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Heydarpour F, Sari AA, Mohebali M, Shirzadi M, Bokaie S. Incidence and Disability-Adjusted Life Years (Dalys) Attributable to Leishmaniasis In Iran, 2013. Ethiop J Health Sci 2017; 26:381-8. [PMID: 27587936 PMCID: PMC4992778 DOI: 10.4314/ejhs.v26i4.10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Leishmaniasis covers a range of clinical manifestations. Estimation of the burden of leishmaniasis may help guide healthcare management personnel and policy-makers in applying effective interventions. The present study aimed to calculate the incidence and burden of cutaneous and visceral leishmaniasis in Iran in 2013. Methods To evaluate the epidemiological aspects of the disease in Iran, published studies over the past 20 years were searched and the viewpoints of relevant specialists in Iran were obtained. Data were collected from the Ministry of Health and from the Tehran University of Medical Sciences. To calculate years of life lost due to premature death, standard expected years of life lost was used. Standard life table of Global Burden of Disease (GBD) 2010 with the life expectancy of 86.02 years for both sexes was used to calculate the remaining potential years of life at any age from death. Results The overall incidence of cutaneous and visceral leishmaniasis was calculated as 22 and 0.092 per 100000 population of Iran, respectively. The burden of leishmaniasis was 99.5 years: 95.34 and 4.16 years for cutaneous and visceral, respectively. Sensitivity was analyzed and deaths predicted by the Institute of Health Metrics and Evaluation added, the burden of visceral leishmaniasis was 726 years. Conclusion The share of leishmaniasis burden in Iran is lower than the global burden of the disease. GBD 2010 standard method is recommended to calculate the burden of leishmaniasis in different countries and set local priorities on the basis of these measures.
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Affiliation(s)
- Fatemeh Heydarpour
- Department of Epidemiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Ali Akbari Sari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Ppublic Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Shirzadi
- Department of Zoonoses, Communicable Disease Management Center, Ministry of Health, treatment and Education, Tehran, Iran
| | - Saied Bokaie
- Department of Epidemiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
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Berger BA, Cossio A, Saravia NG, Castro MDM, Prada S, Bartlett AH, Pho MT. Cost-effectiveness of meglumine antimoniate versus miltefosine caregiver DOT for the treatment of pediatric cutaneous leishmaniasis. PLoS Negl Trop Dis 2017; 11:e0005459. [PMID: 28384261 PMCID: PMC5404883 DOI: 10.1371/journal.pntd.0005459] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 04/25/2017] [Accepted: 03/06/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Oral miltefosine has been shown to be non-inferior to first-line, injectable meglumine antimoniate (MA) for the treatment of cutaneous leishmaniasis (CL) in children. Miltefosine may be administered via in-home caregiver Directly Observed Therapy (cDOT), while patients must travel to clinics to receive MA. We performed a cost-effectiveness analysis comparing miltefosine by cDOT versus MA for pediatric CL in southwest Colombia. METHODOLOGY/PRINCIPLE FINDINGS We developed a Monte Carlo model comparing the cost-per-cure of miltefosine by cDOT compared to MA from patient, government payer, and societal perspectives (societal = sum of patient and government payer perspective costs). Drug effectiveness and adverse events were estimated from clinical trials. Healthcare utilization and costs of travel were obtained from surveys of providers and published sources. The primary outcome was cost-per-cure reported in 2015 USD. Treatment efficacy, costs, and adherence were varied in sensitivity analysis to assess robustness of results. Treatment with miltefosine resulted in substantially lower cost-per-cure from a societal and patient perspective, and slightly higher cost-per-cure from a government payer perspective compared to MA. Mean societal cost-per-cure were $531 (SD±$239) for MA and $188 (SD±$100) for miltefosine, a mean cost-per-cure difference of +$343. Mean cost-per-cure from a patient perspective were $442 (SD ±$233) for MA and $30 (SD±$16) for miltefosine, a mean difference of +$412. Mean cost-per-cure from a government perspective were $89 (SD±$55) for MA and $158 (SD±$98) for miltefosine, with a mean difference of -$69. Results were robust across a variety of assumptions in univariate and multi-way analysis. CONCLUSIONS/SIGNIFICANCE Treatment of pediatric cutaneous leishmaniasis with miltefosine via cDOT is cost saving from patient and societal perspectives, and moderately more costly from the government payer perspective compared to treatment with MA. Results were robust over a range of sensitivity analyses. Lower drug price for miltefosine could result in cost saving from a government perspective.
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Affiliation(s)
- Brandon A. Berger
- University of Chicago Pritzker School of Medicine, Chicago, Illinois, United States of America
| | - Alexandra Cossio
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Valle de Cauca, Colombia
| | - Nancy Gore Saravia
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Valle de Cauca, Colombia
| | - Maria del Mar Castro
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Valle de Cauca, Colombia
| | - Sergio Prada
- PROESA, Universidad Icesi, Cali, Valle de Cauca, Colombia
| | - Allison H. Bartlett
- Department of Pediatrics, Section of Infectious Diseases, University of Chicago Medicine, Chicago, Illinois, United States of America
| | - Mai T. Pho
- Department of Medicine, Section of Infectious Diseases and Global Health, University of Chicago, Chicago, Illinois, United States of America
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de Araújo MV, David CC, Neto JC, de Oliveira LAPL, da Silva KCJ, Dos Santos JM, da Silva JKS, de A Brandão VBC, Silva TMS, Camara CA, Alexandre-Moreira MS. Evaluation on the leishmanicidal activity of 2-N,N'-dialkylamino-1,4-naphthoquinone derivatives. Exp Parasitol 2017; 176:46-51. [PMID: 28174101 DOI: 10.1016/j.exppara.2017.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 12/20/2016] [Accepted: 02/03/2017] [Indexed: 10/20/2022]
Abstract
Parasites of the Leishmania genus are the causative agents of leishmaniasis in humans, a disease that affects more than 12 million people worldwide. In this study was evaluated in vitro leishmanicidal activity of 2-N,N'-dialkylamino-1,4-naphthoquinone derivatives, covering a series of fourteen 2-N-morpholino-, 2-N-thiomorpholino, 2-N-piperidino, 2-N-(N4-methyl)-piperazino naphthoquinones (1a-n) derived from nor-lapachol and lawsone, belong to some other di-alkyaminoderivatives. At the cytotoxicity assay on peritoneal macrophages, the compounds possessing larger alkyl groups and N-methyl-piperazino moiety (1d, 1h, 1i and 1k), showed toxic effects similar to the standard drug used pentamidine. However, the other compounds of the series showed no deleterious effect on the host cell. Meanwhile, these cytotoxic derivatives (1d, 1h and 1i) had pronounced leishmanicidal activity against L. amazonensis promastigotes, and treatments with six other compounds (1d, 1e, 1f, 1h, 1k and 1n) had significant effect leishmanicidal against L. chagasi promastigotes. In the assay against L. chagasi amastigotes, eight compounds (1a, 1b, 1c, 1d, 1h, 1i, 1k and 1m) showed significant activity. Moreover, the compounds (1a, 1b, 1c, and 1m) showed effect against amastigotes of L. chagasi and not being toxic to the host cell. These data show the derivatives as promising substances for research leishmanicidal activity.
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Affiliation(s)
- Morgana V de Araújo
- Laboratory of Pharmacology and Immunity, Institute of Biological Sciences and Health, Federal University of Alagoas, 57020-720, Maceió, AL, Brazil.
| | - Cibelle Cabral David
- Laboratory of Bioactive Compounds Synthesis, Molecular Sciences Department, Federal Rural University of Pernambuco, 52171-900, Recife, PE, Brazil.
| | - José Clementino Neto
- Laboratory of Pharmacology and Immunity, Institute of Biological Sciences and Health, Federal University of Alagoas, 57020-720, Maceió, AL, Brazil.
| | - Luiz A P L de Oliveira
- Laboratory of Pharmacology and Immunity, Institute of Biological Sciences and Health, Federal University of Alagoas, 57020-720, Maceió, AL, Brazil.
| | - Karoline Cristina Jatobá da Silva
- Laboratory of Pharmacology and Immunity, Institute of Biological Sciences and Health, Federal University of Alagoas, 57020-720, Maceió, AL, Brazil.
| | - Jefferson Miguel Dos Santos
- Laboratory of Pharmacology and Immunity, Institute of Biological Sciences and Health, Federal University of Alagoas, 57020-720, Maceió, AL, Brazil.
| | - João Kayke S da Silva
- Laboratory of Pharmacology and Immunity, Institute of Biological Sciences and Health, Federal University of Alagoas, 57020-720, Maceió, AL, Brazil
| | - Victoria B C de A Brandão
- Laboratory of Bioactive Compounds Synthesis, Molecular Sciences Department, Federal Rural University of Pernambuco, 52171-900, Recife, PE, Brazil.
| | - Tania M S Silva
- Laboratory of Bioactive Compounds Synthesis, Molecular Sciences Department, Federal Rural University of Pernambuco, 52171-900, Recife, PE, Brazil.
| | - Celso A Camara
- Laboratory of Bioactive Compounds Synthesis, Molecular Sciences Department, Federal Rural University of Pernambuco, 52171-900, Recife, PE, Brazil.
| | - Magna S Alexandre-Moreira
- Laboratory of Pharmacology and Immunity, Institute of Biological Sciences and Health, Federal University of Alagoas, 57020-720, Maceió, AL, Brazil.
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Metzdorf IP, da Costa Lima MS, de Fatima Cepa Matos M, de Souza Filho AF, de Souza Tsujisaki RA, Franco KG, Shapiro JT, de Almeida Borges F. Molecular characterization of Leishmania infantum in domestic cats in a region of Brazil endemic for human and canine visceral leishmaniasis. Acta Trop 2017; 166:121-125. [PMID: 27851895 DOI: 10.1016/j.actatropica.2016.11.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 09/26/2016] [Accepted: 11/11/2016] [Indexed: 12/01/2022]
Abstract
Leishmaniasis is a "neglected tropical disease" and serious public health issue in Brazil. While dogs are recognized as particularly important reservoirs, recent reports of domestic cats infected with Leishmania sp. in urban areas suggest their participation in the epidemiological chain of the parasite in endemic areas. The aim of this study was to screen domestic cats for Leishmania sp. infection in an area where human and canine visceral leishmaniasis are endemic, followed by the identification of the species circulating in cats. We collected peripheral blood, lymph-node aspirates and bone marrow from 100 adult animals, both male and female, and analyzed the samples using cytological and molecular (PCR) detection techniques. We detected Leishmania in 6% of animals, which were then analyzed by RFLP-PCR to identify the species. Leishmania infantum (synonym: L. chagasi), a species responsible for visceral leishmaniasis in humans and other animals, was identified from all six samples. Amastigotes were observed in the peripheral blood, bone marrow and lymph-node aspirates in 4 of the 6 PCR-positive animals. The presence of infected cats in endemic areas should not be neglected, because it demonstrates the potential role of these animals in the biological cycle of the pathogen.
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Affiliation(s)
- Isabel Parizotto Metzdorf
- Laboratório de Doenças Parasitárias, Universidade Federal de Mato Grosso do Sul, UFMS, 79070-900 Campo Grande, MS, Brazil.
| | - Manoel Sebastião da Costa Lima
- Laboratório de Imunopatologia e Biologia Molecular, Fundação Oswaldo Cruz (Fiocruz), Centro de Pesquisas Ageu Magalhães (CPqAM), CEP: 50.740- 465 Recife, PE, Brazil.
| | - Maria de Fatima Cepa Matos
- Laboratório de Biologia Molecular e Culturas Celulares, Universidade Federal de Mato Grosso do Sul, UFMS, 79090-900 Campo Grande, MS, Brazil.
| | | | - Rosianne A de Souza Tsujisaki
- Laboratório de Biologia Molecular e Culturas Celulares, Universidade Federal de Mato Grosso do Sul, UFMS, 79090-900 Campo Grande, MS, Brazil.
| | - Karina Garcia Franco
- Laboratório de Biologia Molecular e Culturas Celulares, Universidade Federal de Mato Grosso do Sul, UFMS, 79090-900 Campo Grande, MS, Brazil.
| | - Julie Teresa Shapiro
- School of Natural Resources and Environment, University of Florida, 103 Black Hall, Gainesville FL 32611, USA; Department of Wildlife Ecology and Conservation, University of Florida, Newins-Ziegler Hall, Gainesville FL 32611, USA.
| | - Fernando de Almeida Borges
- Laboratório de Doenças Parasitárias, Universidade Federal de Mato Grosso do Sul, UFMS, 79070-900 Campo Grande, MS, Brazil.
