Influence of Helminth Infections on the Clinical Course of and Immune Response toLeishmania braziliensisCutaneous Leishmaniasis

Abstract

Helminths influence both the clinical outcome and the immune response of patients with CL. These results may have clinical implications for the care of patients with CL caused by Leishmania braziliensis, because screening for and treatment of helminths may improve responses to treatment and possibly reduce the risk of progression to mucosal disease.

Antihelminthic Therapy and Antimony in Cutaneous Leishmaniasis: A Randomized, Double-Blind, Placebo-Controlled Trial in Patients Co-Infected with Helminths and Leishmania braziliensis

“…19 In a recent study by our group, we showed that while CL patients co-infected with helminths presented with smaller initial lesion size, healing time was delayed in these patients, providing the rationale for the current study. 15 Although no statistically significant difference was observed between groups, there was a tendency for delayed healing in the early treatment group. There are potential explanations for our negative findings.…”

“…13,14 In a recent study, we showed that CL in patients coinfected with helminths took longer to heal. 15 In light of this result, we evaluated the effect of early antihelminthic therapy on the outcome of CL co-infected with helminths.…”

Schistosoma mansoni antigens alter the cytokine response in vitro during cutaneous leishmaniasis

“…However, the time for the lesion to heal was approximately double in coinfected patients (O'Neal et al 2007). The authors postulate that these effects are due to a stronger Th2-immune response induced by the helminth infection, which adversely affects the Th1 immune response, which compromises host defence against Leishmania sp.…”

“…Other drugs, such as pentoxifylline, inhibit TNF-α synthesis and thus down-modulates the immune response when associated with antimony therapy. This results in an increased cure rate and a decreased healing time of CL and mucosal leishmaniasis (Lessa et al 2001, Machado et al 2007. Therefore, the combination of conventional treatment with an immunomodulatory strategy may be more efficient in preventing or diminishing the tissue damage in CL or mucosal leishmaniasis.…”

Clinical, immunological, and genetic aspects in leprosy

“…Thus, the clinical forms with predominance of Th2 response are classified as MB, because this response is not effective in killing M. leprae, Th2 responses are strongly promoted by some parasitic infections with helminth infection downregulating the Th1 immune response to vaccination [Sabin et al, 1996], and increasing the severity of leishmaniasis [O'Neal et al, 2007].…”