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1.
Rev Soc Bras Med Trop ; 54: e0514, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33759920

RESUMEN

A 31-year-old male patient developed an ulcer on the glans penis that evolved for three months without healing. We diagnosed it as leishmaniasis using polymerase chain reaction. No immunosuppression or associated diseases were observed. The patient was treated with meglumine antimoniate that cured the lesion in a month post-treatment. Here, we report this case of cutaneous leishmaniasis lesion at the unusual location of glans penis in an immunocompetent individual. The lesion likely developed due to the bite of a vector, highlighting the need for considering cutaneous leishmaniasis among differential diagnosis of sexually transmitted diseases in areas endemic for leishmaniasis.


Asunto(s)
Antiprotozoarios , Leishmaniasis Cutánea , Compuestos Organometálicos , Adulto , Antiprotozoarios/uso terapéutico , Brasil , Genitales , Humanos , Leishmaniasis Cutánea/diagnóstico , Leishmaniasis Cutánea/tratamiento farmacológico , Masculino , Meglumina/uso terapéutico , Antimoniato de Meglumina/uso terapéutico , Compuestos Organometálicos/uso terapéutico , Reacción en Cadena de la Polimerasa
2.
Rev Soc Bras Med Trop ; 54: e0633, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33759923

RESUMEN

In this study, we present two cases of cutaneous leishmaniasis in patients with end-stage renal disease, who were treated solely with intramuscular pentamidine. In such cases, treatment implies a fine line between therapeutic efficacy and toxicity. This is suggestive of a knowledge gap; however, findings indicate that this is still the fastest and safest alternative to the treatment with antimonials. Also, it can help avoid the side effects that occur upon using antimonials.


Asunto(s)
Antiprotozoarios , Fallo Renal Crónico , Leishmaniasis Cutánea , Antiprotozoarios/uso terapéutico , Humanos , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/terapia , Leishmaniasis Cutánea/complicaciones , Leishmaniasis Cutánea/tratamiento farmacológico , Pentamidina/uso terapéutico , Diálisis Renal
4.
Medicine (Baltimore) ; 100(10): e24890, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33725845

RESUMEN

RATIONALE: Cystoisosporiasis is an intestinal infectious disease caused by a coccidian protozoa, Cystoisospora belli (C. belli). It can cause prolonged and refractory diarrhea most commonly in immunocompromised patients, while immunocompetent individuals usually exhibit no symptoms or self-limited diarrhea. PATIENT CONCERNS: We herein report a case of chronic cystoisosporiasis in an immunocompetent patient. A 62-year-old man, who had been first diagnosed with cystoisosporiasis 15 years ago and had been treated with oral administration of trimethoprim-sulfamethoxazole (TMP-SMX), complained of persistent watery diarrhea. He was negative for anti-human immunodeficiency virus antibody and anti-human T-cell leukemia virus type 1 (HTLV-1) antibody. DIAGNOSIS: Biopsy specimens from the duodenum revealed oocysts in the atrophic absorptive epithelium and protozoa were detected through stool examination, indicating the recurrence of cystoisosporiasis. Capsule endoscopy showed diffuse atrophic mucosa with white villi in the entire small intestine. We diagnosed him with chronic cystoisosporiasis that occurred in an immunocompetent adult. INTERVENTIONS: Since oral administration of TMP-SMX and ciprofloxacin were ineffective, the intravenous administration of TMP-SMX was initiated. OUTCOMES: Intravenous TMP-SMX exhibited a significant improvement. LESSONS: This case indicates that even immunocompetent individuals may develop recurrent and refractory cystoisosporiasis. Furthermore, intravenous treatment of antibiotic agents should be considered when the impaired absorptive ability from the small intestine is suspected.


