Objective:To evaluate the in vitro and in vivo efficacy of quercetin and its immunomodulatory and anti-oxidative activity against Leishmania major(L.major).Methods:L.major promastigotes and amastigotes were incubated ...Objective:To evaluate the in vitro and in vivo efficacy of quercetin and its immunomodulatory and anti-oxidative activity against Leishmania major(L.major).Methods:L.major promastigotes and amastigotes were incubated with different concentrations of quercetin to estimate EC_(50).For in vivo study,the base of tails of mice was infected with L.major.After developing ulcers in the inoculation site,mice were treated with 50 mg/kg quercetin orally for 28 consecutive days.The wound-healing potential of quercetin was evaluated by histopathological analysis of tissue sections stained by hematoxylin and eosin as well as Masson's trichrome.In addition,the levels of tumor necrosis factor-α,interleukin-6,malondialdehyde,and adiponectin,the ferric reducing ability of plasma,as well as superoxide dismutase and glutathione peroxidase activities were measured.Results:The EC_(50)values of quercetin against L.major promastigotes and intracellular amastigotes were 0.27 and 0.85μM,respectively.Histopathological analysis showed that fewer inflammatory cells,more fibroblasts,and more collagen deposition were observed in tissue sections of quercetin-treated mice.In addition,treatment with quercetin markedly increased glutathione peroxidase activity,the ferric reducing ability of plasma and adiponectin levels while decreasing malondialdehyde,interleukin-6,and tumor necrosis factor-αlevels.Conclusions:Quercetin shows anti-leishmanial activity,immunomodulatory,anti-oxidative,and anti-inflammatory effects.Therefore,it may be further explored as an effective drug in treating leishmaniasis.展开更多
Objective: To investigate the leishmanicidal effects of two antioxidants, caffeic acid and quercetin on Leishmania major(L.major) promastigotes in vitro, and their immunomodulatory effects on infected phagocytes deriv...Objective: To investigate the leishmanicidal effects of two antioxidants, caffeic acid and quercetin on Leishmania major(L.major) promastigotes in vitro, and their immunomodulatory effects on infected phagocytes derived from susceptible BALB/c mice.Methods: Caffeic acid and quercetin-induced cell death was examined by Pi-Hoechst double staining of L.major promastigotes and MTT assay, in the presence or absence of protease inhibitors in vitro.Caffeic acid or quercetin were administered subcutaneously to BALB/c mice infected with L.major promastigotes through a dorsal air pouch.Nitric oxide and superoxide anion production by phagocytes infiltrating the air pouch and the expression of inducible nitric oxide synthase(i NOS), tumor necrosis factor alpha(TNF-a) and nuclear factor kappa B in the air pouch membrane were therefore evaluated using appropriate methods.Results: Caffeic acid and quercetin displayed a dose-dependent cytotoxic effect against L.major promastigotes, and induced cell death via caspases-independent pathways.In vivo, L.major promastigotes inoculation into air pouch cavity of BALB/c mice leads to a sequential influx of neutrophils(hours), followed by macrophages(days).Results showed that L.major delayed apoptosis of infected neutrophils and macrophages by the cleavage of the nuclear factor kappa B p65^(RelA) subunit, and persisted by inhibiting TNF-a and i NOS expression and reactive oxygen species generation.Caffeic acid or quercetin restored reactive oxygen species production and TNF-a-induced i NOS activity, and abrogate apoptosis delay of infected phagocytes.Conclusions: The leishmanicidal effect of caffeic acid and quercetin on promastigotes and amastigotes, as well as reactivation of infected phagocytes apoptosis, suggested a potential therapeutic role against cutaneous leishmaniasis.展开更多
AIM To investigate the modulatory effect of B-1 cells on murine peritoneal macrophages infected with Leishmania major(L. major) in vitro.METHODS Peritoneal macrophages obtained from BALB/c andBALB/c XID mice were infe...AIM To investigate the modulatory effect of B-1 cells on murine peritoneal macrophages infected with Leishmania major(L. major) in vitro.METHODS Peritoneal macrophages obtained from BALB/c andBALB/c XID mice were infected with L. major and cultured in the presence or absence of B-1 cells obtained from wild-type BALB/c mice. Intracellular amastigotes were counted, and interleukin-10(IL-10) production was quantified in the cellular supernatants using an enzymelinked immunosorbent assay. The levels of the lipid mediator prostaglandin E2(PGE2) were determined using a PGE2 enzyme immunoassay kit(Cayman Chemical, Ann Arbor, MI), and the number of lipid bodies was quantified in the cytoplasm of infected macrophages in the presence and absence of B-1 cells. Culturing the cells with selective PGE2-neutralizing drugs inhibited PGE2 production and confirmed the role of this lipid mediator in IL-10 production. In contrast, we demonstrated that B-1 cells derived from IL-10 KO mice did not favor the intracellular growth of L. major.RESULTS We report that B-1 cells promote the growth of L. major amastigotes inside peritoneal murine macrophages. We demonstrated that the modulatory effect was independent of physical contact between the cells, suggesting that soluble factor(s) were released into the cultures. We demonstrated in our co-culture system that B-1 cells trigger IL-10 production by L. major-infected macrophages. Furthermore, the increased secretion of IL-10 was attributed to the presence of the lipid mediator PGE2 in supernatants of L. major-infected macrophages. The presence of B-1 cells also favors the production of lipid bodies by infected macrophages. In contrast, we failed to obtain the same effect on parasite replication inside L. major-infected macrophages when the B-1 cells were isolated from IL-10 knockout mice. CONCLUSION Our results show that elevated levels of PGE2 and IL-10 produced by B-1 cells increase L. major growth, as indicated by the number of parasites in cell cultures.展开更多
Objective: To evaluate the effect of doxorubicin and its pegylated liposomal formulation(Doxil, Caelyx) on in vitro susceptibility of promastigote and amastigote stages of Leishmania major. Methods: Throughout in vitr...Objective: To evaluate the effect of doxorubicin and its pegylated liposomal formulation(Doxil, Caelyx) on in vitro susceptibility of promastigote and amastigote stages of Leishmania major. Methods: Throughout in vitro assays the IC50 was calculated in the promastigotes and amastigotes forms in J774 macrophage cell line. Also as cytotoxicity in J774 cell line macrophages. Results: Doxorubicin and Doxil showed the same activity against promastigote form with IC50 values of 10.49 μg/m L and 9.63 μg/m L, respectively. Similarly, the amastigote stage was susceptible at concentration of at least 1 μg/m L when compared to positive control(P<0.000 1). Also, cytotoxicity assay against macrophage revealed no toxicity on the host cells at IC50 concentrations. Conclusions: Our findings demonstrated the efficacy of both doxorubicin and its pegylated liposomal formulation on Leishmania major at low concentrations. Further researches are needed for evaluating the safety of drugs in animal model particularly as topical formulation.展开更多