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105
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Akhoundi M, Downing T, Votýpka J, Kuhls K, Lukeš J, Cannet A, Ravel C, Marty P, Delaunay P, Kasbari M, Granouillac B, Gradoni L, Sereno D. Leishmania infections: Molecular targets and diagnosis. Mol Aspects Med 2017; 57:1-29. [PMID: 28159546 DOI: 10.1016/j.mam.2016.11.012] [Citation(s) in RCA: 186] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 11/08/2016] [Accepted: 11/28/2016] [Indexed: 12/15/2022]
Abstract
Progress in the diagnosis of leishmaniases depends on the development of effective methods and the discovery of suitable biomarkers. We propose firstly an update classification of Leishmania species and their synonymies. We demonstrate a global map highlighting the geography of known endemic Leishmania species pathogenic to humans. We summarize a complete list of techniques currently in use and discuss their advantages and limitations. The available data highlights the benefits of molecular markers in terms of their sensitivity and specificity to quantify variation from the subgeneric level to species complexes, (sub) species within complexes, and individual populations and infection foci. Each DNA-based detection method is supplied with a comprehensive description of markers and primers and proposal for a classification based on the role of each target and primer in the detection, identification and quantification of leishmaniasis infection. We outline a genome-wide map of genes informative for diagnosis that have been used for Leishmania genotyping. Furthermore, we propose a classification method based on the suitability of well-studied molecular markers for typing the 21 known Leishmania species pathogenic to humans. This can be applied to newly discovered species and to hybrid strains originating from inter-species crosses. Developing more effective and sensitive diagnostic methods and biomarkers is vital for enhancing Leishmania infection control programs.
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Affiliation(s)
- Mohammad Akhoundi
- Service de Parasitologie-Mycologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, Nice, France; MIVEGEC, UMR CNRS5290-IRD224-Université de Montpellier Centre IRD, Montpellier, France.
| | - Tim Downing
- School of Biotechnology, Dublin City University, Dublin, Ireland
| | - Jan Votýpka
- Biology Centre, Institute of Parasitology, Czech Academy of Sciences, České Budějovice, Czech Republic; Department of Parasitology, Faculty of Science, Charles University in Prague, Prague, Czech Republic
| | - Katrin Kuhls
- Division of Molecular Biotechnology and Functional Genomics, Technical University of Applied Sciences Wildau, Wildau, Germany
| | - Julius Lukeš
- Biology Centre, Institute of Parasitology, Czech Academy of Sciences, České Budějovice, Czech Republic; Faculty of Sciences, University of South Bohemia, České Budějovice, Czech Republic; Canadian Institute for Advanced Research, Toronto, Canada
| | - Arnaud Cannet
- Inserm U1065, Centre Méditerranéen de Médecine Moléculaire, Université de Nice-Sophia Antipolis, Nice, France
| | - Christophe Ravel
- French National Reference Centre on Leishmaniasis, Montpellier University, Montpellier, France
| | - Pierre Marty
- Service de Parasitologie-Mycologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, Nice, France; Inserm U1065, Centre Méditerranéen de Médecine Moléculaire, Université de Nice-Sophia Antipolis, Nice, France
| | - Pascal Delaunay
- Service de Parasitologie-Mycologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, Nice, France; Inserm U1065, Centre Méditerranéen de Médecine Moléculaire, Université de Nice-Sophia Antipolis, Nice, France; MIVEGEC, UMR CNRS5290-IRD224-Université de Montpellier Centre IRD, Montpellier, France
| | - Mohamed Kasbari
- Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail, ANSES, Laboratoire de Santé Animale, Maisons-Alfort, Cedex, France
| | - Bruno Granouillac
- IRD/UMI 233, INSERM U1175, Montpellier University, Montpellier, France; MIVEGEC, UMR CNRS5290-IRD224-Université de Montpellier Centre IRD, Montpellier, France
| | - Luigi Gradoni
- Unit of Vector-borne Diseases and International Health, Istituto Superiore di Sanità, Rome, Italy
| | - Denis Sereno
- MIVEGEC, UMR CNRS5290-IRD224-Université de Montpellier Centre IRD, Montpellier, France; Intertryp UMR IRD177, Centre IRD de Montpellier, Montpellier, France
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106
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Agallou M, Margaroni M, Athanasiou E, Toubanaki DK, Kontonikola K, Karidi K, Kammona O, Kiparissides C, Karagouni E. Identification of BALB/c Immune Markers Correlated with a Partial Protection to Leishmania infantum after Vaccination with a Rationally Designed Multi-epitope Cysteine Protease A Peptide-Based Nanovaccine. PLoS Negl Trop Dis 2017; 11:e0005311. [PMID: 28114333 PMCID: PMC5295723 DOI: 10.1371/journal.pntd.0005311] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 02/07/2017] [Accepted: 01/09/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Through their increased potential to be engaged and processed by dendritic cells (DCs), nanovaccines consisting of Poly(D,L-lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) loaded with both antigenic moieties and adjuvants are attractive candidates for triggering specific defense mechanisms against intracellular pathogens. The aim of the present study was to evaluate the immunogenicity and prophylactic potential of a rationally designed multi-epitope peptide of Leishmania Cysteine Protease A (CPA160-189) co-encapsulated with Monophosphoryl lipid A (MPLA) in PLGA NPs against L. infantum in BALB/c mice and identify immune markers correlated with protective responses. METHODOLOGY/PRINCIPAL FINDINGS The DCs phenotypic and functional features exposed to soluble (CPA160-189, CPA160-189+MPLA) or encapsulated in PLGA NPs forms of peptide and adjuvant (PLGA-MPLA, PLGA-CPA160-189, PLGA-CPA160-189+MPLA) was firstly determined using BALB/c bone marrow-derived DCs. The most potent signatures of DCs maturation were obtained with the PLGA-CPA160-189+MPLA NPs. Subcutaneous administration of PLGA-CPA160-189+MPLA NPs in BALB/c mice induced specific anti-CPA160-189 cellular and humoral immune responses characterized by T cells producing high amounts of IL-2, IFN-γ and TNFα and IgG1/IgG2a antibodies. When these mice were challenged with 2x107 stationary phase L. infantum promastigotes, they displayed significant reduced hepatic (48%) and splenic (90%) parasite load at 1 month post-challenge. This protective phenotype was accompanied by a strong spleen lymphoproliferative response and high levels of IL-2, IFN-γ and TNFα versus low IL-4 and IL-10 secretion. Although, at 4 months post-challenge, the reduced parasite load was preserved in the liver (61%), an increase was detected in the spleen (30%), indicating a partial vaccine-induced protection. CONCLUSIONS/SIGNIFICANCE This study provide a basis for the development of peptide-based nanovaccines against leishmaniasis, since it reveals that vaccination with well-defined Leishmania MHC-restricted epitopes extracted from various immunogenic proteins co-encapsulated with the proper adjuvant or/and phlebotomine fly saliva multi-epitope peptides into clinically compatible PLGA NPs could be a promising approach for the induction of a strong and sustainable protective immunity.
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Affiliation(s)
- Maria Agallou
- Department of Microbiology, Hellenic Pasteur Institute, Athens, Greece
| | - Maritsa Margaroni
- Department of Microbiology, Hellenic Pasteur Institute, Athens, Greece
| | - Evita Athanasiou
- Department of Microbiology, Hellenic Pasteur Institute, Athens, Greece
| | | | - Katerina Kontonikola
- Chemical Process & Energy Resources Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Konstantina Karidi
- Chemical Process & Energy Resources Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Olga Kammona
- Chemical Process & Energy Resources Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Costas Kiparissides
- Chemical Process & Energy Resources Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
- Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evdokia Karagouni
- Department of Microbiology, Hellenic Pasteur Institute, Athens, Greece
- * E-mail:
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The Role of Natural Products in Drug Discovery and Development against Neglected Tropical Diseases. Molecules 2016; 22:molecules22010058. [PMID: 28042865 PMCID: PMC6155950 DOI: 10.3390/molecules22010058] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 12/23/2016] [Accepted: 12/27/2016] [Indexed: 12/20/2022] Open
Abstract
Endemic in 149 tropical and subtropical countries, neglected tropical diseases (NTDs) affect more than 1 billion people annually, including 875 million children in developing economies. These diseases are also responsible for over 500,000 deaths per year and are characterized by long-term disability and severe pain. The impact of the combined NTDs closely rivals that of malaria and tuberculosis. Current treatment options are associated with various limitations including widespread drug resistance, severe adverse effects, lengthy treatment duration, unfavorable toxicity profiles, and complicated drug administration procedures. Natural products have been a valuable source of drug regimens that form the cornerstone of modern pharmaceutical care. In this review, we highlight the potential that remains untapped in natural products as drug leads for NTDs. We cover natural products from plant, marine, and microbial sources including natural-product-inspired semi-synthetic derivatives which have been evaluated against the various causative agents of NTDs. Our coverage is limited to four major NTDs which include human African trypanosomiasis (sleeping sickness), leishmaniasis, schistosomiasis and lymphatic filariasis.
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108
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Arginase Is Essential for Survival of Leishmania donovani Promastigotes but Not Intracellular Amastigotes. Infect Immun 2016; 85:IAI.00554-16. [PMID: 27795357 PMCID: PMC5203656 DOI: 10.1128/iai.00554-16] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 10/16/2016] [Indexed: 12/12/2022] Open
Abstract
Studies of Leishmania donovani have shown that both ornithine decarboxylase and spermidine synthase, two enzymes of the polyamine biosynthetic pathway, are critical for promastigote proliferation and required for maximum infection in mice. However, the importance of arginase (ARG), the first enzyme of the polyamine pathway in Leishmania, has not been analyzed in L. donovani. To test ARG function in intact parasites, we generated Δarg null mutants in L. donovani and evaluated their ability to proliferate in vitro and trigger infections in mice. The Δarg knockout was incapable of growth in the absence of polyamine supplementation, but the auxotrophic phenotype could be bypassed by addition of either millimolar concentrations of ornithine or micromolar concentrations of putrescine or by complementation with either glycosomal or cytosolic versions of ARG. Spermidine supplementation of the medium did not circumvent the polyamine auxotrophy of the Δarg line. Although ARG was found to be essential for ornithine and polyamine synthesis, ornithine decarboxylase appeared to be the rate-limiting enzyme for polyamine production. Mouse infectivity studies revealed that the Δarg lesion reduced parasite burdens in livers by an order of magnitude but had little impact on the numbers of parasites recovered from spleens. Thus, ARG is essential for proliferation of promastigotes but not intracellular amastigotes. Coupled with previous studies, these data support a model in which L. donovani amastigotes readily salvage ornithine and have some access to host spermidine pools, while host putrescine appears to be unavailable for salvage by the parasite.
