The in vitro activity of MG was assayed against L. amazonensis (promastigotes, axenic amastigotes, and intramacrophagic amastigotes). Cytotoxicity tests were performed with J774A.1 macrophages and THP-1 cell derived macrophages. To evaluate mechanisms of action, we analyzed cellular TNF-α, IL-12, IFN-γ, IL-10, IL-6, NO, ROS levels, arginase activity, and structural mechanisms (phagocytic and lysosomal activities) involving macrophage activation. Meglumine antimoniate and amphotericin B were used as reference drugs. It was observed that MG effectively inhibited the growth of both promastigote (IC50 5.71 µM) and amastigote-like forms (EC50 5.39 µM), with much higher selectivity indexes than the reference drugs, being more benign towards J774A.1 macrophages than meglumine antimoniate and amphotericin B, at 1631- and 70.92-fold respectively, with respect to the promastigote form. Additionally, MG proved to be even more active against intracellular amastigotes of the parasite (EC50 4.24 µM). Our results showed that antileishmania activity was associated with increased TNF-α, IL-12, NO and ROS levels, as well as decreased IL-6 and decreased arginase activity. In addition, MG induced increased phagocytic capability, and lysosomal volume in macrophages; structural parameters of microbicidal activity. Taken together, our results suggest that MG may be a promising candidate for new drug development against leishmaniasis.

Behavior and biocompatibility of rabbit bone marrow mesenchymal stem cells with bacterial cellulose membrane.

BACKGROUND: Tissue engineering has been shown to exhibit great potential for the creation of biomaterials capable of developing into functional tissues. Cellular expansion and integration depends on the quality and surface-determinant factors of the scaffold, which are required for successful biological implants. The objective of this research was to characterize and evaluate the in vitro characteristics of rabbit bone marrow mesenchymal stem cells (BM-MSCs) associated with a bacterial cellulose membrane (BCM). We assessed the adhesion, expansion, and integration of the biomaterial as well as its ability to induce macrophage activation. Finally, we evaluated the cytotoxicity and toxicity of the BCM. METHODS: Samples of rabbit bone marrow were collected. Mesenchymal stem cells were isolated from medullary aspirates to establish fibroblast colony-forming unit assay. Osteogenic, chondrogenic, and adipogenic differentiation was performed. Integration with the BCM was assessed by scanning electron microscopy at 1, 7, and 14 days. Cytotoxicity was assessed via the production of nitric oxide, and BCM toxicity was assessed with the MTT assay; phagocytic activity was also determined. RESULTS: The fibroblastoid colony-forming unit (CFU-F) assay showed cells with a fibroblastoid morphology organized into colonies, and distributed across the culture area surface. In the growth curve, two distinct phases, lag and log phase, were observed at 15 days. Multipotentiality of the cells was evident after induction of osteogenic, chondrogenic, and adipogenic lineages. Regarding the BM-MSCs' bioelectrical integration with the BCM, BM-MSCs were anchored in the BCM in the first 24 h. On day 7 of culture, the cytoplasm was scattered, and on day 14, the cells were fully integrated with the biomaterial. We also observed significant macrophage activation; analysis of the MTT assay and the concentration of nitric oxide revealed no cytotoxicity of the biomaterial. CONCLUSION: The BCM allowed the expansion and biointegration of bone marrow progenitor cells with a stable cytotoxic profile, thus presenting itself as a biomaterial with potential for tissue engineering.

Gallic and ellagic acids: two natural immunomodulator compounds solve infection of macrophages by Leishmania major.

Leishmaniasis is a complex of parasitic protozoan diseases caused by more than 20 different species of parasites from Leishmania genus. Conventional treatments are high costly, and promote a sort of side effects. Besides, protozoan resistance to treatments has been reported. Natural products have been investigated as a source of new therapeutic alternatives, not only acting directly against the parasite but also being able to synergistically act on the host immune system in order to control parasitemia. Gallic acid (GA) and ellagic acid (EA) are plant-derived phenolic compounds which are able to induce antiinflammatory, gastroprotective, and anticarcinogenic activities. Therefore, the antileishmania, cytotoxic, and immunomodulatory activities of GA and EA were evaluated in this study. Both GA and EA were able to inhibit the growth of Leishmania major promastigotes (effective concentration (EC50) values 16.4 and 9.8 µg/mL, respectively). The cytotoxicity against BALB/c murine macrophages for GA and EA was also assessed (CC50 values 126.6 and 23.8 µg/mL, respectively). Interestingly, GA and EA also significantly reduced the infection and infectivity of macrophages infected by L. major (EC50 values 5.0 and 0.9 µg/mL, respectively), with selectivity index higher than 20. Furthermore, both GA and EA induced high immunomodulatory activity evidenced by the increase of phagocytic capability, lysosomal volume, nitrite release, and intracellular calcium [Ca2+i] in macrophages. Further investigations are reinforced in order to evaluate the therapeutic effects of GA and EA in in vivo experimental infection model of leishmaniasis.

