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Barik S, Goswami S, Nanda PK, Sarkar A, Saha B, Sarkar A, Bhattacharjee S. TGF-beta plays dual roles in immunity and pathogenesis in leishmaniasis. Cytokine 2025; 187:156865. [PMID: 39874938 DOI: 10.1016/j.cyto.2025.156865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2024] [Revised: 01/12/2025] [Accepted: 01/20/2025] [Indexed: 01/30/2025]
Abstract
Transforming growth factor-beta (TGF-β), displaying a dual role in immunosuppression and pathogenesis, has emerged as a key regulator of anti-leishmanial immune responses. In Leishmania infections, TGF-β drives immune deviation by enhancing regulatory T-cell (T-reg) differentiation and inhibiting macrophage activation, suppressing critical antiparasitic responses. This cytokine simultaneously promotes fibroblast proliferation, extracellular matrix production, and fibrosis in infected tissues, which aids in wound healing but impedes immune cell infiltration, particularly in visceral leishmaniasis, where splenic disorganization and compromised immune access are notable. In conjunction with IL-6, TGF-β modulates pathogenic Th17 responses which intensify inflammatory damage and disrupt tissue architecture. While TGF-β's immunosuppressive actions enable parasite persistence, its role in maintaining tissue integrity introduces therapeutic potential. Targeted modulation of TGF-β signaling, through selective inhibitors of TGF-β receptors or signaling intermediates, has the potential to enhance parasite clearance while minimizing immunopathology. Experimental studies suggest that phase-specific intervention strategies may allow for controlled immunostimulation or fibrosis reduction, enhancing host resistance without incurring inflammatory injury. This review discusses the intricate role of TGF-β in orchestrating immune deviation, fibrosis, and pathogenesis in leishmaniasis, proposing novel therapeutic avenues for selective modulation of TGF-β pathways to restore host immunity.
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Affiliation(s)
- Susmita Barik
- Trident Academy of Creative Technology, Bhubaneswar, Odisha, India
| | - Sanghamitra Goswami
- Department of Molecular Biology and Bioinformatics, Tripura University, Agartala, India
| | | | - Argajit Sarkar
- Department of Molecular Biology and Bioinformatics, Tripura University, Agartala, India
| | - Bhaskar Saha
- Trident Academy of Creative Technology, Bhubaneswar, Odisha, India; JSPS Government Homeopathic Medical College, Ramanthapur, Hyderabad, India
| | - Arup Sarkar
- Trident Academy of Creative Technology, Bhubaneswar, Odisha, India.
| | - Surajit Bhattacharjee
- Department of Molecular Biology and Bioinformatics, Tripura University, Agartala, India.
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Madero-Velázquez L, Mínguez A, Mayorga L, Ramírez JJ, Moreno N, Amorós C, Nieto MA, Mena R, Benítez JM, Gimeno-Pitarch L, Maroto N, Suria C, Rodríguez-Moranta F, Ordás I, Ruiz L, García-Brenes MA, Martín-Cardona A, de Célix CR, Cárdenas K, Ginard D, Medina L, Pedrero N, Plaza R, Salmoral R, Martínez-Pérez TJ, Algara V, Merino E, Zabana Y, Gutiérrez A. Leishmaniasis in Patients With Inflammatory Bowel Disease: A National Multicenter Study of GETECCU. United European Gastroenterol J 2025. [PMID: 39776301 DOI: 10.1002/ueg2.12740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Revised: 11/18/2024] [Accepted: 11/24/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND Leishmaniasis (LI) is a vector-borne illness caused by a protozoan of the genus Leishmania. Data on the features of LI in patients with inflammatory bowel disease (IBD) are scarce. AIM To describe the characteristics of patients with IBD who present with leishmaniasis, infection outcomes and the risk factors associated with developing visceral leishmaniasis (VL). METHODS An observational retrospective study performed in 26 hospitals in Spain, including all adult patients with IBD who developed Leishmaniasis from 2012 to 2022. RESULTS A total of 73 patients were included [mean age 48 years; 65% male; 68% Crohn's disease]. Sixty patients (82.2%) presented localized cutaneous Leishmaniasis (CL), 2 (2.7%) diffuse CL, 3 (4.1%) mucocutaneous Leishmaniasis (MCL) and 8 (11%) VL. All patients were under biologicals (69 [94.5%]) or immunosuppressants (IMM) (4 [5.5%]) at Leishmaniasis diagnosis. AntiTNF was used in 97%, while 2 patients (3%) were receiving ustekinumab. Leishmaniasis resolution was achieved by 48% and 96% of the patients after 1 and 12 months, respectively. Biological withdrawal after Leishmaniasis diagnosis was not statistically related to increased rates of infection resolution among patients with localized CL. Age was the only risk factor associated with VL (OR 1.2, 95%CI 1.04-1.39; p = 0.012). CONCLUSIONS Leishmaniasis in patients with IBD doesn't seem to follow a complicated clinical course, even in those with localized CL who do not discontinue biological therapy after infection diagnosis. Age might be a risk factor for developing VL. This infection should be considered for immunosuppressed patients with IBD and suggestive symptoms dwelling or travelling to endemic areas.
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Affiliation(s)
- L Madero-Velázquez
- Gastroenterology Department, Hospital General Universitario Dr Balmis de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - A Mínguez
- Gastroenterology Department, Hospital Policlínico Universitario La Fe, Valencia, Spain
| | - L Mayorga
- Gastroenterology Department, Hospital Universitario Valle de Hebrón, Barcelona, Spain
| | - J J Ramírez
- Gastroenterology Department, Hospital Lluis Alcanyis de Xativa, Valencia, Spain
| | - N Moreno
- Gastroenterology Department, Hospital Universitario Dr Peset, Valencia, Spain
| | - C Amorós
- Gastroenterology Department, Hospital Arnau de Vilanova, Valencia, Spain
| | - M A Nieto
- Gastroenterology Department, Hospital Universitario Reina Sofia de Murcia, Murcia, Spain
| | - R Mena
- Gastroenterology Department, Consorci Sanitari de Terrasa, Terrasa, Spain
| | - J M Benítez
- Gastroenterology Department, Hospital Universitario Reina Sofía, IMIBIC, Córdoba, Spain
| | - L Gimeno-Pitarch
- Gastroenterology Department, Hospital General Universitario de Castellón, Castellón, Spain
| | - N Maroto
- Gastroenterology Department, Hospital de Manises, Valencia, Spain
| | - C Suria
- Gastroenterology Department, Hospital Clínico de Valencia, Valencia, Spain
| | - F Rodríguez-Moranta
- Gastroenterology Department, Hospital Universitario de Bellvitge, Barcelona, Spain
| | - I Ordás
- Gastroenterology Department, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - L Ruiz
- Gastroenterology Department, Consorcio Hospital General Universitario de València, Valencia, Spain
| | - M A García-Brenes
- Gastroenterology Department, Hospital Clínico San Carlos de Madrid, Madrid, Spain
| | - A Martín-Cardona
- Gastroenterology Department, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Hospital Universitari Mútua Terrassa, University of Barcelona, Terrassa, Instituto de Salud Carlos III, Madrid, Spain
| | - C Rubín de Célix
- Gastroenterology Department, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - K Cárdenas
- Gastroenterology Department, Hospital Virgen de los Lirios de Alcoy, Alicante, Spain
| | - D Ginard
- Gastroenterology Department, Hospital Universitario Son Espasses, Mallorca, Spain
