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Ullah W, Khan A, Niaz S, Al-Garadi MA, Nasreen N, Swelum AA, Ben Said M. Epidemiological survey, molecular profiling and phylogenetic analysis of cutaneous leishmaniasis in Khyber Pakhtunkhwa, Pakistan. Trans R Soc Trop Med Hyg 2024; 118:273-286. [PMID: 38055843 DOI: 10.1093/trstmh/trad086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/22/2023] [Accepted: 11/16/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL), an emerging vector-borne ailment in Khyber Pakhtunkhwa (KPK), Pakistan, exhibits diverse spread patterns and outbreaks. METHODS To comprehend its epidemiology and identify parasite species, we conducted an active survey on suspected CL cases (n=8845) in KPK. RESULTS Microscopy and internal transcribed spacer-1 PCR-restriction fragment length polymorphism (RFLP) molecular techniques detected Leishmania spp. in blood samples. Phylogenetic analysis gauged genetic affinities with other areas. District Bannu displayed the highest CL impact (14.58%), while Swat had the lowest impact (4.33%) among cases. Annual blood examination rate, parasite incidence and slide positivity rate were 4.96 per 1000 people, 0.0233 and 0.047%, respectively. CL infections were prevalent in 1- to 20-y-olds, with males (57.17%) more vulnerable than females (42.82%). Single lesions occurred in 43.73% of patients, while 31.2% people had two lesions, 17.31% had three lesions and 7.74% had more than three lesions. Most had sand-fly exposure but lacked preventive measures like repellents and bed nets. Leishmania tropica was confirmed via RFLP analysis in amplified samples. Phylogenetic analysis unveiled genetic parallels between L. tropica of KPK and isolates from China, Iran, Afghanistan, India, Syria and Morocco. CONCLUSIONS Urgent comprehensive control measures are imperative. Early detection, targeted interventions and raising awareness of CL and sand-fly vectors are vital for reducing the disease's impact. International collaboration and monitoring are crucial to tackle Leishmania spp.'s genetic diversity and curtail its cross-border spread.
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Affiliation(s)
- Wasia Ullah
- Depart ment of Zoology, Abdul Wali Khan University, Khyber Pakhtunkhwa, Pakistan
| | - Adil Khan
- Department of Botany/Zoology, Bacha Khan University Charsadda, Khyber Pakhtunkhwa, Pakistan
- Department of Biology, Mountain Allison university, Sackville, new Brunswick, Canada
| | - Sadaf Niaz
- Depart ment of Zoology, Abdul Wali Khan University, Khyber Pakhtunkhwa, Pakistan
| | - Maged A Al-Garadi
- Department of Animal Production, College of Food and Agriculture Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Nasreen Nasreen
- Depart ment of Zoology, Abdul Wali Khan University, Khyber Pakhtunkhwa, Pakistan
| | - Ayman A Swelum
- Department of Animal Production, College of Food and Agriculture Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mourad Ben Said
- Laboratory of Microbiology, National School of Veterinary Medicine of Sidi Thabet, University of Manouba, Manouba 2010, Tunisia
- Department of Basic Sciences, Higher Institute of Biotechnology of Sidi Thabet, University of Manouba, Manouba 2010, Tunisia
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Usman M, Natala AJ, Jatau ID, Ogo NI, Jeelani G, Goto Y, Nozaki T, McKerrow JH, Balogun EO. Molecular identification of phlebotomine sand flies and the harbored Leishmania spp. in Sokoto State, Nigeria. Front Cell Infect Microbiol 2023; 13:1219629. [PMID: 37719668 PMCID: PMC10500309 DOI: 10.3389/fcimb.2023.1219629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Female sand flies are hematophagous, feeding on animals and in the process serve as vectors for Leishmania, the parasites that cause leishmaniasis in humans. Leishmaniasis are a group of parasitic neglected tropical diseases in 98 countries including Nigeria and kills ~60,000 people/year. In Nigeria, Sokoto State is endemic to leishmaniasis but there is a knowledge gap on the identity of the prevalent sand flies and the Leishmania species they transmit. Hence, this cross-sectional study was designed to take inventory of the species of sand flies in Sokoto using genetic methods. Methods 1,260 (310 females) sand flies were collected from three Local Government Areas (L.G.A) of Sokoto State- Wamakko, Sokoto South and Kware. Genomic DNA was extracted from each fly and DNA amplification by polymerase chain reaction (PCR) was carried out on the DNA samples using primers targeting the arthropods mitochondrial cytochrome oxidase subunit 1 (mt-coI) gene, and nested PCR with primers targeting the gene for Leishmania internal transcribed spacer-1 (its-1) of ribosomal RNA its-1rRNA. The PCR products were sequenced. Results Gene sequence analysis revealed five species of sand flies belonging to the old-world genera namely Phlebotomus and Sergentomyia. The identified species were P. papatasi (6.45%), S. adleri (6.45%), S. affinis (9.7%), S. distincta (9.7%), S. schwetzi (67.7%). Within the sampling period, sand flies were most abundant in the rainy months of August (104/33.5%) and September (116/37.4%) with all the five identified species occurring. Sequence analysis of its-1 gene identified Leishmania infantum in two sand flies (2/310)- P. papatasi (from Sokoto South) and S. affinis (from Wamakko). BLAST search in NCBI and phylogenetic analysis revealed that the sand fly species are related to the species reported in different parts of Africa, while the L. infantum is identical to strain reported in Brazil (KY379083.1). Discussion Phlebotomus papatasi and four species belonging to the genus Sergentomyia are the most prevalent sand flies in Sokoto State, Nigeria and they harbor L. infantum solely. The results shed light on why visceral leishmaniasis is the most predominant form of the disease. Therefore, we recommend that adequate care for dogs must be instituted as dogs are the major animal reservoir for L. infantum.
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Affiliation(s)
- Mahmud Usman
- Department of Veterinary Parasitology and Entomology, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Audu Joseph Natala
- Department of Veterinary Parasitology and Entomology, Ahmadu Bello University, Zaria, Nigeria
| | - Isa Danladi Jatau
- Department of Veterinary Parasitology and Entomology, Ahmadu Bello University, Zaria, Nigeria
| | - Ndudim Isaac Ogo
- Parasitology Division, National Veterinary Research Institute, Vom, Plateau State, Nigeria
| | - Ghulam Jeelani
- Department of Biomedical Chemistry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuyuki Goto
- Laboratory of Molecular Immunology, Department of Animal Resource Sciences, Graduate School of Agricultural and Life Sciences, Tokyo University, Tokyo, Tokyo, Japan
| | - Tomoyoshi Nozaki
- Department of Biomedical Chemistry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - James H. McKerrow
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego, CA, United States
| | - Emmanuel Oluwadare Balogun
- Department of Biomedical Chemistry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego, CA, United States
- Department of Biochemistry, Ahmadu Bello University, Zaria, Nigeria
- Africa Centre of Excellence for Neglected Tropical Diseases and Forensic Biotechnology, Ahmadu Bello University, Zaria, Nigeria
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Elawad MA, Elkhalifa MEM, Hamdoon AAE, Salim LHM, Ahmad Z, Ayaz M. Natural products derived steroids as potential anti-leishmanial agents; disease prevalence, underlying mechanisms and future perspectives. Steroids 2023; 193:109196. [PMID: 36764565 DOI: 10.1016/j.steroids.2023.109196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 01/31/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023]
Abstract
Leishmaniasis is a vector-borne infection caused by protozoan parasites from the genus leishmania and is among the most neglected tropical diseases. It is highly prevalent disease, affecting about 350 million population worldwide. Only limited number of anti-leishmanial agents are approved for clinical use till now and they are associated with side effects and have limited efficacy. Subsequently, natural products based discovery of more safe and effective drugs against leishmania is under scientific consideration. Various studies reported the efficacy of natural products against intracellular and extracellular forms of leishmania species. This work is aimed to evaluate current literature focused on the anti-leihmanial efficacy of steroidal moieties from natural products and their mechanism of action. Compounds including steroidal saponins, steroidal alkaloids and phytosterols were found to exhibit considerable anti-leishmanial efficacy. For instance, steroidal saponin, (25R)-spirost-5-en-3b-ol,3-O-α-rhamnopyranosyl-(1 → 4)-α-rhamnopyranosyl-(1 → 4)-[a-rhamnopyranosyl-(1 → 2)]-glucopyranoside isolated from A. paradoxum has completely eradicated Leishmania major promastigotes at 50 µg mL-1 dose. Spirostanic saponins isolated from Solanum paniculatum L. were effective against Leishmania amazonensis promastigotes. Turgidosterones isolated from Panicum turgidum exhibited high leishmanicidal potentials against Leishmania donovani promastigotes with IC50 of 4.95-8.03 µg mL-1 and even better activity against amastigotes exhibiting an IC50 of 4.50-9.29 µg mL-1. Likewise, racemoside-A from Asparagus racemosus was found effective against an antimonial sensitive (AG83) and antimonial resistant (GE1F8R) strains of the L. donovani. Moreover, steroidal alkaloids including hookerianamide-1, hookerianamide-H, hookerianamide-J, hookerianamide-K, dehydrosarsalignone, vagenine-A, sarcovagine-C, holaphylline, saracodine, holamine, 15-α hydroxyholamine, holacurtin, N-desmethyl holacurtine and elasticine has exhibited time and dose-dependent efficacy against various strains of leishmania. β-sitosterol was found active against multiple strains of leishmania. These compounds mainly exhibit their therapeutic efficacy via liberation of ROS, mitochondrial depolarization, morphological and ultra-structural changes, accumulation of lipid droplets, depletion of non-protein thiols and triggering apoptotic pathways. In conclusion, leishmaniasis is a major health problem in many countries. Plants-derived steroids moieties have reveled efficacy against leishmaniasis and is a source of lead compounds. Further detailed molecular studies are warranted for the discovery of more effective and safe anti-leishmanial drugs.
