Combining diagnostic procedures for the management of leishmaniasis in areas with high prevalence of Leishmania guyanensis

Benício, Ednelza; Gadelha, Ellen Pricilla Nunes; Talhari, Anette Chrusciak; Silva, Roberto Moreira da; Ferreira, L.A.F.M.; Santos, M C; Mira, Marcelo Távora; Oliveira, Cíntia Mara Costa de; Talhari, Carolina; Talhari, Sinésio; Machado, Paulo Roberto Lima; Schriefer, Albert

doi:10.1590/s0365-05962011000600012

Cited by 16 publications

(8 citation statements)

References 12 publications

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“…More recently, trials with miltefosine performed at FMT-HVD demonstrated that this compound had an effi cacy of 71.4% in the treatment of L. (V.) guyanensis (27) . The implementation of new diagnostic tests, such as polymerase chain reaction (PCR), for ATL diagnosis at FMT-HVD has created the opportunity for this reference unit to enhance their role in the species-specifi c detection of the parasite and to improve the current knowledge about the disease behavior in the region (28) .…”

Section: Clinical Characteristics Diagnosis and Treatmentmentioning

confidence: 99%

Tegumentary leishmaniasis in the State of Amazonas: what have we learned and what do we need?

Guerra

Maciel

Guerra

et al. 2015

Rev. Soc. Bras. Med. Trop.

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Section: Clinical Characteristics Diagnosis and Treatmentmentioning

confidence: 99%

Tegumentary leishmaniasis in the State of Amazonas: what have we learned and what do we need?

Guerra

Maciel

Guerra

et al. 2015

Rev. Soc. Bras. Med. Trop.

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“…In the Amazonas, L . guyanensis is the main etiological agent of ATL [ 3 ]. Classical forms of ATL (cutaneous, disseminated, diffuse and mucosal leishmaniasis) are caused by L .…”

Section: Introductionmentioning

confidence: 99%

Polymorphisms in the TOLLIP Gene Influence Susceptibility to Cutaneous Leishmaniasis Caused by Leishmania guyanensis in the Amazonas State of Brazil

et al. 2015

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IntroductionThe clinical outcome to Leishmania-infection is determined by the individual adaptive immune T helper cell responses and their interactions with parasitized host cells. An early development of a proinflammatory immune response (Th1 response) is necessary for Leishmania-infection resolution. The Toll-interacting protein (TOLLIP) regulates human Toll-like receptors signaling pathways by down regulating the proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) and inducing the ant-inflammatory cytokine interleukin-10 (IL-10). Polymorphisms in the TOLLIP gene are associated with infectious diseases.Material and MethodsThe polymorphisms rs5743899 and rs3750920 in the TOLLIP gene were genotyped by polymerase chain reaction and restriction fragment length polymorphism (RFLP) analysis in 631 patients with cutaneous leishmaniasis (CL) caused by L. guyanensis and 530 individuals with no history of leishmaniasis.ResultsThe G and T alleles of the rs5743899 and rs3750920 were more common in patients with CL than in healthy individuals (P = 2.6 x10-8 ; odds ratio [OR], 1.7 [ 95% confidence interval (CI) 1.4–2.0] and P = 1.9 x10-8 ; OR, 1.6 [95% CI 1.4–1.9] respectively). The r2 and D’ linkage disequilibrium between the two polymorphisms are 0.05 and 0.473 with a confidence bounds of 0.37 to 0.57 respectively.ConclusionThe two polymorphisms are independently associated with an increased risk of developing CL.

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“…guyanensis . [ 2 ]. Another limitation is the non-blind evaluation by the medical staff, which may cause a bias in the recording of data.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of vectors and infection in peri-urban zones, that were not previously endemic areas, are emerging. [ 1 , 2 ]…”

Section: Introductionmentioning

confidence: 99%

An open label randomized clinical trial comparing the safety and effectiveness of one, two or three weekly pentamidine isethionate doses (seven milligrams per kilogram) in the treatment of cutaneous leishmaniasis in the Amazon Region

et al. 2018

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BackgroundAmerican Cutaneous Leishmaniasis (ACL), a vector borne disease, is caused by various species of Leishmania and in the Amazonas, Leishmania guyanensis is predominant. The recommended drugs for treatment of cutaneous leishmaniasis (CL) in Brazil are pentavalent antimonials, pentamidine isethionate (PI) and amphotericin B. Pentamidine was initially used as metanolsulfonate or mesylate (Lomidine) at a dose of 4 mg/kg/daily, containing 2.3mg of base. This drug was withdrawn from the market in the eighties, and currently is available as PI. The PI dose required to achieve an equivalent dose of pentamidine base is 7 mg/kg, rather than the 4 mg/kg that is currently recommended in Brazil.ObjectivesThe aim of this study was to evaluate the efficacy and safety of PI in a single dose, two or three doses of 7 mg/kg body weight, intramuscularly, with an interval of seven days between each dose.Materials and methodsThis study was conducted as a controlled, randomized, open–label clinical trial for a total number of 159 patients with CL. Individuals aged 16–64 years with one to six lesions of confirmed CL based on amastigotes visualization in direct examination of Giemsa stained of dermal scraping from the border of the lesion with no previous treatment for CL and no abnormal values for liver enzymes were eligible to participate in the study. Patients with history of diabetes, cardiac, renal, and hepatic disease as well as pregnant women were excluded. Cure was defined as complete healing in the diameters of the ulcers and lesions skin six months after the end of the treatment.ResultsFrom November 2013 to December 2015, 159 patients were screened and allocated in three groups for treatment with PI: i) 53 patients were treated with a single dose intramuscularly injection of 7 mg/kg body weight; ii) 53 received two doses of 7 mg/kg within an interval of seven days; and iii) 53 were treated with three doses of 7mg/kg with an interval of seven days between each dose. In 120 patients, L. guyanensis was identified. A cure rate of 45%, 81.1% and 96.2% were observed in the first, second and third group, respectively. The cure in the three PI dose group was higher compared to the single-dose (p<0.0001) and two-dose groups (p = 0.03). No serious adverse events occurred.ConclusionThe present study shows that PI is a safe drug and its efficacy varied with the number of doses. The administration of PI in patients with ACL, predominantly caused by L. guyanensis, was mostly efficient in three or two doses of 7 mg/kg.Trial registrationClinicalTrials.gov NCT02919605

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Combining diagnostic procedures for the management of leishmaniasis in areas with high prevalence of Leishmania guyanensis

Cited by 16 publications

References 12 publications

Tegumentary leishmaniasis in the State of Amazonas: what have we learned and what do we need?

Tegumentary leishmaniasis in the State of Amazonas: what have we learned and what do we need?

Polymorphisms in the TOLLIP Gene Influence Susceptibility to Cutaneous Leishmaniasis Caused by Leishmania guyanensis in the Amazonas State of Brazil

An open label randomized clinical trial comparing the safety and effectiveness of one, two or three weekly pentamidine isethionate doses (seven milligrams per kilogram) in the treatment of cutaneous leishmaniasis in the Amazon Region

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