| | - L Medina
- Gastroenterology Department, Hospital Marina Baixa, Villajoyosa, Spain
| | - N Pedrero
- Gastroenterology Department, Hospital General Universitario Santa Lucía, Cartagena, Spain
| | - R Plaza
- Gastroenterology Department, Hospital Universitario Infanta Leonor de Madrid, Madrid, Spain
| | - R Salmoral
- Gastroenterology Department, Hospital General Universitario de Toledo, Toledo, Spain
| | - T J Martínez-Pérez
- Gastroenterology Department, Hospital Universitario Virgen de la Luz de Cuenca, Cuenca, Spain
| | - V Algara
- Gastroenterology Department, Hospital Universitario del Vinalopó, Elche, Spain
| | - E Merino
- Infectious Diseases Department, Hospital General Universitario Dr Balmis de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Y Zabana
- Gastroenterology Department, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Hospital Universitari Mútua Terrassa, University of Barcelona, Terrassa, Instituto de Salud Carlos III, Madrid, Spain
| | - A Gutiérrez
- Gastroenterology Department, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital General Universitario Dr Balmis de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Madrid, Spain
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Goyzueta-Mamani LD, Pagliara Lage D, Barazorda-Ccahuana HL, Paco-Chipana M, Candia-Puma MA, Davila-Del-Carpio G, Galdino AS, Machado-de-Avila RA, Cordeiro Giunchetti R, D’Antonio EL, Ferraz Coelho EA, Chávez-Fumagalli MA. Exploring the Potential of Malvidin and Echiodinin as Probable Antileishmanial Agents Through In Silico Analysis and In Vitro Efficacy. Molecules 2025; 30:173. [PMID: 39795229 PMCID: PMC11722285 DOI: 10.3390/molecules30010173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Revised: 12/30/2024] [Accepted: 01/03/2025] [Indexed: 01/13/2025] Open
Abstract
Leishmaniasis, a neglected tropical disease caused by Leishmania species, presents serious public health challenges due to limited treatment options, toxicity, high costs, and drug resistance. In this study, the in vitro potential of malvidin and echioidinin is examined as antileishmanial agents against L. amazonensis, L. braziliensis, and L. infantum, comparing their effects to amphotericin B (AmpB), a standard drug. Malvidin demonstrated greater potency than echioidinin across all parasite stages and species. Against L. amazonensis, malvidin's IC50 values were 197.71 ± 17.20 µM (stationary amastigotes) and 258.07 ± 17 µM (axenic amastigotes), compared to echioidinin's 272.99 ± 29.90 μM and 335.96 ± 19.35 μM. AmpB was more potent, with IC50 values of 0.06 ± 0.01 µM and 0.10 ± 0.03 µM. Malvidin exhibited lower cytotoxicity (CC50: 2920.31 ± 80.29 µM) than AmpB (1.06 ± 0.12 µM) and a favorable selectivity index. It reduced infection rates by 35.75% in L. amazonensis-infected macrophages. The in silico analysis revealed strong binding between malvidin and Leishmania arginase, with the residues HIS139 and PRO258 playing key roles. Gene expression analysis indicated malvidin's modulation of oxidative stress and DNA repair pathways, involving genes like GLO1 and APEX1. These findings suggest malvidin's potential as a safe, natural antileishmanial compound, warranting further in vivo studies to confirm its therapeutic efficacy and pharmacokinetics in animal models.
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Affiliation(s)
- Luis Daniel Goyzueta-Mamani
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru; (L.D.G.-M.); (H.L.B.-C.); (M.P.-C.); (M.A.C.-P.)
| | - Daniela Pagliara Lage
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (D.P.L.); (E.A.F.C.)
| | - Haruna Luz Barazorda-Ccahuana
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru; (L.D.G.-M.); (H.L.B.-C.); (M.P.-C.); (M.A.C.-P.)
| | - Margot Paco-Chipana
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru; (L.D.G.-M.); (H.L.B.-C.); (M.P.-C.); (M.A.C.-P.)
| | - Mayron Antonio Candia-Puma
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru; (L.D.G.-M.); (H.L.B.-C.); (M.P.-C.); (M.A.C.-P.)
- Facultad de Ciencias Farmacéuticas, Bioquímicas y Biotecnológicas, Universidad Católica de Santa María, Arequipa 04000, Peru;
| | - Gonzalo Davila-Del-Carpio
- Facultad de Ciencias Farmacéuticas, Bioquímicas y Biotecnológicas, Universidad Católica de Santa María, Arequipa 04000, Peru;
| | - Alexsandro Sobreira Galdino
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal São João Del-Rei, Divinópolis 35501-296, Brazil;
- Instituto Nacional de Ciência e Tecnologia em Biotecnologia Industrial (INCT-BI), Distrito Federal, Brasilia 70070-010, Brazil
| | | | - Rodolfo Cordeiro Giunchetti
- Laboratório de Biologia das Interações Celulares, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil;
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais (INCT-DT), Salvador 40110-160, Brazil
| | - Edward L. D’Antonio
- Department of Natural Sciences, University of South Carolina Beaufort, 1 University Boulevard, Bluffton, SC 29909, USA;
| | - Eduardo Antonio Ferraz Coelho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (D.P.L.); (E.A.F.C.)
| | - Miguel Angel Chávez-Fumagalli
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru; (L.D.G.-M.); (H.L.B.-C.); (M.P.-C.); (M.A.C.-P.)
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Capistrano Costa NT, de Souza Pereira AM, Silva CC, Souza EDO, de Oliveira BC, Ferreira LFGR, Hernandes MZ, Pereira VRA. Exploring Bioinformatics Solutions for Improved Leishmaniasis Diagnostic Tools: A Review. Molecules 2024; 29:5259. [PMID: 39598648 PMCID: PMC11596704 DOI: 10.3390/molecules29225259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/16/2024] [Accepted: 08/21/2024] [Indexed: 11/29/2024] Open
Abstract
Significant populations in tropical and sub-tropical locations all over the world are severely impacted by a group of neglected tropical diseases called leishmaniases. This disease is caused by roughly 20 species of the protozoan parasite from the Leishmania genus. Disease prevention strategies that include early detection, vector control, treatment of affected individuals, and vaccination are all essential. The diagnosis is critical for selecting methods of therapy, preventing transmission of the disease, and minimizing symptoms so that the affected individual can have a better quality of life. Nevertheless, the diagnostic methods do eventually have limitations, and there is no established gold standard. Some disadvantages include the existence of cross-reactions with other species, and limited sensitivity and specificity, which are mostly determined by the type of antigen used to perform the tests. A viable alternative for a more precise diagnosis is the application of recombinant antigens, which have been generated using bioinformatics approaches and have shown increased diagnostic accuracy. This approach proves valuable as it spans from epitope selection to predicting the interactions within the antibody-antigen complex through docking analysis. As a result, identifying potential new antigens using bioinformatics resources becomes an effective technique since it may result in an earlier and more accurate diagnosis. Consequently, the primary aim of this review is to conduct a comprehensive overview of the most significant in silico tools developed over time, with a focus on evaluating their efficacy and exploring their potential applications in optimizing the selection of highly specific molecules for a more effective diagnosis of leishmaniasis.