In vitro antioxidant, antitumor and leishmanicidal activity of riparin A, an analog of the Amazon alkamides from Aniba riparia (Lauraceae) / Atividade antioxidante, antitumoral e leishmanicida in vitro da riparina A, um análogo das alcamidas amazônicas de Aniba riparia (Lauraceae)

Aniba riparia (Lauraceae) is an important medicinal plant found in the Amazon region and presents alkaloids of the type alkamide known as riparins. Riparin A is structurally represented as the fundamental core of all Amazon riparins. This work aimed to assess the in vitro antioxidant, antitumor and antileishmanial effects of riparin A. Riparin A presented weak antioxidant capacity by tecniques of DPPH• (EC50 of 296.2 μg mL-1) and ABTS•+ (EC50 of 450.1 μg mL-1), showed moderate activity against colon carcinoma (HCT-116: IC50 of 21.7 μg mL-1) and leishmanicidal activity on promastigotes of L. amazonensis (IC50 of 307.0 ± 79.6, 193.7 ± 44.3 and 81.8 ± 11.2 μg mL-1, respectively, after 24, 48 and 72 h of incubation). Then, in addition to its structural simplicity, riparin A revealed promising biological activities and remarkable in vitro leishmanicidal action, an important result in epidemiological point of view to control leishmaniasis in Brazil, including in the Amazon region.

Aniba riparia (Lauraceae) é uma importante planta medicinal encontrada na região amazônica que apresenta alcaloides do tipo alcamida e conhecidos como riparinas. Este trabalho teve como objetivo avaliar os efeitos antioxidantes, antitumorais e leishmanicidas in vitro da riparina A. Riparina A apresentou fraca capacidade antioxidante pelas técnicas do DPPH• (CE50 de 296,2 μg mL-1) e ABTS•+ (CE50 de 450,1 μg mL-1), mostrou moderada atividade contra carcinoma de cólon (HCT-116: CI50 de 21,7 μg mL-1) e atividade leishmanicida sobre formas promastigotas de Leishmania amazonensis (CI50 de 307,0 ± 79,6; 193,7 ± 44,3 e 81,8 ± 11,2 μg mL-1, respectivamente, após 24, 48 e 72 h de incubação). Assim, além de sua simplicidade estrutural, a riparina A revelou atividades biológicas promissoras e significativa ação leishmanicida in vitro, resultado importante diante da relevância epidemiológica para controle da leishmaniose no Brasil, inclusive na região amazônica.

Syzygium cumini (L.) Skeels essential oil and its major constituent α-pinene exhibit anti-Leishmania activity through immunomodulation in vitro.

ETHNOPHARMACOLOGICAL RELEVANCE: Syzygium cumini (L.) Skeels (Myrtaceae), commonly known as "jambolão" in Brazil is widely used in folk medicine against leishmaniasis, inflammation, chronic diarrhea, and ulcers. It is one of the most commonly used plants for the treatment of diabetes worldwide. In previous studies, Syzygium cumini was shown to possess antihyperlipidemic and anti-allergic properties, and to exhibit good performance as an antimicrobial agent against bacteria, fungi, and protozoa parasites of the genus Leishmania and Trypanosoma. This study was aimed at evaluating the effects of S. cumini essential oil (ScEO) and its major component α-pinene on Leishmania (Leishmania) amazonensis, as well as their cytotoxicity and possible mechanisms of action. MATERIALS AND METHODS: To evaluate the anti-proliferative effect on Leishmania, effects on promastigote and axenic amastigote forms were assessed using tetrazolium salt (MTT) assay. The intramacrophagic amastigotes were exposed to ScEO and α-pinene to determine the survival index. To gain insight into the mechanism of action involved in the effect on the samples, we evaluated the modulation of macrophage activation state by observing structural (phagocytic and lysosomal activities) and cellular (nitric oxide increase) changes. To assess the safety profile of ScEO and α-pinene, murine macrophages and human red blood cells were treated with ScEO and α-pinene and the selectivity index was calculated for each treatment. RESULTS: α-Pinene was effective against Leishmania amazonensis promastigote forms, with a half-maximal inhibitory concentration (IC50) value of 19.7µg/mL. α-Pinene was more active (IC50 values of 16.1 and 15.6µg/mL against axenic and intracellular amastigotes, respectively) than ScEO (IC50 values of 43.9 and 38.1µg/mL against axenic and intracellular amastigotes, respectively). Our results showed that the anti-Leishmania effects were mediated by immunomodulatory activity, as evidenced by the observed increases in both phagocytic and lysosomal activity, and the elevated NO levels. ScEO and α-pinene exhibited low cytotoxicity against murine macrophages and human erythrocytes. The 50% cytotoxicity concentration (CC50) values for the macrophages in the MTT assay were 614.1 and 425.2µg/mL for ScEO and α-pinene, respectively, while the corresponding half-maximal hemolytic concentration (HC50) values were 874.3 and 233.3µg/mL. CONCLUSIONS: Taken together, the results demonstrate that ScEO and its major constituent α-pinene have significant anti-Leishmania activity, modulated by macrophage activation, with acceptable levels of cytotoxicity in murine macrophages and human erythrocytes. Further work is warranted, involving more in-depth mechanistic studies and in vivo investigations.

