Cutaneous leishmaniasis

Farah, F. S.

doi:10.1001/archderm.103.5.467

Cited by 19 publications

(3 citation statements)

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“…The need for macrophage activation to eliminate Leishmania spp. has already been demonstrated in both in vitro and in vivo infection models [65,66], and the inability of these cells to eliminate infection has been pointed out as one of the factors involved in the clinical evolution of diffuse CL [67]. Patients with diffuse CL present a failure of the immune response, being unable to mount a necessary type 1 response; therefore, there is no adequate infection control resulting in chronic lesions and an inability to respond to treatment [68].…”

Section: Discussionmentioning

confidence: 99%

Is There Any Difference in the In Situ Immune Response in Active Localized Cutaneous Leishmaniasis That Respond Well or Poorly to Meglumine Antimoniate Treatment or Spontaneously Heal?

et al. 2023

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Localized cutaneous leishmaniasis caused by Leishmania braziliensis can either respond well or poorly to the treatment or heal spontaneously; It seems to be dependent on the parasite and/or host factors, but the mechanisms are not fully understood. We evaluated the in situ immune response in eighty-two active lesions from fifty-eight patients prior to treatment classified as early spontaneous regression (SRL-n = 14); treatment responders (GRL-n = 20); and non-responders (before first treatment/relapse, PRL1/PRL2-n = 24 each). Immunohistochemistry was used to identify cell/functional markers which were correlated with the clinical characteristics. PRL showed significant differences in lesion number/size, clinical evolution, and positive parasitological examinations when compared with the other groups. SRL presented a more efficient immune response than GRL and PRL, with higher IFN-γ/NOS2 and a lower percentage of macrophages, neutrophils, NK, B cells, and Ki-67+ cells. Compared to SRL, PRL had fewer CD4+ Tcells and more CD163+ macrophages. PRL1 had more CD68+ macrophages and Ki-67+ cells but less IFN-γ than GRL. PRL present a less efficient immune profile, which could explain the poor treatment response, while SRL had a more balanced immune response profile for lesion healing. Altogether, these evaluations suggest a differentiated profile of the organization of the inflammatory process for lesions of different tegumentary leishmaniasis evolution.

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Section: Discussionmentioning

confidence: 99%

Is There Any Difference in the In Situ Immune Response in Active Localized Cutaneous Leishmaniasis That Respond Well or Poorly to Meglumine Antimoniate Treatment or Spontaneously Heal?

et al. 2023

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“…Because of this site of infection we also did not apply local treatments such as cryosurgery [6]. Treatment with daily subcutaneous administration with IFN-y resulted in complete healing of the ulcerative lesion which commenced rapidly and pro ceeded faster than could be expected in a self-limited course of disease [3]. We continued the therapy for 28 days in accordance with other protocols [l 5, 16, 20, 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…In most cases the lesion in cutaneous leishmania-KARGER 11-MaiI karger(« karger.ch F a x + 41 6 Ï 3 0 6 12 34 sis gradually heals leaving a scar. However, with species of the New World, but also of the Old World, diffuse local, mucocutaneous (L. braziliensis complex), or even systemic dissemination may occur [3][4][5], Several local or systemic therapies have been reported [5 -7 , for rcvicw| which may abrogate the disease. The mainstay of therapy for diffuse cutaneous, mucocutaneous or visceral leishmaniasis has been pcntavalent antimony.…”

Section: Introductionmentioning

confidence: 99%

Successful Treatment of Cutaneous Leishmaniasis Using Systemic Interferon-Gamma

Kolde¹,

Luger²,

Sorg

et al. 1996

Dermatology

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Background: Interferon-gamma (IFN-γ) is one decisive cytokine of T-helper type 1 (Th 1) cells in experimental leishmaniasis. It activates macrophages to kill intracellular parasites and leads to a decline of less mature macrophages in the infiltrate. Application of IFN-γ heals the disease in susceptible mice and has recently been shown to be of benefit in human disease when given locally or in combination with antileishmanial drugs. Objective: We investigated the clinical and histological effects of systemic application of IFN-γ in a case of human cutaneous leishmaniasis in which an ulcerating lesion endangered the left upper eyelid of a 4-year-old boy. Results: IFN-γ (100 µg/m2 of body surface per day) was given subcutaneously for a period of 28 days. The well-tolerated treatment resulted in rapid and complete healing of the lesion without functional impairment. Histological examination disclosed the formation of dermal granulomas. Immunohistochemical characterization of the myelomonocytic cells in the lesion before and after treatment revealed a marked decrease of less-mature macrophages in the infiltrate. This phenomenon equals observations in healing lesions during naturally occurring resistance in murine leishmaniasis. Conclusion: Systemic monotherapy with IFN-γ can be an effective treatment for complicated cases of human cutaneous leishmaniasis without the side effects sometimes observed with systemic pentavalent antimony. Its effects on the myelomonocytic infiltrate are similar to the ones observed during the physiological immune response in natural resistance.

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Lebanon

Kurban¹,

Kurban²

1994

Global Dermatology

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Cutaneous leishmaniasis

Cited by 19 publications

References 0 publications

Is There Any Difference in the In Situ Immune Response in Active Localized Cutaneous Leishmaniasis That Respond Well or Poorly to Meglumine Antimoniate Treatment or Spontaneously Heal?

Is There Any Difference in the In Situ Immune Response in Active Localized Cutaneous Leishmaniasis That Respond Well or Poorly to Meglumine Antimoniate Treatment or Spontaneously Heal?

Successful Treatment of Cutaneous Leishmaniasis Using Systemic Interferon-Gamma

Lebanon

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