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Affiliation(s)
- Natáli T. Capistrano Costa
- Medicinal Theoretical Chemistry Laboratory, Department of Pharmaceutical Sciences, Health Sciences Center, Universidade Federal de Pernambuco, Recife 50670-901, PE, Brazil; (N.T.C.C.); (E.d.O.S.); (L.F.G.R.F.); (M.Z.H.)
| | - Allana M. de Souza Pereira
- Immunopathology and Molecular Biology Laboratory, Departament of Immunology, Aggeu Magalhaes Institute, Recife 50740-465, PE, Brazil;
| | - Cibele C. Silva
- Immunopathology and Molecular Biology Laboratory, Departament of Immunology, Aggeu Magalhaes Institute, Recife 50740-465, PE, Brazil;
| | - Emanuelle de Oliveira Souza
- Medicinal Theoretical Chemistry Laboratory, Department of Pharmaceutical Sciences, Health Sciences Center, Universidade Federal de Pernambuco, Recife 50670-901, PE, Brazil; (N.T.C.C.); (E.d.O.S.); (L.F.G.R.F.); (M.Z.H.)
| | | | - Luiz Felipe G. R. Ferreira
- Medicinal Theoretical Chemistry Laboratory, Department of Pharmaceutical Sciences, Health Sciences Center, Universidade Federal de Pernambuco, Recife 50670-901, PE, Brazil; (N.T.C.C.); (E.d.O.S.); (L.F.G.R.F.); (M.Z.H.)
| | - Marcelo Z. Hernandes
- Medicinal Theoretical Chemistry Laboratory, Department of Pharmaceutical Sciences, Health Sciences Center, Universidade Federal de Pernambuco, Recife 50670-901, PE, Brazil; (N.T.C.C.); (E.d.O.S.); (L.F.G.R.F.); (M.Z.H.)
| | - Valéria R. A. Pereira
- Immunopathology and Molecular Biology Laboratory, Departament of Immunology, Aggeu Magalhaes Institute, Recife 50740-465, PE, Brazil;
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Guavita Falla PM, Rodríguez Lechtig B, Peñaranda Contreras E, Cortés Correa C. Disseminated Cutaneous Lesions in an Immunocompromised Patient: A Diagnostic Challenge. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:1034-1038. [PMID: 38969171 DOI: 10.1016/j.ad.2024.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 03/07/2024] [Accepted: 03/16/2024] [Indexed: 07/07/2024] Open
Affiliation(s)
- P M Guavita Falla
- Dermatology Program, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Dermatology Service, Hospital Universitario de La Samaritana, Bogotá, Colombia.
| | - B Rodríguez Lechtig
- Dermatology Service, Hospital Universitario de La Samaritana, Bogotá, Colombia; Dermatology Program, School of Medicine, Universidad El Bosque, Bogotá, Colombia
| | - E Peñaranda Contreras
- Dermatology Program, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Dermatology Service, Hospital Universitario de La Samaritana, Bogotá, Colombia
| | - C Cortés Correa
- Dermatology Program, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Dermatology Service, Hospital Universitario de La Samaritana, Bogotá, Colombia
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6
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Guavita Falla PM, Rodríguez Lechtig B, Peñaranda Contreras E, Cortés Correa C. Disseminated Cutaneous Lesions in an Immunocompromised Patient: A Diagnostic Challenge. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T1034-T1038. [PMID: 39413917 DOI: 10.1016/j.ad.2024.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 03/07/2024] [Accepted: 03/16/2024] [Indexed: 10/18/2024] Open
Affiliation(s)
- P M Guavita Falla
- Dermatology Program, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Dermatology Service, Hospital Universitario de La Samaritana, Bogotá, Colombia.
| | - B Rodríguez Lechtig
- Dermatology Service, Hospital Universitario de La Samaritana, Bogotá, Colombia; Dermatology Program, School of Medicine, Universidad El Bosque, Bogotá, Colombia
| | - E Peñaranda Contreras
- Dermatology Program, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Dermatology Service, Hospital Universitario de La Samaritana, Bogotá, Colombia
| | - C Cortés Correa
- Dermatology Program, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Dermatology Service, Hospital Universitario de La Samaritana, Bogotá, Colombia
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Zehra T, Marino J, Wang W, Frantsuzov G, Nadeem S. Rethinking Histology Slide Digitization Workflows for Low-Resource Settings. MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION : MICCAI ... INTERNATIONAL CONFERENCE ON MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION 2024; 15004:427-436. [PMID: 39896892 PMCID: PMC11786607 DOI: 10.1007/978-3-031-72083-3_40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2025]
Abstract
Histology slide digitization is becoming essential for telepathology (remote consultation), knowledge sharing (education), and using the state-of-the-art artificial intelligence algorithms (augmented/automated end-to-end clinical workflows). However, the cumulative costs of digital multi-slide high-speed brightfield scanners, cloud/on-premises storage, and personnel (IT and technicians) make the current slide digitization workflows out-of-reach for limited-resource settings, further widening the health equity gap; even single-slide manual scanning commercial solutions are costly due to hardware requirements (high-resolution cameras, high-spec PC/workstation, and support for only high-end microscopes). In this work, we present a new cloud slide digitization workflow for creating scanner-quality whole-slide images (WSIs) from uploaded low-quality videos, acquired from cheap and inexpensive microscopes with built-in cameras. Specifically, we present a pipeline to create stitched WSIs while automatically deblurring out-of-focus regions, upsampling input 10X images to 40X resolution, and reducing brightness/contrast and light-source illumination variations. We demonstrate the WSI creation efficacy from our workflow on World Health Organization-declared neglected tropical disease, Cutaneous Leishmaniasis (prevalent only in the poorest regions of the world and only diagnosed by sub-specialist dermatopathologists, rare in poor countries), as well as other common pathologies on core biopsies of breast, liver, duodenum, stomach and lymph node. The code and pretrained models will be accessible via our GitHub (https://github.com/nadeemlab/DeepLIIF), and the cloud platform will be available at https://deepliif.org for uploading microscope videos and downloading/viewing WSIs with shareable links (no sign-in required) for telepathology and knowledge sharing.
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Affiliation(s)
- Talat Zehra
- Jinnah Sindh Medical University, Karachi, Pakistan
| | - Joseph Marino
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - Wendy Wang
- Memorial Sloan Kettering Cancer Center, New York, USA
| | | | - Saad Nadeem
- Memorial Sloan Kettering Cancer Center, New York, USA
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Ekemen S, Nalcaci M, Toz S, Sanjoba C, Demirkesen C, Cetin ED, Tecimer T, Yildiz P, Gursel M, Ince U, Ozbel Y, Coban C. Diagnostic challenges in cutaneous leishmaniasis due to atypical Leishmania infantum: pathologists' insights from re-emergence zones. Front Med (Lausanne) 2024; 11:1453211. [PMID: 39328317 PMCID: PMC11425964 DOI: 10.3389/fmed.2024.1453211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Accepted: 09/02/2024] [Indexed: 09/28/2024] Open
Abstract
Background Leishmaniasis, a parasitic infection affecting both humans and animals, is increasingly spreading across Mediterranean and European regions, largely driven by human migration and environmental changes. In countries like Türkiye and across Europe, which have seen large influxes of migrants, the incidence of cutaneous leishmaniasis (CL) is rising, with cases now appearing in cities where the disease was previously undocumented. In these previously non-endemic areas, physicians unfamiliar with the characteristic lesions may misdiagnose CL, particularly in cases with only cutaneous manifestations. This study aims to evaluate the impact of re-emerging CL on the routine diagnostic practices of pathologists in Türkiye, by retrospectively reviewing cases. Methods We conducted a retrospective analysis of CL cases diagnosed between 2013 and 2022 at a single pathology center in Türkiye, covering multiple provinces. Twelve cases of CL were identified and analyzed based on clinical presentation, pre-diagnosis, histopathological findings, and molecular diagnostics. DNA extraction and PCR were performed on paraffin-embedded tissue samples to identify the Leishmania species involved. Results Out of the twelve CL cases reviewed, seven exhibited morphological findings strongly suggestive of CL (MFSS of CL), warranting further microbiological evaluation. All patients presented with non-healing skin lesions characterized by central ulceration, crater-like formations, or papulonodular lesions. Notably, CL was included in the clinical pre-diagnosis in only 58.3% of cases, while it was not considered in the remaining 41.7% of cases. Clinicians initially pre-diagnosed skin tumors in six cases (50%), four of which led to wide surgical excision. Histopathological examination in all cases revealed chronic or mixed (acute/chronic) inflammation, predominantly rich in histiocytes. To further investigate the role of Leishmania species in the pre-diagnosis, DNA extraction and PCR were performed on paraffin-embedded tissue samples, identifying L. infantum as the causative agent in 10 cases and L. major in two cases. Notably, L. infantum was the causative agent in all five cases initially misdiagnosed as skin tumors, which were also associated with a granulomatous type of chronic inflammation.