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Affiliation(s)
- Mohammed Ahmed Elawad
- Public Health Department, Health Sciences College at Lieth, Umm Al Qura University, Makkah, Saudi Arabia; University of Khartoum, Faculty of Public and Environmental Health, Sudan.
| | - Modawy Elnour Modawy Elkhalifa
- Public Health Department, Health Sciences College at Lieth, Umm Al Qura University, Makkah, Saudi Arabia; University of Khartoum, Faculty of Public and Environmental Health, Sudan.
| | - Alashary Adam Eisa Hamdoon
- Public Health Department, Health Sciences College at Lieth, Umm Al Qura University, Makkah, Saudi Arabia; University of Khartoum, Faculty of Public and Environmental Health, Sudan.
| | - Liga Hasan Mohammed Salim
- Public Health Department, Health Sciences College at Lieth, Umm Al Qura University, Makkah, Saudi Arabia; University of Khartoum, Faculty of Public and Environmental Health, Sudan.
| | - Zeeshan Ahmad
- Department of Pharmacy, Facutly of Biological Sciences, University of Malakand, Chakdara 18000, Dir (L), KPK, Pakistan
| | - Muhammad Ayaz
- Department of Pharmacy, Facutly of Biological Sciences, University of Malakand, Chakdara 18000, Dir (L), KPK, Pakistan.
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Kumar P, Kumar P, Singh N, Khajuria S, Patel R, Rajana VK, Mandal D, Velayutham R. Limitations of current chemotherapy and future of nanoformulation-based AmB delivery for visceral leishmaniasis-An updated review. Front Bioeng Biotechnol 2022; 10:1016925. [PMID: 36588956 PMCID: PMC9794769 DOI: 10.3389/fbioe.2022.1016925] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/31/2022] [Indexed: 12/15/2022] Open
Abstract
Visceral leishmaniasis (VL) is the most lethal of all leishmaniasis diseasesand the second most common parasiticdisease after malaria and,still, categorized as a neglected tropical disease (NTD). According to the latest WHO study, >20 Leishmania species spread 0.7-1.0 million new cases of leishmaniasis each year. VL is caused by the genus, Leishmania donovani (LD), which affects between 50,000 and 90,000 people worldwide each year. Lack of new drug development, increasing drug resistance, toxicity and high cost even with the first line of treatmentof Amphotericin B (AmB), demands new formulation for treatment of VLFurther the lack of a vaccine, allowedthe researchers to develop nanofomulation-based AmB for improved delivery. The limitation of AmB is its kidney and liver toxicity which forced the development of costly liposomal AmB (AmBisome) nanoformulation. Success of AmBisome have inspired and attracted a wide range of AmB nanoformulations ranging from polymeric, solid lipid, liposomal/micellar, metallic, macrophage receptor-targetednanoparticles (NP) and even with sophisticated carbon/quantum dot-based AmBnano delivery systems. Notably, NP-based AmB delivery has shown increased efficacy due to increased uptake, on-target delivery and synergistic impact of NP and AmB. In this review, we have discussed the different forms of leishmaniasis disease and their current treatment options with limitations. The discovery, mechanism of action of AmB, clinical status of AmB and improvement with AmBisome over fungizone (AmB-deoxycholate)for VL treatment was further discussed. At last, the development of various AmB nanoformulation was discussed along with its adavantages over traditional chemotherapy-based delivery.
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Affiliation(s)
- Prakash Kumar
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Pawan Kumar
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Nidhi Singh
- National Institute of Pharmaceutical Education and Research, Ahmedabad, India
| | - Salil Khajuria
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Rahul Patel
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Vinod Kumar Rajana
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Debabrata Mandal
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India,*Correspondence: Ravichandiran Velayutham, ; Debabrata Mandal,
| | - Ravichandiran Velayutham
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India,National Institute of Pharmaceutical Education and Research, Kolkata, India,*Correspondence: Ravichandiran Velayutham, ; Debabrata Mandal,
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Saini I, Joshi J, Kaur S. Unwelcome prevalence of leishmaniasis with several other infectious diseases. Int Immunopharmacol 2022; 110:109059. [DOI: 10.1016/j.intimp.2022.109059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/12/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022]
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Zhuang L, Su J, Tu P. Cutaneous leishmaniasis presenting with painless ulcer on the right forearm: A case report. World J Clin Cases 2022; 10:2301-2306. [PMID: 35321164 PMCID: PMC8895175 DOI: 10.12998/wjcc.v10.i7.2301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/13/2021] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Leishmaniasis includes a range of chronic infections in humans and animals and can be caused by more than 20 species of Leishmania protozoa. The manifestations of leishmaniasis are diverse and dependent on the immune response capacity of the host and the type of Leishmania. In East Asia, leishmaniasis is relatively rare and prone to misdiagnosis and underdiagnosis.
CASE SUMMARY We report a case of a 36-year-old male with cutaneous leishmaniasis. The patient had been misdiagnosed with a bacterial skin infection and was given a dressing change and oral levofloxacin, which proved ineffective. Histopathological examination revealed amastigote (Leishman-Donovan body) in the histocytes, and nucleic acid sequencing proved that the pathogen was Leishmania major. The patient was treated successfully by regional injection of sodium gluconate (600 mg) three times. The ulcer healed and did not recur at 1.5-year follow-up.
CONCLUSION Skin ulcers caused by leishmaniasis are easily misdiagnosed in non-epidemic countries, yet it should not be overlooked.
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Affiliation(s)
- Le Zhuang
- Department of Dermatology, Peking University The First Hospital, Beijing 100034, China
- Department of Dermatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong province, China
| | - Jing Su
- Department of Pathology, School of Basic Medical Sciences, The Third Hospital, Peking University Health Science Center, Beijing 100034, China
| | - Ping Tu
- Department of Dermatology, Peking University The First Hospital, Beijing 100034, China
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Tharakan SJ, Peter Cv D, Karthik R, Rupa V, Rose W, Thomas M, Manuel M, Rupali P, Pulimood S, Rao Ajjampur SS. Case Report: A Single-Center Case Series on Skin Manifestations of Leishmaniasis from a Non-Endemic State in Southern India. Am J Trop Med Hyg 2020; 104:928-933. [PMID: 33377447 DOI: 10.4269/ajtmh.20-0938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 10/21/2020] [Indexed: 11/07/2022] Open
Abstract
Leishmaniasis is endemic in the Indian subcontinent with predominance of visceral leishmaniasis (VL) due to Leishmania donovani. Cutaneous leishmaniasis (CL) is uncommon, and mucocutaneous leishmaniasis (MCL) is rarely reported in this region. Recent reports reveal a changing epidemiology and atypical manifestations. A retrospective study of 52 suspected cases with cutaneous and mucosal involvement seen from January 2008 to December 2018 in a tertiary care setting in a non-endemic state in southern India is reported. Twelve patients were confirmed to have leishmaniasis; seven had MCL, two had CL, and three had post-kala-azar dermal leishmaniasis (PKDL). All cases were male, with a median age of 41.5 years (interquartile range, 30-55.5 years), and the median duration of the disease was 6 years (interquartile range, 1-9.5 years). Patients with MCL had mucosal involvement including destructive ulcero-proliferative lesions due to delayed diagnosis; none had a history of travel to countries endemic for MCL and all were attributable to L. donovani species. On the other hand, Leishmania major which was the causative species in both CL patients was associated with travel to the Middle East. Patients with PKDL presented with multiple plaques and hypopigmented patches; one had concomitant VLand all were from endemic areas. Hitherto uncommon MCL, caused by potentially atypical variants of L. donovani, has emerged as a new manifestation of leishmaniasis in this region. A high index of suspicion based on lesions seen and history of travel combined with PCR-based diagnostics are required to confirm diagnosis for the various skin manifestations of leishmaniasis.
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Affiliation(s)
| | - Dincy Peter Cv
- Departments of Dermatology Unit-II, Christian Medical College, Vellore, India
| | - Rajiv Karthik
- Infectious Diseases, Christian Medical College, Vellore, India
| | - Vedantam Rupa
- ENT Unit-III, Christian Medical College, Vellore, India
| | - Winsley Rose
- Child Health Unit-III, Christian Medical College, Vellore, India
| | - Meera Thomas
- Pathology, Christian Medical College, Vellore, India
| | - Malathi Manuel
- The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India
| | | | - Susanne Pulimood
- Departments of Dermatology Unit-II, Christian Medical College, Vellore, India
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Taslimi Y, Zahedifard F, Taheri T, Doroud D, Latif Dizaji S, Saljoughian N, Rafati S. Comparison of Protective Potency of DNA and Live Vaccines Expressing A2-CPA-CPB -CTE Antigens against Visceral Leishmaniasis in Syrian Hamster as Preliminary Study. IRANIAN JOURNAL OF PARASITOLOGY 2020; 15:383-392. [PMID: 33082803 PMCID: PMC7548471 DOI: 10.18502/ijpa.v15i3.4203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Visceral leishmaniasis is the most severe form of leishmaniasis caused by Leishmania (L.) donovani complex. Drug-resistant strains have been developed as a consequence of the current chemotherapeutic interventions, which has increased the need for advanced preventive and therapeutic strategies. A2-CPA-CPB-CTE-recombinant strain of L. tarentolae, which is non-pathogenic to humans, was shown protective in live vaccine as well as its DNA vaccine counterpart in both murine and canine models. Methods: We evaluated the effectiveness of these DNA and live vaccination harboring A2-CPA-CPB-CTE in protecting hamsters against L. infantum infection using prime-boost regimens, namely DNA/DNA and Live/Live (n=9 hamsters per group). Cationic solid lipid nanoparticles (cSLN) were utilized as an adjuvant for DNA priming and electroporation for boosting DNA. At different time points post-challenge, parasite burden and body weight as well as humoral immune responses were measured. Results: Both immunization strategies partially protect hamsters against L. infantum challenge. This protective immunity is associated with remarkable decrease in parasite load in liver and spleen of vaccinated hamsters eight weeks after challenge compared to control group. Conclusion: Both test groups (DNA/DNA and Live/Live) elicited high levels of IgG2 and total IgG as humoral immune responses and lower level of parasite propagation in both liver and spleen.