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109
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Yizengaw E, Getahun M, Tajebe F, Cruz Cervera E, Adem E, Mesfin G, Hailu A, Van der Auwera G, Yardley V, Lemma M, Skhedy Z, Diro E, Yeshanew A, Melkamu R, Mengesha B, Modolell M, Munder M, Müller I, Takele Y, Kropf P. Visceral Leishmaniasis Patients Display Altered Composition and Maturity of Neutrophils as well as Impaired Neutrophil Effector Functions. Front Immunol 2016; 7:517. [PMID: 27965662 PMCID: PMC5126105 DOI: 10.3389/fimmu.2016.00517] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 11/07/2016] [Indexed: 11/13/2022] Open
Abstract
Immunologically, active visceral leishmaniasis (VL) is characterized by profound immunosuppression, severe systemic inflammatory responses, and an impaired capacity to control parasite replication. Neutrophils are highly versatile cells, which play a crucial role in the induction as well as the resolution of inflammation, the control of pathogen replication, and the regulation of immune responses. Neutrophil functions have been investigated in human cutaneous leishmaniasis; however, their role in human VL is poorly understood. In the present study we evaluated the activation status and effector functions of neutrophils in patients with active VL and after successful anti-leishmanial treatment. Our results show that neutrophils are highly activated and have degranulated; high levels of arginase, myeloperoxidase, and elastase, all contained in neutrophils' granules, were found in the plasma of VL patients. In addition, we show that a large proportion of these cells are immature. We also analyzed effector functions of neutrophils that are essential for pathogen clearance and show that neutrophils have an impaired capacity to release neutrophil extracellular traps, produce reactive oxygen species, and phagocytose bacterial particles, but not Leishmania parasites. Our results suggest that impaired effector functions, increased activation, and immaturity of neutrophils play a key role in the pathogenesis of VL.
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Affiliation(s)
- Endalew Yizengaw
- Department of Immunology, University of Gondar , Gondar , Ethiopia
| | - Mulusew Getahun
- Department of Immunology, University of Gondar , Gondar , Ethiopia
| | | | | | - Emebet Adem
- Leishmaniasis Research and Treatment Centre, Gondar University , Gondar , Ethiopia
| | - Getnet Mesfin
- Department of Immunology, University of Gondar , Gondar , Ethiopia
| | - Asrat Hailu
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University , Addis Ababa , Ethiopia
| | - Gert Van der Auwera
- Department of Biomedical Sciences, Institute of Tropical Medicine , Antwerp , Belgium
| | - Vanessa Yardley
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine , London , UK
| | - Mulualem Lemma
- Department of Internal Medicine, University of Gondar , Gondar , Ethiopia
| | - Ziv Skhedy
- Department of Mathematics and Statistics, University of Hasselt , Hasselt , Belgium
| | - Ermias Diro
- Leishmaniasis Research and Treatment Centre, Gondar University , Gondar , Ethiopia
| | - Arega Yeshanew
- Leishmaniasis Research and Treatment Centre, Gondar University , Gondar , Ethiopia
| | - Roma Melkamu
- Leishmaniasis Research and Treatment Centre, Gondar University , Gondar , Ethiopia
| | - Bewketu Mengesha
- Leishmaniasis Research and Treatment Centre, Gondar University , Gondar , Ethiopia
| | - Manuel Modolell
- Department of Cellular Immunology, Max-Planck-Institute for Immunobiology and Epigenetics , Freiburg , Germany
| | - Markus Munder
- Third Department of Medicine (Hematology, Oncology, and Pneumology), University Medical Center Mainz , Mainz , Germany
| | - Ingrid Müller
- Department of Medicine, Imperial College London , London , UK
| | - Yegnasew Takele
- Department of Medicine, Imperial College London, London, UK; Leishmaniasis Research and Treatment Centre, Gondar University, Gondar, Ethiopia
| | - Pascale Kropf
- Department of Medicine, Imperial College London , London , UK
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Diro E, Yansouni CP, Takele Y, Mengesha B, Lynen L, Hailu A, van Griensven J, Boelaert M, Büscher P. Diagnosis of Visceral Leishmaniasis Using Peripheral Blood Microscopy in Ethiopia: A Prospective Phase-III Study of the Diagnostic Performance of Different Concentration Techniques Compared to Tissue Aspiration. Am J Trop Med Hyg 2016; 96:190-196. [PMID: 27799651 DOI: 10.4269/ajtmh.16-0362] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 09/25/2016] [Indexed: 11/07/2022] Open
Abstract
Visceral leishmaniasis (VL) is a fatal parasitic disease. Unfortunately, diagnosis of VL in east Africa currently relies on aspiration of tissue from the spleen or bone marrow, which is painful and potentially dangerous. We sought to determine whether peripheral blood could be used instead of invasive tissue aspirates to diagnose VL, using three parasite concentration techniques. Three hundred and one consecutive people suspected of having VL were recruited. Compared with microscopy of tissue aspirates, the diagnostic accuracy of peripheral blood microscopy was as follows: whole blood thin smear sensitivity 1.5% (95% confidence interval [CI] 0.0-8.3) and specificity 100% (95% CI 76.8-100); buffy-coat smear sensitivity 19.5% (95% CI 14.3-25.6) and specificity 98.9% (95% CI 94.1-100); peripheral blood mononuclear cell (PBMC) smear sensitivity 33.7% (95% CI 27.3-40.5) and specificity 95.7% (95% CI 89.6-98.6). Sensitivity of PBMC smears was significantly higher in human immunodeficiency virus (HIV)-coinfected patients (N = 48/301); two-sample test of proportions, P = 0.0097; sensitivity 55.9% (95% CI 37.9-72.8) and specificity 92.9% (95% CI 66.1-99.8), and correlated with the degree of parasite load in the tissue. Combining the results from smears of both PBMC and buffy coat yielded a sensitivity and specificity of 67.6% (95% CI 49.1-82.6) and 92.9% (95% CI 66.1-99.8), respectively, in HIV-coinfected patients. In this setting, VL could be ruled-in with peripheral blood microscopy in a substantial number of VL suspects and may reduce the number of tissue aspirations performed, particularly in HIV-coinfected patients. More sensitive and logistically feasible methods than light microscopy are needed to detect Leishmania donovani parasites present in blood.
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Affiliation(s)
- Ermias Diro
- University of Gondar, Gondar, Ethiopia.,Institute of Tropical Medicine, Antwerp, Belgium
| | - Cedric P Yansouni
- J.D. MacLean Centre for Tropical Diseases at McGill University, Montreal, Canada.
| | | | | | | | - Asrat Hailu
- School of Medicine, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
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Can You Judge a Disease Host by the Company It Keeps? Predicting Disease Hosts and Their Relative Importance: A Case Study for Leishmaniasis. PLoS Negl Trop Dis 2016; 10:e0005004. [PMID: 27716833 PMCID: PMC5055336 DOI: 10.1371/journal.pntd.0005004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 08/25/2016] [Indexed: 11/23/2022] Open
Abstract
Zoonoses are an important class of infectious diseases. An important element determining the impact of a zoonosis on domestic animal and human health is host range. Although for particular zoonoses some host species have been identified, until recently there have been no methods to predict those species most likely to be hosts or their relative importance. Complex inference networks infer potential biotic interactions between species using their degree of geographic co-occurrence, and have been posited as a potential tool for predicting disease hosts. Here we present the results of an interdisciplinary, empirical study to validate a model based on such networks for predicting hosts of Leishmania (L.) mexicana in Mexico. Using systematic sampling to validate the model predictions we identified 22 new species of host (34% of all species collected) with the probability to be a host strongly dependent on the probability of co-occurrence of vector and host. The results confirm that Leishmania (L.) mexicana is a generalist parasite but with a much wider host range than was previously thought. These results substantially change the geographic risk profile for Leishmaniasis and provide insights for the design of more efficient surveillance measures and a better understanding of potential dispersal scenarios. Emerging and neglected zoonoses are an important global threat to public health. Host range, in particular, is a crucial factor in determining disease risk and the potential for adequate interventions. Here we show that Leishmania has a very wide host range and that Complex Inference Networks can be used to infer ecological relationships in the context of zoonoses, identifying both the potential hosts and their relative importance. These results substantially change the risk profile and potential control measures that can be used to combat the disease, allowing for the design of more efficient surveillance measures and a better understanding of potential dispersal scenarios.
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112
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Berry I, Berrang-Ford L. Leishmaniasis, conflict, and political terror: A spatio-temporal analysis. Soc Sci Med 2016; 167:140-9. [DOI: 10.1016/j.socscimed.2016.04.038] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 03/06/2016] [Accepted: 04/27/2016] [Indexed: 11/26/2022]
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Mendonça SCF. Differences in immune responses against Leishmania induced by infection and by immunization with killed parasite antigen: implications for vaccine discovery. Parasit Vectors 2016; 9:492. [PMID: 27600664 PMCID: PMC5013623 DOI: 10.1186/s13071-016-1777-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 08/26/2016] [Indexed: 01/06/2023] Open
Abstract
The leishmaniases are a group of diseases caused by different species of the protozoan genus Leishmania and transmitted by sand fly vectors. They are a major public health problem in almost all continents. There is no effective control of leishmaniasis and its geographical distribution is expanding in many countries. Great effort has been made by many scientists to develop a vaccine against leishmaniasis, but, so far, there is still no effective vaccine against the disease. The only way to generate protective immunity against leishmaniasis in humans is leishmanization, consisting of the inoculation of live virulent Leishmania as a means to acquire long-lasting immunity against subsequent infections. At present, all that we know about human immune responses to Leishmania induced by immunization with killed parasite antigens came from studies with first generation candidate vaccines (killed promastigote extracts). In the few occasions that the T cell-mediated immune responses to Leishmania induced by infection and immunization with killed parasite antigens were compared, important differences were found both in humans and in animals. This review discusses these differences and their relevance to the development of a vaccine against leishmaniasis, the major problems involved in this task, the recent prospects for the selection of candidate antigens and the use of attenuated Leishmania as live vaccines.
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Affiliation(s)
- Sergio C F Mendonça
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Av. 4365 - Manguinhos, 21040-360, Rio de Janeiro, Brazil.
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Resende LA, Aguiar-Soares RDDO, Gama-Ker H, Roatt BM, de Mendonça LZ, Alves MLR, da Silveira-Lemos D, Corrêa-Oliveira R, Martins-Filho OA, Araújo MSS, Fujiwara RT, Gontijo NF, Reis AB, Giunchetti RC. Impact of LbSapSal Vaccine in Canine Immunological and Parasitological Features before and after Leishmania chagasi-Challenge. PLoS One 2016; 11:e0161169. [PMID: 27556586 PMCID: PMC4996460 DOI: 10.1371/journal.pone.0161169] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 07/24/2016] [Indexed: 11/18/2022] Open
Abstract
Dogs represent the most important domestic reservoir of L. chagasi (syn. L. infantum). A vaccine against canine visceral leishmaniasis (CVL) would be an important tool for decreasing the anxiety related to possible L. chagasi infection and for controlling human visceral leishmaniasis (VL). Because the sand fly salivary proteins are potent immunogens obligatorily co-deposited during transmission of Leishmania parasites, their inclusion in an anti-Leishmania vaccine has been investigated in past decades. We investigated the immunogenicity of the "LbSapSal" vaccine (L. braziliensis antigens, saponin as adjuvant, and Lutzomyia longipalpis salivary gland extract) in dogs at baseline (T0), during the post-vaccination protocol (T3rd) and after early (T90) and late (T885) times following L. chagasi-challenge. Our major data indicated that immunization with "LbSapSal" is able to induce biomarkers characterized by enhanced amounts of type I (tumor necrosis factor [TNF]-α, interleukin [IL]-12, interferon [IFN]-γ) cytokines and reduction in type II cytokines (IL-4 and TGF-β), even after experimental challenge. The establishment of a prominent pro-inflammatory immune response after "LbSapSal" immunization supported the increased levels of nitric oxide production, favoring a reduction in spleen parasitism (78.9%) and indicating long-lasting protection against L. chagasi infection. In conclusion, these results confirmed the hypothesis that the "LbSapSal" vaccination is a potential tool to control the Leishmania chagasi infection.