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Affiliation(s)
- Suheyla Ekemen
- Vocational School of Health Services, Acibadem University, Istanbul, Türkiye
- Division of Malaria Immunology, Department of Microbiology and Immunology, Institute of Medical Science (IMSUT), The University of Tokyo, Tokyo, Japan
- Japan Science and Technology Research Partnership for Sustainable Development (SATREPS) One Health Project, Tokyo, Japan
| | - Muhammed Nalcaci
- Department of Parasitology, Ege University School of Medicine, Izmir, Türkiye
| | - Seray Toz
- Japan Science and Technology Research Partnership for Sustainable Development (SATREPS) One Health Project, Tokyo, Japan
- Department of Parasitology, Ege University School of Medicine, Izmir, Türkiye
| | - Chizu Sanjoba
- Japan Science and Technology Research Partnership for Sustainable Development (SATREPS) One Health Project, Tokyo, Japan
- Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Cuyan Demirkesen
- Department of Pathology, Acibadem University School of Medicine, Istanbul, Türkiye
| | - Emel D Cetin
- Acibadem Central Pathology Laboratory, Istanbul, Türkiye
| | - Tulay Tecimer
- Acibadem Central Pathology Laboratory, Istanbul, Türkiye
| | - Pelin Yildiz
- Department of Pathology, Acibadem University School of Medicine, Istanbul, Türkiye
| | - Mayda Gursel
- Izmir Biomedicine and Genome Center, Basic and Translational Research Program, Izmir, Türkiye
| | - Umit Ince
- Vocational School of Health Services, Acibadem University, Istanbul, Türkiye
- Department of Pathology, Acibadem University School of Medicine, Istanbul, Türkiye
- Acibadem Central Pathology Laboratory, Istanbul, Türkiye
| | - Yusuf Ozbel
- Japan Science and Technology Research Partnership for Sustainable Development (SATREPS) One Health Project, Tokyo, Japan
- Department of Parasitology, Ege University School of Medicine, Izmir, Türkiye
| | - Cevayir Coban
- Division of Malaria Immunology, Department of Microbiology and Immunology, Institute of Medical Science (IMSUT), The University of Tokyo, Tokyo, Japan
- Japan Science and Technology Research Partnership for Sustainable Development (SATREPS) One Health Project, Tokyo, Japan
- International Vaccine Design Center, Institute of Medical Science (IMSUT), The University of Tokyo, Tokyo, Japan
- The University of Tokyo Pandemic Preparedness, Infection and Advanced Research Center (UTOPIA), The University of Tokyo, Tokyo, Japan
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9
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Klein PA, Wagner GA, Barr RJ, Klein JA, Rogers RS. Empiric intralesional tumescent drug delivery of antimicrobials effectively treated a painful necrotizing skin infection. JAAD Case Rep 2024; 50:40-43. [PMID: 39036615 PMCID: PMC11259981 DOI: 10.1016/j.jdcr.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Affiliation(s)
| | - Gerald A. Wagner
- Department of Pediatrics, University of California Irvine, Irvine, California
| | - Ronald J. Barr
- Department of Dermatology, University of California Irvine, Irvine, California
| | - Jeffrey A. Klein
- Department of Dermatology, University of California Irvine, Irvine, California
| | - Roy S. Rogers
- Department of Dermatology, Mayo Clinic Arizona, Phoenix, Arizona
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10
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Jodidio M, Schwartz RA. Honey therapies for dermatological disorders: more than just a sweet elixir. Int J Dermatol 2024; 63:422-430. [PMID: 38013499 DOI: 10.1111/ijd.16925] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
Honey possesses antibacterial, anti-inflammatory, and healing properties that benefit wound healing and tissue regeneration. For centuries, honey has been utilized in traditional medicine as a binder or vehicle for creams and lotions and also for therapeutic purposes. The overuse of antibiotics and antimicrobial agents leading to drug resistance has emphasized the resurgence of honey's application in wound care. For many dermatological disorders, there is an interest in developing therapeutics with fewer side effects than traditional therapies and enhanced wound healing abilities to expedite tissue regeneration. This paper reviews the properties and components of honey that contribute to its wound-healing-based applications, the types of honey employed in medicine, and its dermatological applications. Based on the evidence from case reports, clinical trials, and in vitro studies, honey has been characterized as a safe, cost-effective, and readily available treatment option for many skin conditions, including microbial infections, atopic dermatitis, psoriasis, necrotizing fasciitis, ulcers, as well as thermal and other types of wounds.
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Affiliation(s)
- Maya Jodidio
- Dermatology, Pediatrics and Pathology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Robert A Schwartz
- Dermatology, Pediatrics and Pathology, Rutgers New Jersey Medical School, Newark, NJ, USA
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, NJ, USA
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11
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Bi K, Li X, Zhang R, Zheng X, Wang F, Zou Y, Wang L. Clinical and laboratory characterization of cutaneous leishmaniasis in Chinese migrant workers returned from Iraq. PLoS Negl Trop Dis 2024; 18:e0012006. [PMID: 38437246 PMCID: PMC10939275 DOI: 10.1371/journal.pntd.0012006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 03/14/2024] [Accepted: 02/16/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Imported cutaneous leishmaniasis (CL) is a growing problem with increasing global travel to endemic areas. Returned travelers with CL are easy to be misdiagnosed and mistreated due to the lack of awareness for the disease to the physicians in non-endemic region that may lead to unfavorable outcome. Our study intends to summarize the characteristics of Leishmania infection imported from Iraq, so as to help Chinese physicians diagnose and treat the disease. All CL patients were treated with intralesional injection of antimony. METHODS The definitive diagnosis of CL is based on the parasite identification by microscopic examination directly on lesion smear or parasite culture, PCR amplification of Leishmania-specific internal transcribed spacer 1 (ITS-1). The phylogenetic analysis, the immunopathological examination and the cytokine detection were proceeded after the diagnosis. RESULTS We have identified 25 CL cases in migrant Chinese workers returned from Iraq for the first time with L. major as the major species of infected Leishmania parasite. Clinical features of the Iraq-imported CL include the history of skin exposure to sandflies bite and the lesions mostly on the exposed limbs. More ulcerative wet lesion was observed than nodular dry lesion. PCR is not only used to detect Leishmania parasite with high sensitivity, but also to identify the species of infected parasite through sequencing the amplified Leishmania-specific ITS-1 gene. The phylogenetic analysis based on the amplified ITS-1 sequences revealed that the infected Leishmania was closed related to the species and strains endemic in Iraq. The immunopathological examination revealed the T-cell filtrated cellular immune response with less B cells and NK cells involved. The cytokine profile measured in the skin lesion also confirmed the Th1 cellular response with higher expression levels of IFN-γ, IL-6 and IL-8. The skin lesions in CL patients were healed after being treated locally with antimony. CONCLUSIONS The clinical and parasitological features of these Chinese CL cases imported from Iraq provide useful information for the diagnosis and treatment of CL that is not commonly seen in Chinese local population.