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Affiliation(s)
- Yasaman Taslimi
- Department of Immunotherapy and Leishmania Vaccine Research, Pasteur Institute of Tehran, Tehran, Iran
| | - Farnaz Zahedifard
- Department of Immunotherapy and Leishmania Vaccine Research, Pasteur Institute of Tehran, Tehran, Iran
| | - Tahereh Taheri
- Department of Immunotherapy and Leishmania Vaccine Research, Pasteur Institute of Tehran, Tehran, Iran
| | - Delaram Doroud
- Quality Control Department, Production and Research Complex, Pasteur Institute of Tehran, Tehran, Iran
| | - Sakineh Latif Dizaji
- Department of Laboratory Animal Science, Pasteur Institute of Tehran, Tehran, Iran
| | - Noushin Saljoughian
- Department of Immunotherapy and Leishmania Vaccine Research, Pasteur Institute of Tehran, Tehran, Iran
| | - Sima Rafati
- Department of Immunotherapy and Leishmania Vaccine Research, Pasteur Institute of Tehran, Tehran, Iran
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Ziaei Hezarjaribi H, Karamian M, Geran Orimi T, Pagheh AS, Emadi SN, Fakhar M, Derakhshani-Niya M. Phylogenetic position of Leishmania tropica isolates from an old endemic focus in south-eastern Iran; relying on atypical cutaneous leishmaniasis. Transbound Emerg Dis 2020; 68:1493-1503. [PMID: 32881318 DOI: 10.1111/tbed.13818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 08/23/2020] [Accepted: 08/28/2020] [Indexed: 02/07/2023]
Abstract
Cutaneous leishmaniasis (CL) is a major health problem in Iran, with a heavy burden on human health and society. There is little knowledge about the molecular epidemiology of the disease, as well as phylogenetic relationship of causative agents in south-eastern Iran. The aim of the present study was to investigate the molecular aspects of CL, especially atypical CL in the Bam district, Kerman province, south-eastern Iran, as an endemic region of CL in Iran. The smears were collected from lesion samples of 353 patients clinically suspected to CL, who attended local health centres in the Bam district during 2016-2017. Direct smears were examined for Leishmania parasites using the Giemsa staining technique. Amplification of kinetoplast DNA (kDNA) and the ribosomal internal transcribed spacer 1(ITS-1) gene were carried out using polymerase chain reaction (PCR). Then, the ITS1-PCR products were sequenced for phylogenetic analysis. Overall, 278 cases were confirmed as CL by microscopic examination of Giemsa-stained slides. Clinical presentation of the lesions was basically of two types: (a) typical lesions and (b) atypical including lupoid ulcers, sporotrichoid, nodular and exudative lesions. The PCR assay on all specimens of skin lesions proved L. tropica as the main pathogenic agent. Phylogenic analysis revealed high similarity among isolates from the Bam district in the south-east with isolates from Birjand in eastern Iran, as well as with isolates from Herat province in western Afghanistan. The study provided valuable information concerning the genetic diversity of the parasite as one of the factors influencing the clinical manifestations in CL in south-eastern Iran, which could be the basis for planning future control strategies.
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Affiliation(s)
- Hajar Ziaei Hezarjaribi
- Molecular and Cell Biology Research Center, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis (INRCL) and Toxoplasmosis (INRCT), Department of Parasitolgy, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Karamian
- Department of Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Tahmineh Geran Orimi
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis (INRCL) and Toxoplasmosis (INRCT), Department of Parasitolgy, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abdol Sattar Pagheh
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Seyed Naser Emadi
- Skin Research Center, Razi and Imam Khomeini Hospitals, Department of Dermatology, Faculty of Medicine, Tehran University of Medical Sciences, and Iranian Red Crescent, Tehran, Iran
| | - Mahdi Fakhar
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis (INRCL) and Toxoplasmosis (INRCT), Department of Parasitolgy, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Zeb I, Ali A, Nawab J, Khan MQ, Kamil A, Tsai KH. Cutaneous leishmaniasis in male schoolchildren in the upper and lower Dir districts of Khyber Pakhtunkhwa, and a review of previous record in Pakistan. Acta Trop 2020; 209:105578. [PMID: 32533937 DOI: 10.1016/j.actatropica.2020.105578] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/06/2020] [Accepted: 06/07/2020] [Indexed: 11/27/2022]
Abstract
Documented reports are limited, showing cutaneous leishmaniasis (CL) as a severe threat to schoolchildren in Pakistan. The present study aimed to investigate the clinico-epidemiology and associated risk factors of CL in local and Afghan male schoolchildren between 6 and 16 years of age. The experimental strategy involved a questionnaire for the collection of information and clinical diagnosis (microscopy and semi-nested PCR) of 113 CL symptomatic schoolchildren out of 8,833 schoolchildren (7,175 local and 1,658 Afghan refugees) studying in nineteen schools of the Upper and Lower Dir Districts, Khyber Pakhtunkhwa, Pakistan. Previous records of CL in Pakistan was studied, and spatial analysis was performed on elevation and agro-ecological maps using Arc-GIS v10.3.1. Active lesions were found predominant (n=113, 1.2%: cutaneous lesions, 97, 86%, and lesions with mucosal involvement, 16, 14%) than scars (20, 0.25%). Active lesions of both local (100, 88%) and Afghan refugees (13, 12%), and infected age groups were found significantly different. Majority of the lesions were dry crusted (98, 86.7%), single (83, 73%), and frequently infecting facial region (59, 52%). Avoiding bed nets, living in mud houses and animal shelters were highly associated with CL infection. Temergara (30, 26.5%) and Rabath (14, 12.3%) were hyperendemic CL foci. Microscopically, 71 (63%) cases were positive, while the PCR assay revealed Leishmania tropica in 110 (97.3%) cases. Previous record revealed that L. tropica is dominant throughout Pakistan, and dry mountains and plateaus of northwestern and southwestern regions are spatially at high-risk. Measures should be taken to reduce CL infection by eliminating the associated risk factors, promoting PCR-based diagnosis and basic medical facilities.
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Lasse C, Azevedo CS, de Araújo CN, Motta FN, Andrade MA, Rocha AP, Sampaio I, Charneau S, Gèze M, Grellier P, Santana JM, Bastos IMD. Prolyl Oligopeptidase From Leishmania infantum: Biochemical Characterization and Involvement in Macrophage Infection. Front Microbiol 2020; 11:1060. [PMID: 32547514 PMCID: PMC7271538 DOI: 10.3389/fmicb.2020.01060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/29/2020] [Indexed: 11/13/2022] Open
Abstract
Leishmania infantum is a flagellated protozoan and one of the main causative agents of visceral leishmaniasis. This disease usually affects the human reticuloendothelial system, can cause death and available therapies may lead to serious side effects. Since it is a neglected tropical disease, the incentives for the development of new drugs are insufficient. It is important to know Leishmania virulence factors that contribute most to the disease in order to develop drugs. In the present work, we have produced L. infantum prolyl oligopeptidase (rPOPLi) in Escherichia coli, and investigated its biochemical properties as well as the effect of POP inhibitors on its enzymatic activity and on the inhibition of the macrophage infection by L. infantum. The optimal activity occurred at pH 7.5 and 37°C in the presence of DTT, the latter increased rPOPLi catalytic efficiency 5-fold on the substrate N-Suc-Gly-Pro-Leu-Gly-Pro-AMC. The enzyme was inhibited by TPCK, TLCK and by two POP specific inhibitors, Z-Pro-prolinal (ZPP, IC50 4.2 nM) and S17092 (IC50 3.5 nM). Besides being a cytoplasmic enzyme, POPLi is also found in punctuate structures within the parasite cytoplasm or associated with the parasite plasma membrane in amastigotes and promastigotes, respectively. Interestingly, S17092 and ZPP prevented parasite invasion in murine macrophages, supporting the involvement of POPLi in the invasive process of L. infantum. These data suggest POPLi as a virulence factor that offers potential as a target for designing new antileishmanial drugs.
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Affiliation(s)
- Camila Lasse
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of Brasília, Brasília, Brazil
| | - Clênia S Azevedo
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of Brasília, Brasília, Brazil.,UMR 7245 MCAM, Musèum National d'Histoire Naturelle, Centre National de la Recherche Scientifique, Paris, France
| | - Carla N de Araújo
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of Brasília, Brasília, Brazil.,Faculty of Ceilandia, University of Brasília, Brasília, Brazil
| | - Flávia N Motta
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of Brasília, Brasília, Brazil.,Faculty of Ceilandia, University of Brasília, Brasília, Brazil
| | - Milene A Andrade
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of Brasília, Brasília, Brazil.,UMR 7245 MCAM, Musèum National d'Histoire Naturelle, Centre National de la Recherche Scientifique, Paris, France
| | - Amanda Pereira Rocha
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of Brasília, Brasília, Brazil
| | - Iracyara Sampaio
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of Brasília, Brasília, Brazil
| | - Sébastien Charneau
- Laboratory of Protein Chemistry and Biochemistry, Department of Cell Biology, University of Brasília, Brasília, Brazil
| | - Marc Gèze
- UMR 7245 MCAM, Musèum National d'Histoire Naturelle, Centre National de la Recherche Scientifique, Paris, France.,CeMIM, Musèum National d'Histoire Naturelle, Paris, France
| | - Philippe Grellier
- UMR 7245 MCAM, Musèum National d'Histoire Naturelle, Centre National de la Recherche Scientifique, Paris, France
| | - Jaime M Santana
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of Brasília, Brasília, Brazil
| | - Izabela M D Bastos
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of Brasília, Brasília, Brazil
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Evaluation of MDR1 and MRPA genes expression in different types of dry cutaneous leishmaniasis. BMC Res Notes 2019; 12:803. [PMID: 31831065 PMCID: PMC6909633 DOI: 10.1186/s13104-019-4784-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 11/04/2019] [Indexed: 11/23/2022] Open
Abstract
Objective The resistance to antimony-containing glucantime is a major obstacle to successful treatment, especially in endemic areas. Looking the molecular mechanisms involved in this drug resistance will help in choosing the best treatment. The aim of this study was to evaluate the expression of multidrug-resistance 1 (MDR1) and multidrug-resistance protein A (MRPA) genes in acute, chronic non-lupoid, and chronic lupoid forms of dry type cutaneous leishmaniasis (DTCL). Results MDR1 gene was over-expressed as 14.4- and 1.56-folds in the chronic lupoid and acute forms compared with the chronic non-lupoid form, respectively. Results comparison showed P < 0.05 between the chronic non-lupoid and acute groups, P < 0.01 between acute and chronic lupoid groups, and P < 0.001 between the chronic non-lupoid and chronic lupoid groups. MRPA gene was over-expressed as 266 and 17.7-fold in the chronic lupoid and chronic non-lupoid forms compared with the acute form, respectively. Statistical analysis showed P < 0.01 between the chronic non-lupoid and chronic lupoid groups, P < 0.05 between acute and chronic non-lupoid groups, and P < 0.001 between the acute and chronic lupoid groups.