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Affiliation(s)
- Lucilene Aparecida Resende
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Rodrigo Dian de Oliveira Aguiar-Soares
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Henrique Gama-Ker
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Bruno Mendes Roatt
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Ludmila Zanandreis de Mendonça
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marina Luiza Rodrigues Alves
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Denise da Silveira-Lemos
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Centro de Pesquisa René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Rodrigo Corrêa-Oliveira
- Laboratório de Imunologia Celular e Molecular, Centro de Pesquisa René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Olindo Assis Martins-Filho
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Centro de Pesquisa René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Márcio Sobreira Silva Araújo
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Centro de Pesquisa René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Toshio Fujiwara
- Laboratório de Imunologia e Genômica de Parasitos – Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Nelder Figueiredo Gontijo
- Laboratório de Fisiologia de Insetos Hematófagos, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alexandre Barbosa Reis
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- Laboratório de Imunologia Celular e Molecular, Centro de Pesquisa René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Rodolfo Cordeiro Giunchetti
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Centro de Pesquisa René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
- * E-mail: ;
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115
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Evaluation of Immunofluorescence Antibody Test Used for the Diagnosis of Canine Leishmaniasis in the Mediterranean Basin: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0161051. [PMID: 27537405 PMCID: PMC4990183 DOI: 10.1371/journal.pone.0161051] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 07/30/2016] [Indexed: 11/23/2022] Open
Abstract
With an expected sensitivity (Se) of 96% and specificity (Sp) of 98%, the immunofluorescence antibody test (IFAT) is frequently used as a reference test to validate new diagnostic methods and estimate the canine leihmaniasis (CanL) true prevalence in the Mediterranean basin. To review the diagnostic accuracy of IFAT to diagnose CanL in this area with reference to its Se and Sp and elucidate the potential causes of their variations, a systematic review was conducted (31 studies for the 26-year period). Three IFAT validation methods stood out: the classical contingency table method, methods based on statistical models and those based on experimental studies. A variation in the IFAT Se and Sp values and cut-off values was observed. For the classical validation method based on a meta-analysis, the Se of IFAT was estimated in this area as 89.86% and 31.25% in symptomatic and asymptomatic dogs, respectively. The Sp of IFAT was estimated in non-endemic and endemic areas as 98.12% and 96.57%, respectively. IFAT can be considered as a good standard test in non-endemic areas for CanL, but its accuracy declines in endemic areas due to the complexity of the disease. Indeed, the accuracy of IFAT is due to the negative results obtained in non-infected dogs from non-endemic areas and to the positive results obtained in sera of symptomatic dogs living in endemic areas. But IFAT results are not unequivocal when it comes to determining CanL infection on asymptomatic dogs living in endemic areas. Statistical methods might be a solution to overcome the lack of gold standard, to better categorize groups of animals investigated, to assess optimal cut-off values and to allow a better estimate of the true prevalence aiming information on preventive/control measures for CanL.
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Ramírez JD, Hernández C, León CM, Ayala MS, Flórez C, González C. Taxonomy, diversity, temporal and geographical distribution of Cutaneous Leishmaniasis in Colombia: A retrospective study. Sci Rep 2016; 6:28266. [PMID: 27328969 PMCID: PMC4916406 DOI: 10.1038/srep28266] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 06/01/2016] [Indexed: 11/13/2022] Open
Abstract
Leishmaniases are tropical zoonotic diseases, caused by kinetoplastid parasites from the genus Leishmania. New World (NW) species are related to sylvatic cycles although urbanization processes have been reported in some South American Countries such as Colombia. Currently, few studies show the relative distribution of Leishmania species related to cutaneous Leishmaniasis (CL) in South America due to the lack of accurate surveillance and public health systems. Herein, we conducted a systematic estimation of the Leishmania species causing CL in Colombia from 1980 to 2001 via molecular typing and isoenzymes. A total of 327 Leishmania isolates from humans, sandflies and reservoirs were typed as L. panamensis 61.3% (201), L. braziliensis 27.1% (88), L. lainsoni 0.6% (2), L. guyanensis 0.9% (3), L. infantum chagasi 4% (12), L. equatoriensis 0.6% (2), L. mexicana 2.1% (8), L. amazonensis 2.8% (9) and L. colombiensis 0.6% (2). This is the first report of two new Leishmania species circulating in Colombia and suggests the need to convince the Colombian government about the need to deploy and standardize tools for the species identification to provide adequate management to individuals suffering this pathology.
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Affiliation(s)
- Juan David Ramírez
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá-Colombia
| | | | - Cielo M. León
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá-Colombia
| | - Martha S. Ayala
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá-Colombia
| | - Carolina Flórez
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá-Colombia
| | - Camila González
- Centro de Investigaciones en Microbiología y Parasitología Tropica (CIMPAT), Universidad de Los Andes, Bogotá-Colombia
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Haouas N. Estimations of cutaneous leishmaniasis burden: a constant challenge. THE LANCET. INFECTIOUS DISEASES 2016; 16:515-516. [PMID: 26879177 DOI: 10.1016/s1473-3099(16)00058-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 06/05/2023]
Affiliation(s)
- Najoua Haouas
- College of Applied Medical Sciences, Clinical Laboratory Sciences Department, University of Hail, Saudi Arabia; Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire, Département de Biologie Clinique B, Faculté de Pharmacie, Université de Monastir, Tunisia.
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118
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Du R, Hotez PJ, Al-Salem WS, Acosta-Serrano A. Old World Cutaneous Leishmaniasis and Refugee Crises in the Middle East and North Africa. PLoS Negl Trop Dis 2016; 10:e0004545. [PMID: 27227772 PMCID: PMC4882064 DOI: 10.1371/journal.pntd.0004545] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Rebecca Du
- Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development, Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Peter J. Hotez
- Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development, Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- Department of Biology, Baylor University, Waco, Texas, United States of America
- James A. Baker III Institute, Rice University, Houston, Texas, United States of America
| | - Waleed S. Al-Salem
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, England, United Kingdom
| | - Alvaro Acosta-Serrano
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, England, United Kingdom
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, England, United Kingdom
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119
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Menon SS, Rossi R, Nshimyumukiza L, Zinszer K. Decentralized control of human visceral leishmaniasis in endemic urban areas of Brazil: a literature review. Trop Med Health 2016; 44:9. [PMID: 27433128 PMCID: PMC4940922 DOI: 10.1186/s41182-016-0011-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/17/2016] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Human migration and concomitant HIV infections are likely to bring about major changes in the epidemiology of some parasitic infections in Brazil. Human visceral leishmaniasis (HVL) control is particularly fraught with intricacies. It is against a backdrop of decentralized health care that the complex HVL control initiatives are brought to bear. This comprehensive review aims to explore the obstacles facing decentralized HVL control in urban endemic areas in Brazil. METHOD A literature search was carried out in December 2015 by means of three databases: MEDLINE, Google Scholar, and Web of Science. RESULTS Although there have been many strides that have been made in elucidating the eco-epidemiology of Leishmania infantum, which forms the underpinnings of the national control program, transmission risk factors for HVL are still insufficiently elucidated in urban settings. Decentralized HVL epidemiological surveillance and control for animal reservoirs and vectors may compromise sustainability. In addition, it may hamper timely human HVL case management. With the burgeoning of the HIV-HVL co-infection, the potential human transmission may be underestimated. CONCLUSION HVL is a disease with focal transmission at a critical juncture, which warrants that the bottlenecks facing the control program within contexts of decentralized healthcare systems be taken into account. In addition, HIV-driven HVL epidemics may substantially increase the transmission potential of the human reservoir. Calculating the basic reproductive number to fine-tune interventions will have to take into consideration the specific socio-economic development context.
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Affiliation(s)
- Sonia S. Menon
- />International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 P3, 9000 Ghent, Belgium
- />Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
| | | | - Leon Nshimyumukiza
- />Department of Social and Preventive Medicine, Laval University, Boston, USA
| | - Kate Zinszer
- />Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
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Handler MZ, Patel PA, Kapila R, Al-Qubati Y, Schwartz RA. Cutaneous and mucocutaneous leishmaniasis: Clinical perspectives. J Am Acad Dermatol 2016; 73:897-908; quiz 909-10. [PMID: 26568335 DOI: 10.1016/j.jaad.2014.08.051] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 08/11/2014] [Accepted: 08/22/2014] [Indexed: 10/22/2022]
Abstract
Leishmaniasis is endemic in 98 countries and territories, with 1.2 million new cases per year, making it a worldwide concern. The deadly visceral form is a leading cause of death from tropical parasitic infections, second only to malaria. Leishmaniasis appears to be increasing in many countries because of extended urbanization. The disease reservoir includes small mammals; parasite transmission occurs via bite of the female phlebotomine sandfly. Disease manifestations vary and largely depend upon the Leishmania species acquired. It may be first evident with a range of findings-from a localized cutaneous ulcer to diffuse painless dermal nodules-or, in the mucocutaneous form, ulceration of the oropharynx. In the potentially deadly visceral form, the internal organs and bone marrow are affected.
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Affiliation(s)
- Marc Z Handler
- Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Parimal A Patel
- Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Rajendra Kapila
- Infectious Diseases, Rutgers New Jersey Medical School, Newark, New Jersey; Medicine, Rutgers New Jersey Medical School, Newark, New Jersey; Preventive Medicine and Community Health, Rutgers New Jersey Medical School, Newark, New Jersey
| | | | - Robert A Schwartz
- Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey; Medicine, Rutgers New Jersey Medical School, Newark, New Jersey; Preventive Medicine and Community Health, Rutgers New Jersey Medical School, Newark, New Jersey; Rutgers School of Public Affairs and Administration, Newark, New Jersey.
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121
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Karunaweera ND. Leishmaniasis: Path toward elimination from the Indian subcontinent. Trop Parasitol 2016; 6:2-4. [PMID: 26998429 PMCID: PMC4778179 DOI: 10.4103/2229-5070.175023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Nadira D Karunaweera
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka E-mail:
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Adem E, Tajebe F, Getahun M, Kiflie A, Diro E, Hailu A, Shkedy Z, Mengesha B, Mulaw T, Atnafu S, Deressa T, Mathewos B, Abate E, Modolell M, Munder M, Müller I, Takele Y, Kropf P. Successful Treatment of Human Visceral Leishmaniasis Restores Antigen-Specific IFN-γ, but not IL-10 Production. PLoS Negl Trop Dis 2016; 10:e0004468. [PMID: 26962865 PMCID: PMC4786308 DOI: 10.1371/journal.pntd.0004468] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 01/27/2016] [Indexed: 12/31/2022] Open
Abstract
One of the key immunological characteristics of active visceral leishmaniasis (VL) is a profound immunosuppression and impaired production of Interferon-γ (IFN-γ). However, recent studies from Bihar in India showed using a whole blood assay, that whole blood cells have maintained the capacity to produce IFN-γ. Here we tested the hypothesis that a population of low-density granulocytes (LDG) might contribute to T cell responses hyporesponsiveness via the release of arginase. Our results show that this population is affected by the anticoagulant used to collect blood: the frequency of LDGs is significantly lower when the blood is collected with heparin as compared to EDTA; however, the anticoagulant does not impact on the levels of arginase released. Next, we assessed the capacity of whole blood cells from patients with active VL to produce IFN-γ and IL-10 in response to antigen-specific and polyclonal activation. Our results show that whole blood cells produce low or levels below detection limit of IFN-γ and IL-10, however, after successful treatment of VL patients, these cells gradually regain their capacity to produce IFN-γ, but not IL-10, in response to activation. These results suggest that in contrast to VL patients from Bihar, India, whole blood cells from VL patients from Gondar, Ethiopia, have lost their ability to produce IFN-γ during active VL and that active disease is not associated with sustained levels of IL-10 production following stimulation. The leishmaniases, a group of diseases caused by Leishmania parasites, belong to the most neglected tropical diseases: they are mainly found in low-income countries and affect the poorest populations. These parasites infect cells of the immune system called macrophages, which can kill the intracellular parasites in response to soluble mediators they receive from other cells of the immune system, the lymphocytes. Visceral leishmaniasis is the most severe form of the leishmaniases and is characterized by enlarged liver and spleen, fever, weight-loss and anaemia and represents a major public health problem in Ethiopia. Currently there is no vaccine available, the existing treatment has many severe side effects and drug-resistance is increasing. In the present study, we worked with patients suffering from visceral leishmaniasis. This form of the disease is fatal if the patients are not treated. We studied the ability of lymphocytes isolated from their blood to produce soluble mediators before and at different times after the end of treatment. Our results show that the lymphocytes have an impaired capacity to produce the soluble mediator required to instruct infected cells to kill the intracellular parasites, but that this lack of response is gradually restored with time after successful treatment.