We report four disseminated cutaneous leishmaniasis(DCL) cases referred to leishmaniasis laboratory at the School of Public Health,Tehran University of Medical Sciences with multiple nodular,ulcerative and crusted les...We report four disseminated cutaneous leishmaniasis(DCL) cases referred to leishmaniasis laboratory at the School of Public Health,Tehran University of Medical Sciences with multiple nodular,ulcerative and crusted lesions extended on the face,trunk,and extremities.None of the patients had any complication and historical involvement in their immunological system conditions that suggest as the criteria for DCL.Direct smears of ulcers were positive for Leishmania parasite.The parasite was isolated from the active lesions and identified as Leishmania major(L major) using PCR-RFLP assay and sequencing analysis.展开更多
Objective: To appraise the activity of voriconazole against Leishmania major(L. major) in vitro and its effectiveness on wound regeneration in cutaneous leishmaniasis in BALB/c mice Methods: The IC_(50) of voriconazol...Objective: To appraise the activity of voriconazole against Leishmania major(L. major) in vitro and its effectiveness on wound regeneration in cutaneous leishmaniasis in BALB/c mice Methods: The IC_(50) of voriconazole against promastigotes and intra-macrophage amastigotes of L. major was investigated in vitro. The in vivo study was performed by treating the L. major infected BALB/c mice. When the wounds appeared in the base of tail, treatment was started by administration of 30 mg/kg voriconazole for 28 consecutive days orally. Results: The IC_(50) of voriconazole against promastigotes and intra-macrophage amastigotes were 0.74 and 0.89μM, respectively. Voriconazole decreased lipid peroxidation and IL-6 level. Histopathologica findings indicated accelerated healing in the voriconazole treated group compared to other groups. Conclusions: Our results demonstrate that voriconazole can be an option in treating the cutaneous leishmaniasis by L. major.展开更多
It has been shown that some parasites interfere with malignant tumor cells growth in vivo or in vitro. In this work anticancer activity of three live protozoan parasites;Toxoplasma gondii, Trichomonas vaginalis and Le...It has been shown that some parasites interfere with malignant tumor cells growth in vivo or in vitro. In this work anticancer activity of three live protozoan parasites;Toxoplasma gondii, Trichomonas vaginalis and Leishmania major on fibrosarcoma cells growth has been investigated in cell culture medium. In this experimental study, WEHI-164 fibrosarcoma cells treated with alive Toxoplasma gondii tachyzoite, Trichomonas vaginalis trophozoite or Leishmania major promastigote as case groups or left intact as control groups. Following 24 hours incubation the number of cells, lactate dehydrogenase (LDH) and apoptosis were determined in case and control groups. Toxoplasma gondii tachyzoite decreased cell proliferation and increased cell lyses’ but it did not induce apoptosis. Trichomonas vaginalis or Leishmania major didn’t show any effects on cell proliferation, cell lyses or apoptosis. Therefore Toxoplasma gondii may have anticancer activity and further works is recommended to understand the mechanisms of action.展开更多
Objective： To determine the adjuvant potential of artemisinin with a soluble leishmanial antigen in vaccinating BALB/c mice. Methods： Seventy two female BALB/c mice were randomly assigned into six groups. The mice w...Objective： To determine the adjuvant potential of artemisinin with a soluble leishmanial antigen in vaccinating BALB/c mice. Methods： Seventy two female BALB/c mice were randomly assigned into six groups. The mice were vaccinated with soluble Leishmania antigens （SLA） alone, artemisinin co-administered with SLA, SLA and Bacille Calmette Gu fin （BCG） vaccine, and artemisinin and BCG alone. Unvaccinated mice formed the control group. The induction of cell-mediated immunity following vaccination was determined by measuring in vitro lymphocyte proliferation and the production of interleukin （IL）-4, IL-5 and gamma interferon （IFN-γ） determined by flow cytometry. Protection against L. major was determined by quantifying parasite burdens in L. major infected footpads using a limiting dilution assay and by measuring lesion sizes of the infected footpad compared to the contralateral uninfected footpad. Results： Mice receiving SLA plus artemisinin produced significantly high levels of IL-4 and IL-5 （P 〈 0.05） and low levels of IFN-γ, resulting in exacerbated disease. In addition, subcutaneous administration of SLA ＋ artemisinin, artemisinin alone or SLA alone resulted in the development of large footpad swellings and high parasite loads that were comparable to those of the control unvaccinated mice （P 〉 0.05）, resulting in exacerbated disease. Conclusion： These data suggest that artemisinin is not a suitable adjuvant for Leishmania vaccines. However, since artemisinin has been shown to be effective against Leishmania parasites in vitro and in vivo, further studies ought to be conducted to determine its immunochemotherapeutic potential when co-administered with Leishmania antigens.展开更多
Rationale:American tegumentary leishmaniasis comprises cutaneous and mucocutaneous manifestations caused by parasitic infections by various Leishmania species.This report details the clinical interventions for a patie...Rationale:American tegumentary leishmaniasis comprises cutaneous and mucocutaneous manifestations caused by parasitic infections by various Leishmania species.This report details the clinical interventions for a patient with American tegumentary leishmaniasis in Mendoza,Argentina,a non-endemic region.Patient concerns:A 43-year-old male was admitted to a tertiary care hospital in Mendoza,Argentina Republic with a history of progressive nasal discharge,septal perforation,facial pain,and pruritus.Despite treatment for presumed nasal myiasis and vasculitis with granulomatosis,symptoms persisted.Diagnosis:American tegumentary leishmaniasis.Interventions:Intravenous liposomal amphotericin B.Outcomes:Follow-up at 30 days showed no recurrence of symptoms with a remarkable clinical improvement of the nasal lesion.Lessons:This case sheds light on the necessity of accurate identification for timely intervention and the need to recognize the diverse manifestations of American tegumentary leishmaniasis to avoid misdiagnosis.展开更多
Objective:To evaluate the immunological response elicited by an inactivated bacterial vector carrying the K39 antigen of Leishmania infantum,and a purified antigen.Methods:Mice were subjected to the following treatmen...Objective:To evaluate the immunological response elicited by an inactivated bacterial vector carrying the K39 antigen of Leishmania infantum,and a purified antigen.Methods:Mice were subjected to the following treatments:(1)Purified recombinant K39(rK39)protein at a 20μg dose with complete Freund’s adjuvant;(2)Inactivated Escherichia coli(BL21 DE3)carrying the K39 protein at an equivalent total protein content of 200μg;(3)Inactivated bacteria lacking the K39 protein;(4)Non-immunized control animals.Serological monitoring was performed.All groups were challenged by intraperitoneal injection of 10^(7) Leishmania infantum promastigotes.After euthanasia,the liver and spleen were collected to analyze the levels of TNF,IFN-γ,IL-12,IL-4,and IL-10.Results:Mice immunized with purified rK39 or the inactivated bacterial vector carrying the K39 antigen of Leishmania infantum showed a long-lasting immune response with high levels of polyclonal antibodies specifically recognizing the recombinant proteins.The IgG1 subclass was the predominant immunoglobulin;however,the induction of IgG2a and the profile of cytokines produced were indicative of the induction of a mixed-type response.Conclusions:The inactivated bacterial vector carrying the K39 antigen,as well as the purified antigen can induce a long-lasting immune response in immunized mice,predominantly favouring a Th2 profile response.展开更多