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Affiliation(s)
- Kuo Bi
- Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Xiaoli Li
- Beijing Institute of Tropical Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
- Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, PR China
| | - Rui Zhang
- Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Xiaoyan Zheng
- Beijing Institute of Tropical Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
- Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, PR China
| | - Fei Wang
- Beijing Institute of Tropical Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
- Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, PR China
| | - Yang Zou
- Beijing Institute of Tropical Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
- Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, PR China
| | - Lei Wang
- Beijing Institute of Tropical Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
- Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, PR China
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12
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Carvalho AM, Costa RS, Lago A, Bacellar O, Beiting DP, Scott P, Carvalho LP, Carvalho EM. In Situ versus Systemic Immune Response in the Pathogenesis of Cutaneous Leishmaniasis. Pathogens 2024; 13:199. [PMID: 38535542 PMCID: PMC10975199 DOI: 10.3390/pathogens13030199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 04/01/2024] Open
Abstract
The role of the immune response in the pathogenesis of cutaneous leishmaniasis (CL) due to Leishmania (Viannia) braziliensis is predominantly carried out via blood cells. Here, we evaluate whether cytokine production by peripheral blood mononuclear cells (PBMCs) reflects what has been documented at the lesion site. The participants included 22 CL patients diagnosed with a positive PCR. PBMCs were stimulated for 72 h with a soluble leishmania antigen (SLA). Biopsies obtained from the edge of the ulcers were incubated for the same period. Cytokines in supernatants were assessed via ELISA. TNF, IL-1β, IL-6, IL-17, and granzyme B (GzmB) were higher in the supernatants of biopsies than in PBMCs, but IFN-γ was higher in the supernatants of PBMCs than in biopsies. There was a positive correlation between IFN-γ and TNF in PBMCs, and an inverse correlation between TNF and IL-10 in the cells from the lesion site. A strong correlation between IL-1β, IL-17, and GzmB was observed in the biopsies, and a positive correlation was detected between these cytokines and the lesion size. Our results indicate that the immune response in L. braziliensis lesions is different from that observed in peripheral blood, and our data suggest that in addition to IL-1β and GzmB, IL-17 participates in the pathology of CL.
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Affiliation(s)
- Augusto M. Carvalho
- Gonçalo Moniz Institute (IGM), Fiocruz, Salvador 40296-710, BA, Brazil; (A.M.C.); (R.S.C.); (L.P.C.)
- Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador 40110-160, BA, Brazil; (A.L.); (O.B.)
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Ministério da Ciência e Tecnologia e Inovação (MCTI), CNPq, Salvador 40110-160, BA, Brazil
| | - Rúbia S. Costa
- Gonçalo Moniz Institute (IGM), Fiocruz, Salvador 40296-710, BA, Brazil; (A.M.C.); (R.S.C.); (L.P.C.)
- Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador 40110-160, BA, Brazil; (A.L.); (O.B.)
| | - Alexsandro Lago
- Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador 40110-160, BA, Brazil; (A.L.); (O.B.)
| | - Olívia Bacellar
- Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador 40110-160, BA, Brazil; (A.L.); (O.B.)
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Ministério da Ciência e Tecnologia e Inovação (MCTI), CNPq, Salvador 40110-160, BA, Brazil
| | - Daniel P. Beiting
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-4539, USA; (D.P.B.); (P.S.)
| | - Phillip Scott
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-4539, USA; (D.P.B.); (P.S.)
| | - Lucas P. Carvalho
- Gonçalo Moniz Institute (IGM), Fiocruz, Salvador 40296-710, BA, Brazil; (A.M.C.); (R.S.C.); (L.P.C.)
- Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador 40110-160, BA, Brazil; (A.L.); (O.B.)
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Ministério da Ciência e Tecnologia e Inovação (MCTI), CNPq, Salvador 40110-160, BA, Brazil
| | - Edgar M. Carvalho
- Gonçalo Moniz Institute (IGM), Fiocruz, Salvador 40296-710, BA, Brazil; (A.M.C.); (R.S.C.); (L.P.C.)
- Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador 40110-160, BA, Brazil; (A.L.); (O.B.)
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Ministério da Ciência e Tecnologia e Inovação (MCTI), CNPq, Salvador 40110-160, BA, Brazil
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13
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Vasconcelos SA, de Sousa RLT, Costa E, Diniz e Souza JP, Cavalcante D, da Silva ACL, de Mendonça IL, Mallet J, Teixeira CR, Werneck GL, Araújo-Pereira T, Pita-Pereira D, Britto C, Vilela ML, Gomes R. Characterisation of an area of coexistent visceral and cutaneous leishmaniasis transmission in the State of Piauí, Brazil. Mem Inst Oswaldo Cruz 2024; 119:e230181. [PMID: 38324880 PMCID: PMC10841424 DOI: 10.1590/0074-02760230181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/26/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND In Brazil, transmission of visceral and cutaneous leishmaniasis has expanded geographically over the last decades, with both clinical forms occurring simultaneously in the same area. OBJECTIVES This study characterised the clinical, spatial, and temporal distribution, and performed entomological surveillance and natural infection analysis of a leishmaniasis-endemic area. METHODS In order to characterise the risk of leishmaniasis transmission in Altos, Piauí, we described the clinical and socio-demographic variables and the spatial and temporal distribution of cases of American visceral leishmaniasis (AVL) and American cutaneous leishmaniasis (ACL) cases and identified potential phlebotomine vectors. FINDINGS The urban area concentrated almost 54% of ACL and 86.8% of AVL cases. The temporal and spatial distribution of AVL and ACL cases in Altos show a reduction in the number of risk areas, but the presence of permanent disease transmission foci is observed especially in the urban area. 3,808 phlebotomine specimens were captured, with Lutzomyia longipalpis as the most frequent species (98.45%). Of the 35 females assessed for natural infection, one specimen of Lu. longipalpis tested positive for the presence of Leishmania infantum and Leishmania braziliensis DNA. MAIN CONCLUSION Our results indicate the presence of risk areas for ACL and AVL in the municipality of Altos and highlight the importance of entomological surveillance to further understand a possible role of Lu. longipalpis in ACL transmission.
