RESUMEN
The present gold standard of the treatment of cutaneous leishmaniasis (CL) is pentavalent antimonials either sodium stibogluconate (Pentostam) or meglumine antimoniate (Glucantime), These drugs are quite toxic. They are given by injection and usually administered intramuscularly or intravenously for three weeks or intralesionally for seven or more weeks. That is why the successful introduction of radiofrequency-induced heat therapy using a Thermomed™ 1.8 instrument administered in a single application, with minimal toxic effects, is so important for the treatment of CL.
Asunto(s)
Calor/uso terapéutico , Leishmaniasis Cutánea/terapia , Terapia por Radiofrecuencia/métodos , Adolescente , Adulto , Anciano , Animales , Antiprotozoarios/uso terapéutico , Niño , Preescolar , Citocinas/biosíntesis , Femenino , Humanos , Inyecciones Intramusculares/efectos adversos , Masculino , Antimoniato de Meglumina/efectos adversos , Antimoniato de Meglumina/uso terapéutico , Antimoniato de Meglumina/toxicidad , Persona de Mediana Edad , Pentostatina/efectos adversos , Pentostatina/uso terapéutico , Pentostatina/toxicidad , Terapia por Radiofrecuencia/efectos adversos , Terapia por Radiofrecuencia/instrumentación , Adulto JovenRESUMEN
Controlled heat delivered as radio waves has been used successfully in the treatment of cutaneous leishmaniasis (CL). Here we investigated whether local heat therapy has systemic effects, as measured by the modulation of cytokine production following heat therapy of CL lesions compared with antimonial (Glucantime) treatment. Patients with CL were randomly assigned into this study. Heat (50 degrees C for 30s) was applied once. The control group received Glucantime therapy for 20 d. Cytokine production by peripheral blood mononuclear cells was assayed on days 0, 14 and 28 after onset of treatment. At the end of 28 d, 75% of lesions were healing or healed in the heat therapy group and 90% in the control group (P=0.1261). There was a decrease in IFN-gamma, IL-5 and TNF-alpha levels comparing day 0 with day 28 in both groups, but no difference between the two therapy groups. In patients with only one of several lesions treated with heat therapy, the untreated lesions also healed. Local heat therapy in CL lesions leads to systemic cytokine responses similar to that induced by systemic Glucantime therapy.