BACKGROUND Visceral leishmaniasis(VL)is a systemic protozoan infection caused by Leishmania donovani(L.donovani)and transmitted by sand flies,causing macrophage invasion in the liver,spleen,and bone marrow.Diagnosis o...BACKGROUND Visceral leishmaniasis(VL)is a systemic protozoan infection caused by Leishmania donovani(L.donovani)and transmitted by sand flies,causing macrophage invasion in the liver,spleen,and bone marrow.Diagnosis of VL is currently based on clinical signs,symptoms,and specific in-vitro markers and bone marrow investigations.However,VL's specific hematological and bone marrow manifestation in Sudanese pediatric patients is not well studied.AIM To examine the blood and bone marrow characteristics in pediatric patients from Sudan who have VL.METHODS This is a retrospective hospital-based study with a sample of 107 consecutive Sudanese pediatric patients.The data focused on hematological and bone marrow results.We included only the completed records of the pediatric patients with VL in the Tropical Disease Teaching Hospital in Khartoum,Sudan from the period of 2016 to 2020.RESULTS The majority of pediatric patients included in this study are below 5-years-old(n=59,55.2%).Moreover,anemia,thrombocytopenia,and leukopenia were among the prevalent characteristics in the population under study.To further analyze the data,we developed a machine learning model using boosted forest algorithms to predict L.donovani parasites load,with a mean accuracy of 0.88 for the training dataset and an accuracy of 0.46,0.50,and 0.74 for mild,moderate,and severe L.donovani parasite load in the validation dataset.CONCLUSION This study shows that the most common bone marrow change among Sudanese VL children was increased chronic inflammatory cells(n=88,82.2%)with present macrophage hemophagocytes(n=103,96.3%).While anemia and thrombocytopenia were the most common hematological changes.These results will hopefully lead to an early diagnosis and hence better management for Sudanese pediatric patients with suspected VL.展开更多
We evaluated some eco-epidemiological characteristics of the sand fly fauna in an ecotourism area in the Atlantic Forest located in Rio de Janeiro, southeastern Brazil. During a period of one year, sandflies were coll...We evaluated some eco-epidemiological characteristics of the sand fly fauna in an ecotourism area in the Atlantic Forest located in Rio de Janeiro, southeastern Brazil. During a period of one year, sandflies were collected in three different locations, where the sampled residences were located, respectively, one inside the forest, the other two, respectively at the edge of the forest and the other in a more urbanized area. These three types of ecotopes were evaluated: home, peridomicile and kennel. Four hundred and fifty-six sandflies were collected and six species belonging to five genera were identified: Migonemyia migonei, Lutzomyia longipalpis, Nyssomyia intermedia, Evandromyia sallesi, Evandromyia edwardsi and Brumptomyia wedge. The two most abundant species collected were M. migonei and L. longipalpis, contributing 70% and 18% respectively, totaling 88% of the individuals collected. The results suggested that modifications of the natural environment due to anthropic action probably resulted in changes in the composition of the sand fly population. At point (3), where spraying occurred irregularly, even representing a degraded environment, only one species was captured, M. migonei. Differently at points (1) and (2), areas located respectively in the interior and on the edge of the Atlantic Forest, a greater number of sand fly species was observed. However, after a few years, anthropic actions ceased, followed by the implementation of reforestation projects and currently the landscape is very different, showing considerable forest recovery. For this reason, ecotourism activities are increasing in the area, creating potentially dangerous conditions caused by the exposure of greater numbers of people and dogs to insect vectors. Therefore, the implementation of environmental education projects is essential. However, we suggest that the use of warning signs to be placed at the entrances to the main traffic routes, alerting tourists to the risk of infection and indicating protective measures, would be very useful.展开更多
Leishmania is associated with a broad spectrum of diseases, ranging from simple cutaneous to invasive visceral leishmaniasis. Here, the sequences of ten cysteine proteases of types A, B and C of Leishmania major were ...Leishmania is associated with a broad spectrum of diseases, ranging from simple cutaneous to invasive visceral leishmaniasis. Here, the sequences of ten cysteine proteases of types A, B and C of Leishmania major were obtained from GeneDB database. Prediction of MHC class I epitopes of these cysteine proteases was performed by NetCTL program version 1.2. In addition, by using BcePred server, different structural properties of the proteins were predicted to find out their potential B cell epitopes. According to this computational analysis, nine regions were predicted as B cell epitopes. The results provide useful information for designing peptide-based vaccines.展开更多
interleukin 12 (IL-12) is a powerful stimulus for the growth of activated T and natural killer cells,their generation of interferon γ(IFN-γ),and the differentiation of T helper type 1(Th1) effector cells from naive ...interleukin 12 (IL-12) is a powerful stimulus for the growth of activated T and natural killer cells,their generation of interferon γ(IFN-γ),and the differentiation of T helper type 1(Th1) effector cells from naive precursors in vitro. Using this characterized model of CD4 cell differentiation, we examined the immunologic effects of IL-12 administered either at the time of infection; when naive T cells are primed,or after 14 days of in fection,by which time CDt subset differentiation has occurred.Given with the inoculationof parasites,IL-12 induced IFN-γand IL-10 and markedly suppressed IL-4. Effects on IL10 and IL-4 are comparable in mice with homozygous disruption of the IFN-γgene (IFNγ%),and suppression of IL-4 was unchanged by administration of neutralizing anti-IL-10antibody.Induction of IFN-γand IL-10 mRNA by IL-12 also occurred in infected SCID mice.Given after day 14 of infection, however, IL-12 not only induced IFN-γand IL-10but also induced IL-4 in normal and IFN-γ% mice. These data demonstrate direct effects of IL-12 independent of IFN-γ IL-10,and IL-4 and demonstrate that the ineffectiveness of IL-12 administered following infection with Leishmania major correlates with resistance of differentiated Th2 cells to the IL-4 suppressing activity of IL-12.展开更多
Objective:Current therapy strategies of leishmaniasis have some problems such as high cost,toxicity and side effects.Plant extracts can be a source of drugs to control leishmaniasis.In this study,the effect of hydroal...Objective:Current therapy strategies of leishmaniasis have some problems such as high cost,toxicity and side effects.Plant extracts can be a source of drugs to control leishmaniasis.In this study,the effect of hydroalcoholic and chloroformic extracts of Vigna radiata,Tamarix ramosissima,and Carthamus lanatus on Leishmania major and L.tropica was studied.Methods:The plant samples were collected from west of Iran and their extracts were prepared.Antipromastigote activity assay of all extracts was done using tetrazolium-dye assay.Results:Only high concentrations of V.radiata and C.lanatus were able to inhibit Leishmania,while both high and low concentrations of T.ramosissima had antileishmanial effect.No difference was observed between hydroalcoholic with chloroformic extract of each plant.Conclusion:Altogether,the results revealed the antileishmanial activity of T.ramosissima extracts against L.major and L.tropica,indicating its potential as an antileishmanial agent.展开更多
