What makes mucosal and anergic diffuse cutaneous leishmaniases so clinically and immunopathogically different? A review in Brazil

2019 ◽  
Vol 113 (9) ◽  
pp. 505-516 ◽  
Author(s):  
Fernando T Silveira
Keyword(s):  
Latin America ◽  
Cutaneous Leishmaniasis ◽  
Macrophage Activation ◽  
Surface Antigens ◽  
Leishmania Species ◽  
Cutaneous Lesions ◽  
American Cutaneous Leishmaniasis ◽  
Mucosal Tissues ◽  
Species Specific ◽  
Almost All

Abstract American cutaneous leishmaniasis (ACL) is a parasitic protozoan disease caused by different Leishmania species widely distributed throughout Latin America. Fifteen Leishmania species belonging to the subgenera Viannia, Leishmania and Mundinia are known to cause ACL. Seven of these species are found in Brazil, of which Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis have the highest potential to cause mucosal (ML) and anergic diffuse cutaneous leishmaniasis (DCL), respectively, the most severe forms of ACL. The clinical and immunopathological differences between these two clinical forms are reviewed here, taking into account their different physiopathogenic mechanisms of dissemination from cutaneous lesions to mucosal tissues in the case of ML and to almost all body surfaces in the case of anergic DCL. We also discuss some immunopathogenic mechanisms of species-specific Leishmania antigens (from the subgenera Viannia and Leishmania) that are most likely associated with the clinical and immunopathological differences between ML and anergic DCL. Those discussions emphasize the pivotal importance of some surface antigens of L. (V.) braziliensis and L. (L.) amazonensis, such as lipophosphoglycan, phosphatidylserine and CD200 (an immunoregulatory molecule that inhibits macrophage activation), that have been shown to exert strong influences on the clinical and immunopathological differences between ML and anergic DCL.

IMMUNOTHERAPY AS A TREATMENT OF AMERICAN CUTANEOUS LEISHMANIASIS: PRELIMINARY STUDIES IN BRAZIL

PEDIATRICS ◽  
1995 ◽  
Vol 95 (6) ◽  
pp. 891-891
Author(s):  
W. Mayrink ◽  
P. A. Magalhaes ◽  
M. S.M. Michalick
Keyword(s):  
Adverse Effects ◽  
Cutaneous Leishmaniasis ◽  
Rural Areas ◽  
Day Treatment ◽  
Controlled Trial ◽  
The Other ◽  
Self Administration ◽  
Cutaneous Lesions ◽  
American Cutaneous Leishmaniasis ◽  
Close Supervision

Treatment of American cutaneous leishmaniasis has been successful with antimony compounds for 80 years. There are certain conditions where the chemotherapy cannot be used—pregnant women and patients with heart or renal disease. A group in Brazil carried out a sequential trial (not a random controlled trial) of vaccine composed of killed parasites from five stocks of the leishmania, while another group received the traditional therapy of antimony. The immunotherapy program was intensive requiring 10 daily injections followed by a 10-day free period. Of 62 patients (aged 3 to 70 years) so treated, 47 (76%) were considered clinically cured; 41 required 2-10 of the 10-day treatment courses; and the other 6 required 11-19 courses. There were no adverse effects. Results were better in patients with single cutaneous and multiple cutaneous lesions, and less effective in those patients with mucocutaneous lesions. The authors make the point that because leishmaniasis occurs especially in rural areas, it would be possible to give patients a supply of syringes and vials and have self-administration at home, whereas, with the antimony treatment, close supervision of patients is necessary.

scholarly journals Identification of Leishmania species by high-resolution DNA dissociation in cases of American cutaneous leishmaniasis

2020 ◽  
Vol 95 (4) ◽  
pp. 459-468
Author(s):  
John Verrinder Veasey ◽  
Ricardo Andrade Zampieri ◽  
Rute Facchini Lellis ◽  
Thaís Helena Proença de Freitas ◽  
Lucile Maria Floeter Winter
Keyword(s):  
High Resolution ◽  
Cutaneous Leishmaniasis ◽  
Leishmania Species ◽  
American Cutaneous Leishmaniasis

scholarly journals Anti-Leishmanial Effect of Oral Zinc Sulfate in Acute Cutaneous Leishmaniasis: A Mini-review