Asunto(s)
Antiprotozoarios/administración & dosificación , Parasitosis Intestinales/diagnóstico , Parasitosis Intestinales/tratamiento farmacológico , Isosporiasis/diagnóstico , Isosporiasis/tratamiento farmacológico , Combinación Trimetoprim y Sulfametoxazol/administración & dosificación , Administración Intravenosa , Administración Oral , Antiprotozoarios/uso terapéutico , Endoscopía Capsular , Enfermedad Crónica , Diarrea/parasitología , Humanos , Inmunocompetencia , Masculino , Persona de Mediana Edad , Recurrencia , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico
5.
BMC Infect Dis ; 21(1): 168, 2021 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-33568075

RESUMEN

BACKGROUND: Human alveolar echinococcosis (AE) caused by Echinococcus multilocularis is an underreported, often misdiagnosed and mistreated parasitic disease mainly due to its low incidence. The aim of this study was to describe the epidemiological and clinical characteristics of human AE patients in Hungary for the first time. METHOD: Between 2003 and 2018, epidemiological and clinical data of suspected AE patients were collected retrospectively from health database management systems. RESULTS: This case series included a total of 16 AE patients. The mean age of patients was 53 years (range: 24-78 years). The sex ratio was 1:1. Four patients (25%) revealed no recurrence after radical surgery and adjuvant albendazole (ABZ) therapy. For five patients (31.3%) with unresectable lesions, a stabilization of lesions with ABZ treatment was achieved. In seven patients (43.8%), progression of AE was documented. The mean diagnostic delay was 33 months (range: 1-122 months). Three AE related deaths (fatality rate 18.8%) were recorded. CONCLUSIONS: AE is an emerging infectious disease in Hungary with a high fatality rate since based on our results, almost every fifth AE patient died in the study period. Differential diagnosis and appropriate surgical and medical therapy for AE is an urging challenge for clinicians in Hungary, as well as in some other European countries where E. multilocularis is prevalent.


Asunto(s)
Equinococosis/diagnóstico , Adulto , Anciano , Albendazol/uso terapéutico , Animales , Antiprotozoarios/uso terapéutico , Diagnóstico Tardío , Diagnóstico Diferencial , Equinococosis/tratamiento farmacológico , Equinococosis/epidemiología , Equinococosis/parasitología , Echinococcus multilocularis/aislamiento & purificación , Femenino , Humanos , Hungría/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
6.
Rev Soc Bras Med Trop ; 54: e04542020, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33533816

RESUMEN

INTRODUCTION: The objective of this study was to estimate the direct medical costs of the treatment for mucosal leishmaniasis (ML) using three therapeutic approaches in the Brazilian context. METHODS: We performed this economic assessment from the perspective of the Brazilian public healthcare system. The following therapeutic approaches were evaluated: meglumine antimoniate, liposomal amphotericin B, and miltefosine. Direct medical costs were estimated considering four treatment components: a) drug, b) combined medical products, c) procedures, and d) complementary tests. RESULTS: Treatment with meglumine antimoniate had the lowest average cost per patient (US$ 167.66), followed by miltefosine (US$ 259.92) in the outpatient treatment regimen. The average cost of treatment with liposomal amphotericin B was US$ 715.35 both in inpatient regimen. In all estimates, the drugs accounted for more than 60% of the total cost for each treatment approach. CONCLUSIONS: These results demonstrate the marked differences in costs between the therapeutic alternatives for ML. In addition to efficacy rates and costs related to adverse events, our data have the potential to support a complete cost-effectiveness study in the future. Complete analyses comparing costs and benefits for interventions will assist health managers in choosing drugs for ML treatment in Brazil as well as in establishing effective public health policies.


Asunto(s)
Antiprotozoarios , Leishmaniasis Mucocutánea , Antiprotozoarios/uso terapéutico , Brasil , Análisis Costo-Beneficio , Humanos , Leishmaniasis Mucocutánea/tratamiento farmacológico , Antimoniato de Meglumina/uso terapéutico
7.
J Med Microbiol ; 70(3)2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33625354

RESUMEN

Introduction. Cryptosporidium parvum causes intestinal parasitic infections affecting both immunosuppressed and immunocompetent individuals.Gap statement. Given the absence of effective treatments for cryptosporidiosis, especially in immunodeficient patients, the present study was designed to assess the therapeutic efficacy of secnidazole (SEC) and its combination with nitazoxanide (NTZ) in comparison to single NTZ treatment in relation to the immune status of a murine model of C. parvum infection.Methodology. The infected groups were administered NTZ, SEC or NTZ-SEC for three or five successive doses. At days 10 and 12 post-infection (p.i.), the mice were sacrificed, and the efficacy of the applied drugs was evaluated by comparing the histopathological alterations in ileum and measuring the T helper Th1 (interferon gamma; IFN-γ), Th2 [interleukin (IL)-4 and IL-10] and Th17 (IL-17) cytokine profiles in serum.Results. The NTZ-SEC combination recorded the maximal reduction of C. parvum oocyst shedding, endogenous stages count and intestinal histopathology, regardless of the immune status of the infected mice. The efficacy of NTZ-SEC was dependent on the period of administration, as the 5 day-based treatment protocol was also more effective than the 3 day-based one in terms of immunocompetence and immunosuppression. The present treatment schedule induced an immunomodulatory effect from SEC that developed a protective immune response against C. parvum infection with reduced production of serum IL-17, IFN-γ, IL-4 and IL-10.Conclusions. Application of NTZ-SEC combined therapy may be useful in treatment of C. parvum, especially in cases involving immunosuppression.