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Affiliation(s)
- Silvia Alcântara Vasconcelos
- Fundação Oswaldo Cruz-Fiocruz, Escritório Técnico Regional, Teresina, PI, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Programa de Pós-Graduação em Medicina Tropical, Rio de Janeiro, RJ, Brasil
| | - Raimundo Leoberto Torres de Sousa
- Fundação Oswaldo Cruz-Fiocruz, Escritório Técnico Regional, Teresina, PI, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
| | - Enéas Costa
- Fundação Oswaldo Cruz-Fiocruz, Escritório Técnico Regional, Teresina, PI, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Programa de Pós-Graduação em Medicina Tropical, Rio de Janeiro, RJ, Brasil
| | | | - Diane Cavalcante
- Universidade Federal do Ceará, Departamento de Patologia, Fortaleza, CE, Brasil
| | | | | | - Jacenir Mallet
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório Interdisciplinar em Vigilância Entomológica em Diptera e Hemiptera, Rio de Janeiro, RJ, Brasil
| | | | | | - Thais Araújo-Pereira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
| | - Daniela Pita-Pereira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
- Centro Universitário Lusíada, Santos, SP, Brasil
| | - Constança Britto
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
| | - Maurício Luiz Vilela
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório Interdisciplinar em Vigilância Entomológica em Diptera e Hemiptera, Rio de Janeiro, RJ, Brasil
| | - Regis Gomes
- Fundação Oswaldo Cruz-Fiocruz, Escritório Técnico Regional, Eusébio, CE, Brasil
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14
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Soughi M, Ardigo M, Boughaleb S, Zouine O, Elousrouti LT, Douhi Z, Elloudi S, Baybay H, Mernissi FZ. Atypical cutaneous leishmaniasis: Contribution of confocal microscopy. JAAD Case Rep 2024; 44:91-93. [PMID: 38322793 PMCID: PMC10844035 DOI: 10.1016/j.jdcr.2023.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Affiliation(s)
- Meryem Soughi
- Department of Dermatology, Hassan II University Hospital, Fez, Morocco
- URL CNRST N15, Human Pathology, Biomedicine and Environment Laboratory, Faculty of Medicine, Pharmacy and Dental medecine of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Marco Ardigo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Saadia Boughaleb
- Department of Dermatology, Hassan II University Hospital, Fez, Morocco
| | - Oumaima Zouine
- Department of Dermatology, Hassan II University Hospital, Fez, Morocco
| | - Layla Tahri Elousrouti
- Biomedical and Translational Research Laboratory, Faculty of Medicine, Pharmacy, and Dental Medicine of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Zakia Douhi
- Department of Dermatology, Hassan II University Hospital, Fez, Morocco
- URL CNRST N15, Human Pathology, Biomedicine and Environment Laboratory, Faculty of Medicine, Pharmacy and Dental medecine of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Sara Elloudi
- Department of Dermatology, Hassan II University Hospital, Fez, Morocco
- URL CNRST N15, Human Pathology, Biomedicine and Environment Laboratory, Faculty of Medicine, Pharmacy and Dental medecine of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Hanan Baybay
- Department of Dermatology, Hassan II University Hospital, Fez, Morocco
- URL CNRST N15, Human Pathology, Biomedicine and Environment Laboratory, Faculty of Medicine, Pharmacy and Dental medecine of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Fatima Zahra Mernissi
- Department of Dermatology, Hassan II University Hospital, Fez, Morocco
- URL CNRST N15, Human Pathology, Biomedicine and Environment Laboratory, Faculty of Medicine, Pharmacy and Dental medecine of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
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15
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Shrestha A, Mishra A, Mishra A, Shrestha R, Shrestha R. Uncommon presentation of cutaneous leishmaniasis: late-onset facial involvement after a decade-a rare case report. Oxf Med Case Reports 2024; 2024:omad141. [PMID: 38292157 PMCID: PMC10823326 DOI: 10.1093/omcr/omad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 11/13/2023] [Accepted: 11/29/2023] [Indexed: 02/01/2024] Open
Abstract
Leishmaniasis is a parasitic infection that can involve the skin, mucosal membranes, and internal organs. It is endemic to the tropics. A forty-three-year-old male, diagnosed and treated for visceral leishmaniasis 15 years ago, presented with a complaint of a progressively growing lesion on his face for five years. A detailed history, clinical examination, and histopathological examination were done to reach a diagnosis of cutaneous leishmaniasis (CL). Treatment with oral fluconazole 300 mg daily for six months, followed by 50 mg miltefosine three times a day for another two months, led to complete resolution of symptoms, and the lesion on the face was cured. Early diagnosis is crucial to averting unwarranted treatment and potential complications. This case aims to inform clinicians of the high index of suspicion when diagnosing CL; given the delayed presentation, the previous medical history and the natural course of the lesion are of utmost importance.
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Affiliation(s)
- Amrita Shrestha
- Department of Dermatology and Venereology, Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Bagmati Province, Nepal
| | - Aman Mishra
- Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Kathmandu, Bagmati Province, Nepal
| | - Aakash Mishra
- Kathmandu Medical College Teaching Hospital, Kathmandu, Bagmati Province, Nepal
| | - Rojina Shrestha
- Department of Pharmacology, National Academy of Medical Sciences, Kathmandu, Bagmati Province, Nepal
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16
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Leal JFDC, Barroso DH, Trindade NS, de Miranda VL, Gurgel-Gonçalves R. Automated Identification of Cutaneous Leishmaniasis Lesions Using Deep-Learning-Based Artificial Intelligence. Biomedicines 2023; 12:12. [PMID: 38275373 PMCID: PMC10813291 DOI: 10.3390/biomedicines12010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/12/2023] [Accepted: 12/17/2023] [Indexed: 01/27/2024] Open
Abstract
The polymorphism of cutaneous leishmaniasis (CL) complicates diagnosis in health care services because lesions may be confused with other dermatoses such as sporotrichosis, paracocidiocomycosis, and venous insufficiency. Automated identification of skin diseases based on deep learning (DL) has been applied to assist diagnosis. In this study, we evaluated the performance of AlexNet, a DL algorithm, to identify pictures of CL lesions in patients from Midwest Brazil. We used a set of 2458 pictures (up to 10 of each lesion) obtained from patients treated between 2015 and 2022 in the Leishmaniasis Clinic at the University Hospital of Brasilia. We divided the picture database into training (80%), internal validation (10%), and testing sets (10%), and trained and tested AlexNet to identify pictures of CL lesions. We performed three simulations and trained AlexNet to differentiate CL from 26 other dermatoses (e.g., chromomycosis, ecthyma, venous insufficiency). We obtained an average accuracy of 95.04% (Confidence Interval 95%: 93.81-96.04), indicating an excellent performance of AlexNet in identifying pictures of CL lesions. We conclude that automated CL identification using AlexNet has the potential to assist clinicians in diagnosing skin lesions. These results contribute to the development of a mobile application to assist in the diagnosis of CL in health care services.
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Affiliation(s)
- José Fabrício de Carvalho Leal
- Graduate Program in Tropical Medicine, Center for Tropical Medicine, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil;
- Laboratory of Medical Parasitology and Vector Biology, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil; (N.S.T.); (V.L.d.M.)
| | - Daniel Holanda Barroso
- Postgraduate Program in Medical Sciences, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil;
| | - Natália Santos Trindade
- Laboratory of Medical Parasitology and Vector Biology, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil; (N.S.T.); (V.L.d.M.)
| | - Vinícius Lima de Miranda
- Laboratory of Medical Parasitology and Vector Biology, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil; (N.S.T.); (V.L.d.M.)
| | - Rodrigo Gurgel-Gonçalves
- Graduate Program in Tropical Medicine, Center for Tropical Medicine, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil;
- Laboratory of Medical Parasitology and Vector Biology, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil; (N.S.T.); (V.L.d.M.)
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17
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González-Morales LD, Moreno-Rodríguez A, Vázquez-Jiménez LK, Delgado-Maldonado T, Juárez-Saldivar A, Ortiz-Pérez E, Paz-Gonzalez AD, Lara-Ramírez EE, Yépez-Mulia L, Meza P, Rivera G. Triose Phosphate Isomerase Structure-Based Virtual Screening and In Vitro Biological Activity of Natural Products as Leishmania mexicana Inhibitors. Pharmaceutics 2023; 15:2046. [PMID: 37631260 PMCID: PMC10458937 DOI: 10.3390/pharmaceutics15082046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
Cutaneous leishmaniasis (CL) is a public health problem affecting more than 98 countries worldwide. No vaccine is available to prevent the disease, and available medical treatments cause serious side effects. Additionally, treatment failure and parasite resistance have made the development of new drugs against CL necessary. In this work, a virtual screening of natural products from the BIOFACQUIM and Selleckchem databases was performed using the method of molecular docking at the triosephosphate isomerase (TIM) enzyme interface of Leishmania mexicana (L. mexicana). Finally, the in vitro leishmanicidal activity of selected compounds against two strains of L. mexicana, their cytotoxicity, and selectivity index were determined. The top ten compounds were obtained based on the docking results. Four were selected for further in silico analysis. The ADME-Tox analysis of the selected compounds predicted favorable physicochemical and toxicological properties. Among these four compounds, S-8 (IC50 = 55 µM) demonstrated a two-fold higher activity against the promastigote of both L. mexicana strains than the reference drug glucantime (IC50 = 133 µM). This finding encourages the screening of natural products as new anti-leishmania agents.