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Affiliation(s)
- Emebet Adem
- Department of Immunology, University of Gondar, Ethiopia
| | | | | | - Amare Kiflie
- Department of Immunology, University of Gondar, Ethiopia
| | - Ermias Diro
- Department of Internal Medicine, University of Gondar, Ethiopia
| | - Asrat Hailu
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Ethiopia
| | - Ziv Shkedy
- Department of Mathematics and Statistics, University of Hasselt, Belgium
| | - Bewketu Mengesha
- Leishmaniasis Research and Treatment Centre, Gondar University, Ethiopia
| | - Tadele Mulaw
- Leishmaniasis Research and Treatment Centre, Gondar University, Ethiopia
| | - Saba Atnafu
- Leishmaniasis Research and Treatment Centre, Gondar University, Ethiopia
| | | | | | - Ebba Abate
- Department of Immunology, University of Gondar, Ethiopia
| | - Manuel Modolell
- Department of Cellular Immunology, Max-Planck-Institute for Immunobiology and Epigenetics, Freiburg, Germany
| | - Markus Munder
- Third Department of Medicine (Hematology, Oncology, and Pneumology), University Medical Center Mainz, Mainz, Germany
| | - Ingrid Müller
- Department of Medicine, Imperial College London, London, United Kingdom
| | - Yegnasew Takele
- Leishmaniasis Research and Treatment Centre, Gondar University, Ethiopia
- Department of Medicine, Imperial College London, London, United Kingdom
| | - Pascale Kropf
- Department of Medicine, Imperial College London, London, United Kingdom
- * E-mail:
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Pinheiro MPG, Silva MMDM, Silva Júnior JB, da Silva JHT, Alves MDL, Ximenes MDFFDM. Sand flies (Diptera, Psychodidae, Phlebotominae), vectors of Leishmania protozoa, at an Atlantic Forest Conservation Unit in the municipality of Nísia Floresta, Rio Grande do Norte state, Brazil. Parasit Vectors 2016; 9:83. [PMID: 26864023 PMCID: PMC4750182 DOI: 10.1186/s13071-016-1352-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 01/29/2016] [Indexed: 11/20/2022] Open
Abstract
Background Sand flies are insect vectors of protozoa from the genus Leishmania, causative parasites of visceral and American tegumentary leishmaniases. The present study discusses the bioecological aspects of sand fly species, transmitters of Leishmania protozoa, in different ecotopes of an Atlantic Forest Conservation Unit located in the metropolitan region of Natal, Rio Grande do Norte state, Brazil. Methods Two monthly captures were made in 1 year, using CDC light traps, in two anthropized and two preserved environments. Results A total of 2936 sand flies belonging to the following ten species were captured: Evandromyia walkeri, Evandromyia evandroi, Psychodopygus wellcomei, Sciopemyia sordellii, Psathyromyia brasiliensis, Lutzomyia longipalpis, Evandromyia lenti, Psathyromyia shannoni, Nyssomyia whitmani and Nyssomyia intermedia. The most common species was E. walkeri (77.6 %), followed by E. evandroi (17.5 %). Forest was the site with the greatest abundance (32.4 %), followed by bamboo grove (26.3 %). Conclusions Sand flies were generally more abundant in the rainy season and L. longipalpis, a vector species of Leishmania infantum, was adapted to anthropized environments. It was confirmed that P. wellcomei, a vector of Leishmania braziliensis in Amazônia, is a species associated with more preserved environments, and occurs only in the rainy season.
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Affiliation(s)
- Marcos Paulo Gomes Pinheiro
- Laboratório de Entomologia, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, 3000, Natal, Rio Grande do Norte, Brazil.
| | - Marcel Miranda de Medeiros Silva
- Laboratório de Entomologia, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, 3000, Natal, Rio Grande do Norte, Brazil.
| | - João Batista Silva Júnior
- Laboratório de Entomologia, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, 3000, Natal, Rio Grande do Norte, Brazil.
| | - José Hilário Tavares da Silva
- Laboratório de Entomologia, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, 3000, Natal, Rio Grande do Norte, Brazil.
| | - Maria de Lima Alves
- Laboratório de Entomologia, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, 3000, Natal, Rio Grande do Norte, Brazil.
| | - Maria de Fátima Freire de Melo Ximenes
- Laboratório de Entomologia, Centro de Biociências, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, 3000, Natal, Rio Grande do Norte, Brazil.
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Faraj C, Yukich J, Adlaoui EB, Wahabi R, Mnzava AP, Kaddaf M, El Idrissi AL, Ameur B, Kleinschmidt I. Effectiveness and Cost of Insecticide-Treated Bed Nets and Indoor Residual Spraying for the Control of Cutaneous Leishmaniasis: A Cluster-Randomized Control Trial in Morocco. Am J Trop Med Hyg 2016; 94:679-685. [PMID: 26811431 PMCID: PMC4775907 DOI: 10.4269/ajtmh.14-0510] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 03/19/2015] [Indexed: 11/08/2022] Open
Abstract
Cutaneous leishmaniasis (CL) remains an important public health problem in Morocco. A cluster-randomized trial was conducted with the following three study arms: 1) long-lasting insecticide-treated nets (LLINs) plus standard of care environmental management (SoC-EM), 2) indoor residual spraying (IRS) with α-cypermethrin plus SoC-EM, and 3) SoC-EM alone. Incidence of new CL cases by passive and active case detection, sandfly abundance, and cost and cost-effectiveness was compared between study arms over 5 years. Incidence of CL and sandfly abundance were significantly lower in the IRS arm compared with SoC-EM (CL incidence rate ratio = 0.32, 95% confidence interval [CI] = 0.15–0.69, P = 0.005 and sandfly abundance ratio = 0.39, 95% CI = 0.18–0.85, P = 0.022). Reductions in the LLIN arm of the study were not significant, possibly due to poor compliance. IRS was effective and more cost-effective for the prevention of CL in Morocco.
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Affiliation(s)
| | - Joshua Yukich
- *Address correspondence to Joshua Yukich, Tulane University School of Public Health and Tropical Medicine, Department of Tropical Medicine, 1440 Canal Street, Suite 2300, New Orleans, LA 70112-2715. E-mail:
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4-Arylamino-6-nitroquinazolines: Synthesis and their activities against neglected disease leishmaniasis. Eur J Med Chem 2016; 108:13-20. [DOI: 10.1016/j.ejmech.2015.11.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 11/03/2015] [Accepted: 11/09/2015] [Indexed: 11/21/2022]
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Abstract
Conradina canescens (Lamiaceae) is an endemic evergreen shrub native to Florida, Mississippi and Alabama, with no phytochemical or biological studies registered in the literature. Thus, a phytochemical study and a toxicity analysis of the chloroform extract obtained from the leaves of C. canescens were performed for the first time. In our preliminary screening, the crude extract and its fractions were subjected to cytotoxicity, antimicrobial and antileishmanial bioassays. The crude extract showed substantial cytotoxic, antimicrobial and antileishmanial activities. A total of six compounds, namely ursolic acid (62.4%), betulin (8.4%), β-amyrin (4.6%), myrtenic acid (2.9%), n-tetracosane (1.4%), and oleanolic acid (1.1%), were isolated. The structures of the isolated compounds were established by spectroscopic studies using NMR and IR spectroscopy.
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Hernández-Chinea C, Carbajo E, Sojo F, Arvelo F, Kouznetsov VV, Romero-Bohórquez AR, Romero PJ. In vitro activity of synthetic tetrahydroindeno[2,1-c]quinolines on Leishmania mexicana. Parasitol Int 2015; 64:479-83. [DOI: 10.1016/j.parint.2015.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 06/19/2015] [Accepted: 06/22/2015] [Indexed: 11/28/2022]
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Furtado AS, Nunes FBBDF, Santos AMD, Caldas ADJM. Análise espaço-temporal da leishmaniose visceral no estado do Maranhão, Brasil. CIENCIA & SAUDE COLETIVA 2015; 20:3935-42. [DOI: 10.1590/1413-812320152012.01672015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/09/2015] [Indexed: 11/22/2022] Open
Abstract
Resumo Este estudo analisou a distribuição espaço-temporal dos casos de leishmaniose visceral (LV) no estado do Maranhão, no período de 2000 a 2009. A partir do número de casos notificados, foram elaborados mapas temáticos para demonstrar a evolução da distribuição geográfica da doença no estado. Utilizou-se o método MCMC para estimação dos parâmetros do modelo bayesiano espaço-temporal para a identificação das áreas de risco. De 2000 a 2009, foram notificados 5.389 casos de leishmaniose visceral, distribuídos em todas as 18 Unidades Regionais de Saúde do estado, com as maiores incidências em: Caxias, Imperatriz, Presidente Dutra e Chapadinha. As Unidades Regionais de Saúde com maiores riscos relativos por biênio foram: Caxias e Barra do Corda (2000-2001), Imperatriz e Presidente Dutra (2002-2003), Imperatriz e Caxias (2004-2005), Presidente Dutra e Codó (2006-2007), e Imperatriz e Caxias (2008-2009). Houve uma considerável expansão geográfica da LV no Maranhão, sendo necessária a adoção de medidas mais eficazes de prevenção e controle da doença no estado.
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Genome-Wide Prediction of Vaccine Candidates for Leishmania major: An Integrated Approach. J Trop Med 2015; 2015:709216. [PMID: 26681959 PMCID: PMC4670862 DOI: 10.1155/2015/709216] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 10/30/2015] [Accepted: 11/02/2015] [Indexed: 12/11/2022] Open
Abstract
Despite the wealth of information regarding genetics of the causative parasite and experimental immunology of the cutaneous leishmaniasis, there is currently no licensed vaccine against it. In the current study, a two-level data mining strategy was employed, to screen the Leishmania major genome for promising vaccine candidates. First, we screened a set of 25 potential antigens from 8312 protein coding sequences, based on presence of signal peptides, GPI anchors, and consensus antigenicity predictions. Second, we conducted a comprehensive immunogenic analysis of the 25 antigens based on epitopes predicted by NetCTL tool. Interestingly, results revealed that candidate antigen number 1 (LmjF.03.0550) had greater number of potential T cell epitopes, as compared to five well-characterized control antigens (CSP-Plasmodium falciparum, M1 and NP-Influenza A virus, core protein-Hepatitis B virus, and PSTA1-Mycobacterium tuberculosis). In order to determine an optimal set of epitopes among the highest scoring predicted epitopes, the OptiTope tool was employed for populations susceptible to cutaneous leishmaniasis. The epitope (127SLWSLLAGV) from antigen number 1, found to bind with the most prevalent allele HLA-A⁎0201 (25% frequency in Southwest Asia), was predicted as most immunogenic for all the target populations. Thus, our study reasserts the potential of genome-wide screening of pathogen antigens and epitopes, for identification of promising vaccine candidates.