Objectives: To detect Leishmania species in human patients, animal reservoirs and Phlebotomus sandflies in Waziristan, Pakistan. Methods: Tissue smears and aspirates from 448 cutaneous leishmaniasis(CL) suspected pati...Objectives: To detect Leishmania species in human patients, animal reservoirs and Phlebotomus sandflies in Waziristan, Pakistan. Methods: Tissue smears and aspirates from 448 cutaneous leishmaniasis(CL) suspected patients were analyzed. To sort out role of the reservoir hosts, skin scrapings, spleen and liver samples from 104 rodents were collected. Furthermore, buffy coat samples were obtained from 60 domestic animals. Sandflies were also trapped. All human, animals and sandfly samples were tested by microscopy, kinetoplastic PCR and internal transcribed spacer 1(ITS1) PCR followed by restriction fragment length polymorphism for detection of Leishmania species. Results: An overall prevalence of 3.83% and 5.21% through microscopy and ITS1 PCR respectively was found. However, the statistically non-significant correlation was found between area, gender, and number of lesions. The presence of rodents, sandflies, domestic animals and internally displaced people increased the risk of CL. Using ITS1-PCR-RFLP, Leishmania tropica(L. tropica) was confirmed in 106 samples while 25 of the isolates were diagnosed as Leishmania major(L. major). Similarly, 3/104 rodents were positive for L. major and 14 pools of DNA samples containing Phlebotomus sergenti sandflies were positive for L. tropica. None of samples from domestic animals were positive for leishmaniasis. Conclusions: In the present study, L. tropica and L. major are found to be the main causative agents of CL in study area. Movement of internally displaced people from CL endemic areas presents a risk for nearby CL free areas. To the best of our knowledge, we report for the first time L. major infection in rodents(Rattus rattus) and L. tropica in Phlebotomus sergenti sandflies trapped in Waziristan, Pakistan.展开更多
L Leishmania major are intramacrophage parasite whose eradication requires the induction of T helper 1(Th1)effector cells.Interleukin 12(IL-12) mediates Th1 effector cells development and enhances interferon γproduct...L Leishmania major are intramacrophage parasite whose eradication requires the induction of T helper 1(Th1)effector cells.Interleukin 12(IL-12) mediates Th1 effector cells development and enhances interferon γproduction by T cells and natural killer cells.Infection of macrophages in vitro by promastigotes of L. major caused no IL-12 p40 transcripts. Using competitor construct to quantitate a number of transcripts, a kinetic analysis of cytokine induction during the first few days of infection by L. major was performed.In resistant mice,the transcripts for IL-2, IL-4 and IL-10 were subsequently downregulated, whereas in susceptible mice,these transcripts were only slightly decreased, and IL4 continued to be reexpressed at high levels. IL-12 transcripts were first detected in vivo by 7 d after infection.Challenge of macrophages in vitro confirmed that amastigotes induced IL-12 p40 mRNA.Reexamination of the cytokine rnRNA at 4d revealed expression of IL-13 in all strains analyzed,suggesting that IL-2 and IL-13 may mediate the IL-12independent production of IFN-γ during the first days after infection. Leishmania have evolved to avoid inducing IL-12 from host macrophages during transmission from the insect vector, and cause a striking induction of mRNAs for IL-2, IL-4, IL-10, and IL-13 in CD+4T cells. Each of these activities may favor survival of the organism.展开更多
Parasite-specific CD8+ T cells have been shown to transfer protection against nLeishmania major in susceptible BALB/c mice.An epitope-tagged expression library was used to identify the antigen recognized by a protecti...Parasite-specific CD8+ T cells have been shown to transfer protection against nLeishmania major in susceptible BALB/c mice.An epitope-tagged expression library was used to identify the antigen recognized by a protective CD8+ T cells clone. The expression library allowed recombinant proteins made in bacteria to be captured by macrophages for presentation to T cells restricted to major histompatibility complex class n. A conserved 36-kilodalton member of the tryptophanaspartic acid repeat family of proteins was identified that was expressed in both stages of the parasite life cycle. A 24-kilodalton portion of this antigen protected susceptible mice when administered as a vaccine with interleukin-12before injection.展开更多
BACKGROUND Leishmaniasis includes a range of chronic infections in humans and animals and can be caused by more than 20 species of Leishmania protozoa.The manifestations of leishmaniasis are diverse and dependent on t...BACKGROUND Leishmaniasis includes a range of chronic infections in humans and animals and can be caused by more than 20 species of Leishmania protozoa.The manifestations of leishmaniasis are diverse and dependent on the immune response capacity of the host and the type of Leishmania.In East Asia,leishmaniasis is relatively rare and prone to misdiagnosis and underdiagnosis.CASE SUMMARY We report a case of a 36-year-old male with cutaneous leishmaniasis.The patient had been misdiagnosed with a bacterial skin infection and was given a dressing change and oral levofloxacin,which proved ineffective.Histopathological examination revealed amastigote(Leishman-Donovan body)in the histocytes,and nucleic acid sequencing proved that the pathogen was Leishmania major.The patient was treated successfully by regional injection of sodium gluconate(600 mg)three times.The ulcer healed and did not recur at 1.5-year follow-up.CONCLUSION Skin ulcers caused by leishmaniasis are easily misdiagnosed in non-epidemic countries,yet it should not be overlooked.展开更多
Objective: To examine the prevalence and clinical manifestations of cutaneous leishmaniasis(CL) in Iran.Methods: This study was conducted in Iran between 2011 and 2013. Sampling, preparing, developing, and fixing of s...Objective: To examine the prevalence and clinical manifestations of cutaneous leishmaniasis(CL) in Iran.Methods: This study was conducted in Iran between 2011 and 2013. Sampling, preparing, developing, and fixing of suspicious skin lesions were completed in healthcare centers in 31 Iranian provinces as well as in the Academic Reference Laboratory and the National Reference Laboratory. The information was then analyzed at the Ministry of Health's Information Management Center of Contagious Diseases.Results: Over a three-year period, the number of people identified with CL was 56 546.The highest incidence was reported in 2011(27.5 per 100 000). Wet CL accounted for 43.7% of cases while 43.3% resulted from sporotrichoid leishmaniasis. The results showed that there was a higher incidence of CL due to Leishmania major(50.2%) than to Leishmania tropica. The results of this study found that the highest incidence of CL had happened respectively in Ilam, Fars and, Khorasan Razavi Provinces between 2011 and 2013.Conclusions: Although the incidence of the disease is declining, CL is still a public health concern and disease control protocols need to be established. Therefore, further studies are needed to identify the vectors, reservoirs, and disease species as well as to develop appropriate disease control strategies.展开更多
基金The study was financially supported by INSF(grant number 96006039).
