Leishmaniasis Recidivans Recurrence after 43 Years: A Clinical and Immunologic Report after Successful Treatment

Marovich, Mary; Lira, Rosalía; Shepard, Marc; Fuchs, Glenn H.; Kruetzer, Richard; Nutman, Thomas B.; Neva, Franklin A.

doi:10.1086/322643

Cited by 40 publications

(46 citation statements)

References 11 publications

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“…Specific data on the effects of topical steroids on the clinical course of leishmaniasis are sparse, but the inhibition of epidermal regeneration and parasitic clearance has been postulated. 26 To our knowledge, this report is the first report identifying the DNA of this species of Leishmania in human oral secretions. Although it is common knowledge that the LeishmanDonovan bodies in an individual suffering from VL exist in many organs of the body and several reports from India and Africa have shown viable Leishmania in nasal, oral, and nasopharyngeal secretions and even feces, the data are limited concerning L. donovani.…”

Section: Discussionmentioning

confidence: 78%

Consecutive Cutaneous and Visceral Leishmaniasis Manifestations Involving a Novel Leishmania Species in Two HIV Patients in Thailand

Chusri¹,

Hortiwakul²,

Silpapojakul³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. Leishmaniasis is an emerging disease in Thailand. Herein, we report on two human immunodeficiency virus (HIV)-infected patients with leishmaniasis who presented with overlapping manifestations between cutaneous and visceral leishmaniasis. Sequencing analysis of the internal transcribed spacer 1 (ITS1) of the ribosomal RNA gene showed that the species was identical to a new species recently described in Thailand. The detection of DNA of this Leishmania species in saliva may have important implications for transmission and epidemiological studies.

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Section: Discussionmentioning

confidence: 78%

Consecutive Cutaneous and Visceral Leishmaniasis Manifestations Involving a Novel Leishmania Species in Two HIV Patients in Thailand

Chusri¹,

Hortiwakul²,

Silpapojakul³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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“…Reports indicate that local trauma, surgery, or corticosteroids may contribute in the reactivation of leishmaniasis [8,12,25]. The most common mechanism of re-activation hypothesized is a defect in the cellular immunity of the host.…”

Section: Discussionmentioning

confidence: 99%

“…LR is rare and usually follows a chronic and relapsing course. It recurs typically at the site of an original lesion that had apparently healed after a variable period (months or years) and often within the edge of the scar [8,9]. The recurrent lesions may be notoriously difficult to treat, thus the name chronic relapsing cutaneous leishmaniasis.…”

Section: Introductionmentioning

confidence: 99%

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Leishmaniasis recidivans in Ethiopia: cutaneous and mucocutaneous features

Dassoni

Daba

Naafs³

et al. 2017

J Infect Dev Ctries

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Cutaneous leishmaniasis (CL) is endemic in Ethiopia. An unusual clinical form of this disease is leishmaniasis recidivans (LR), a prolonged, relapsing form of cutaneous leishmaniasis resembling tuberculosis of the skin that may persist for many years with a chronic and relapsing course. This rare variant has been shown to be caused by Leishmania tropica species in the Old World and by Leishmania braziliensis, Leishmania amazonensis, Leishmania panamensis, and Leishmania guyanensis in the New World, as reported in various studies. To our knowledge, there are no reports from Ethiopia, and mucocutaneous involvement of LR has not been described to date. This was a retrospective analysis of the patients seen at the Italian Dermatological Center in Mekelle on the Tigrean highlands over a threeyear period (2008)(2009)(2010)(2011). Seven patients with typical clinical features of LR were seen. Two of them presented with signs of mucosal involvement. To date, Leishmania aethiopica is shown to be the only species causing CL that is endemic in the Ethiopian highlands. Therefore, it had to be assumed that the lesions in these patients were caused by this species. The aims of this communication are to report, for the first time, the presence of LR, most likely due to Leishmania aethiopica, in Ethiopia, and to report mucosal involvement in this rare clinical form of CL.