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Fekri-SoofiAbadi M, Fekri M, Moradabadi A, Vahidi R, Shamsi-Meymandi S, Dabiri D, Dabiri S. Ability of real-time PCR for differential diagnosis of various forms of cutaneous leishmaniasis: a comparative study with histopathology. BMC Res Notes 2019; 12:615. [PMID: 31547842 PMCID: PMC6757515 DOI: 10.1186/s13104-019-4666-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 09/18/2019] [Indexed: 11/30/2022] Open
Abstract
Objective Histopathological studies suggest that parasite load is different between acute and chronic forms of cutaneous leishmaniasis (CL). However, highly sensitive detection methods are still needed to distinguish different forms of leishmaniasis. In the present study, we developed a quantitative real-time polymerase chain reaction (PCR) to detect and quantify Leishmania tropica parasites in paraffin-embedded tissue samples. Results The ability of real-time PCR for leishmania detection was higher than histopathological evaluation. The quantitative real-time PCR (qPCR) quantified parasite loads were highly correlated with microscopic results (r = 0.598; P < 0.001). Among patients, the parasite load was inversely correlated with disease duration (acute CL lesions had very higher parasite load than chronic CL lesions), but there was no difference in the parasite load according to the patients’ age and sex as well as location of the lesions. In contrast to Ridley scoring system (P < 0.001), there were no statistically significant differences in the relative number of parasites among the lupoid and non-lupoid forms of chronic lesions in real-time PCR (P = 0.549), which indicates the superiority of histopathological evaluation for chronic forms differentiation.
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Affiliation(s)
- Maryam Fekri-SoofiAbadi
- Pathology and Stem Cell Research Center, Department of Pathology, Afzalipour Medical School, Kerman University of Medical Sciences, 22 Bahman Blvd, 7616913555, Kerman, Iran
| | - Meisam Fekri
- Department of Medicine, Montefiore New Rochelle Hospital, Albert Einstein College of Medicine, New York, USA
| | - Alireza Moradabadi
- Pathology and Stem Cell Research Center, Department of Pathology, Afzalipour Medical School, Kerman University of Medical Sciences, 22 Bahman Blvd, 7616913555, Kerman, Iran
| | - Reza Vahidi
- Pathology and Stem Cell Research Center, Department of Pathology, Afzalipour Medical School, Kerman University of Medical Sciences, 22 Bahman Blvd, 7616913555, Kerman, Iran
| | - Simin Shamsi-Meymandi
- Dermatology Department, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Donya Dabiri
- Pathology and Stem Cell Research Center, Department of Pathology, Afzalipour Medical School, Kerman University of Medical Sciences, 22 Bahman Blvd, 7616913555, Kerman, Iran
| | - Shahriar Dabiri
- Pathology and Stem Cell Research Center, Department of Pathology, Afzalipour Medical School, Kerman University of Medical Sciences, 22 Bahman Blvd, 7616913555, Kerman, Iran.
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ÖZAVCI H, KAPLAN M. Cloning and molecular characterization of thiol-specific antioxidant gene of Leishmania tropica Turkey isolate. Turk J Med Sci 2019; 49:392-402. [PMID: 30761841 PMCID: PMC7350880 DOI: 10.3906/sag-1808-98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim Thiol-specific antioxidant (TSA) protein is one of the most promising molecules among candidates for vaccine against cutaneous leishmaniasis. It was found to be significantly protective against different Leishmania species. In this study, cloning and molecular characterization of thiol-specific antioxidant gene of L. tropica Turkey isolate (LtTSA) were aimed. Materials and methods LtTSA was amplified by PCR using the specific primers of TSA gene and cloned into the pcDNA3.1 vector. The cloning was confirmed by PCR screening, restriction enzyme reactions, and DNA sequence analysis. Finally, three-dimensional structure and antigenic properties of the protein encoded by the LtTSA were determined Results Six hundred base pair bands belonging to LtTSA were shown with electrophoresis. It was found that LtTSA and its encoded protein have high similarity with different Leishmania species. LtTSA protein consisting of 199 amino acids was found to have 7 different antigenic regions. Conclusion LtTSA and its encoded TSA protein were found to be highly immunogenic and similar to TSA proteins previously tested as a vaccine candidate.
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Affiliation(s)
- Hamza ÖZAVCI
- Department of Medical Parasitology, Faculty of Medicine, Fırat University, ElazığTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Mustafa KAPLAN
- Department of Medical Parasitology, Faculty of Medicine, Fırat University, ElazığTurkey
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Khoshhali M, Hosseini SM, Nilforoushzadeh MA, Jaffary F, Baghbaderani AZ. Development of a scoring system using a statistical model to predict cure status in patients with cutaneous leishmaniasis. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:1. [PMID: 28400823 PMCID: PMC5361442 DOI: 10.4103/1735-1995.199095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 05/01/2016] [Accepted: 10/26/2016] [Indexed: 12/02/2022]
Abstract
Background: The present study was performed to develop a scoring system for predicting cure status in patients with cutaneous leishmaniasis (CL). Materials and Methods: This study included 199 patients with CL from Skin Diseases and Leishmaniasis Research Center (Isfahan, Iran). Data were collected as longitudinal in each visit of patients. We applied ordinal logistic generalized estimating equation regression to predict score on this correlated data. To evaluate the fitted model, split sample validation method was applied. SPSS software was used for data analysis. Results: The regression coefficients of the fitted model were used to calculate score for cure status. Based on split-sample validation method, overall correct classification rate was 82%. Conclusion: This study suggested a scoring system predict cure status in CL patients based on clinical characteristics. Using this method, score for a CL patient is easily obtained by physicians or health workers.
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Affiliation(s)
- Mehri Khoshhali
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayed Mohsen Hosseini
- Skin Diseases and Leishmaniasis Research Center, Department of Biostatistics and Epidemiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Fariba Jaffary
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Azevedo CS, Guido BC, Pereira JL, Nolasco DO, Corrêa R, Magalhães KG, Motta FN, Santana JM, Grellier P, Bastos IMD. Revealing a Novel Otubain-Like Enzyme from Leishmania infantum with Deubiquitinating Activity toward K48-Linked Substrate. Front Chem 2017; 5:13. [PMID: 28386537 PMCID: PMC5362604 DOI: 10.3389/fchem.2017.00013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 02/28/2017] [Indexed: 11/13/2022] Open
Abstract
Deubiquitinating enzymes (DUBs) play an important role in regulating a variety of eukaryotic processes. In this context, exploring the role of deubiquitination in Leishmania infantum could be a promising alternative to search new therapeutic targets for leishmaniasis. Here we present the first characterization of a DUB from L. infantum, otubain (OtuLi), and its localization within parasite. The recombinant OtuLi (rOtuLi) showed improved activity on lysine 48 (K48)-linked over K63-linked tetra-ubiquitin (Ub) and site-directed mutations on amino acids close to the catalytic site (F82) or involved in Ub interaction (L265 and F182) caused structural changes as shown by molecular dynamics, resulting in a reduction or loss of enzyme activity, respectively. Furthermore, rOtuLi stimulates lipid droplet biogenesis (an inflammatory marker) and induces IL-6 and TNF-α secretion in peritoneal macrophages, both proinflammatory cytokines. Our findings suggest that OtuLi is a cytoplasmic enzyme with K48-linked substrate specificity that could play a part in proinflammatory response in stimulated murine macrophages.
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Affiliation(s)
- Clênia S Azevedo
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of Brasilia Brasilia, Brazil
| | - Bruna C Guido
- Laboratory of Electron Microscopy, Department of Cell Biology, University of Brasilia Brasilia, Brazil
| | - Jhonata L Pereira
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of Brasilia Brasilia, Brazil
| | - Diego O Nolasco
- Physics Course, Catholic University of BrasiliaBrasilia, Brazil; Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Catholic University of BrasiliaBrasilia, Brazil
| | - Rafael Corrêa
- Laboratory of Immunology and Inflammation, Department of Cell Biology, University of Brasilia Brasilia, Brazil
| | - Kelly G Magalhães
- Laboratory of Immunology and Inflammation, Department of Cell Biology, University of Brasilia Brasilia, Brazil
| | - Flávia N Motta
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of BrasiliaBrasilia, Brazil; Faculty of Ceilandia, University of BrasíliaBrasilia, Brazil
| | - Jaime M Santana
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of Brasilia Brasilia, Brazil
| | - Philippe Grellier
- UMR 7245 Centre Nationnal de la Recherche Scientifique, Muséum National d'Histoire Naturelle, Sorbonne Universités Paris, France
| | - Izabela M D Bastos
- Pathogen-Host Interface Laboratory, Department of Cell Biology, University of Brasilia Brasilia, Brazil
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Vasievich MP, Villarreal JDM, Tomecki KJ. Got the Travel Bug? A Review of Common Infections, Infestations, Bites, and Stings Among Returning Travelers. Am J Clin Dermatol 2016; 17:451-462. [PMID: 27344566 DOI: 10.1007/s40257-016-0203-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The popularity of international travel continues to increase among Americans, even though they often experience subsequent illness on return from their journey. The pathogens responsible are not necessarily endemic to the destination itself but are often the result of poor sanitary conditions or activities engaged in while away. Skin disease ranks third among all medical concerns in returning travelers. This review addresses the pathogenesis, epidemiology, clinical presentation, and treatment of the most common skin diseases in returning travelers: insect bites and bedbugs, cutaneous larva migrans, scabies, tungiasis, myiasis, leishmaniasis, viral exanthems, and marine envenomation. Primary care physicians and dermatologists should be familiar with these illnesses and a general approach to their evaluation and management.