文摘Objective:To evaluate the in vitro and in vivo efficacy of quercetin and its immunomodulatory and anti-oxidative activity against Leishmania major(L.major).Methods:L.major promastigotes and amastigotes were incubated with different concentrations of quercetin to estimate EC_(50).For in vivo study,the base of tails of mice was infected with L.major.After developing ulcers in the inoculation site,mice were treated with 50 mg/kg quercetin orally for 28 consecutive days.The wound-healing potential of quercetin was evaluated by histopathological analysis of tissue sections stained by hematoxylin and eosin as well as Masson's trichrome.In addition,the levels of tumor necrosis factor-α,interleukin-6,malondialdehyde,and adiponectin,the ferric reducing ability of plasma,as well as superoxide dismutase and glutathione peroxidase activities were measured.Results:The EC_(50)values of quercetin against L.major promastigotes and intracellular amastigotes were 0.27 and 0.85μM,respectively.Histopathological analysis showed that fewer inflammatory cells,more fibroblasts,and more collagen deposition were observed in tissue sections of quercetin-treated mice.In addition,treatment with quercetin markedly increased glutathione peroxidase activity,the ferric reducing ability of plasma and adiponectin levels while decreasing malondialdehyde,interleukin-6,and tumor necrosis factor-αlevels.Conclusions:Quercetin shows anti-leishmanial activity,immunomodulatory,anti-oxidative,and anti-inflammatory effects.Therefore,it may be further explored as an effective drug in treating leishmaniasis.
基金Supported by the Research project “Implication of phagocytes dependent oxidative stress in inflammatory diseases and leishmaniasis” with project No.CNEPRU F00220130061Algerian Ministry of Higher Education and Scientific Research
文摘Objective: To investigate the leishmanicidal effects of two antioxidants, caffeic acid and quercetin on Leishmania major(L.major) promastigotes in vitro, and their immunomodulatory effects on infected phagocytes derived from susceptible BALB/c mice.Methods: Caffeic acid and quercetin-induced cell death was examined by Pi-Hoechst double staining of L.major promastigotes and MTT assay, in the presence or absence of protease inhibitors in vitro.Caffeic acid or quercetin were administered subcutaneously to BALB/c mice infected with L.major promastigotes through a dorsal air pouch.Nitric oxide and superoxide anion production by phagocytes infiltrating the air pouch and the expression of inducible nitric oxide synthase(i NOS), tumor necrosis factor alpha(TNF-a) and nuclear factor kappa B in the air pouch membrane were therefore evaluated using appropriate methods.Results: Caffeic acid and quercetin displayed a dose-dependent cytotoxic effect against L.major promastigotes, and induced cell death via caspases-independent pathways.In vivo, L.major promastigotes inoculation into air pouch cavity of BALB/c mice leads to a sequential influx of neutrophils(hours), followed by macrophages(days).Results showed that L.major delayed apoptosis of infected neutrophils and macrophages by the cleavage of the nuclear factor kappa B p65^(RelA) subunit, and persisted by inhibiting TNF-a and i NOS expression and reactive oxygen species generation.Caffeic acid or quercetin restored reactive oxygen species production and TNF-a-induced i NOS activity, and abrogate apoptosis delay of infected phagocytes.Conclusions: The leishmanicidal effect of caffeic acid and quercetin on promastigotes and amastigotes, as well as reactivation of infected phagocytes apoptosis, suggested a potential therapeutic role against cutaneous leishmaniasis.
文摘AIM To investigate the modulatory effect of B-1 cells on murine peritoneal macrophages infected with Leishmania major(L. major) in vitro.METHODS Peritoneal macrophages obtained from BALB/c andBALB/c XID mice were infected with L. major and cultured in the presence or absence of B-1 cells obtained from wild-type BALB/c mice. Intracellular amastigotes were counted, and interleukin-10(IL-10) production was quantified in the cellular supernatants using an enzymelinked immunosorbent assay. The levels of the lipid mediator prostaglandin E2(PGE2) were determined using a PGE2 enzyme immunoassay kit(Cayman Chemical, Ann Arbor, MI), and the number of lipid bodies was quantified in the cytoplasm of infected macrophages in the presence and absence of B-1 cells. Culturing the cells with selective PGE2-neutralizing drugs inhibited PGE2 production and confirmed the role of this lipid mediator in IL-10 production. In contrast, we demonstrated that B-1 cells derived from IL-10 KO mice did not favor the intracellular growth of L. major.RESULTS We report that B-1 cells promote the growth of L. major amastigotes inside peritoneal murine macrophages. We demonstrated that the modulatory effect was independent of physical contact between the cells, suggesting that soluble factor(s) were released into the cultures. We demonstrated in our co-culture system that B-1 cells trigger IL-10 production by L. major-infected macrophages. Furthermore, the increased secretion of IL-10 was attributed to the presence of the lipid mediator PGE2 in supernatants of L. major-infected macrophages. The presence of B-1 cells also favors the production of lipid bodies by infected macrophages. In contrast, we failed to obtain the same effect on parasite replication inside L. major-infected macrophages when the B-1 cells were isolated from IL-10 knockout mice. CONCLUSION Our results show that elevated levels of PGE2 and IL-10 produced by B-1 cells increase L. major growth, as indicated by the number of parasites in cell cultures.