Asunto(s)
Antiprotozoarios/uso terapéutico , Criptosporidiosis/tratamiento farmacológico , Inmunomodulación/efectos de los fármacos , Metronidazol/análogos & derivados , Nitrocompuestos/uso terapéutico , Tiazoles/uso terapéutico , Animales , Criptosporidiosis/inmunología , Criptosporidiosis/parasitología , Criptosporidiosis/patología , Cryptosporidium parvum/efectos de los fármacos , Citocinas/sangre , Modelos Animales de Enfermedad , Esquema de Medicación , Quimioterapia Combinada , Íleon/efectos de los fármacos , Íleon/parasitología , Íleon/patología , Huésped Inmunocomprometido , Masculino , Metronidazol/uso terapéutico , Ratones , Carga de Parásitos
8.
Parasit Vectors ; 14(1): 36, 2021 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-33422141

RESUMEN

BACKGROUND: Zoonotic visceral leishmaniasis by Leishmania infantum is a first-order pathology in canine veterinary clinics in endemic areas. Moreover, canine infections are considered the main reservoir for human disease; despite their importance in the control of the disease within a One Health approach, no scientometric study has been published. Aims of the study included analyzing the impact of canine leishmaniasis (CanL) on the scientific literature, drugs or combinations used, trends in the period from 2000 to 2020 and efficacy criteria employed. METHODS: A Web of Science (WOS)-based analysis of publications on CanL and chemotherapy of the disease in the period 2000-2020 was carried out using a stepwise methodology. Data were analyzed by year, geographical origin, chemical groups, drugs and combinations, and efficacy criteria. RESULTS: Reports on CanL (n = 3324) represented < 16% of all publications on leishmaniasis (n = 20,968), and of these around 18% (n = 596) were related to chemotherapy. Publication records on CanL followed the distribution of the infection by L. infantum in endemic areas although Mediterranean countries were overrepresented in the reports on chemotherapy of CanL. Publications on the main antileishmanial drugs used in clinical practice showed a sustained tendency in the period analyzed. Pentavalent antimonials (SbV), alone or in combination with allopurinol, represented > 50% of all publications on chemotherapy of CanL despite the availability of more recently marketed drugs. CONCLUSIONS: Chemotherapy of CanL still relies on SbV and combinations and to a lesser extent on miltefosine (MIL). Reports on chemotherapy are scarce and mostly publicly funded, and the variability of experimental conditions hampers the direct comparison of the efficacy of drugs, combinations and schedules. The vast majority of reports on efficacy do not include any information on supportive therapy; this reduces the actual value of the studies if intended for the practical management of the disease. Complete reports on the chemotherapy (etiological + symptomatic) would add value to the trials performed.


Asunto(s)
Antiprotozoarios/uso terapéutico , Enfermedades de los Perros/tratamiento farmacológico , Quimioterapia/métodos , Leishmaniasis/tratamiento farmacológico , Alopurinol/uso terapéutico , Anfotericina B/uso terapéutico , Animales , Enfermedades de los Perros/epidemiología , Perros , Combinación de Medicamentos , Humanos , Leishmania infantum , Leishmaniasis/epidemiología , Leishmaniasis Visceral/epidemiología , Leishmaniasis Visceral/terapia , Fosforilcolina/análogos & derivados , Publicaciones
9.
Exp Parasitol ; 221: 108059, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33338468