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“…Increasing cases of SbV treatment failure have been described (2,7,10,12,15), suggesting that antimony-resistant parasites could be transmitted even in hosts developing an efficient immune response. These data strongly suggest that NO-SbIII cross-resistance could have a dreadful implication for the spread of chemoresistance in the field.…”

mentioning

confidence: 99%

Lower Nitric Oxide Susceptibility of Trivalent Antimony-Resistant Amastigotes ofLeishmania infantum

Holzmüller

Sereno

Lemesre

2005

Antimicrob Agents Chemother

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We previously documented the induction of Leishmania amastigote apoptosis by trivalent antimony (SbIII) and nitric oxide (NO). We demonstrate here that SbIII-resistant amastigotes were resistant to NO toxicity when delivered extracellularly by NO donors or intracellularly via macrophage activation. Shared biochemical targets for SbIII and NO resistance in Leishmania are discussed.Leishmania infantum or Leishmania chagasi is responsible for canine and human visceral leishmaniasis in both the Old and the New Worlds. Leishmania parasites develop as flagellated promastigotes in the insect vector and reside as intracellular nonflagellated amastigotes in the mammalian host, which are responsible for the clinical disease manifestations. Basic treatment of leishmaniasis consists of the administration of pentavalent antimony (SbV) in the form of sodium stibogluconate or meglumine antimoniate. The mode of action of SbV implicates its reduction by the host cell to the trivalent form (SbIII) (8,9,21,23). Besides this, successful chemotherapy in murine and canine models has been correlated with the efficiency of natural immunity (5, 26), and synergism between SbV and immunostimulant cytokines has been proven to be pertinent in the treatment of leishmaniasis (14,18). We recently demonstrated that both nitric oxide (NO) and SbIII lead to Leishmania amastigote cell death with some characteristics of apoptosis (11,22). Moreover, the activity of SbIII may be directly linked to the induction of reactive oxygen intermediates such as NO (24). In order to clarify more precisely the potency of NO and SbIII, we investigated the cross-resistance of SbIII-resistant parasites to NO.SbIII-resistant amastigotes previously described (20) were used in all experiments. The susceptibility to NO of wild-type (WT) amastigotes and amastigotes resistant to 120 g/ml potassium antimonyl tartrate (LiSbIIIR120) was ascertained using either acidified sodium nitrite (NaNO 2 ) or the NO donors SNAP (S-nitroso-N-acetylpenicillamine) and DETA-NONO-For NaNO 2 , 10 7 amastigotes per ml were incubated for 2 h at 37 Ϯ 1°C in the dark in 0.01 M phosphate-buffered saline (PBS), pH 4.5, in the presence of 0 to 10 mM NaNO 2 . After a wash in PBS, parasites were seeded in 96-well microplates at 2 ϫ 10 5 /well in 100 l of medium for axenic amastigotes (MAA) (13). To estimate parasite survival after NO treatment, amastigotes were cultured in the presence of 2.5 Ci of [ 3 H]thymidine for 24 h and then filtered through GF/C filters (Whatman International) for radioactivity determination. The relative inhibition of [ 3 H]thymidine incorporation by 50% (IC 50 ) was calculated. The NO donors SNAP and DETA-NONOate were added directly in the culture medium at concentrations ranging from 0 to 500 M, immediately after inoculation of 2 ϫ 10 5 amastigotes/100 l of MAA in 96-well microplates. After 72 h of incubation, the effective concentrations of NO donors inhibiting WT and LiSbIIIR120 amastigote growth by 50% (IC 50 ) were estimated by MTT test (21). IC 50 for WT and LiSbIIIR...

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Leishmaniasis Recidivans Recurrence after 43 Years: A Clinical and Immunologic Report after Successful Treatment

Cited by 40 publications

References 11 publications

Consecutive Cutaneous and Visceral Leishmaniasis Manifestations Involving a Novel Leishmania Species in Two HIV Patients in Thailand

Consecutive Cutaneous and Visceral Leishmaniasis Manifestations Involving a Novel Leishmania Species in Two HIV Patients in Thailand

Leishmaniasis recidivans in Ethiopia: cutaneous and mucocutaneous features

Lower Nitric Oxide Susceptibility of Trivalent Antimony-Resistant Amastigotes ofLeishmania infantum

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