基金financially supported by Vice Chancellors for Research and Technology of Mazandaran University of Medical Sciences(project number:1919)
文摘Objective: To evaluate the effect of doxorubicin and its pegylated liposomal formulation(Doxil, Caelyx) on in vitro susceptibility of promastigote and amastigote stages of Leishmania major. Methods: Throughout in vitro assays the IC50 was calculated in the promastigotes and amastigotes forms in J774 macrophage cell line. Also as cytotoxicity in J774 cell line macrophages. Results: Doxorubicin and Doxil showed the same activity against promastigote form with IC50 values of 10.49 μg/m L and 9.63 μg/m L, respectively. Similarly, the amastigote stage was susceptible at concentration of at least 1 μg/m L when compared to positive control(P<0.000 1). Also, cytotoxicity assay against macrophage revealed no toxicity on the host cells at IC50 concentrations. Conclusions: Our findings demonstrated the efficacy of both doxorubicin and its pegylated liposomal formulation on Leishmania major at low concentrations. Further researches are needed for evaluating the safety of drugs in animal model particularly as topical formulation.
基金supported by School of Public Health, Tehran University of Medical Sciences
文摘We report four disseminated cutaneous leishmaniasis(DCL) cases referred to leishmaniasis laboratory at the School of Public Health,Tehran University of Medical Sciences with multiple nodular,ulcerative and crusted lesions extended on the face,trunk,and extremities.None of the patients had any complication and historical involvement in their immunological system conditions that suggest as the criteria for DCL.Direct smears of ulcers were positive for Leishmania parasite.The parasite was isolated from the active lesions and identified as Leishmania major(L major) using PCR-RFLP assay and sequencing analysis.
文摘Objective: To appraise the activity of voriconazole against Leishmania major(L. major) in vitro and its effectiveness on wound regeneration in cutaneous leishmaniasis in BALB/c mice Methods: The IC_(50) of voriconazole against promastigotes and intra-macrophage amastigotes of L. major was investigated in vitro. The in vivo study was performed by treating the L. major infected BALB/c mice. When the wounds appeared in the base of tail, treatment was started by administration of 30 mg/kg voriconazole for 28 consecutive days orally. Results: The IC_(50) of voriconazole against promastigotes and intra-macrophage amastigotes were 0.74 and 0.89μM, respectively. Voriconazole decreased lipid peroxidation and IL-6 level. Histopathologica findings indicated accelerated healing in the voriconazole treated group compared to other groups. Conclusions: Our results demonstrate that voriconazole can be an option in treating the cutaneous leishmaniasis by L. major.
文摘It has been shown that some parasites interfere with malignant tumor cells growth in vivo or in vitro. In this work anticancer activity of three live protozoan parasites;Toxoplasma gondii, Trichomonas vaginalis and Leishmania major on fibrosarcoma cells growth has been investigated in cell culture medium. In this experimental study, WEHI-164 fibrosarcoma cells treated with alive Toxoplasma gondii tachyzoite, Trichomonas vaginalis trophozoite or Leishmania major promastigote as case groups or left intact as control groups. Following 24 hours incubation the number of cells, lactate dehydrogenase (LDH) and apoptosis were determined in case and control groups. Toxoplasma gondii tachyzoite decreased cell proliferation and increased cell lyses’ but it did not induce apoptosis. Trichomonas vaginalis or Leishmania major didn’t show any effects on cell proliferation, cell lyses or apoptosis. Therefore Toxoplasma gondii may have anticancer activity and further works is recommended to understand the mechanisms of action.
文摘Objective： To determine the adjuvant potential of artemisinin with a soluble leishmanial antigen in vaccinating BALB/c mice. Methods： Seventy two female BALB/c mice were randomly assigned into six groups. The mice were vaccinated with soluble Leishmania antigens （SLA） alone, artemisinin co-administered with SLA, SLA and Bacille Calmette Gu fin （BCG） vaccine, and artemisinin and BCG alone. Unvaccinated mice formed the control group. The induction of cell-mediated immunity following vaccination was determined by measuring in vitro lymphocyte proliferation and the production of interleukin （IL）-4, IL-5 and gamma interferon （IFN-γ） determined by flow cytometry. Protection against L. major was determined by quantifying parasite burdens in L. major infected footpads using a limiting dilution assay and by measuring lesion sizes of the infected footpad compared to the contralateral uninfected footpad. Results： Mice receiving SLA plus artemisinin produced significantly high levels of IL-4 and IL-5 （P 〈 0.05） and low levels of IFN-γ, resulting in exacerbated disease. In addition, subcutaneous administration of SLA ＋ artemisinin, artemisinin alone or SLA alone resulted in the development of large footpad swellings and high parasite loads that were comparable to those of the control unvaccinated mice （P 〉 0.05）, resulting in exacerbated disease. Conclusion： These data suggest that artemisinin is not a suitable adjuvant for Leishmania vaccines. However, since artemisinin has been shown to be effective against Leishmania parasites in vitro and in vivo, further studies ought to be conducted to determine its immunochemotherapeutic potential when co-administered with Leishmania antigens.
基金supported by the Consejo Nacional de Investigaciones Cientıfícas y Técnicas(CONICET)(PIP 2021-2023/11220200102779CO).
文摘Rationale:American tegumentary leishmaniasis comprises cutaneous and mucocutaneous manifestations caused by parasitic infections by various Leishmania species.This report details the clinical interventions for a patient with American tegumentary leishmaniasis in Mendoza,Argentina,a non-endemic region.Patient concerns:A 43-year-old male was admitted to a tertiary care hospital in Mendoza,Argentina Republic with a history of progressive nasal discharge,septal perforation,facial pain,and pruritus.Despite treatment for presumed nasal myiasis and vasculitis with granulomatosis,symptoms persisted.Diagnosis:American tegumentary leishmaniasis.Interventions:Intravenous liposomal amphotericin B.Outcomes:Follow-up at 30 days showed no recurrence of symptoms with a remarkable clinical improvement of the nasal lesion.Lessons:This case sheds light on the necessity of accurate identification for timely intervention and the need to recognize the diverse manifestations of American tegumentary leishmaniasis to avoid misdiagnosis.
基金supported by grants from the Brazilian Agencies:Coordenação de Aperfeiçoamento de Pessoal de Nível Superior(CAPES-Financial code 001)Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq)Fundação Cearense de Apoio ao Desenvolvimento Científico e Tecnológico(FUNCAP).