RESUMEN

Treatment for visceral leishmaniasis (VL) is hindered mainly by the toxicity and/or high cost of therapeutic drugs. In addition, parasite resistance has been registered. Thus, there is an urgent need for the identification of novel, effective and low-cost antileishmanial agents. Since drug discovery is a long and expensive process, drug repositioning for treatment of leishmaniasis should be considered. In the present study, Ivermectin (IVE), a broad-spectrum drug used for treatment of parasitic diseases, was evaluated in vitro and in vivo against Leishmania infantum species. Results in vitro showed that IVE presented 50% Leishmania and macrophage inhibitory concentrations (IC50 and CC50, respectively) of 3.64 ± 0.48 µM and 427.50 ± 17.60 µM, respectively, with a selectivity index (SI) of 117.45; whereas Amphotericin B (AmpB), which was used as control, showed IC50 and CC50 values of 0.12 ± 0.05 µM and 1.06 ± 0.23 µM, respectively, with a corresponding SI of 8.90. Treatment with IVE effectively reduced the infection percentage and parasite burden in infected and treated macrophages and displayed a prophylactic activity by inhibiting macrophage infection with pre-treated parasites. Furthermore, preliminary studies suggested that IVE targets the parasite's mitochondria. Activity of IVE in its free format or incorporated into Pluronic® F127-based polymeric micelles (IVE/Mic) was also evaluated in vivo as a treating drug for L. infantum-infected BALB/c mice. Miltefosine was used as a control. Results showed that Miltefosine, IVE and IVE/Mic-treated animals presented significant reductions in the parasite load in their spleens, livers, bone marrows and draining lymph nodes, as well as development of an antileishmanial Th1-type immune response one and 15 days after treatment. Notably, IVE/Mic showed a better parasitological and immunological response in comparison to other alternative treatments. In conclusion, results suggest that IVE/Mic could be considered in future studies as a therapeutic alternative to treat VL.


Asunto(s)
Antiprotozoarios/farmacología , Antiprotozoarios/uso terapéutico , Ivermectina/farmacología , Ivermectina/uso terapéutico , Leishmania infantum/efectos de los fármacos , Leishmaniasis Visceral/tratamiento farmacológico , Anfotericina B/farmacología , Animales , Antiprotozoarios/toxicidad , Eritrocitos/efectos de los fármacos , Femenino , Humanos , Inmunoglobulina G/biosíntesis , Inmunoglobulina G/sangre , Concentración 50 Inhibidora , Ivermectina/toxicidad , Macrófagos Peritoneales/efectos de los fármacos , Potencial de la Membrana Mitocondrial , Ratones , Ratones Endogámicos BALB C , Especies Reactivas de Oxígeno/metabolismo , Bazo/parasitología
11.
J Ethnopharmacol ; 264: 113262, 2021 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-32818574

RESUMEN

ETHNOPHARMACOLOGICAL RELEVANCE: In the Peruvian Amazon as in the tropical countries of South America, the use of medicinal Piper species (cordoncillos) is common practice, particularly against symptoms of infection by protozoal parasites. However, there is few documented information about the practical aspects of their use and few scientific validation. The starting point of this work was a set of interviews of people living in six rural communities from the Peruvian Amazon (Alto Amazonas Province) about their uses of plants from Piper genus: one community of Amerindian native people (Shawi community) and five communities of mestizos. Infections caused by parasitic protozoa take a huge toll on public health in the Amazonian communities, who partly fight it using traditional remedies. Validation of these traditional practices contributes to public health care efficiency and may help to identify new antiprotozoal compounds. AIMS OF STUDY: To record and validate the use of medicinal Piper species by rural people of Alto Amazonas Province (Peru) and annotate active compounds using a correlation study and a data mining approach. MATERIALS AND METHODS: Rural communities were interviewed about traditional medication against parasite infections with medicinal Piper species. Ethnopharmacological surveys were undertaken in five mestizo villages, namely: Nueva Arica, Shucushuyacu, Parinari, Lagunas and Esperanza, and one Shawi community (Balsapuerto village). All communities belong to the Alto Amazonas Province (Loreto region, Peru). Seventeen Piper species were collected according to their traditional use for the treatment of parasitic diseases, 35 extracts (leaves or leaves and stems) were tested in vitro on P. falciparum (3D7 chloroquine-sensitive strain and W2 chloroquine-resistant strain), Leishmania donovani LV9 strain and Trypanosoma brucei gambiense. Assessments were performed on HUVEC cells and RAW 264.7 macrophages. The annotation of active compounds was realized by metabolomic analysis and molecular networking approach. RESULTS: Nine extracts were active (IC50 ≤ 10 µg/mL) on 3D7 P. falciparum and only one on W2 P. falciparum, six on L. donovani (axenic and intramacrophagic amastigotes) and seven on Trypanosoma brucei gambiense. Only one extract was active on all three parasites (P. lineatum). After metabolomic analyses and annotation of compounds active on Leishmania, P. strigosum and P. pseudoarboreum were considered as potential sources of leishmanicidal compounds. CONCLUSIONS: This ethnopharmacological study and the associated in vitro bioassays corroborated the relevance of use of Piper species in the Amazonian traditional medicine, especially in Peru. A series of Piper species with few previously available phytochemical data have good antiprotozoal activity and could be a starting point for subsequent promising work. Metabolomic approach appears to be a smart, quick but still limited methodology to identify compounds with high probability of biological activity.