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Al-Kamel MA. Leishmaniasis in Yemen: a clinicoepidemiological study of leishmaniasis in central Yemen. Int J Dermatol 2015; 55:849-55. [PMID: 26547479 DOI: 10.1111/ijd.13041] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 03/08/2015] [Accepted: 03/15/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Leishmaniasis is a serious public health problem in Yemen. OBJECTIVES This study was designed to identify clinical and epidemiological features of leishmaniasis in Yemen. METHODS The study was conducted at the Regional Leishmaniasis Control Center in central Yemen. Data sourced from the medical records of 152 patients with confirmed active leishmaniasis, managed during April-August 2013, were analyzed. RESULTS A total of 94.1% of patients were rural residents. Al Bayda was the most endemic governorate (59.9%). Children represented the group at highest risk (57.2%), followed by adult females (32.9%); together these groups accounted for 90.1% of all patients. Mucocutaneous leishmaniasis was the most prevalent form (49.3%), followed by cutaneous leishmaniasis (47.4%), and visceral leishmaniasis (3.3%). The wet ulcer was the most common type of lesion (49.7%) and the single lesion (69.4%) represented the most common presentation. All patients were ignorant of the nature of the disease, and 55.9% had a history of using "popular" treatments. CONCLUSIONS Cutaneous, mucocutaneous, and visceral leishmaniases have significant endemicity in Yemen, especially in central areas. Al Bayda is the governorate with the highest endemicity, and rural children and women represent the populations at highest risk. Mucocutaneous leishmaniasis seems to be the most prevalent form and a single wet ulcer is the most common presentation. Infected refugees may represent new foci for imported Leishmania species. Ecology, geography, climate change, cultural gender- and age-specific duties, urban night activities, and use of popular treatments are among proven risk factors.
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Mouri O, Benhamou M, Leroux G, Chartrel N, Devidas A, Thellier M, Amoura Z, Costedoat-Chalumeau N, Buffet P. Spontaneous remission of fully symptomatic visceral leishmaniasis. BMC Infect Dis 2015; 15:445. [PMID: 26499862 PMCID: PMC4619209 DOI: 10.1186/s12879-015-1191-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 10/07/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL), i.e., infection with Leishmania sp. associated with high fever, weight loss, massive splenomegaly and markedly altered laboratory parameters, is generally fatal if untreated. The possibility of transient spontaneous remission of fully symptomatic visceral leishmaniasis (VL) has been mentioned but, to our knowledge) has never been documented. CASE PRESENTATION We report the first documented history of a patient with overt, confirmed VL experiencing a complete remission in the absence of any anti-leishmanial therapy. The diagnosis of VL at the time of the self-resolving episode was strongly suspected based on clinical presentation and presence of antileishmanial antibody, then unequivocally confirmed years later by the presence of an amastigote on a stored smear and the positive quantitative PCR with Leishmania-specific primers from the material scraped from this same slide CONCLUSION This report demonstrates that complete spontaneous remission may occur in patients with overt, fully symptomatic VL. VL should therefore be considered in cases of self-resolving or relapsing episodes of fever of unknown origin. Confirmation should be based on both serological tests and specific PCR on a blood sample.
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Affiliation(s)
- Oussama Mouri
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Parasitologie, F-75013, Paris, France.
| | - Mathilde Benhamou
- AP-HP, Hôpital Cochin, Service de Rééducation et Réadaptation, F-75014, Paris, France.
| | - Gaëlle Leroux
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Médecine Interne, F-75013, Paris, France.
| | - Nathalie Chartrel
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Parasitologie, F-75013, Paris, France.
| | - Alain Devidas
- Hopital Sud Francilien, Service d'Hématologie, Corbeil-Essonnes, France.
| | - Marc Thellier
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Parasitologie, F-75013, Paris, France. .,UPMC Université Paris 06, Centre Immunologie et Maladies Infectieuses, F-75005, Paris, France.
| | - Zahir Amoura
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Médecine Interne, F-75013, Paris, France.
| | - Nathalie Costedoat-Chalumeau
- AP-HP, Hôpital Cochin, Service de Médecine Interne. Centre de référence maladies auto-immunes et systémiques rares, Service de Médecine Interne, F-75014, Paris, France.
| | - Pierre Buffet
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Parasitologie, F-75013, Paris, France. .,UPMC Université Paris 06, Centre Immunologie et Maladies Infectieuses, F-75005, Paris, France.
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de Almeida L, Alves KF, Maciel-Rezende CM, Jesus LDOP, Pires FR, Junior CV, Izidoro MA, Júdice WADS, dos Santos MH, Marques MJ. Benzophenone derivatives as cysteine protease inhibitors and biological activity against Leishmania(L.) amazonensis amastigotes. Biomed Pharmacother 2015; 75:93-9. [DOI: 10.1016/j.biopha.2015.08.030] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 07/08/2015] [Accepted: 08/23/2015] [Indexed: 01/31/2023] Open
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Kariyawasam KKGDUL, Edirisuriya CS, Senerath U, Hensmen D, Siriwardana HVYD, Karunaweera ND. Characterisation of cutaneous leishmaniasis in Matara district, southern Sri Lanka: evidence for case clustering. Pathog Glob Health 2015; 109:336-43. [PMID: 26345305 DOI: 10.1179/2047773215y.0000000032] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Leishmaniasis is a neglected tropical disease transmitted by Phlebotomus spp. sand flies. Cutaneous leishmaniasis (CL) in Sri Lanka is caused by Leishmania donovani. Transmission patterns are different in Southern and Northern Sri Lanka. Current study examined the prevalence, risk factors and distribution of CL in Matara District, Southern Sri Lanka. Total of 2260 individuals from four District Secretariat divisions (DSDs) were screened by house to house surveys using an interviewer administered questionnaire. The study population had an age range of 1-90 years (median = 43 ± 17.31), low monthly income ( < 20 000 LKR, 52.8%) and a male to female ratio of 1 : 2. Thirty eight patients were diagnosed by light microscopy, culture and/or PCR with a disease prevalence of 1.68%. Spatial mapping provided evidence for significant case clustering, which tended to be more prominent with proximity to forest areas. The risk factors identified were un-plastered brick walls, absence or low usage of protective measures against insect bites, low income and excessive time (>4 hours/day) spent outdoors. However, exposure of limbs while outdoors, unawareness about the disease, type of occupation, common water source as the mode of water supply and presence of animal shelters within 200 m were not associated with the risk of acquiring the disease. Peri-domestic transmission is likely to contribute to the observed case clustering with all age groups at risk of acquiring the infection. Human behavioural habits coinciding with that of the vector, sand fly are likely to enable host-vector contact promoting its spread. Appropriate vector control measures, improvement of housing conditions, public education regarding preventive measures are required to contain the spread of disease.
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Harrabi M, Bettaieb J, Ghawar W, Toumi A, Zaâtour A, Yazidi R, Chaâbane S, Chalghaf B, Hide M, Bañuls AL, Ben Salah A. Spatio-temporal Genetic Structuring of Leishmania major in Tunisia by Microsatellite Analysis. PLoS Negl Trop Dis 2015; 9:e0004017. [PMID: 26302440 PMCID: PMC4547700 DOI: 10.1371/journal.pntd.0004017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 07/30/2015] [Indexed: 01/06/2023] Open
Abstract
In Tunisia, cases of zoonotic cutaneous leishmaniasis caused by Leishmania major are increasing and spreading from the south-west to new areas in the center. To improve the current knowledge on L. major evolution and population dynamics, we performed multi-locus microsatellite typing of human isolates from Tunisian governorates where the disease is endemic (Gafsa, Kairouan and Sidi Bouzid governorates) and collected during two periods: 1991–1992 and 2008–2012. Analysis (F-statistics and Bayesian model-based approach) of the genotyping results of isolates collected in Sidi Bouzid in 1991–1992 and 2008–2012 shows that, over two decades, in the same area, Leishmania parasites evolved by generating genetically differentiated populations. The genetic patterns of 2008–2012 isolates from the three governorates indicate that L. major populations did not spread gradually from the south to the center of Tunisia, according to a geographical gradient, suggesting that human activities might be the source of the disease expansion. The genotype analysis also suggests previous (Bayesian model-based approach) and current (F-statistics) flows of genotypes between governorates and districts. Human activities as well as reservoir dynamics and the effects of environmental changes could explain how the disease progresses. This study provides new insights into the evolution and spread of L. major in Tunisia that might improve our understanding of the parasite flow between geographically and temporally distinct populations. In Tunisia, zoonotic cutaneous leishmaniasis (ZCL) constitutes a significant public health problem. Since 1884, the Gafsa, Kairouan and Sidi Bouzid governorates are the most endemic areas of ZCL. This study used a multi-locus microsatellite typing approach to study the evolution and the population dynamics of Leishmania major in Tunisia. Within the same area, in twenty years, parasite populations evolved by producing a genetically differentiated population, probably better adapted to the ecosystem. In agreement with the reported human cases of ZCL, the genetic data on samples from the three governorates shows that the disease did not spread according to a geographical gradient. Furthermore, L. major flows seem to still occur between governorates and neighboring districts. This study suggests that environmental changes, human activities and reservoir systems have influenced the spread and evolution of L. major populations. Our findings provide important knowledge on the epidemiology of L. major in Tunisia and might help understanding why the disease is still spreading from the south to the center, despite the control measures that have been put into place.
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Affiliation(s)
- Myriam Harrabi
- Institut Pasteur, Tunis, Tunisia
- Faculté des Sciences de Bizerte-Université de Carthage, Tunis, Tunisia
- * E-mail:
| | | | | | | | | | | | | | | | - Mallorie Hide
- UMR MIVEGEC (IRD 224-CNRS5290-Universités Montpellier 1 et 2), Centre IRD, Montpellier, France
| | - Anne-Laure Bañuls
- UMR MIVEGEC (IRD 224-CNRS5290-Universités Montpellier 1 et 2), Centre IRD, Montpellier, France
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Leishmanicidal activities of novel methylseleno-imidocarbamates. Antimicrob Agents Chemother 2015; 59:5705-13. [PMID: 26149985 DOI: 10.1128/aac.00997-15] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 06/29/2015] [Indexed: 11/20/2022] Open
Abstract
The generation of new antileishmanial drugs has become a priority. Selenium and its derivatives stand out as having promising leishmanicidal activity. In fact, some parasites express selenoproteins and metabolize selenium. Recently, selenium derivatives have shown the potential to reduce parasitemia, clinical manifestations, and mortality in parasite-infected mice. In this paper, after selecting four candidates according to drug similarity parameters, we observed that two of them, called compounds 2b [methyl-N,N'-di(thien-2-ylcarbonyl)-imidoselenocarbamate] and 4b [methyl-N,N'-di(5-nitrothien-3-ylcarbonyl)-imidoselenocarbamate], exhibit low 50% inhibitory concentrations (IC50s) (<3 μM) and good selectivity indexes (SIs) (>5) in Leishmania major promastigotes and lack toxicity on macrophages. In addition, in analysis of their therapeutic potential against L. major in vitro infection, both compounds display a dramatic reduction of amastigote burden (∼80%) with sublethal concentrations. Furthermore, in macrophages, these selenocompounds induce nitric oxide production, which has been described to be critical for defense against intracellular pathogens. Compounds 2b and 4b were demonstrated to cause cell cycle arrest in G1. Interestingly, evaluation of expression of genes related to proliferation (PCNA), treatment resistance (ABC transporter and alpha-tubulin), and virulence (quinonoid dihydropteridine reductase [QDPR]) showed several alterations in gene expression profiling. All these results prompt us to propose both compounds as candidates to treat leishmanial infections.