文摘Objective:To evaluate the immunological response elicited by an inactivated bacterial vector carrying the K39 antigen of Leishmania infantum,and a purified antigen.Methods:Mice were subjected to the following treatments:(1)Purified recombinant K39(rK39)protein at a 20μg dose with complete Freund’s adjuvant;(2)Inactivated Escherichia coli(BL21 DE3)carrying the K39 protein at an equivalent total protein content of 200μg;(3)Inactivated bacteria lacking the K39 protein;(4)Non-immunized control animals.Serological monitoring was performed.All groups were challenged by intraperitoneal injection of 10^(7) Leishmania infantum promastigotes.After euthanasia,the liver and spleen were collected to analyze the levels of TNF,IFN-γ,IL-12,IL-4,and IL-10.Results:Mice immunized with purified rK39 or the inactivated bacterial vector carrying the K39 antigen of Leishmania infantum showed a long-lasting immune response with high levels of polyclonal antibodies specifically recognizing the recombinant proteins.The IgG1 subclass was the predominant immunoglobulin;however,the induction of IgG2a and the profile of cytokines produced were indicative of the induction of a mixed-type response.Conclusions:The inactivated bacterial vector carrying the K39 antigen,as well as the purified antigen can induce a long-lasting immune response in immunized mice,predominantly favouring a Th2 profile response.
文摘BACKGROUND Visceral leishmaniasis(VL)is a systemic protozoan infection caused by Leishmania donovani(L.donovani)and transmitted by sand flies,causing macrophage invasion in the liver,spleen,and bone marrow.Diagnosis of VL is currently based on clinical signs,symptoms,and specific in-vitro markers and bone marrow investigations.However,VL's specific hematological and bone marrow manifestation in Sudanese pediatric patients is not well studied.AIM To examine the blood and bone marrow characteristics in pediatric patients from Sudan who have VL.METHODS This is a retrospective hospital-based study with a sample of 107 consecutive Sudanese pediatric patients.The data focused on hematological and bone marrow results.We included only the completed records of the pediatric patients with VL in the Tropical Disease Teaching Hospital in Khartoum,Sudan from the period of 2016 to 2020.RESULTS The majority of pediatric patients included in this study are below 5-years-old(n=59,55.2%).Moreover,anemia,thrombocytopenia,and leukopenia were among the prevalent characteristics in the population under study.To further analyze the data,we developed a machine learning model using boosted forest algorithms to predict L.donovani parasites load,with a mean accuracy of 0.88 for the training dataset and an accuracy of 0.46,0.50,and 0.74 for mild,moderate,and severe L.donovani parasite load in the validation dataset.CONCLUSION This study shows that the most common bone marrow change among Sudanese VL children was increased chronic inflammatory cells(n=88,82.2%)with present macrophage hemophagocytes(n=103,96.3%).While anemia and thrombocytopenia were the most common hematological changes.These results will hopefully lead to an early diagnosis and hence better management for Sudanese pediatric patients with suspected VL.
文摘We evaluated some eco-epidemiological characteristics of the sand fly fauna in an ecotourism area in the Atlantic Forest located in Rio de Janeiro, southeastern Brazil. During a period of one year, sandflies were collected in three different locations, where the sampled residences were located, respectively, one inside the forest, the other two, respectively at the edge of the forest and the other in a more urbanized area. These three types of ecotopes were evaluated: home, peridomicile and kennel. Four hundred and fifty-six sandflies were collected and six species belonging to five genera were identified: Migonemyia migonei, Lutzomyia longipalpis, Nyssomyia intermedia, Evandromyia sallesi, Evandromyia edwardsi and Brumptomyia wedge. The two most abundant species collected were M. migonei and L. longipalpis, contributing 70% and 18% respectively, totaling 88% of the individuals collected. The results suggested that modifications of the natural environment due to anthropic action probably resulted in changes in the composition of the sand fly population. At point (3), where spraying occurred irregularly, even representing a degraded environment, only one species was captured, M. migonei. Differently at points (1) and (2), areas located respectively in the interior and on the edge of the Atlantic Forest, a greater number of sand fly species was observed. However, after a few years, anthropic actions ceased, followed by the implementation of reforestation projects and currently the landscape is very different, showing considerable forest recovery. For this reason, ecotourism activities are increasing in the area, creating potentially dangerous conditions caused by the exposure of greater numbers of people and dogs to insect vectors. Therefore, the implementation of environmental education projects is essential. However, we suggest that the use of warning signs to be placed at the entrances to the main traffic routes, alerting tourists to the risk of infection and indicating protective measures, would be very useful.
基金supported by a grant (No. 88-GR-SC-47) from Shiraz University
文摘Leishmania is associated with a broad spectrum of diseases, ranging from simple cutaneous to invasive visceral leishmaniasis. Here, the sequences of ten cysteine proteases of types A, B and C of Leishmania major were obtained from GeneDB database. Prediction of MHC class I epitopes of these cysteine proteases was performed by NetCTL program version 1.2. In addition, by using BcePred server, different structural properties of the proteins were predicted to find out their potential B cell epitopes. According to this computational analysis, nine regions were predicted as B cell epitopes. The results provide useful information for designing peptide-based vaccines.
文摘interleukin 12 (IL-12) is a powerful stimulus for the growth of activated T and natural killer cells,their generation of interferon γ(IFN-γ),and the differentiation of T helper type 1(Th1) effector cells from naive precursors in vitro. Using this characterized model of CD4 cell differentiation, we examined the immunologic effects of IL-12 administered either at the time of infection; when naive T cells are primed,or after 14 days of in fection,by which time CDt subset differentiation has occurred.Given with the inoculationof parasites,IL-12 induced IFN-γand IL-10 and markedly suppressed IL-4. Effects on IL10 and IL-4 are comparable in mice with homozygous disruption of the IFN-γgene (IFNγ%),and suppression of IL-4 was unchanged by administration of neutralizing anti-IL-10antibody.Induction of IFN-γand IL-10 mRNA by IL-12 also occurred in infected SCID mice.Given after day 14 of infection, however, IL-12 not only induced IFN-γand IL-10but also induced IL-4 in normal and IFN-γ% mice. These data demonstrate direct effects of IL-12 independent of IFN-γ IL-10,and IL-4 and demonstrate that the ineffectiveness of IL-12 administered following infection with Leishmania major correlates with resistance of differentiated Th2 cells to the IL-4 suppressing activity of IL-12.