Asunto(s)
Antiprotozoarios/metabolismo , Etnofarmacología/métodos , Medicina Tradicional/métodos , Metabolómica/métodos , Piper/metabolismo , Extractos Vegetales/metabolismo , Animales , Antimaláricos/aislamiento & purificación , Antimaláricos/metabolismo , Antimaláricos/uso terapéutico , Antiprotozoarios/aislamiento & purificación , Antiprotozoarios/uso terapéutico , Femenino , Células Endoteliales de la Vena Umbilical Humana/efectos de los fármacos , Células Endoteliales de la Vena Umbilical Humana/metabolismo , Humanos , Leishmania donovani/efectos de los fármacos , Leishmania donovani/metabolismo , Mesocricetus , Ratones , Perú/etnología , Extractos Vegetales/aislamiento & purificación , Extractos Vegetales/uso terapéutico , Plasmodium falciparum/efectos de los fármacos , Plasmodium falciparum/metabolismo , Células RAW 264.7 , Encuestas y Cuestionarios
13.
PLoS Negl Trop Dis ; 14(12): e0008947, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33338041

RESUMEN

Leishmaniasis is among the world's most neglected diseases. Dogs are the main reservoirs/hosts of Leishmania infantum, causative agent of both canine and human visceral leishmaniosis. Canine leishmaniasis (CanL) represents a public health problem as one of the most prevalent zoonotic diseases worldwide. Current therapeutics present drawbacks; thus, there is a need for more effective, safer, and cheaper drugs. The aim of this study was to evaluate and to compare the efficacy of oral administration of artesunate or meglumine antimoniate/allopurinol in dogs with clinical leishmaniasis. Forty-two dogs with naturally occurring clinical leishmaniasis were included in this open-label, simple randomized positive-control clinical field trial with 6 months of follow-up. Dogs received meglumine antimoniate 100 mg/kg/day and allopurinol 30 mg/kg/day for 28 days (control group, n = 26) or artesunate 25 mg/kg/day for 6 days (test group, n = 16). The animals were evaluated for their clinical evolution, parasite load (by qPCR) and humoral response at different time points: 0, 30, 90, and 180 days after treatment. Data analyses showed a significant improvement in both groups in clinical scores, parasitemia and antibody titers after treatment. Compared to the control group, the artesunate group showed significantly lower clinical score (P = 0.0001), lower parasitemia (P = 0.0001) and antibody titers after 6 months of follow-up. Compared to baseline values, a rapid, significant reduction (P < 0.012) in antibody levels, 2.28- versus 3.04-fold for the control versus artesunate groups, respectively, was observed 30 days after treatment. Antibody levels continued to decrease further in the artesunate group, where 58% of cases became seronegative at the 6-month follow-up. All qPCR-positive dogs were negative after treatment with artesunate, while 14.3% remained positive with the appearance of two new cases in the control group. Artesunate was well tolerated, and no side effects were recorded. Treatment failures were similar in both groups with 27.27% (6/22), including 18.18% (4/22) mortality in the control group, versus 26.66% (4/15), including 13.33% (2/15) mortality in the artesunate group. This is the first report showing the potential of artesunate in the treatment of dogs with clinical leishmaniasis. Artesunate showed higher efficacy than the current first-line treatment for CanL without any adverse effects. It could be a good alternative chemotherapy for CanL, and may be considered for further studies in human leishmaniases. Further clinical trials are needed to confirm these findings, to determine if there are relapses after treatment and if dogs remain infective to sandflies, to define the ideal therapeutic dosage and duration of treatment with artesunate.