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Affiliation(s)
- Matthew P Vasievich
- Department of Dermatology, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, USA.
| | - Jose Dario Martinez Villarreal
- Department of Internal Medicine, University Hospital, "José E. González," Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Kenneth J Tomecki
- Department of Dermatology, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, USA
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Lupoid leishmaniasis among the known cases of cutaneous leishmaniasis in Herat Province, western Afghanistan. J Infect Public Health 2016; 9:557-63. [DOI: 10.1016/j.jiph.2015.12.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 11/20/2015] [Accepted: 12/11/2015] [Indexed: 11/23/2022] Open
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A Comparison between the Effects of Glucantime, Topical Trichloroacetic Acid 50% plus Glucantime, and Fractional Carbon Dioxide Laser plus Glucantime on Cutaneous Leishmaniasis Lesions. Dermatol Res Pract 2016; 2016:6462804. [PMID: 27148363 PMCID: PMC4842369 DOI: 10.1155/2016/6462804] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 03/14/2016] [Accepted: 03/30/2016] [Indexed: 11/18/2022] Open
Abstract
Background. Cutaneous leishmaniasis is an endemic disease in Iran. Pentavalent antimonial drugs have been the first line of therapy in cutaneous leishmaniasis for many years. However, the cure rate of these agents is still not favorable. This study was carried out to compare the efficacies of intralesional glucantime with topical trichloroacetic acid 50% (TCA 50%) + glucantime and fractional carbon dioxide laser + glucantime in the treatment of cutaneous leishmaniasis. Methods. A total of 90 patients were randomly divided into three groups of 30 to be treated with intralesional injection of glucantime, a combination of topical TCA 50% and glucantime, or a combination of fractional laser and glucantime. The overall clinical improvement and changes in sizes of lesions and scars were assessed and compared among three groups. Results. The mean duration of treatment was 6.1 ± 2.1 weeks in all patients (range: 2–12 weeks) and 6.8 ± 1.7, 5.2 ± 1.0, and 6.3 ± 3.0 weeks in glucantime, topical TCA plus glucantime, and fractional laser plus glucantime groups, respectively (P = 0.011). Complete improvement was observed in 10 (38.5%), 27 (90%), and 20 (87%) patients of glucantime, glucantime + TCA, and glucantime + laser groups, respectively (P < 0.001). Conclusion. Compared to glucantime alone, the combination of intralesional glucantime and TCA 50% or fractional CO2 laser had significantly higher and faster cure rate in patients with cutaneous leishmaniasis.
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Firdessa R, Good L, Amstalden MC, Chindera K, Kamaruzzaman NF, Schultheis M, Röger B, Hecht N, Oelschlaeger TA, Meinel L, Lühmann T, Moll H. Pathogen- and Host-Directed Antileishmanial Effects Mediated by Polyhexanide (PHMB). PLoS Negl Trop Dis 2015; 9:e0004041. [PMID: 26431058 PMCID: PMC4592236 DOI: 10.1371/journal.pntd.0004041] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 08/06/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is a neglected tropical disease caused by protozoan parasites of the genus Leishmania. CL causes enormous suffering in many countries worldwide. There is no licensed vaccine against CL, and the chemotherapy options show limited efficacy and high toxicity. Localization of the parasites inside host cells is a barrier to most standard chemo- and immune-based interventions. Hence, novel drugs, which are safe, effective and readily accessible to third-world countries and/or drug delivery technologies for effective CL treatments are desperately needed. METHODOLOGY/PRINCIPAL FINDINGS Here we evaluated the antileishmanial properties and delivery potential of polyhexamethylene biguanide (PHMB; polyhexanide), a widely used antimicrobial and wound antiseptic, in the Leishmania model. PHMB showed an inherent antileishmanial activity at submicromolar concentrations. Our data revealed that PHMB kills Leishmania major (L. major) via a dual mechanism involving disruption of membrane integrity and selective chromosome condensation and damage. PHMB's DNA binding and host cell entry properties were further exploited to improve the delivery and immunomodulatory activities of unmethylated cytosine-phosphate-guanine oligodeoxynucleotides (CpG ODN). PHMB spontaneously bound CpG ODN, forming stable nanopolyplexes that enhanced uptake of CpG ODN, potentiated antimicrobial killing and reduced host cell toxicity of PHMB. CONCLUSIONS Given its low cost and long history of safe topical use, PHMB holds promise as a drug for CL therapy and delivery vehicle for nucleic acid immunomodulators.
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Affiliation(s)
- Rebuma Firdessa
- Institute for Molecular Infection Biology, University of Würzburg, Würzburg, Germany
| | - Liam Good
- Royal Veterinary College, University of London, London, United Kingdom
| | | | | | | | - Martina Schultheis
- Institute for Molecular Infection Biology, University of Würzburg, Würzburg, Germany
| | - Bianca Röger
- Institute for Molecular Infection Biology, University of Würzburg, Würzburg, Germany
| | - Nina Hecht
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Würzburg, Germany
| | | | - Lorenz Meinel
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Würzburg, Germany
| | - Tessa Lühmann
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Würzburg, Germany
| | - Heidrun Moll
- Institute for Molecular Infection Biology, University of Würzburg, Würzburg, Germany
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Chaurasia M, Pawar VK, Jaiswal AK, Dube A, Paliwal SK, Chourasia MK. Chondroitin nanocapsules enhanced doxorubicin induced apoptosis against leishmaniasis via Th1 immune response. Int J Biol Macromol 2015; 79:27-36. [DOI: 10.1016/j.ijbiomac.2015.04.043] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 04/06/2015] [Accepted: 04/08/2015] [Indexed: 01/30/2023]
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Leishmaniasis acquired by travellers to endemic regions in Europe: A EuroTravNet multi-centre study. Travel Med Infect Dis 2014; 12:167-72. [DOI: 10.1016/j.tmaid.2013.12.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/02/2013] [Accepted: 12/03/2013] [Indexed: 01/09/2023]
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Gupta R, Kumar V, Kushawaha PK, Tripathi CP, Joshi S, Sahasrabuddhe AA, Mitra K, Sundar S, Siddiqi MI, Dube A. Characterization of glycolytic enzymes--rAldolase and rEnolase of Leishmania donovani, identified as Th1 stimulatory proteins, for their immunogenicity and immunoprophylactic efficacies against experimental visceral leishmaniasis. PLoS One 2014; 9:e86073. [PMID: 24475071 PMCID: PMC3901665 DOI: 10.1371/journal.pone.0086073] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 12/04/2013] [Indexed: 11/18/2022] Open
Abstract
Th1 immune responses play an important role in controlling Visceral Leishmaniasis (VL) hence, Leishmania proteins stimulating T-cell responses in host, are thought to be good vaccine targets. Search of such antigens eliciting cellular responses in Peripheral blood mononuclear cells (PBMCs) from cured/exposed/Leishmania patients and hamsters led to the identification of two enzymes of glycolytic pathway in the soluble lysate of a clinical isolate of Leishmania donovani--Enolase (LdEno) and aldolase (LdAld) as potential Th1 stimulatory proteins. The present study deals with the molecular and immunological characterizations of LdEno and LdAld. The successfully cloned and purified recombinant proteins displayed strong ability to proliferate lymphocytes of cured hamsters' along with significant nitric-oxide production and generation of Th1-type cytokines (IFN-γ and IL-12) from stimulated PBMCs of cured/endemic VL patients. Assessment of their prophylactic potentials revealed ∼ 90% decrease in parasitic burden in rLdEno vaccinated hamsters against Leishmania challenge, strongly supported by an increase in mRNA expression levels of iNOS, IFN-γ, TNF-α and IL-12 transcripts along with extreme down-regulation of TGF-β, IL-4 and IL-10. However, animals vaccinated with rLdAld showed comparatively lesser prophylactic efficacy (∼ 65%) with inferior immunological response. Further, with a possible implication in vaccine design against VL, identification of potential T-cell epitopes of both the proteins was done using computational approach. Additionally, in-silico 3-D modelling of the proteins was done in order to explore the possibility of exploiting them as potential drug targets. The comparative molecular and immunological characterizations strongly suggest rLdEno as potential vaccine candidate against VL and supports the notion of its being effective T-cell stimulatory protein.