Eugenia uniflora L. Essential Oil as a Potential Anti-Leishmania Agent: Effects on Leishmania amazonensis and Possible Mechanisms of Action.

Eugenia uniflora L. is a member of the Myrtaceae family and is commonly known as Brazilian cherry tree. In this study, we evaluated the chemical composition of Eugenia uniflora L. essential oil (EuEO) by using gas chromatography-mass spectrometry (GC-MS) and assessed its anti-Leishmania activity. We also explored the potential mechanisms of action and cytotoxicity of EuEO. Thirty-two compounds were identified, which constituted 92.65% of the total oil composition. The most abundant components were sesquiterpenes (91.92%), with curzerene (47.3%), γ -elemene (14.25%), and trans- ß -elemenone (10.4%) being the major constituents. The bioactivity shown by EuEO against promastigotes (IC50, 3.04 µ g·mL(-1)) and amastigotes (IC50, 1.92 µ g·mL(-1)) suggested significant anti-Leishmania activity. In the cytotoxicity determination, EuEO was 20 times more toxic to amastigotes than to macrophages. Hemolytic activity was 63.22% at the highest concentration tested (400 µ g·mL(-1)); however, there appeared to be no toxicity at 50 µ g·mL(-1). While the data show that EuEO activity is not mediated by nitric oxide production, they do suggest that macrophage activation may be involved in EuEO anti-Leishmania activity, as evidenced by increases in both the phagocytic capacity and the lysosomal activity. More studies are needed to determine in vivo activity as well as additional mechanisms of the anti-Leishmania activity.

Aspectos epidemiológicos e vetoriais da dengue na cidade de Teresina, Piauí – Brasil, 2002 a 2006 / Epidemiological and vector-related indicators of dengue fever in Teresina city, Piaui State, Brazil, from 2002 to 2006

O objetivo deste estudo é descrever os indicadores epidemiológicos e vetoriais da dengue em Teresina-PI, de 2002 a 2006. Utilizou-se dados referentes à ocorrência da doença, do Sistema de Informação de Agravos de Notificação (Sinan), monitoramento do Aedes aegypti do Sistema de Informação de Febre Amarela e Dengue (FAD), além de dados populacionais e do meio ambiente. A relação entre o número de casos notificados, precipitação pluviométrica e temperatura e entre o índice de infestação predial e índice de pendência foi analisada pela correlação de Spearman. Nesse período, foram notificados 11.003 casos de dengue, com coeficiente de incidência variando de 592,7/100.000 habitantes em 2002 e 19,5/100.000 habitantes em 2004, com maior incidência na faixa etária de 15 a 49 anos (305,5/100.000 habitantes) e maior proporção no sexo feminino (60 por cento). A menor taxa de letalidade ocorreu em 2003 (6,25 por cento) e a maior em 2006 (20 por cento), com predomínio na faixa etária de 20 a 49 anos (36,36 por cento). Foi encontrada correlação positiva entre o número de casos, pluviosidade e temperatura e não houve associação entre índice de infestação predial e índice de pendência por estrato. Os depósitos de armazenamento de água para consumo predominaram como principais criadouros. A dengue na cidade de Teresina apresentou maior incidência no primeiro semestre de cada ano, coincidindo com o período de maior índice pluviométrico e de infestação predial. As estratégias de combate ao Ae. aegypti não têm sido eficazes, pois tais medidas não têm produzido o efeito epidemiológico desejado, sendo necessária ênfase especial na redução de criadouros artificiais, principalmente aqueles utilizados para armazenamento de água nos domicílios, com a diminuição dos riscos domésticos da proliferação do vetor.