Asunto(s)
Alopurinol/uso terapéutico , Antiprotozoarios/uso terapéutico , Artesunato/uso terapéutico , Enfermedades de los Perros/tratamiento farmacológico , Leishmania infantum/efectos de los fármacos , Leishmaniasis Visceral/veterinaria , Antimoniato de Meglumina/uso terapéutico , Animales , Enfermedades de los Perros/parasitología , Perros , Femenino , Leishmaniasis Visceral/tratamiento farmacológico , Leishmaniasis Visceral/parasitología , Masculino , Carga de Parásitos/veterinaria , Parasitemia/tratamiento farmacológico , Zoonosis
14.
BMJ Case Rep ; 13(12)2020 Dec 21.
Artículo en Inglés | MEDLINE | ID: mdl-33370946

RESUMEN

Acute gastroenteritis with persistent vomiting, high degree fever and blood streaking stools often suggests bacterial aetiology in children. Authors report a 13-year-old boy presenting with acute watery diarrhoea with persistent vomiting, fever of 103°F, abdominal cramps and blood streaking stools who failed to show any response to parenteral third-generation cephalosporin for 72 hours. The stool examination revealed numerous cystic and amoeboid forms of Blastocystis hominis Metronidazole was started and the boy promptly responded within 24 hours. There was no recurrence of symptoms then onwards. The case highlights the crucial stool examination in case of acute diarrhoeal disease for rare aetiology.


Asunto(s)
Antiprotozoarios/uso terapéutico , Infecciones por Blastocystis/diagnóstico , Blastocystis hominis/aislamiento & purificación , Gastroenteritis/diagnóstico , Enfermedad Aguda/terapia , Adolescente , Infecciones por Blastocystis/tratamiento farmacológico , Infecciones por Blastocystis/parasitología , Heces/parasitología , Gastroenteritis/tratamiento farmacológico , Gastroenteritis/parasitología , Humanos , Masculino , Metronidazol/uso terapéutico , Resultado del Tratamiento
15.
An Acad Bras Cienc ; 92(suppl 2): e20180968, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33146273

RESUMEN

Leishmaniasis is a neglected disease caused by Leishmania. Chemotherapy remains the mainstay for leishmaniasis control; however, available drugs fail to provide a parasitological cure, and are associated with high toxicity. Natural products are promising leads for the development of novel chemotherapeutics against leishmaniasis. This work investigated the leishmanicidal properties of ethanolic extract of Croton blanchetianus (EECb) on Leishmania infantum and Leishmania amazonensis, and found that EECb, rich in terpenic compounds, was active against promastigote and amastigote forms of both Leishmania species. Leishmania infantum promastigotes and amastigotes presented IC50 values of 208.6 and 8.8 µg/mL, respectively, whereas Leishmania amazonensis promastigotes and amastigotes presented IC50 values of 73.6 and 3.1 µg/mL, respectively. Promastigotes exposed to EECb (100 µg/mL) had their body cellular volume reduced and altered to a round shape, and the flagellum was duplicated, suggesting that EECb may interfere with the process of cytokinesis, which could be the cause of the decline in the parasite multiplication rate. Regarding possible EECb targets, a marked depolarization of the mitochondrial membrane potential was observed. No cytotoxic effects of EECb were observed in murine macrophages at concentrations below 60 µg/mL, and the CC50 obtained was 83.8 µg/mL. Thus, the present results indicated that EECb had effective and selective effects against Leishmania infantum and Leishmania amazonensis, and that these effects appeared to be mediated by mitochondrial dysfunction.


Asunto(s)
Antiprotozoarios , Croton , Animales , Antiprotozoarios/farmacología , Antiprotozoarios/uso terapéutico , Ratones , Ratones Endogámicos BALB C , Mitocondrias , Extractos Vegetales/farmacología
16.
BMC Infect Dis ; 20(1): 867, 2020 Nov 19.
Artículo en Inglés | MEDLINE | ID: mdl-33213392