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MESH Headings
- Amino Acid Sequence
- Animals
- Antigens, Protozoan/immunology
- Cricetinae
- Cytokines/biosynthesis
- Disease Models, Animal
- Epitopes, T-Lymphocyte/chemistry
- Epitopes, T-Lymphocyte/immunology
- Fructose-Bisphosphate Aldolase/chemistry
- Fructose-Bisphosphate Aldolase/genetics
- Fructose-Bisphosphate Aldolase/metabolism
- Glycolysis
- Hypersensitivity, Delayed/immunology
- Immunoglobulin G/immunology
- Leishmania donovani/enzymology
- Leishmania donovani/genetics
- Leishmania donovani/immunology
- Leishmaniasis Vaccines/immunology
- Leishmaniasis, Visceral/immunology
- Leishmaniasis, Visceral/prevention & control
- Leukocytes, Mononuclear/immunology
- Leukocytes, Mononuclear/metabolism
- Lymphocyte Activation/immunology
- Male
- Models, Molecular
- Mycobacterium bovis/immunology
- Nitric Oxide/metabolism
- Phosphopyruvate Hydratase/chemistry
- Phosphopyruvate Hydratase/genetics
- Phosphopyruvate Hydratase/metabolism
- Protein Conformation
- Th1 Cells/immunology
- Th1 Cells/metabolism
- Vaccination
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Affiliation(s)
- Reema Gupta
- Divisions of Parasitology, CSIR-Central Drug Research Institute, Lucknow, India
| | - Vikash Kumar
- Molecular and Structural Biology, CSIR-Central Drug Research Institute, Lucknow, India
| | | | | | - Sumit Joshi
- Divisions of Parasitology, CSIR-Central Drug Research Institute, Lucknow, India
| | | | - Kalyan Mitra
- Electron Microscopy, CSIR-Central Drug Research Institute, Lucknow, India
| | - Shyam Sundar
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | | | - Anuradha Dube
- Divisions of Parasitology, CSIR-Central Drug Research Institute, Lucknow, India
- * E-mail:
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Saljoughian N, Zahedifard F, Doroud D, Doustdari F, Vasei M, Papadopoulou B, Rafati S. Cationic solid-lipid nanoparticles are as efficient as electroporation in DNA vaccination against visceral leishmaniasis in mice. Parasite Immunol 2013; 35:397-408. [DOI: 10.1111/pim.12042] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 05/23/2013] [Indexed: 02/03/2023]
Affiliation(s)
- N. Saljoughian
- Molecular Immunology and Vaccine Research Laboratory; Pasteur Institute of Iran; Tehran Iran
| | - F. Zahedifard
- Molecular Immunology and Vaccine Research Laboratory; Pasteur Institute of Iran; Tehran Iran
| | - D. Doroud
- Department of Quality Control; Research and Production Complex; Pasteur Institute of Iran; Tehran Iran
| | - F. Doustdari
- Molecular Immunology and Vaccine Research Laboratory; Pasteur Institute of Iran; Tehran Iran
| | - M. Vasei
- Department of Pathology; Shariati Hospital; Tehran University of Medical Sciences; Tehran Iran
| | - B. Papadopoulou
- Research Centre in Infectious Disease; CHU de Quebec Research Centre (CHUL); Quebec QC Canada
- Department of Microbiology; Infectious Disease and Immunology; Faculty of Medicine; Laval University; Quebec QC Canada
| | - S. Rafati
- Molecular Immunology and Vaccine Research Laboratory; Pasteur Institute of Iran; Tehran Iran
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Donovan MJ, Tripathi V, Favila MA, Geraci NS, Lange MC, Ballhorn W, McDowell MA. Indoleamine 2,3-dioxygenase (IDO) induced by Leishmania infection of human dendritic cells. Parasite Immunol 2013; 34:464-72. [PMID: 22803643 DOI: 10.1111/j.1365-3024.2012.01380.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Dendritic cells (DC) play a pivotal role in regulating immunity, establishing immunologically privileged tissue microenvironments and maintaining homoeostasis. It is becoming increasingly clear that one key mechanism that mediates many DC functions is production of the immunomodulatory enzyme indoleamine 2,3-dioxygenase (IDO). For pathogens that cause chronic infection, exploitation of host DCs is a solution to establish and persist within a host. Leishmania parasites cause a range of clinical manifestations, all involving chronic infection, and are proficient at avoiding immune responses. We demonstrate here that infection of human myeloid-derived DC with L. major and L. donovani induces IDO expression using a mechanism that involves autocrine or paracrine stimulation with a DC-secreted factor. Leishmania-induced IDO suppresses allogeneic and tetanus toxoid-specific lymphocyte proliferation, an inhibition that is reversed with the IDO inhibitor, 1-methyl tryptophan (1-MT). Furthermore, IDO expression by human DC does not require live Leishmania infection, as parasite lysates also up-regulate IDO mRNA production. Our data suggest that one mechanism Leishmania parasites utilize to circumvent immune clearance may be to promote the induction of IDO among host DC within the infection microenvironment.
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Affiliation(s)
- M J Donovan
- Department of Biological Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46656, USA
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Abu-Amero KK, Jaeger M, Plantinga T, Netea MG, Hassan HY. Genetic variation of TLR2 and TLR4 among the Saudi Arabian population: insight into the evolutionary dynamics of the Arabian Peninsula. Genet Test Mol Biomarkers 2013; 17:166-9. [PMID: 23289617 DOI: 10.1089/gtmb.2012.0281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
TLR2 and TLR4 genetic variation has been investigated among the Saudis with the aim of gaining further insight into the evolutionary history of the Arabian Peninsula. Two polymorphisms located in the TLR2 gene (Pro631His and Arg753Gln, rs5743704 and rs5743708, respectively), and two (Asp299Gly and Thr399Ile, rs4986790 and rs4986791, respectively), located in the TLR4 gene have been genotyped in 201 unrelated individuals from Saudi Arabia. While the G allele has been fixed in the Arg753Gln (g.2477 G>A) polymorphism, Pro631His (g.2111 C>A) show remarkable frequencies, a polymorphism that until now has been reported exclusively among European populations. The two TLR4 markers analyzed showed moderate frequencies (ranging from 4% to 5%). Considering the reported protective role of these polymorphisms against malaria, the data suggest that the regional variation at these gene loci could have been shaped by both evolutionary infection pressure and bidirectional human migrations in the past. The population admixture may be due to the existence of gene flow from Sub-Saharan Africa and the Levant to the Arabian Peninsula.
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Affiliation(s)
- Khaled K Abu-Amero
- Opthalmic Genetics Laboratory, Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Abstract
PURPOSE OF REVIEW To provide an updated perspective of the most common parasitic infections occurring in solid-organ transplant (SOT) recipients. RECENT FINDINGS Parasitic infections are an emerging problem in SOT programs and represent a diagnostic and therapeutic challenge. Transplantation in endemic areas - including medical tourism, international travel and migration - justify the necessity of considering parasitic infections in the differential diagnosis of posttransplant complications. Molecular techniques, such as PCR, may improve the diagnostic accuracy and help during the follow-up. SUMMARY Parasitic infections are an uncommon but potentially severe complication in SOT recipients. An increase of donors emigrated from tropical areas and more posttransplant patients traveling to endemic areas have led to a rise in parasitic infections reported among SOT recipients. Transplant physicians should get familiar with parasitic infections and promote adherence to preventive measures in SOT recipients.
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de Araújo VEM, Morais MHF, Reis IA, Rabello A, Carneiro M. Early clinical manifestations associated with death from visceral leishmaniasis. PLoS Negl Trop Dis 2012; 6:e1511. [PMID: 22347514 PMCID: PMC3274500 DOI: 10.1371/journal.pntd.0001511] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 12/21/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In Brazil, lethality from visceral leishmaniasis (VL) is high and few studies have addressed prognostic factors. This historical cohort study was designed to investigate the prognostic factors for death from VL in Belo Horizonte (Brazil). METHODOLOGY The analysis was based on data of the Reportable Disease Information System-SINAN (Brazilian Ministry of Health) relating to the clinical manifestations of the disease. During the study period (2002-2009), the SINAN changed platform from a Windows to a Net-version that differed with respect to some of the parameters collected. Multivariate logistic regression models were performed to identify variables associated with death from VL, and these were included in prognostic score. PRINCIPAL FINDINGS Model 1 (period 2002-2009; 111 deaths from VL and 777 cured patients) included the variables present in both SINAN versions, whereas Model 2 (period 2007-2009; 49 deaths from VL and 327 cured patients) included variables common to both SINAN versions plus the additional variables included in the Net version. In Model 1, the variables significantly associated with a greater risk of death from VL were weakness (OR 2.9; 95%CI 1.3-6.4), Leishmania-HIV co-infection (OR 2.4; 95%CI 1.2-4.8) and age ≥60 years (OR 2.5; 95%CI 1.5-4.3). In Model 2, the variables were bleeding (OR 3.5; 95%CI 1.2-10.3), other associated infections (OR 3.2; 95%CI 1.3-7.8), jaundice (OR 10.1; 95%CI 3.7-27.2) and age ≥60 years (OR 3.1; 95%CI 1.4-7.1). The prognosis score was developed using the variables associated with death from VL of the latest version of the SINAN (Model 2). The predictive performance of which was evaluated by sensitivity (71.4%), specificity (73.7%), positive and negative predictive values (28.9% and 94.5%) and area under the receiver operating characteristic curve (75.6%). CONCLUSIONS Knowledge regarding the factors associated with death from VL may improve clinical management of patients and contribute to lower mortality.
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Affiliation(s)
- Valdelaine Etelvina Miranda de Araújo
- Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Pós-graduação em Parasitologia, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Secretaria Municipal de Saúde, Prefeitura de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Helena Franco Morais
- Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Pós-graduação em Parasitologia, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Secretaria Municipal de Saúde, Prefeitura de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Ilka Afonso Reis
- Departamento de Estatística, Instituto de Ciências Exatas, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Rabello
- Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Pós-graduação em Parasitologia, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Pós-graduação em Ciências da Saúde, Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Purohit HM, Shah AN, Amin BK, Shevkani MR. Diffuse cutaneous leishmaniasis - A rare cutaneous presentation in an HIV-positive patient. Indian J Sex Transm Dis AIDS 2012; 33:62-4. [PMID: 22529461 PMCID: PMC3326857 DOI: 10.4103/0253-7184.93834] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Hemang M. Purohit
- Centre of Excellence, Antiretroviral Therapy Centre, Room No. 201-202, O.P.D. Building, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Asha N. Shah
- Centre of Excellence, Antiretroviral Therapy Centre, Room No. 201-202, O.P.D. Building, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Bipin K. Amin
- Centre of Excellence, Antiretroviral Therapy Centre, Room No. 201-202, O.P.D. Building, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Manoj R. Shevkani
- Centre of Excellence, Antiretroviral Therapy Centre, Room No. 201-202, O.P.D. Building, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
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Colomo Rodríguez N, Ruiz De Adana Navas MS, González Romero S, González Molero I, Reguera Iglesias JM. Leishmaniasis visceral en un paciente con diabetes tipo 1 y trasplante aislado de páncreas. ACTA ACUST UNITED AC 2011; 58:375-7. [DOI: 10.1016/j.endonu.2011.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 02/02/2011] [Accepted: 02/09/2011] [Indexed: 11/26/2022]
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Nieto A, Domínguez-Bernal G, Orden JA, De La Fuente R, Madrid-Elena N, Carrión J. Mechanisms of resistance and susceptibility to experimental visceral leishmaniosis: BALB/c mouse versus Syrian hamster model. Vet Res 2011; 42:39. [PMID: 21345200 PMCID: PMC3052183 DOI: 10.1186/1297-9716-42-39] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2010] [Accepted: 02/23/2011] [Indexed: 11/10/2022] Open
Abstract
Several animal models have been established to study visceral leishmaniosis (VL), a worldwide vector-borne disease affecting humans and domestic animals that constitutes a serious public health problem. BALB/c mice and Syrian hamsters are the most widely used experimental models. In this paper, we summarize the advantages and disadvantages of these two experimental models and discuss the results obtained using these models in different studies of VL. Studies using the BALB/c mouse model have underscored differences between the liver and spleen in the course of VL, indicating that pathological evaluation of the visceral organs is essential for understanding the immune mechanisms induced by Leishmania infantum infection. The main goal of this review is to collate the relevant literature on Leishmania pathogenesis into a sequence of events, providing a schematic view of the main components of adaptive and innate immunity in the liver and spleen after experimental infection with L. infantum or L. donovani. This review also presents several viewpoints and reflections about some controversial aspects of Leishmania research, including the choice of experimental model, route of administration, inoculum size and the relevance of pathology (intimately linked to parasite persistence): a thorough understanding of which is essential for future VL research and the successful development of efficient control strategies for Leishmania spp.