2021 ◽  
pp. 26-31
Author(s):  
Tagwa A. M. Salih ◽  
Bashir A. Yousef
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Zinc Sulfate ◽  
Geographical Area ◽  
Parasitic Infection ◽  
Leishmania Species ◽  
Skin Lesions ◽  
Inhibitory Effect ◽  
Cutaneous Lesions ◽  
Significant Addition ◽  
And Function

Cutaneous Leishmaniasis (CL) is an endemic parasitic infection caused by various Leishmania species, with a specific predisposition of each species into a particular geographical area. Cutaneous lesions can either be a single, limited skin lesion or multiple, large, locally destructions skin lesions.  Several therapies are proposed for CL, but severe side effects, high costs, and incomplete efficacy make researchers find replaceable therapies. Since the usage of zinc sulfate as a therapeutic agent has a long history in treating of various dermatological diseases, Zinc plays an essential role in the development and function of innate immunity cells (neutrophils and natural killer cells), which play significant roles in killing parasites. It also has a significant inhibitory effect on key enzymes involved in the carbohydrate metabolism and virulence of L. major and L.tropica. Therefore, its use as an oral therapy for CL might represent a significant addition to the armamentarium of anti-leishmanial medications.  This review summarizes and discusses previous and recent findings regarding the therapeutic roles of oral zinc sulfate in cutaneous leishmaniasis therapy. 

scholarly journals Cutaneous Leishmaniasis and/or Dermal Leishmanoid in Himachal Pradesh (India)

2020 ◽  
Author(s):  
Suman Lata ◽  
Sandhya kumari ◽  
Ram Das ◽  
Shweta Pasi ◽  
Ramesh C Dhiman
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Culture Media ◽  
Leishmania Species ◽  
Himachal Pradesh ◽  
Leishmania Parasite ◽  
Significant Finding ◽  
Dipstick Test ◽  
Medical College ◽  
Gandhi Medical College ◽  
Species Specific

Abstract Background: Visceral Leishmaniasis (VL) is in elimination phase in India while cases of Cutaneous Leishmaniasis (CL) are spreading to new foci in different parts of the country. In Himachal Pradesh, a foci of CL have been reported along Satluj River, but the causative agent poses a dilemma. To ascertain the Leishmania species from CL cases from Shimla, Kullu and Kinnaur districts of Himachal Pradesh, the present study was undertaken. Methods: A total of 28 CL patients registered in Department of Dermatology, Indira Gandhi Medical College (IGMC) and Hospital Shimla in 2018, were tested by rk39. Barring 16 cases undergoing treatment, 12 fresh cases were subjected to microscopic detection of Leishmania parasite, PCR and sequencing. Skin biopsies of 3-4 mm diameter were taken in culture medium and in formalin under anesthetic and sterile conditions from the border of the lesions. Imprints were prepared for the detection of Leishmania amastigotes. Biopsy samples were inoculated into different culture media (M199, RPMI 1640, and NNN) and were incubated at 22-24°C. Cultures were examined microscopically for the growth of promastigotes up to four weeks. Polymerase chain reaction (PCR) was performed to characterize leishmania parasite species.Results: Of 28 patients, one patient was found positive for by rK39 dipstick test. One imprint was found positive for leishmania amastigotes. Twelve biopsy DNA samples were subjected to PCR for Leishmania kDNA, of which all the 12 were found positive ITS1 Leishmania specific set of primers while eight were found positive with JW11/12 lesihmania species specific set of primers. Identification of Leishmania species was confirmed by PCR-RFLP and sequencing method. Of 12 Leishmania positive samples, six were identified as L. donovani, three L. tropica, two L. major and one remained unidentified.Conclusion: The detection of L. donovani from cutaneous leishmniasis patients is a significant finding leading towards existence of atypical leishmaniasis in Himachal Pradesh.