RESUMEN

BACKGROUND: Micronutrients are minerals and vitamins and they are essential for normal physiological activities. The objectives of the study were to describe the progress and determinants of micronutrient levels and to assess the effects of micronutrients in the treatment outcome of kalazar. METHODS: A prospective cohort study design was used. The data were collected using patient interviews, measuring anthropometric indicators, and collecting laboratory samples. The blood samples were collected at five different periods during the leishmaniasis treatments: before starting anti-leishmaniasis treatments, in the first week, in the second week, in the third week, and in the 4th week of anti-leishmaniasis treatments. Descriptive statistics were used to describe the profile of patients and to compare the treatment success rate. The generalized estimating equation was used to identify the determinants of serum micronutrients. RESULTS: The mean age of the patients were 32.88 years [SD (standard deviation) ±15.95]. Male constitute 62.3% of the patients and problematic alcohol use was present in 11.5% of the patients. The serum zinc level of visceral leishmaniasis patients was affected by alcohol (B - 2.7 [95% CI: - 4.01 - -1.5]), DDS (B 9.75 [95% CI: 7.71-11.79]), family size (B -1.63 [95% CI: - 2.68 - -0.58]), HIV (B -2.95 [95% CI: - 4.97 - -0.92]), and sex (B - 1.28 [95% CI: - 2.5 - -0.07]). The serum iron level of visceral leishmaniasis patients was affected by alcohol (B 7.6 [95% CI: 5.86-9.35]), family size (B -5.14 [95% CI: - 7.01 - -3.28]), malaria (B -12.69 [95% CI: - 14.53 - -10.87]), Hookworm (- 4.48 [- 6.82 - -2.14]), chronic diseases (B -7.44 [95% CI: - 9.75 - -5.13]), and HIV (B -5.51 [95% CI: - 8.23 - -2.78]). The serum selenium level of visceral leishmaniasis patient was affected by HIV (B -18.1 [95% CI: - 20.63 - -15.58]) and family size (B -11.36 [95% CI: - 13.02 - -9.7]). The iodine level of visceral leishmaniasis patient was affected by HIV (B -38.02 [95% CI: - 41.98 - -34.06]), DDS (B 25 .84 [95% CI: 22.57-29.1]), smoking (B -12.34 [95% CI: - 15.98 - -8.7]), chronic illness (B -5.14 [95% CI: - 7.82 - -2.46]), and regular physical exercise (B 5.82 [95% CI: 0.39-11.26]). The serum vitamin D level of visceral leishmaniasis patient was affected by HIV (B -9.43 [95% CI: - 10.92 - -7.94]), DDS (B 16.24 [95% CI: 14.89-17.58]), malaria (B -0.61 [95% CI: - 3.37 - -3.37]), and family size (B -1.15 [95% CI: - 2.03 - -0.28]). The serum vitamin A level of visceral leishmaniasis patient was affected by residence (B 0.81 [95% CI: 0.08-1.54]), BMI (B 1.52 [95% CI: 0.42-2.6]), DDS (B 1.62 [95% CI: 0.36-2.88]), family size (B -5.03 [95% CI: - 5.83 - -4.22]), HIV (B -2.89 [95% CI: - 4.44 - -1.34]),MUAC (B 0.86 [95% CI: 0.52-1.21]), and age (B 0.09 [95% CI: 0.07-0.12]). CONCLUSION: The micronutrient levels of visceral leishmaniasis patients were significantly lower. The anti-leishmaniasis treatment did not increase the serum micronutrient level of the patients.


Asunto(s)
Antiprotozoarios/uso terapéutico , Leishmaniasis Visceral/tratamiento farmacológico , Micronutrientes/sangre , Adulto , Consumo de Bebidas Alcohólicas , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/patología , Humanos , Entrevistas como Asunto , Leishmaniasis Visceral/complicaciones , Leishmaniasis Visceral/patología , Malaria/complicaciones , Malaria/patología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Selenio/sangre , Zinc/sangre
18.
Ann Parasitol ; 63(3): 295-302, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33128446

RESUMEN

Visceral leishmaniosis is one of the most fatal old-world neglected disease with estimated 90 thousand worldwide cases emerge each year. In Iraq, the cutaneous and visceral form are endemic but available chemotherapies are either toxic with diverse side effects, expensive available drugs or parasite resistant is arising. Artemisinin (ART) is a semi-synthetic compound which proved its effectiveness against protozoan parasites, such as malaria and Leishmania. In this study, the efficacy of different concentrations of pure artemisinin was screened in vitro against promastigotes and axenic amastigotes by MTT assay after 24, 48 and 27 hours follow up. In addition, the infectivity ability and number was investigated of intra-cellular Leishman bodies in treated murine peritoneal macrophages after 24 and 48 hours ART treatment. The results verified ART efficacy against the promastigotes and axenic amastigotes viability with IC50 measured after 24, 48- and 72-hours treatment. Infectivity percentage of murine macrophages and parasite burden were significantly reduced in treated cells. These findings indicate the leishmanicidal activity of ART against the Iraqi isolate of L. donovani and further in vivo study is recommended for assigning ART as a natural anti visceral leishmaniosis compound.