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Affiliation(s)
- Luis D. González-Morales
- Laboratorio de Biotecnología Farmacéutica, Centro de Biotecnología Genómica, Instituto Politécnico Nacional, Reynosa 88710, Mexico; (L.D.G.-M.); (A.J.-S.); (E.O.-P.); (E.E.L.-R.)
| | - Adriana Moreno-Rodríguez
- Laboratorio de Estudios Epidemiológicos, Clínicos, Diseños Experimentales e Investigación, Facultad de Ciencias Químicas, Universidad Autónoma “Benito Juárez” de Oaxaca, Avenida Universidad S/N, Ex Hacienda Cinco Señores, Oaxaca 68120, Mexico;
| | - Lenci K. Vázquez-Jiménez
- Laboratorio de Biotecnología Farmacéutica, Centro de Biotecnología Genómica, Instituto Politécnico Nacional, Reynosa 88710, Mexico; (L.D.G.-M.); (A.J.-S.); (E.O.-P.); (E.E.L.-R.)
| | - Timoteo Delgado-Maldonado
- Laboratorio de Biotecnología Farmacéutica, Centro de Biotecnología Genómica, Instituto Politécnico Nacional, Reynosa 88710, Mexico; (L.D.G.-M.); (A.J.-S.); (E.O.-P.); (E.E.L.-R.)
| | - Alfredo Juárez-Saldivar
- Laboratorio de Biotecnología Farmacéutica, Centro de Biotecnología Genómica, Instituto Politécnico Nacional, Reynosa 88710, Mexico; (L.D.G.-M.); (A.J.-S.); (E.O.-P.); (E.E.L.-R.)
| | - Eyra Ortiz-Pérez
- Laboratorio de Biotecnología Farmacéutica, Centro de Biotecnología Genómica, Instituto Politécnico Nacional, Reynosa 88710, Mexico; (L.D.G.-M.); (A.J.-S.); (E.O.-P.); (E.E.L.-R.)
| | - Alma D. Paz-Gonzalez
- Laboratorio de Biotecnología Farmacéutica, Centro de Biotecnología Genómica, Instituto Politécnico Nacional, Reynosa 88710, Mexico; (L.D.G.-M.); (A.J.-S.); (E.O.-P.); (E.E.L.-R.)
| | - Edgar E. Lara-Ramírez
- Laboratorio de Biotecnología Farmacéutica, Centro de Biotecnología Genómica, Instituto Politécnico Nacional, Reynosa 88710, Mexico; (L.D.G.-M.); (A.J.-S.); (E.O.-P.); (E.E.L.-R.)
| | - Lilian Yépez-Mulia
- Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias-Pediatría, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Patricia Meza
- Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias-Pediatría, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Gildardo Rivera
- Laboratorio de Biotecnología Farmacéutica, Centro de Biotecnología Genómica, Instituto Politécnico Nacional, Reynosa 88710, Mexico; (L.D.G.-M.); (A.J.-S.); (E.O.-P.); (E.E.L.-R.)
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18
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Ekmekci TR, Güder H. Erysipeloid Leishmaniasis: A Case Series. Cureus 2023; 15:e39026. [PMID: 37323333 PMCID: PMC10265924 DOI: 10.7759/cureus.39026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 06/17/2023] Open
Abstract
Cutaneous leishmaniasis can present in many different clinical forms. Diagnosis of atypical forms is often delayed. It is useful to keep in mind the diagnosis of cutaneous leishmaniasis, a mimicking disease, to reduce unnecessary treatment and patient morbidity. Erysipeloid leishmaniasis should be considered when presented as long-term erysipelas-like lesions that do not respond to antibiotics. We want to present our five patients with erysipeloid leishmaniasis, one of the atypical clinical forms.
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Affiliation(s)
- Tuğba R Ekmekci
- Dermatology, Maltepe University Faculty of Medicine, İstanbul, TUR
| | - Hüsna Güder
- Dermatology, Maltepe University Faculty of Medicine, İstanbul, TUR
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19
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Martinez Niño MA, Camacho Galván JR, Castillo Cruz UDR, Perez-Coronado G. Cutaneous Leishmaniasis in a Non-endemic Area in Mexico. Cureus 2023; 15:e38228. [PMID: 37261149 PMCID: PMC10226841 DOI: 10.7759/cureus.38228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 06/02/2023] Open
Abstract
Leishmaniasis is a zoonotic disease caused by a parasite of the genus Leishmania endemic in 102 countries around the world. Clinical features can be classified as cutaneous, mucocutaneous, and visceral leishmaniasis; this will depend on the species of leishmania responsible for the disease and the immunologic response of the host. We present the case of a 14-year-old male who started with a small papular lesion in the helix of the left ear, which later spread to the rest of the helix, tragus, and part of the auricular concha. On physical examination, an erythematous plaque with a scale that deforms the auricular surface was observed. In histopathology, acute and chronic inflammatory processes were observed with an accumulation of macrophages that contain amastigotes inside (Leishman Donovan bodies). The diagnosis of leishmaniasis represents a challenge in non-endemic regions. It is important to ask about travel history to endemic areas and perform assays to confirm the diagnosis and initiate treatment to prevent mortality and morbidity.
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Affiliation(s)
- Mayte Aseret Martinez Niño
- General Medicine, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, MEX
- Internal Medicine, Universidad Autonoma de Coahuila, Torreón, MEX
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20
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Pagniez J, Petitdidier E, Parra-Zuleta O, Pissarra J, Bras-Gonçalves R. A systematic review of peptide-based serological tests for the diagnosis of leishmaniasis. Parasite 2023; 30:10. [PMID: 37010451 PMCID: PMC10069404 DOI: 10.1051/parasite/2023011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/06/2023] [Indexed: 04/04/2023] Open
Abstract
Serological methods should meet the needs of leishmaniasis diagnosis due to their high sensitivity and specificity, economical and adaptable rapid diagnostic test format, and ease of use. Currently, the performances of serological diagnostic tests, despite improvements with recombinant proteins, vary greatly depending on the clinical form of leishmaniasis and the endemic area. Peptide-based serological tests are promising as they could compensate for antigenic variability and improve performance, independently of Leishmania species and subspecies circulating in the endemic areas. The objective of this systematic review was to inventory all studies published from 2002 to 2022 that evaluate synthetic peptides for serological diagnosis of human leishmaniases and also to highlight the performance (e.g., sensitivity and specificity) of each peptide reported in these studies. All clinical forms of leishmaniasis, visceral and tegumentary, and all Leishmania species responsible for these diseases were considered. Following PRISMA statement recommendations, 1,405 studies were identified but only 22 articles met the selection criteria and were included in this systematic review. These original research articles described 77 different peptides, of which several have promising performance for visceral or tegumentary leishmaniasis diagnosis. This review highlights the importance of and growing interest in synthetic peptides used for serological diagnosis of leishmaniases, and their performances compared to some widely used tests with recombinant proteins.
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Affiliation(s)
- Julie Pagniez
- UMR177 INTERTRYP 911 avenue Agropolis B.P. 64501 34394 Montpellier France
| | - Elodie Petitdidier
- UMR177 INTERTRYP 911 avenue Agropolis B.P. 64501 34394 Montpellier France
| | | | - Joana Pissarra
- UMR177 INTERTRYP 911 avenue Agropolis B.P. 64501 34394 Montpellier France
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21
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Busch D, Bogdan C, Erfurt-Berge C. Clinical Manifestation of Cutaneous Leishmaniasis Following a Mechanical Trauma. THE INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS 2023; 22:146-148. [PMID: 33135533 DOI: 10.1177/1534734620968964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Unusual skin ulcers frequently represent a diagnostic challenge. When the most common disease entities such as arterial, venous or diabetic ulcers have been excluded, the question of further differential diagnoses and procedures arises. Other possible causes include chronic inflammatory diseases, neoplasia, self-inflicted wounds, primary infectious diseases and physical/chemical damage to the skin. To narrow down the differential diagnoses, a detailed history of the patient is essential, which also needs to include events further back in time.