scholarly journals Occupationally Acquired American Cutaneous Leishmaniasis

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Maria Edileuza Felinto de Brito ◽  
Maria Sandra Andrade ◽  
Éricka Lima de Almeida ◽  
Ângela Cristina Rapela Medeiros ◽  
Roberto Pereira Werkhäuser ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Field Work ◽  
Field Studies ◽  
Laboratory Diagnosis ◽  
Immunofluorescence Assay ◽  
Enzyme Electrophoresis ◽  
Daily Routines ◽  
American Cutaneous Leishmaniasis ◽  
Potential Risks ◽  
Species Specific

We report two occupationally acquired cases of American cutaneous leishmaniasis (ACL): one accidental laboratory autoinoculation by contaminated needlestick while handling an ACL lesion sample, and one acquired during field studies on bird biology. Polymerase chain reaction (PCR) assays of patient lesions were positive forLeishmania, subgenusViannia. One isolate was obtained by culture (from patient 2 biopsy samples) and characterized asLeishmania(Viannia)naiffithrough an indirect immunofluorescence assay (IFA) with species-specific monoclonal antibodies (mAbs) and by multilocus enzyme electrophoresis (MLEE). Patients were successfully treated with N-methyl-glucamine. These two cases highlight the potential risks of laboratory and field work and the need to comply with strict biosafety procedures in daily routines. The swab collection method, coupled with PCR detection, has greatly improved ACL laboratory diagnosis.

scholarly journals Inoculation of the Leishmania infantum HSP70-II Null Mutant Induces Long-Term Protection against L. amazonensis Infection in BALB/c Mice

2021 ◽  
Vol 9 (2) ◽  
pp. 363
Author(s):  
Manuel Soto ◽  
Laura Ramírez ◽  
José Carlos Solana ◽  
Emma C. L. Cook ◽  
Elena Hernández-García ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Leishmania Species ◽  
Systemic Response ◽  
Cutaneous Lesions ◽  
Live Attenuated Vaccine ◽  
Disease Evolution ◽  
Circulating Antibodies ◽  
Ifn Γ ◽  
Etiological Agents

Leishmania amazonensis parasites are etiological agents of cutaneous leishmaniasis in the New World. BALB/c mice are highly susceptible to L. amazonensis challenge due to their inability to mount parasite-dependent IFN-γ-mediated responses. Here, we analyzed the capacity of a single administration of the LiΔHSP70-II genetically-modified attenuated L. infantum line in preventing cutaneous leishmaniasis in mice challenged with L. amazonensis virulent parasites. In previous studies, this live attenuated vaccine has demonstrated to induce long-protection against murine leishmaniasis due to Old World Leishmania species. Vaccinated mice showed a reduction in the disease evolution due to L. amazonensis challenge, namely reduction in cutaneous lesions and parasite burdens. In contrast to control animals, after the challenge, protected mice showed anti-Leishmania IgG2a circulating antibodies accompanied to the induction of Leishmania-driven specific IFN-γ systemic response. An analysis performed in the lymph node draining the site of infection revealed an increase of the parasite-specific IFN-ϒ production by CD4+ and CD8+ T cells and a decrease in the secretion of IL-10 against leishmanial antigens. Since the immunity caused by the inoculation of this live vaccine generates protection against different forms of murine leishmaniasis, we postulate LiΔHSP70-II as a candidate for the development of human vaccines.

scholarly journals Comparative analysis of the geographic distribution of the histopathological spectrum and Leishmania species of American cutaneous leishmaniasis in Brazil

2012 ◽  
Vol 87 (3) ◽  
pp. 369-374 ◽  
Author(s):  
Linton Wallis Figueiredo Souza ◽  
Simone Vilas Trancoso Souza ◽  
Ana Cristina Carvalho Botelho
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Leishmania Species ◽  
Minas Gerais ◽  
Biological Behavior ◽  
Geographical Differences ◽  
Cross Sectional ◽  
Mato Grosso ◽  
American Cutaneous Leishmaniasis ◽  
Northern Areas ◽  
The Relationship