Asunto(s)
Antiprotozoarios , Artemisininas , Leishmania donovani , Leishmaniasis Visceral , Animales , Antiprotozoarios/farmacología , Antiprotozoarios/uso terapéutico , Artemisininas/farmacología , Artemisininas/uso terapéutico , Irak , Leishmaniasis Visceral/tratamiento farmacológico , Macrófagos , Ratones
19.
PLoS Negl Trop Dis ; 14(8): e0008575, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32866156

RESUMEN

BACKGROUND: Treatment failure and resistance to the commonly used drugs remains a major obstacle for successful chemotherapy against visceral leishmaniasis (VL). Since the development of novel therapeutics involves exorbitant costs, the effectiveness of the currently available antitrypanosomatid drug suramin has been investigated as an antileishmanial, specifically for VL,in vitro and in animal model experiments. METHODOLOGY/PRINCIPAL: Leishmania donovani promastigotes were treated with suramin and studies were performed to determine the extent and mode of cell mortality, cell cycle arrest and other in vitro parameters. In addition, L. donovani infected BALB/c mice were administered suramin and a host of immunological parameters determined to estimate the antileishmanial potency of the drug. Finally, isothermal titration calorimetry (ITC) and enzymatic assays were used to probe the interaction of the drug with one of its putative targets namely parasitic phosphoglycerate kinase (LmPGK). FINDINGS: The in vitro studies revealed the potential efficacy of suramin against the Leishmania parasite. This observation was further substantiated in the in vivo murine model, which demonstrated that upon suramin administration, the Leishmania infected BALB/c mice were able to reduce the parasitic burden and also generate the host protective immunological responses. ITC and enzyme assays confirmed the binding and consequent inhibition of LmPGK due to the drug. CONCLUSIONS/SIGNIFICANCE: All experiments affirmed the efficacy of suramin against L. donovani infection, which could possibly lead to its inclusion in the repertoire of drugs against VL.


Asunto(s)
Antiprotozoarios/farmacología , Antiprotozoarios/uso terapéutico , Leishmaniasis Visceral/tratamiento farmacológico , Suramina/farmacología , Suramina/uso terapéutico , Animales , Apoptosis/efectos de los fármacos , Citocinas/metabolismo , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Concentración 50 Inhibidora , Leishmania donovani/efectos de los fármacos , Leishmaniasis Visceral/parasitología , Potencial de la Membrana Mitocondrial/efectos de los fármacos , Ratones , Ratones Endogámicos BALB C , Óxido Nítrico/metabolismo , Fosfoglicerato Quinasa/efectos de los fármacos , Células RAW 264.7/efectos de los fármacos , Especies Reactivas de Oxígeno/metabolismo
20.
Rev. patol. respir ; 23(3): 111-113, jul.-sept. 2020.
Artículo en Español | IBECS | ID: ibc-198474

RESUMEN

La amebiasis es una enfermedad infecciosa causada por el protozoo E. hystolitica con múltiples manifestaciones clínicas. La afectación torácica es la segunda localización extraintestinal más frecuente tras la hepática. Presentamos un caso de derrame pleural secundario a un absceso hepático amebiano y realizamos una revisión de esta entidad poco frecuente


Amebiasis is an infectious disease caused by the protozoan E. hystolitica with multiple clinical manifestations. Chest involvement is the second most frequent extraintestinal location after the liver. We present a case of pleural effusion secondary to an amebic liver abscess and we review this rare entity


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Derrame Pleural/diagnóstico por imagen , Derrame Pleural/etiología , Absceso Hepático Amebiano/complicaciones , Absceso Hepático Amebiano/diagnóstico por imagen , Radiografía Torácica , Tomografía Computarizada por Rayos X , Ultrasonografía , Derrame Pleural/tratamiento farmacológico , Absceso Hepático Amebiano/tratamiento farmacológico , Metronidazol/uso terapéutico , Antiprotozoarios/uso terapéutico
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