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Affiliation(s)
- Ana Nieto
- Department of Animal Health, Faculty of Veterinary, Complutense University of Madrid, 28040 Madrid, Spain.
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34
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Abstract
Parasitic infections are an uncommon but potentially severe complication in solid organ transplant (SOT) recipients. An increase in donors who have emigrated from tropical areas and more transplant recipients traveling to endemic areas have led to a rise in parasitic infections reported among SOT recipients. Clinicians should include these infections in their differential diagnosis and promote adherence to preventive measures in SOT recipients.
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Oliveira JMD, Fernandes AC, Dorval MEC, Alves TP, Fernandes TD, Oshiro ET, Oliveira ALLD. [Mortality due to visceral leishmaniasis: clinical and laboratory characteristics]. Rev Soc Bras Med Trop 2010; 43:188-93. [PMID: 20464151 DOI: 10.1590/s0037-86822010000200016] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Accepted: 01/29/2010] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Visceral leishmaniasis is a systemic infectious disease of broad geographical distribution, characterized by high potential for lethality. With the purpose of contributing towards reducing mortality and helping healthcare professionals in clinical management of patients with this disease, this paper aimed to investigate the clinical and laboratory characteristics of cases with a fatal outcome in hospitals in Campo Grande, Mato Grosso do Sul, between 2003 and 2008. METHODS Fifty-five medical files on patients who died due to visceral leishmaniasis were analyzed. RESULTS Among the 55 patients studied, 37 were from the municipality of Campo Grande; 41 (74.5%) were males; and age over 40 years predominated. The patients presented with fever in 89.1% of the cases. The duration of the illness from the onset of symptoms to hospitalization was 78.2 days on average. Leukopenia was seen in 85.5% of the patients. Comorbidities were present in 39 (70.9%) patients; malnutrition and alcoholism were the most frequent of these. Confirmation of the diagnosis occurred on average 6.7 days after admission. Pentavalent antimoniate was the drug most used, and 87.5% of the patients presented some type of adverse reaction. Bacterial infections occurred in 36 patients and were one of the causes of death in 27 (49%). CONCLUSIONS The data showed that early identification of these clinical and laboratory characteristics, at the time when patients are first attended, is extremely important for reducing mortality through instituting efficient therapeutic and prophylactic measures.
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Affiliation(s)
- Janaina Michelle de Oliveira
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS.
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Comparative study of the ability of Leishmania mexicana promastigotes and amastigotes to alter macrophage signaling and functions. Infect Immun 2010; 78:2438-45. [PMID: 20368344 DOI: 10.1128/iai.00812-09] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Leishmania alternates between two morphologically different stages, promastigotes and amastigotes. While the majority of reports focused on how the promastigote form can alter macrophage (Mphi) signaling and function, fewer reports investigated signaling alterations mediated by amastigotes, and there is a lack of comparative studies. In this study, we performed a comparison between the ability of both forms of the parasite to alter Mphi signaling and functions. Here, we show that both promastigotes and amastigotes were able to rapidly activate host protein tyrosine phosphatases (PTPs), importantly the Src homology 2 domain-containing PTP (SHP-1). However, we found that PTP-1B is specifically activated by promastigote but not amastigote infection and that lmcpb(-/-) promastigotes were no longer able to activate PTP-1B. We also show a similarity in the way promastigotes and amastigotes inactivate the transcription factors (TFs) STAT-1alpha and AP-1, but we show differences in the modulation of NF-kappaB, with promastigotes cleaving the p65 subunit, generating a smaller p35 subunit, and amastigotes fully degrading the p65 subunit with no p35 production. Importantly, we show that the cysteine proteinase LmCPb plays a key role in the alteration of NF-kappaB, STAT-1alpha, and AP-1 by promastigote and amastigote infections, ultimately leading to the inability of these TFs to translocate to the nucleus in response to gamma interferon (IFN-gamma) stimulation and thus contributing to the ability of both parasite forms to effectively block IFN-gamma-mediated nitric oxide (NO) production in Mphis.
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New World cutaneous leishmaniasis: updated review of current and future diagnosis and treatment. J Am Acad Dermatol 2010; 63:309-22. [PMID: 20303613 DOI: 10.1016/j.jaad.2009.06.088] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Revised: 06/22/2009] [Accepted: 06/25/2009] [Indexed: 11/20/2022]
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) has traditionally been underrecognized and underreported. Improved awareness is warranted as the number of cases has increased as a result of increased travel to endemic countries, the HIV/AIDS pandemic, and the larger number of military and contract workers deployed overseas. OBJECTIVE We sought to present a systematic review of evidence from a gamut of research trials on the treatment efficacy of different regimens and aggregate this knowledge for use as a guide for clinical practice decisions. METHODS We performed a comprehensive search of print and electronic sources to identify the accumulated research information on New World CL. RESULTS Topical treatment of New World CL lesions is generally not recommended. Findings support the systemic administration of pentavalent antimonials as first-line treatment. Exception to this is infection with L guyanensis in French Guiana where systemic pentamidine is suggested as first-line treatment. LIMITATIONS The reliability of the findings of this review of research evidence is dependent on the individual quality and potential bias in its component principal trials. There was a conscious attempt to only include evidence derived from randomized controlled studies, with adequate randomization, adequate patient numbers, and complete follow-up information. However, because of the relatively small number of such studies on New World CL, evidence from nonrandomized studies and case series studies was also considered. CONCLUSIONS The pentavalent antimony compounds remain the first-line treatment choice for the treatment of New World CL. Concerns with cost, availability, poor compliance, and systemic toxicity, however, may compel clinicians to opt for alternative treatment modalities. Some advances in the development of an antileishmanial vaccine have been made but none is yet available for clinic use. The increase, over recent years, in the incidence of CL warrants an enhanced effort to increase awareness of the disease, assure timely diagnosis, and implement effective management and treatment strategies.
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Molecular epidemiology for vector research on leishmaniasis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2010; 7:814-26. [PMID: 20617005 PMCID: PMC2872317 DOI: 10.3390/ijerph7030814] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Revised: 02/03/2010] [Accepted: 02/16/2010] [Indexed: 11/16/2022]
Abstract
Leishmaniasis is a protozoan disease caused by the genus Leishmania transmitted by female phlebotomine sand flies. Surveillance of the prevalence of Leishmania and responsive vector species in endemic and surrounding areas is important for predicting the risk and expansion of the disease. Molecular biological methods are now widely applied to epidemiological studies of infectious diseases including leishmaniasis. These techniques are used to detect natural infections of sand fly vectors with Leishmania protozoa and are becoming powerful tools due to their sensitivity and specificity. Recently, genetic analyses have been performed on sand fly species and genotyping using PCR-RFLP has been applied to the sand fly taxonomy. In addition, a molecular mass screening method has been established that enables both sand fly species and natural leishmanial infections to be identified simultaneously in hundreds of sand flies with limited effort. This paper reviews recent advances in the study of sand flies, vectors of leishmaniasis, using molecular biological approaches.
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Pereira CG, Silva ALN, de Castilhos P, Mastrantonio EC, Souza RA, Romão RP, Rezende RJ, Pena JDO, Beletti ME, Souza MA. Different isolates from Leishmania braziliensis complex induce distinct histopathological features in a murine model of infection. Vet Parasitol 2009; 165:231-40. [PMID: 19656631 DOI: 10.1016/j.vetpar.2009.07.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2008] [Revised: 07/03/2009] [Accepted: 07/13/2009] [Indexed: 12/01/2022]
Abstract
The aim of this study was to evaluate the histopathological features in tissues of mice infected by human isolates (I, II, and III) or the reference M2903 strain of Leishmania braziliensis complex. BALB/c and C57Bl/6 mice were infected in the hind footpad with 10(6) stationary-phase promastigotes of L. braziliensis complex. The evolution of lesions was observed for 10 weeks and the animals were then euthanized and liver, spleen and popliteal lymph nodes were collected. Tissues were stained with hematoxylin and eosin and analyzed by immunohistochemistry assay. Increased thickness of infected footpads was observed in all animals, lesions were nodular and non-ulcerated. Mice infected with isolate I presented inflammatory infiltrates consisting predominantly of mononuclear cells in all tissues examined, and also a great number of megakaryocytes, compared with other isolates. Infection with isolate II led to an infected footpad enlargement not seen in other isolates. In addition, mononuclear infiltrates in the liver and hemosiderin in spleen were noted. Conversely, mice infected with either isolate III or M2903 strain only showed an increased number of megakaryocytes in spleen. All tissues examined had detectable amastigote forms of Leishmania by immunohistochemistry in all groups. Taking together, our results showed an unforeseen behavior of different isolates of L. braziliensis complex that led to diverse pathological findings.
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Affiliation(s)
- Cristiano G Pereira
- Laboratório de Biologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Brazil
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Roselino AM, Chociay MF, Costa RS, Machado AA, Figueiredo JFDC. L. (L.) chagasi in AIDS and visceral leishmaniasis (kala-azar) co-infection. Rev Inst Med Trop Sao Paulo 2009; 50:251-4. [PMID: 18813767 DOI: 10.1590/s0036-46652008000400012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Accepted: 06/25/2008] [Indexed: 11/22/2022] Open
Abstract
Concomitant skin lesions in visceral leishmaniasis (VL) or kala-azar are rare, being more common the description of post-kala-azar dermal leishmaniasis occurring post treatment of kala-azar. Skin lesions caused by Leishmania donovani are frequently seen in the aids-VL co-infection. In Brazil cutaneous or mucosal forms of tegumentary leishmaniasis concomitant with aids are more commonly registered. Here we present a case of aids-VL co-infection, with unusual cutaneous and digestive compromising attributed to L. (L.) chagasi, with special attention to ecthymatous aspect of the lesion, allied to the absence of parasite on the histological skin biopsy.