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Nagill R, Kaur T, Joshi J, Kaur S. Immunogenicity and efficacy of recombinant 78 kDa antigen of Leishmania donovani formulated in various adjuvants against murine visceral leishmaniasis. ASIAN PAC J TROP MED 2015; 8:513-9. [DOI: 10.1016/j.apjtm.2015.06.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/20/2015] [Accepted: 06/15/2015] [Indexed: 11/16/2022] Open
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Georgiadou SP, Makaritsis KP, Dalekos GN. Leishmaniasis revisited: Current aspects on epidemiology, diagnosis and treatment. J Transl Int Med 2015; 3:43-50. [PMID: 27847886 PMCID: PMC4936444 DOI: 10.1515/jtim-2015-0002] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Leishmaniasis is a vector-borne disease caused by protozoan parasites of the genus Leishmania. It is transmitted by phlebotomine female sand flies of the genera Phlebotomus and Lutzomyia in the old and new world, respectively. More than 20 well-recognized Leishmania species are known to infect humans and cause visceral (VL), cutaneous (CL) and mucocutaneous (ML) forms of the disease. Approximately 350 million people are at risk of contracting the disease and an estimated 1.6 million new cases occur annually. The disease mainly affects poor people in Africa, Asia and Latin America, and is associated with malnutrition, population migration, poor residency conditions, frail immune system and lack of resources. Previously, diagnosis of leishmaniasis relied mainly on invasive techniques of detecting parasites in splenic and bone marrow aspirates. Nevertheless, serological tests using the recombinant kinesin antigen (rK39) and molecular methods (polymerase chain reaction) are considered the best options for diagnosis today, despite problems related to varying sensitivities and specificities and field adaptability. Therapy of leishmaniasis ranges from local treatment of cutaneous lesions to systemic often toxic, therapy for disseminated CL, ML and VL. Agents with efficacy against leishmaniasis include amphotericin B, pentavalent antimonial drugs, paromomycin and miltefosine. No single therapy of VL currently offers satisfactory efficacy along with safety. This article provides a brief and updated systematic review on the epidemiology, diagnosis and treatment of this neglected disease.
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Affiliation(s)
- Sarah P Georgiadou
- Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa, Greece
| | - Konstantinos P Makaritsis
- Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa, Greece
| | - George N Dalekos
- Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa, Greece
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Gandacu D, Glazer Y, Anis E, Karakis I, Warshavsky B, Slater P, Grotto I. Resurgence of cutaneous leishmaniasis in Israel, 2001-2012. Emerg Infect Dis 2015; 20:1605-11. [PMID: 25271882 PMCID: PMC4193169 DOI: 10.3201/eid2010.140182] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Cutaneous leishmaniasis has long been endemic in Israel. After a 15-year period of moderate illness rates, reported incidence increased from 0.4 cases per 100,000 population in 2001 to 4.4 cases per 100,000 population in 2012, and the disease emerged in areas where its presence had previously been minimal. We analyzed all cases reported to the national surveillance system and found that outbreak patterns revealed an expansion of Leishmania major infections over large areas in the southern part of the country and the occurrence of spatially focused L. tropica outbreaks in the northern part of the country. Outbreaks often followed new construction in populated areas. Further study of factors affecting the transmission of cutaneous leishmaniasis is needed in Israel, as well as the development of effective methods to control the disease, an increase in awareness among health care professionals, and intensive public education regarding control measures in areas of known leishmaniasis foci.
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139
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Sadlova J, Seblova V, Votypka J, Warburg A, Volf P. Xenodiagnosis of Leishmania donovani in BALB/c mice using Phlebotomus orientalis: a new laboratory model. Parasit Vectors 2015; 8:158. [PMID: 25881258 PMCID: PMC4364506 DOI: 10.1186/s13071-015-0765-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 02/24/2015] [Indexed: 11/10/2022] Open
Abstract
Background In areas endemic for visceral leishmaniasis (VL), the majority of infected hosts remain asymptomatic but potentially infectious to biting sand flies. Their infectiousness for sand fly vectors is crucial for the transmission of the disease and can be quantified only by xenodiagnosis. However, in the case of human hosts, xenodiagnosis can be problematic for ethical and logistic reasons. The BALB/c mouse model described in this paper was designed to enable xenodiagnostic studies on VL hosts circumventing the need for human volunteers, it permits xenodiagnosis using the same individual host repeatedly, over several months. Methods BALB/c mice were intradermally inoculated in the ear pinnae with Leishmania donovani, primarily metacyclic stages isolated from the thoracic midguts of experimentally-infected Phlebotomus orientalis females. Naïve sand flies were allowed to feed on anaesthetized mice in 1-3-weeks- interval, firstly on the site of inoculation of L. donovani (weeks 2–8 post infection, p.i.), later on the whole body of mice (weeks 9 – 15 p.i.). Infections of sand flies were evaluated microscopically or by PCR analysis. Results Although infected mice did not show any signs of disease, 19% (N = 876) of the P. orientalis females that fed at the site of inoculation, became infected. The majority of L. donovani-positive females (76%) had heavy infections with their stomodeal valves colonized by attached parasites. Inoculated mouse ears remained infective for sand flies until week 15 p.i. Females feeding on other parts of the body remained negative with exception of two groups feeding on contralateral ears by week 12 p.i. On week 15, however, these two mice returned negative at xenodiagnosis of the contralateral ears. In sacrificed mice, the highest parasite numbers were found in inoculated ears and their draining lymph nodes. Infections were detected also in the spleen, liver, blood and rarely in the contralateral ear. Conclusions The study showed that BALB/c mice harbored parasites in sufficient numbers to promote heavy infections in P. orientalis and thus comprised a suitable laboratory model for xenodiagnoses of L. donovani. Parasites persisted in the inoculation site and were found transmissible for months to sand flies biting on the same site.
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Affiliation(s)
- Jovana Sadlova
- Department of Parasitology, Faculty of Science, Charles University in Prague, Prague 2, Vinicna 7, 128 44, Czech Republic.
| | - Veronika Seblova
- Department of Parasitology, Faculty of Science, Charles University in Prague, Prague 2, Vinicna 7, 128 44, Czech Republic.
| | - Jan Votypka
- Department of Parasitology, Faculty of Science, Charles University in Prague, Prague 2, Vinicna 7, 128 44, Czech Republic.
| | - Alon Warburg
- Department of Microbiology & Molecular Genetics, The Institute for Medical Research Israel-Canada, The Kuvin Centre for the Study of Infectious & Tropical Diseases, The Hebrew University - Hadassah Medical School, The Hebrew University of Jerusalem, Jerusalem, 91120, Israel.
| | - Petr Volf
- Department of Parasitology, Faculty of Science, Charles University in Prague, Prague 2, Vinicna 7, 128 44, Czech Republic.
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140
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Baum M, de Castro EA, Pinto MC, Goulart TM, Baura W, Klisiowicz DDR, Vieira da Costa-Ribeiro MC. Molecular detection of the blood meal source of sand flies (Diptera: Psychodidae) in a transmission area of American cutaneous leishmaniasis, Paraná State, Brazil. Acta Trop 2015; 143:8-12. [PMID: 25530542 DOI: 10.1016/j.actatropica.2014.11.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 10/28/2014] [Accepted: 11/07/2014] [Indexed: 11/28/2022]
Abstract
The feeding behavior of sand flies provides valuable information about the vector/host interactions and elucidates the epidemiological patterns of American cutaneous leishmaniasis (ACL) transmission. The aim of this study was to identify the blood meal sources of sand flies in endemic areas of leishmaniasis in Paraná State through polymerase chain reaction (PCR) amplification of a prepronociceptin (PNOC) gene fragment and its subsequent DNA sequencing. Moreover, molecular assays were conducted to evaluate the sensitivity and reproducibility of the PNOC gene amplification. Besides that, a time-course digestion test of the blood using sand flies that fed artificially on BALB/c mice was performed. Of 1263 female sand flies collected in the field, 93 (3.6%) specimens were engorged and 27 allowed efficient amplification of the PNOC gene. These flies had fed on equine (Equus caballus), porcine (Sus scrofa) and canine (Canis lupus familiaris) species. The results also showed that the identification of the blood meal sources of the sand flies using the molecular method was directly linked to the level of digestion of the blood (time-course) and not to the amount of blood that had been ingested or to the presence of inhibitors in the blood.
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Affiliation(s)
- Maurício Baum
- Federal University of Paraná, Biological Sciences Sector, Basic Pathology Department, Polytechnic Center, Curitiba, Paraná, Brazil
| | - Edilene Alcântara de Castro
- Federal University of Paraná, Biological Sciences Sector, Basic Pathology Department, Polytechnic Center, Curitiba, Paraná, Brazil
| | - Mara Cristina Pinto
- State University Paulista Júlio de Mesquita Filho, Faculty of Pharmaceutical Sciences of Araraquara, Biological Sciences Department, Araraquara, São Paulo, Brazil
| | - Thais Marchi Goulart
- State University of Campinas, Institute of Biology, Department of Animal Biology, Campinas, São Paulo, Brazil
| | - Walter Baura
- Federal University of Paraná, Biological Sciences Sector, Basic Pathology Department, Polytechnic Center, Curitiba, Paraná, Brazil
| | - Débora do Rocio Klisiowicz
- Federal University of Paraná, Biological Sciences Sector, Basic Pathology Department, Polytechnic Center, Curitiba, Paraná, Brazil
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141
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Gurung P, Karki R, Vogel P, Watanabe M, Bix M, Lamkanfi M, Kanneganti TD. An NLRP3 inflammasome-triggered Th2-biased adaptive immune response promotes leishmaniasis. J Clin Invest 2015; 125:1329-38. [PMID: 25689249 DOI: 10.1172/jci79526] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 01/06/2015] [Indexed: 01/10/2023] Open
Abstract
Leishmaniasis is a major tropical disease that can present with cutaneous, mucocutaneous, or visceral manifestation and affects millions of individuals, causing substantial morbidity and mortality in third-world countries. The development of a Th1-adaptive immune response is associated with resistance to developing Leishmania major (L. major) infection. Inflammasomes are key components of the innate immune system that contribute to host defense against bacterial and viral pathogens; however, their role in regulating adaptive immunity during infection with protozoan parasites is less studied. Here, we demonstrated that the NLRP3 inflammasome balances Th1/Th2 responses during leishmaniasis. Mice lacking the inflammasome components NLRP3, ASC, or caspase 1 on a Leishmania-susceptible BALB/c background exhibited defective IL-1β and IL-18 production at the infection site and were resistant to cutaneous L. major infection. Moreover, we determined that production of IL-18 propagates disease in susceptible BALB/c mice by promoting the Th2 cytokine IL-4, and neutralization of IL-18 in these animals reduced L. major titers and footpad swelling. In conclusion, our results indicate that activation of the NLRP3 inflammasome is detrimental during leishmaniasis and suggest that IL-18 neutralization has potential as a therapeutic strategy to treat leishmaniasis patients.