This study aims at describing dengue fever epidemiological and vector-related indicators in Teresina, State of Piaui, Brazil from 2002 to 2006. The analysis has included cases registered in the Information System for Notifiable Diseases (Sinan), data on the monitoring of the Aedes aegypti in the Information System for Yellow Fever and Dengue Fever (FAD), and population and environmental data. The relation among notified cases, rainfall and temperature as well as between house infestation rate and pendency rate was analyzed using the Spearman correlation coefficient. In that period, 11,003 dengue fever cases were notified. Incidence rate varied from 592.7/100,000 population in 2002 to 19.5/100,000 population in 2004, with greater incidence in the 15-to 49-year-old group (305.5/100,000 population) and in females (60 percent). The lowest and highest lethality rate occurred, respectively, in 2003 (6.25 percent) and 2006 (20 percent), predominantly in the 20-to 49-year-old group (36.36 percent). There was a positive correlation among the number of cases, rainfall and temperature and there was no association between house infestation rate and pendency rate by stratum. Water storage reservoirs have predominated as the main breeding site. Each year, dengue fever incidence in the city of Teresina was higher during the first semester, which is the period of both higher rainfall and house infestation rate. The strategies for fighting the Ae. aegypti have not been efficacious, because the measures taken are not producing the expected epidemiological effects. It is necessary to adopt control measures with a special focus on the reduction of artificial breeding sites, mainly those used for house water storage, which lowers domestic risks associated with the proliferation of vectors.

Avaliação da efetividade das estratégias de controle da leishmaniose visceral na cidade de Teresina, Estado do Piauí, Brasil: resultados do inquérito inicial – 2004 / Assessment of the effectiveness of control strategies for visceral leishmaniasis in the city of Teresina, State of Piauí, Brazil: baseline survey results – 2004

Este artigo apresenta e discute as implicações dos resultados do inquérito inicial de um estudo de intervenção comunitária para avaliar a efetividade de medidas de controle para a leishmaniose visceral. O estudo foi realizado em dez localidades da cidade de Teresina, Estado do Piauí, Brasil. As localidades foram subdivididas em quadras, quatro delas selecionadas e alocadas aleatoriamente para diferentes intervenções a serem implementadas após o inquérito inicial. No inquérito inicial, realizado no primeiro semestre de 2004, os participantes (n=1.105) responderam a um questionário e tiveram avaliada sua reação ao teste de intradermorreação com antígeno de Montenegro (IDRM). A prevalência global de infecção foi de 36,7 por cento – com tendência a aumentar com a idade –, significativamente mais alta nos homens. A prevalência variou de 24,0 a 47,0 por cento entre localidades. O processo de randomização mostrou-se relativamente satisfatório para variáveis sociodemográficas; houve, entretanto, diferenças significativas na prevalência de positividade na IDRM entre áreas de intervenção. A não-comparabilidade das áreas, no que diz respeito às taxas basais de transmissão, elemento fundamental para inferência causal em doenças infecciosas, pode afetar a validade do estudo de intervenção...

Tratamento tópico da leishmaniose cutânea experimental: avaliação de diferentes formulações contendo sulfato de paromomicina e da associação com imunoterapia / Topical therapy of experimental cutaneous leishmaniasis: assessment of different formulations containing paromomycin sulfate and the combination with immunotherapy

A leishmaniose é uma doença causada por protozoários do gênero Leishmania e nas Américas eles se agrupam em duas categorias: Leishmaniose Visceral Americana (LVA) e Leishmaniose Tegumentar Americana (LTA). A profilaxia da LTA baseia-se no combate aos transmissores, na redução das fontes de infecção e no tratamento de pacientes com agentes quimioterápicos, os quais são muito limitados, tóxicos e requerem um longo período de tratamento. Em virtude dos problemas associados ao tratamento convencional com antimoniais, uma grande diversidade de tratamentos alternativos, de uso tópico ou sistêmico, vem sendo estudados para essa doença. Dentre eles destaca-se a paromomicina que tem mostrado resultados surpreendentes no tratamento das várias formas da doença. Utilizamos a paromomicina em formulações de uso tópico para o tratamento de lesões ulceradas causadas por Leishmania major em camundongos BALB/c. Nossos resultados mostraram que das formulações utilizadas (emulsão e pomada), administradas duas vezes ao dia por doze dias, a emulsão foi mais eficaz que a pomada e que o tratamento conduzido com a remoção das crostas mostrou que essa formação funciona como uma barreira fisica interferindo na eficácia do tratamento. A associação com a uréia, como agente promotor da absorção cutânea, não aumentou a eficácia da pomada. O aumento da concentração de paromomicina nas formulações foi capaz de aumentar a eficiência do tratamento sendo insuficiente para a cura completa dos animais. A utilização da interleucina 12 como adjuvante ao tratamento foi fundamental para a modulação da resposta imunológica e para a cura clínica dos animais. Dessa forma, concluímos que o tratamento com a emulsão a 5 por cento de paromomicina associado a IL-12 durante e após o tratamento é eficaz para a cura clínica da doença neste modelo experimental.