BACKGROUND: Knowledge of the relationship between specific geographical differences and histopathology of the American cutaneous leishmaniasis is limited because host-parasite interactions in space and time are complex. OBJECTIVE: To describe the geographic analysis of the histopathological pattern of localized American cutaneous leishmaniasis and the relationship with Leishmania species. METHODS: A cross-sectional, descriptive and analytical study of a sample consisting of 55 patients of municipal districts of Montes Claros and 32 of Caratinga, Minas Gerais, by comparing with other endemic regions in Brazil, assessing historical and microregional data and developing confidence intervals. RESULTS: A preponderance of cellular exudative reactions in the cutaneous form of American cutaneous leishmaniasis was found in the municipal districts of Caratinga, east of Minas Gerais, Montes Claros, north of Minas Gerais and Uberlândia, Triangulo Mineiro, and also in the states of Mato Grosso and Ceara. Necrotic and exudative granulomatous reactions were found to be more frequent in the northern areas, mainly in the states of Amazonas and Para. Necrotic and exudative reactions were the most frequent form of presentation found throughout Brazil when the predominance of L. braziliensis was below 90% in relation to other species. CONCLUSION: There is a geographic variation of the immune inflammatory response in American cutaneous leishmaniasis. Geographical correlations between the predominant species of Leishmania and the most frequent forms of histopathological presentation of American cutaneous leishmaniasis, which until the present study had not been performed, enables new approaches to the study of Leishmania subpopulations in areas with a predominance of one species and provides evidence of variations in the biological behavior of different species.

scholarly journals Molecular Detection of Leishmania spp. in Skin and Blood of Stray Dogs from Endemic Areas of Cutaneous Leishmaniasis in Saudi Arabia

2019 ◽  
Author(s):  
Abdullah D. ALANAZI ◽  
Robert PUSCHENDORF ◽  
Mohamed S. ALYOUSIF ◽  
Mohamed S. Al-KHALIFA ◽  
Samir A. ALHARBI ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Cutaneous Leishmaniasis ◽  
Leishmania Species ◽  
Molecular Study ◽  
Skin Lesions ◽  
Canine Leishmaniasis ◽  
Cutaneous Lesions ◽  
Cross Sectional ◽  
Blood Samples ◽  
Stray Dogs

Background: Dogs can act as reservoirs of canine leishmaniasis, caused by Leishmania species. The aims of this study were to determine the prevalence of canine leishmaniasis using a PCR technique among stray dogs living in three provinces of Saudi Arabia, Riyadh, Al-Ahsa Oasis and Al-Qaseem, where the disease is endemic; and to identify and document different Leishmania to species levels Methods: This cross-sectional investigation was conducted, from Mar 2016 to Apr 2018, in three parts of Saudi Arabia: Central province (Riyadh), Eastern province (Al-Ahsa Oasis) and Al-Qaseem province. Blood samples were collected from 526 dogs; 40 presented cutaneous nodules so were suspected clinically of cutaneous leishmaniasis. Biopsy tissue collections and parasite cultures were performed. A generic kDNA was performed using different primers for Leishmania differentiation. Results: All blood samples were negative for Leishmania infantum infection by molecular analysis, though forty dogs had thick cutaneous lesions in different parts of their body. Four dogs’ skin lesions were associated with dermatitis, splenomegaly and lymphadenomegaly. Parasite culture was used to diagnose cutaneous leishmaniasis, identifying 31/40 (77.5%) positive samples. Overall, of 526 samples, the prevalence of L. major and L. tropica was found to be 4% and 1.9%, respectively. Gender and age had a significant effect on Leishmania prevalence: (P=0.0212 and 0.0357), respectively. Conclusion: This was the first molecular study of dog leishmaniasis from Saudi Arabia of dogs confirmed to have cutaneous leishmaniasis. Further epidemiological and molecular investigations of domestic and wild canine infections with L. major, L. tropica and L. infantum in endemic and nonendemic areas of Saudi Arabia are required, for leishmaniasis control.

The Role of CD1a expression in the diagnosis of cutaneous leishmaniasis, its relationship with Leishmania species and clinicopathological features

2021 ◽  
Author(s):  
Yasemin Yuyucu Karabulut ◽  
Funda KuŞ Bozkurt ◽  
Ümit Türsen ◽  
Gül Bayram ◽  
Gülhan Örekeci Temel ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Leishmania Species ◽  
Clinicopathological Features
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