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Affiliation(s)
- Ana Maria Roselino
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto/University of São Paulo, Ribeirão Preto, SP, Brasil.
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Carrión J, Folgueira C, Alonso C. Immunization strategies against visceral leishmaniosis with the nucleosomal histones of Leishmania infantum encoded in DNA vaccine or pulsed in dendritic cells. Vaccine 2008; 26:2537-44. [DOI: 10.1016/j.vaccine.2008.03.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2007] [Revised: 02/28/2008] [Accepted: 03/03/2008] [Indexed: 10/22/2022]
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Pandey K, Pant S, Kanbara H, Shuaibu MN, Mallik AK, Pandey BD, Kaneko O, Yanagi T. Molecular detection of Leishmania parasites from whole bodies of sandflies collected in Nepal. Parasitol Res 2008; 103:293-7. [PMID: 18415124 DOI: 10.1007/s00436-008-0967-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2008] [Accepted: 03/14/2008] [Indexed: 11/29/2022]
Abstract
Visceral leishmaniasis is endemic in the southern part of the Terai region of Nepal. Natural infections of Phlebotomus species with Leishmania parasites in these endemic areas were analyzed by a polymerase chain reaction (PCR) amplification-based assay. A total of 401 Phlebotomus argentipes and 202 P. papatasi female sandflies were captured in the Dhanusa district from 2004 to 2006 and analyzed. It was found that 6.7% of P. argentipes, but no P. papatasi, were positive for Leishmania parasites, suggesting that P. argentipes is a major vector in these areas. The infectivity of P. argentipes with Leishmania was consistent with the infection rates reported from other areas of the world. This is the first report of naturally infected Leishmania parasites in sandflies collected from Nepal.
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Affiliation(s)
- Kishor Pandey
- Department of Protozoology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
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Elston DM. The dermatopathology of new and emerging infectious diseases. ACTA ACUST UNITED AC 2007; 23:165-76. [PMID: 18159901 DOI: 10.1016/j.yadr.2007.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Dirk M Elston
- Department of Dermatology, Geisinger Medical Center, 100 North Academy Avenue, Danville, PA 17821, USA.
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Saha S, Mondal S, Ravindran R, Bhowmick S, Modak D, Mallick S, Rahman M, Kar S, Goswami R, Guha SK, Pramanik N, Saha B, Ali N. IL-10- and TGF-beta-mediated susceptibility in kala-azar and post-kala-azar dermal leishmaniasis: the significance of amphotericin B in the control of Leishmania donovani infection in India. THE JOURNAL OF IMMUNOLOGY 2007; 179:5592-603. [PMID: 17911647 DOI: 10.4049/jimmunol.179.8.5592] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Visceral leishmaniasis (VL) or kala-azar is known to be associated with a mixed Th1-Th2 response, and effective host defense requires the induction of IFN-gamma and IL-12. We address the role of the differential decline of IL-10 and TGF-beta in response to sodium antimony gluconate (SAG) and amphotericin B (AmB), the therapeutic success of SAG and AmB in Indian VL, and the significance of IL-10 and TGF-beta in the development and progression of post-kazla-azar dermal leishmaniasis (PKDL). In the active disease, PBMC from VL patients showed suppressed Ag-specific lymphoproliferation, IFN-gamma and IL-12 production, and elevation of IL-10 and TGF-beta. Cure corresponded with an elevation in IFN-gamma and IL-12 production and down-regulation of IL-10 and TGF-beta. Both CD4(+) and CD8(+) T cells were involved in IFN-gamma and IL-10 production. Interestingly, the retention and maintenance of residual IL-10 and TGF-beta in some SAG-treated individuals and the elevation of IL-10 and TGF-beta in PKDL, a sequel to kala-azar, probably reflects the role of these cytokines in reactivation of the disease in the form of PKDL. Contrastingly, AmB treatment of VL resulted in negligible TGF-beta levels and absolute elimination of IL-10, reflecting the better therapeutic activity of AmB and its probable role in the recent decline in PKDL occurrences in India. Moreover, elucidation of immune responses in Indian PKDL patients revealed a spectral pattern of disease progression where disease severity could be correlated inversely with lymphoproliferation and directly with TGF-beta, IL-10, and Ab production. In addition, the enhancement of CD4(+)CD25(+) T cells in active VL, their decline at cure, and reactivation in PKDL suggest their probable immunosuppressive role in these disease forms.
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Affiliation(s)
- Samiran Saha
- Infectious Disease and Immunology Division, Indian Institute of Chemical Biology, Kolkata, India
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Donovan MJ, Jayakumar A, McDowell MA. Inhibition of groups 1 and 2 CD1 molecules on human dendritic cells by Leishmania species. Parasite Immunol 2007; 29:515-24. [PMID: 17883454 DOI: 10.1111/j.1365-3024.2007.00970.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Dendritic cells are potent immune-activating cells, which traditionally are thought of as presenters of protein antigen to lymphocytes to initiate an immune response. Recently, another mechanism of immune surveillance, the detection of lipid antigens, has been found to be mediated by the nonpolymorphic family of CD1 molecules. There are two different CD1 families, Group 1 consisting of CD1a, CD1b and CD1c, and Group 2 consisting only of CD1d. Leishmania donovani-infected dendritic cells have previously been demonstrated to exhibit decreased surface levels of Group 1 CD1 molecules and are no longer able to initiate a CD1b-restricted T cell response. In contrast to L. donovani, which disseminates to the visceral organs, L. major remains localized, forming a cutaneous lesion. We investigate here whether L. major, the aetiological agent of cutaneous leishmaniasis, also inhibits CD1 expression. We demonstrate that infection of human monocyte-derived dendritic cells with either L. major or L. donovani results in transcriptional down-regulation of both Groups 1 and 2 CD1 molecules. Furthermore, infection of monocytes during differentiation results in a cell phenotype similar to undifferentiated monocytes. Finally, we demonstrate that this down-regulation is not mediated by lipophosphoglycan or other phosphoglycans.
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Affiliation(s)
- M J Donovan
- Center for Global Health and Infectious Diseases, Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46656, USA
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Abstract
A 56-year-old man presented with a cutaneous lesion on his right hand (Figure 1). Approximately 6 weeks previously, he had traveled to Costa Rica for missionary work. During his travel he used a diethyltoluamide-containing insect repellant, but spent one night in the jungle without a mosquito net. Four weeks after his return, he noted a 3 x 2.5-cm ulcer with raised edges and surrounding erythema on the dorsum of his right hand. The patient recalled applying insect repellant with his right hand to other exposed areas of his body but was remiss in applying it to the right hand itself. On examination, the patient was noted to have an ulcerated nodule near his right earlobe (Figure 2) and a second 2 x 1-cm ulcer on the volar aspect of his right wrist (Figure 3). There were no mucocutaneous lesions noted. During the next several weeks, numerous nodules developed in a sporotrichoid pattern on the extensor surface of his right arm (Figure 4). Skin biopsy was performed at the time of initial evaluation and revealed cutaneous leishmaniasis due to Leishmania panamensis. After discussing the different treatment options, miltefosine was administered orally for 28 days. The patient experienced an excellent response to therapy.
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Affiliation(s)
- Sameer B Ismailjee
- Department of Medicine, Boonshoft School of Medicine, Wright State University, and the Department of Veterans Affairs Medical Center, Dayton, OH 45428, USA
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48
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Abstract
With diminished and dysregulated cell-mediated immunity, HIV-infected individuals are susceptible to a myriad of skin infections. These infections include the conditions encountered in immunocompetent patients, as well as infections seen almost exclusively in the setting of HIV infection. The HIV/AIDS pandemic has made some previously rare infections more prominent. Although antiretroviral therapy has been helpful in relieving the burden of cutaneous infections in HIV-infected patients, it does not prevent all opportunistic infections in the skin and also has created new dilemmas.
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Affiliation(s)
- Molly T Hogan
- Division of Emergency Services, Harborview Medical Center, University of Washington School of Medicine, Box 359702, 325 9th Avenue, Seattle, WA 98104, USA.
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49
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Abstract
New and emerging diseases present a constant challenge. Globalization of business, international adoption, immigration, and tourism have contributed to the rapid spread of diseases, such as severe acute respiratory syndrome (SARS). Infectious diseases that emerge in Africa or Asia may arrive on US shores within days. This article reviews the new and emerging pathogens important to dermatologists.
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Affiliation(s)
- Dirk M Elston
- Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania 17821, USA.
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Sivakumar R, Sharma P, Chang KP, Singh S. Cloning, expression, and purification of a novel recombinant antigen from Leishmania donovani. Protein Expr Purif 2006; 46:156-65. [PMID: 16172002 DOI: 10.1016/j.pep.2005.07.027] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2005] [Revised: 07/27/2005] [Accepted: 07/28/2005] [Indexed: 02/07/2023]
Abstract
Visceral leishmaniasis (VL) is a major health problem in the tropical and subtropical regions of the world. The conventional methods for diagnosis of Old World Visceral leishmaniasis are difficult, insensitive, and hazardous. There is no recombinant antigen from old world Leishmania species which can be commercially used for rapid diagnosis. There is an urgent need for a less invasive and accurate method. Here, we report a recombinant antigen from Indian Leishmania donovani for its diagnosis. The kinesin gene of a L. donovani clinical isolate (KE16) from India was PCR amplified for cloning and the immunodominant domain was expressed in Escherichia coli. This recombinant protein or Ld-rKE16 was evaluated for serodiagnosis of Indian kala-azar by ELISA. The recombinant antigen was found to be 100% sensitive and specific for Old World VL cases from India, Pakistan, China, and Turkey. The antigen showed no cross-reactivity with sera from other endemic diseases or healthy controls. The expressed Ld-rKE16 antigen is highly specific and sensitive for diagnosing visceral and post-kala-azar dermal leishmaniasis and is ready for commercialization.
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Affiliation(s)
- Ramu Sivakumar
- Division of Clinical Microbiology, Department of Laboratory Medicine, All India Institute of Medical Sciences, P.O. Box 4938, Ansari Nagar, New Delhi 110 029, India
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