基金supported by Kermanshah University of Medical Sciences(Funding No:97318)。
文摘Objective:Current therapy strategies of leishmaniasis have some problems such as high cost,toxicity and side effects.Plant extracts can be a source of drugs to control leishmaniasis.In this study,the effect of hydroalcoholic and chloroformic extracts of Vigna radiata,Tamarix ramosissima,and Carthamus lanatus on Leishmania major and L.tropica was studied.Methods:The plant samples were collected from west of Iran and their extracts were prepared.Antipromastigote activity assay of all extracts was done using tetrazolium-dye assay.Results:Only high concentrations of V.radiata and C.lanatus were able to inhibit Leishmania,while both high and low concentrations of T.ramosissima had antileishmanial effect.No difference was observed between hydroalcoholic with chloroformic extract of each plant.Conclusion:Altogether,the results revealed the antileishmanial activity of T.ramosissima extracts against L.major and L.tropica,indicating its potential as an antileishmanial agent.
基金project entitled PCR and RFLP analysis of Leishmania species from suspected cutaneous leishmaniasis patients and animal reservoirs in Waziristan funded by Relief International,Pakistan(DOSFY15)
文摘Objectives: To detect Leishmania species in human patients, animal reservoirs and Phlebotomus sandflies in Waziristan, Pakistan. Methods: Tissue smears and aspirates from 448 cutaneous leishmaniasis(CL) suspected patients were analyzed. To sort out role of the reservoir hosts, skin scrapings, spleen and liver samples from 104 rodents were collected. Furthermore, buffy coat samples were obtained from 60 domestic animals. Sandflies were also trapped. All human, animals and sandfly samples were tested by microscopy, kinetoplastic PCR and internal transcribed spacer 1(ITS1) PCR followed by restriction fragment length polymorphism for detection of Leishmania species. Results: An overall prevalence of 3.83% and 5.21% through microscopy and ITS1 PCR respectively was found. However, the statistically non-significant correlation was found between area, gender, and number of lesions. The presence of rodents, sandflies, domestic animals and internally displaced people increased the risk of CL. Using ITS1-PCR-RFLP, Leishmania tropica(L. tropica) was confirmed in 106 samples while 25 of the isolates were diagnosed as Leishmania major(L. major). Similarly, 3/104 rodents were positive for L. major and 14 pools of DNA samples containing Phlebotomus sergenti sandflies were positive for L. tropica. None of samples from domestic animals were positive for leishmaniasis. Conclusions: In the present study, L. tropica and L. major are found to be the main causative agents of CL in study area. Movement of internally displaced people from CL endemic areas presents a risk for nearby CL free areas. To the best of our knowledge, we report for the first time L. major infection in rodents(Rattus rattus) and L. tropica in Phlebotomus sergenti sandflies trapped in Waziristan, Pakistan.
文摘L Leishmania major are intramacrophage parasite whose eradication requires the induction of T helper 1(Th1)effector cells.Interleukin 12(IL-12) mediates Th1 effector cells development and enhances interferon γproduction by T cells and natural killer cells.Infection of macrophages in vitro by promastigotes of L. major caused no IL-12 p40 transcripts. Using competitor construct to quantitate a number of transcripts, a kinetic analysis of cytokine induction during the first few days of infection by L. major was performed.In resistant mice,the transcripts for IL-2, IL-4 and IL-10 were subsequently downregulated, whereas in susceptible mice,these transcripts were only slightly decreased, and IL4 continued to be reexpressed at high levels. IL-12 transcripts were first detected in vivo by 7 d after infection.Challenge of macrophages in vitro confirmed that amastigotes induced IL-12 p40 mRNA.Reexamination of the cytokine rnRNA at 4d revealed expression of IL-13 in all strains analyzed,suggesting that IL-2 and IL-13 may mediate the IL-12independent production of IFN-γ during the first days after infection. Leishmania have evolved to avoid inducing IL-12 from host macrophages during transmission from the insect vector, and cause a striking induction of mRNAs for IL-2, IL-4, IL-10, and IL-13 in CD+4T cells. Each of these activities may favor survival of the organism.
文摘Parasite-specific CD8+ T cells have been shown to transfer protection against nLeishmania major in susceptible BALB/c mice.An epitope-tagged expression library was used to identify the antigen recognized by a protective CD8+ T cells clone. The expression library allowed recombinant proteins made in bacteria to be captured by macrophages for presentation to T cells restricted to major histompatibility complex class n. A conserved 36-kilodalton member of the tryptophanaspartic acid repeat family of proteins was identified that was expressed in both stages of the parasite life cycle. A 24-kilodalton portion of this antigen protected susceptible mice when administered as a vaccine with interleukin-12before injection.
基金Supported by Shandong Provincial Natural Science Foundation,No.ZR2020QH138
文摘BACKGROUND Leishmaniasis includes a range of chronic infections in humans and animals and can be caused by more than 20 species of Leishmania protozoa.The manifestations of leishmaniasis are diverse and dependent on the immune response capacity of the host and the type of Leishmania.In East Asia,leishmaniasis is relatively rare and prone to misdiagnosis and underdiagnosis.CASE SUMMARY We report a case of a 36-year-old male with cutaneous leishmaniasis.The patient had been misdiagnosed with a bacterial skin infection and was given a dressing change and oral levofloxacin,which proved ineffective.Histopathological examination revealed amastigote(Leishman-Donovan body)in the histocytes,and nucleic acid sequencing proved that the pathogen was Leishmania major.The patient was treated successfully by regional injection of sodium gluconate(600 mg)three times.The ulcer healed and did not recur at 1.5-year follow-up.CONCLUSION Skin ulcers caused by leishmaniasis are easily misdiagnosed in non-epidemic countries,yet it should not be overlooked.
文摘Objective: To examine the prevalence and clinical manifestations of cutaneous leishmaniasis(CL) in Iran.Methods: This study was conducted in Iran between 2011 and 2013. Sampling, preparing, developing, and fixing of suspicious skin lesions were completed in healthcare centers in 31 Iranian provinces as well as in the Academic Reference Laboratory and the National Reference Laboratory. The information was then analyzed at the Ministry of Health's Information Management Center of Contagious Diseases.Results: Over a three-year period, the number of people identified with CL was 56 546.The highest incidence was reported in 2011(27.5 per 100 000). Wet CL accounted for 43.7% of cases while 43.3% resulted from sporotrichoid leishmaniasis. The results showed that there was a higher incidence of CL due to Leishmania major(50.2%) than to Leishmania tropica. The results of this study found that the highest incidence of CL had happened respectively in Ilam, Fars and, Khorasan Razavi Provinces between 2011 and 2013.Conclusions: Although the incidence of the disease is declining, CL is still a public health concern and disease control protocols need to be established. Therefore, further studies are needed to identify the vectors, reservoirs, and disease species as well as to develop appropriate disease control strategies.