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142
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Boettcher JP, Siwakoti Y, Milojkovic A, Siddiqui NA, Gurung CK, Rijal S, Das P, Kroeger A, Banjara MR. Visceral leishmaniasis diagnosis and reporting delays as an obstacle to timely response actions in Nepal and India. BMC Infect Dis 2015; 15:43. [PMID: 25656298 PMCID: PMC4335691 DOI: 10.1186/s12879-015-0767-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 01/15/2015] [Indexed: 11/10/2022] Open
Abstract
Background To eliminate visceral leishmaniasis (VL) in India and Nepal, challenges of VL diagnosis, treatment and reporting need to be identified. Recent data indicate that VL is underreported and patients face delays when seeking treatment. Moreover, VL surveillance data might not reach health authorities on time. This study quantifies delays for VL diagnosis and treatment, and analyses the duration of VL reporting from district to central health authorities in India and Nepal. Methods A cross-sectional study conducted in 12 districts of Terai region, Nepal, and 9 districts of Bihar State, India, in 2012. Patients were interviewed in hospitals or at home using a structured questionnaire, health managers were interviewed at their work place using a semi-structured questionnaire and in-depth interviews were conducted with central level health managers. Reporting formats were evaluated. Data was analyzed using two-tailed Mann-Whitney U or Fisher’s exact test. Results 92 VL patients having experienced 103 VL episodes and 49 district health managers were interviewed. Patients waited in Nepal 30 days (CI 18-42) before seeking health care, 3.75 times longer than in Bihar (8d; CI 4-12). Conversely, the lag time from seeking health care to receiving a VL diagnosis was 3.6x longer in Bihar (90d; CI 68-113) compared to Nepal (25d; CI 13-38). The time span between diagnosis and treatment was short in both countries. VL reporting time was in Nepal 19 days for sentinel sites and 76 days for “District Public Health Offices (DPHOs)”. In Bihar it was 28 days for “District Malaria Offices”. In Nepal, 73% of health managers entered data into computers compared to 16% in Bihar. In both countries reporting was mainly paper based and standardized formats were rarely used. Conclusions To decrease the delay between onset of symptoms and getting a proper diagnosis and treatment the approaches in the two countries vary: In Nepal health education for seeking early treatment are needed while in Bihar the use of private and non-formal practitioners has to be discouraged. Reinforcement of VL sentinel reporting in Bihar, reorganization of DPHOs in Nepal, introduction of standardized reporting formats and electronic reporting should be conducted in both countries. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-0767-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jan P Boettcher
- Centre for Biological Threats and Special Pathogens, Robert Koch-Institute, Nordufer 20, Berlin, 13353, Germany.
| | - Yubaraj Siwakoti
- Valley College of Technical Sciences, Purbanchal University, Maharajgunj, Kathmandu, 44600, Nepal.
| | - Ana Milojkovic
- Clinical and Molecular Oncology, Max Delbrück Centrum für Molekulare Medizin, Berlin-Buch, Germany.
| | - Niyamat A Siddiqui
- Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna, India.
| | - Chitra K Gurung
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal.
| | - Suman Rijal
- BP Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Pradeep Das
- Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna, India.
| | - Axel Kroeger
- Special Programme for Research and Training in Tropical Diseases WHO-TDR, Geneva, Switzerland. .,Freiburg University Medical Centre, Zentrum für Medizin und Gesundheit, Freiburg, Germany.
| | - Megha R Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal.
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Capriles PV, Baptista LPR, Guedes IA, Guimarães ACR, Custódio FL, Alves-Ferreira M, Dardenne LE. Structural modeling and docking studies of ribose 5-phosphate isomerase from Leishmania major and Homo sapiens: A comparative analysis for Leishmaniasis treatment. J Mol Graph Model 2015; 55:134-47. [DOI: 10.1016/j.jmgm.2014.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 10/22/2014] [Accepted: 11/07/2014] [Indexed: 12/11/2022]
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144
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Saunders EC, de Souza DP, Chambers JM, Ng M, Pyke J, McConville MJ. Use of (13)C stable isotope labelling for pathway and metabolic flux analysis in Leishmania parasites. Methods Mol Biol 2015; 1201:281-296. [PMID: 25388122 DOI: 10.1007/978-1-4939-1438-8_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This protocol describes the combined use of metabolite profiling and stable isotope labelling to define pathways of central carbon metabolism in the protozoa parasite, Leishmania mexicana. Parasite stages are cultivated in standard or completely defined media and then rapidly transferred to chemically equivalent media containing a single (13)C-labelled nutrient. The incorporation of label can be followed over time or after establishment of isotopic equilibrium by harvesting parasites with rapid metabolic quenching. (13)C enrichment of multiple intracellular polar and apolar (lipidic) metabolites can be quantified using gas chromatography-mass spectrometry (GC-MS), while the uptake and secretion of (13)C-labelled metabolites can be measured by (13)C-NMR. Analysis of the mass isotopomer distribution of key metabolites provides information on pathway structure, while analysis of labelling kinetics can be used to infer metabolic fluxes. This protocol is exemplified using L. mexicana labelled with (13)C-U-glucose. The method can be used to measure perturbations in parasite metabolism induced by drug inhibition or genetic manipulation of enzyme levels and is broadly applicable to any cultured parasite stages.
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Affiliation(s)
- Eleanor C Saunders
- Department of Biochemistry and Molecular Biology, Bio21 Institute of Molecular Science and Biotechnology, University of Melbourne, 30 Flemington Rd, Parkville, VIC, 3010, Australia
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145
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Monzote L, Piñón A, Scull R, Setzer WN. Chemistry and Leishmanicidal Activity of the Essential Oil from Artemisia absinthium from Cuba. Nat Prod Commun 2014. [DOI: 10.1177/1934578x1400901236] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Historically, natural products have been a rich source of lead molecules in drug discovery. In particular, products to treat infectious diseases have been developed and several reports about potentialities of essential oils (EO) against Leishmania could be found. In this study, we report the chemical characterization, anti-leishmanial effects and cytotoxicity of the EO from Artemisia absinthium L. Chemical analysis revealed the EO to be composed of 18 compounds, 11 of which were identified, accounting for 64.1% of the composition. The main component of the EO was trans-sabinyl acetate, which made up 36.7%. In vitro anti-leishmanial screening showed that the A. absinthium EO inhibited the growth of promastigotes (14.4 ± 3.6 μg/mL) and amastigotes (13.4 ± 2.4 μg/mL) of L. amazonensis; while cytotoxicity evaluation caused 6 fold higher values than those for the parasites. In a model of experimental cutaneous leishmaniasis in BALB/c mice, five doses of EO at 30 mg/kg by intralesional route demonstrated control of lesion size and parasite burden ( p< 0.05) compared with animals treated with glucantime and untreated mice. In conclusion, in vitro and in vivo results showed the potential of EO from A. absinthium as a promising source for lead or active compounds against Leishmania, which could be explored.
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Affiliation(s)
- Lianet Monzote
- Parasitology Department, Institute of Tropical Medicine Pedro Kouri, Havana, Cuba
| | - Abel Piñón
- Parasitology Department, Institute of Tropical Medicine Pedro Kouri, Havana, Cuba
| | - Ramón Scull
- Institute of Pharmacy and Food, Havana University, Cuba
| | - William N. Setzer
- Department of Chemistry, University of Alabama in Huntsville, Huntsville, Alabama 35899, USA
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146
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Xu W, Hsu FF, Baykal E, Huang J, Zhang K. Sterol biosynthesis is required for heat resistance but not extracellular survival in leishmania. PLoS Pathog 2014; 10:e1004427. [PMID: 25340392 PMCID: PMC4207814 DOI: 10.1371/journal.ppat.1004427] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 08/27/2014] [Indexed: 12/25/2022] Open
Abstract
Sterol biosynthesis is a crucial pathway in eukaryotes leading to the production of cholesterol in animals and various C24-alkyl sterols (ergostane-based sterols) in fungi, plants, and trypanosomatid protozoa. Sterols are important membrane components and precursors for the synthesis of powerful bioactive molecules, including steroid hormones in mammals. Their functions in pathogenic protozoa are not well characterized, which limits the development of sterol synthesis inhibitors as drugs. Here we investigated the role of sterol C14α-demethylase (C14DM) in Leishmania parasites. C14DM is a cytochrome P450 enzyme and the primary target of azole drugs. In Leishmania, genetic or chemical inactivation of C14DM led to a complete loss of ergostane-based sterols and accumulation of 14-methylated sterols. Despite the drastic change in lipid composition, C14DM-null mutants (c14dm(-)) were surprisingly viable and replicative in culture. They did exhibit remarkable defects including increased membrane fluidity, failure to maintain detergent resistant membrane fraction, and hypersensitivity to heat stress. These c14dm(-) mutants showed severely reduced virulence in mice but were highly resistant to itraconazole and amphotericin B, two drugs targeting sterol synthesis. Our findings suggest that the accumulation of toxic sterol intermediates in c14dm(-) causes strong membrane perturbation and significant vulnerability to stress. The new knowledge may help improve the efficacy of current drugs against pathogenic protozoa by exploiting the fitness loss associated with drug resistance.
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Affiliation(s)
- Wei Xu
- Department of Biological Sciences, Texas Tech University, Lubbock, Texas, United States of America
| | - Fong-Fu Hsu
- Department of Internal Medicine, Washington University School of Medicine, Saint Louis, Missouri, United States of America
| | - Eda Baykal
- Department of Physics, Texas Tech University, Lubbock, Texas, United States of America
| | - Juyang Huang
- Department of Physics, Texas Tech University, Lubbock, Texas, United States of America
| | - Kai Zhang
- Department of Biological Sciences, Texas Tech University, Lubbock, Texas, United States of America
- * E-mail:
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147
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Vilas VJDR, Maia-Elkhoury ANS, Yadon ZE, Cosivi O, Sanchez-Vazquez MJ. Visceral leishmaniasis: a One Health approach. Vet Rec 2014; 175:42-4. [PMID: 25013197 DOI: 10.1136/vr.g4378] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Victor J Del Rio Vilas
- Communicable Diseases and Health Analysis, Panaftosa, Pan American Health Organization, Duque de Caxias, Rio de Janeiro, Brazil
| | - Ana N S Maia-Elkhoury
- Communicable Diseases and Health Analysis, Panaftosa, Pan American Health Organization, Duque de Caxias, Rio de Janeiro, Brazil
| | - Zaida E Yadon
- Communicable Diseases and Health Analysis, Panaftosa, Pan American Health Organization, Duque de Caxias, Rio de Janeiro, Brazil
| | - Ottorino Cosivi
- Communicable Diseases and Health Analysis, Panaftosa, Pan American Health Organization, Duque de Caxias, Rio de Janeiro, Brazil
| | - Manuel J Sanchez-Vazquez
- Communicable Diseases and Health Analysis, Panaftosa, Pan American Health Organization, Duque de Caxias, Rio de Janeiro, Brazil
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148
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Global database of leishmaniasis occurrence locations, 1960-2012. Sci Data 2014; 1:140036. [PMID: 25984344 PMCID: PMC4432653 DOI: 10.1038/sdata.2014.36] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 08/28/2014] [Indexed: 12/12/2022] Open
Abstract
The leishmaniases are neglected tropical diseases of significant public health importance. However, information on their global occurrence is disparate and sparse. This database represents an attempt to collate reported leishmaniasis occurrences from 1960 to 2012. Methodology for the collection of data from the literature, abstraction of case locations and data processing procedures are described here. In addition, strain archives and online data resources were accessed. A total of 12,563 spatially and temporally unique occurrences of both cutaneous and visceral leishmaniasis comprise the database, ranging in geographic scale from villages to states. These data can be used for a variety of mapping and spatial analyses covering multiple resolutions.
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149
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Hussain H, Al-Harrasi A, Al-Rawahi A, Green IR, Gibbons S. Fruitful decade for antileishmanial compounds from 2002 to late 2011. Chem Rev 2014; 114:10369-428. [PMID: 25253511 DOI: 10.1021/cr400552x] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Hidayat Hussain
- UoN Chair of Oman's Medicinal Plants and Marine Natural Products, University of Nizwa , P.O. Box 33, Birkat Al Mauz, Nizwa 616, Sultanate of Oman
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150
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Abstract
Leishmaniasis remains an important neglected tropical infection that affects children more than adults. Geographical variation exists in the distribution of the various Leishmania species. Although the majority of the disease burden is found in poor countries, leishmaniasis is also endemic in several countries within Southern Europe. Transmission is mediated by the sandfly and may follow an anthroponotic or zoonotic cycle that also varies by region. The expression of leishmaniasis depends on a complex interaction between the type of infecting species and the host immune response. Infection may be asymptomatic or may manifest as cutaneous disease that is pleiomorphic in presentation, muco-cutaneous disease or the visceral form that may be lethal if untreated. Molecular techniques aid diagnosis especially in cases where amastigotes are not visualised. The efficacy of treatment varies with the type of infecting species and resistance patterns. Preventive measures aimed at avoiding sandfly bites are effective in reducing acquisition of leishmaniasis and should be promoted for travellers visiting endemic regions. The persistent lack of a vaccine against human leishmaniasis is a result of the poor investment in this neglected parasitosis.
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Affiliation(s)
- David Pace
- Department of Paediatrics, Mater Dei Hospital, Tal-Qroqq, Msida MSD 2090, Malta.
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