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Affiliation(s)
- Dorothee Busch
- Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Christian Bogdan
- Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Cornelia Erfurt-Berge
- Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
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22
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Ndlovu K, Kannigadu C, Aucamp J, van Rensburg HDJ, N'Da DD. Exploration of ethylene glycol linked nitrofurantoin derivatives against Leishmania: Synthesis and in vitro activity. Arch Pharm (Weinheim) 2023; 356:e2200529. [PMID: 36759973 DOI: 10.1002/ardp.202200529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/27/2022] [Accepted: 12/30/2022] [Indexed: 02/11/2023]
Abstract
Leishmaniasis is a neglected tropical disease that is caused by the Leishmania parasite. It is estimated that there are more than 350 million people at risk of infection annually. Current treatments that are in clinical use are expensive, have toxic side effects, and are facing parasitic resistance. Therefore, new drugs are urgently required. In the quest for new, safe, and cost-effective drugs, a series of novel ethylene glycol derivatives of nitrofurantoin was synthesised and the in vitro antileishmanial efficacy of the compounds tested against Leishmania donovani and Leishmania major strains. Arylated ethylene glycol derivatives were found to be the most potent, with submicromolar activity up to 294-fold greater than the parent compound nitrofurantoin. Analogues 2j and 2k had the best antipromastigote activities with submicromolar IC50 values against L. major IR-173 and antimonial-resistant L. donovani 9515 strains.
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Affiliation(s)
- Keitumetsi Ndlovu
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom, South Africa
| | - Christina Kannigadu
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom, South Africa
| | - Janine Aucamp
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom, South Africa
| | | | - David D N'Da
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom, South Africa
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23
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Mulholland M, Glancy C, Sweeney E, Surgenor L, Hunter H, Walker S, Christie S, Mallett P. An ulcerated lesion in a previously well child. Arch Dis Child Educ Pract Ed 2023; 108:74-76. [PMID: 34649984 DOI: 10.1136/archdischild-2021-322010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/27/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Melissa Mulholland
- Clinical Education and Simulation Fellow, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Caoimhe Glancy
- Paediatrics, Royal Belfast Hospital for Sick Children (RBHSC), Belfast, UK
| | - Eamonn Sweeney
- Paediatrics, Royal Belfast Hospital for Sick Children (RBHSC), Belfast, UK
| | - Laura Surgenor
- Dermatology, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Helen Hunter
- Dermatology, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Stephen Walker
- Dermatology, Hospital of Tropical Diseases, University College London, London, UK
| | - Sharon Christie
- Paediatric Infectious Diseases, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Peter Mallett
- Paediatrics, Royal Belfast Hospital for Sick Children (RBHSC), Belfast, UK
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24
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Moreira VP, da Silva Mela MF, dos Anjos LR, Saraiva LF, Arenas Velásquez AM, Kalaba P, Fabisiková A, Clementino LDC, Aufy M, Studenik C, Gajic N, Prado-Roller A, Magalhães A, Zehl M, Figueiredo ID, Baviera AM, Cilli EM, Graminha MAS, Lubec G, Gonzalez ERP. Novel Selective and Low-Toxic Inhibitor of LmCPB2.8ΔCTE (CPB) One Important Cysteine Protease for Leishmania Virulence. Biomolecules 2022; 12:1903. [PMID: 36551331 PMCID: PMC9775234 DOI: 10.3390/biom12121903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Leishmaniasis is a highly prevalent, yet neglected disease caused by protozoan parasites of the genus Leishmania. In the search for newer, safer, and more effective antileishmanial compounds, we herein present a study of the mode of action in addition to a detailed structural and biological characterization of LQOF-G6 [N-benzoyl-N'-benzyl-N″-(4-tertbutylphenyl)guanidine]. X-ray crystallography and extensive NMR experiments revealed that LQOF-G6 nearly exclusively adopts the Z conformation stabilized by an intramolecular hydrogen bond. The investigated guanidine showed selective inhibitory activity on Leishmania major cysteine protease LmCPB2.8ΔCTE (CPB) with ~73% inhibition and an IC50-CPB of 6.0 µM. This compound did not show any activity against the mammalian homologues cathepsin L and B. LQOF-G6 has been found to be nontoxic toward both organs and several cell lines, and no signs of hepatotoxicity or nephrotoxicity were observed from the analysis of biochemical clinical plasma markers in the treated mice. Docking simulations and experimental NMR measurements showed a clear contribution of the conformational parameters to the strength of the binding in the active site of the enzyme, and thus fit the differences in the inhibition values of LQOF-G6 compared to the other guanidines. Furthermore, the resulting data render LQOF-G6 suitable for further development as an antileishmanial drug.
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Affiliation(s)
- Vitor Partite Moreira
- Fine Organic Chemistry Lab, School of Sciences and Technology, São Paulo State University (UNESP), Presidente Prudente 19060-080, Brazil
| | | | - Luana Ribeiro dos Anjos
- Fine Organic Chemistry Lab, School of Sciences and Technology, São Paulo State University (UNESP), Presidente Prudente 19060-080, Brazil
| | - Leonardo Figueiredo Saraiva
- Laboratory of Luminescence in Materials and Sensors, School of Sciences and Technology, São Paulo State University (UNESP), Presidente Prudente 19060-560, Brazil
| | | | - Predrag Kalaba
- Department of Pharmaceutical Sciences, Division of Pharmaceutical Chemistry, Faculty of Life Sciences, University of Vienna, Josef Holaubek Platz 2, UZAII, 1090 Vienna, Austria
| | - Anna Fabisiková
- Mass Spectrometry Centre, Faculty of Chemistry, University of Vienna, Währinger Straße 38, 1090 Vienna, Austria
| | | | - Mohammed Aufy
- Department of Pharmaceutical Sciences, Division of Pharmacology and Toxicology, University of Vienna, Josef Holaubek Platz 2, UZAII (2D 259), 1090 Vienna, Austria
| | - Christian Studenik
- Department of Pharmaceutical Sciences, Division of Pharmacology and Toxicology, University of Vienna, Josef Holaubek Platz 2, UZAII (2D 259), 1090 Vienna, Austria
| | - Natalie Gajic
- Centre for X-ray Structure Analysis, Faculty of Chemistry, University of Vienna, Währinger Straße 40-42, 1090 Vienna, Austria
| | - Alexander Prado-Roller
- Centre for X-ray Structure Analysis, Faculty of Chemistry, University of Vienna, Währinger Straße 40-42, 1090 Vienna, Austria
| | - Alvicler Magalhães
- Department of Organic Chemistry, Chemistry School, Federal University of Rio de Janeiro, Rio de Janeiro 21941-598, Brazil
| | - Martin Zehl
- Mass Spectrometry Centre, Faculty of Chemistry, University of Vienna, Währinger Straße 38, 1090 Vienna, Austria
- Department of Analytical Chemistry, Faculty of Chemistry, University of Vienna, Währinger Straße 38, 1090 Vienna, Austria
| | | | - Amanda Martins Baviera
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara 14800-903, Brazil
| | - Eduardo Maffud Cilli
- Department of Biochemistry and Organic Chemistry, Institute of Chemistry, São Paulo State University (UNESP), Araraquara 14800-060, Brazil
| | - Marcia A. S. Graminha
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara 14800-903, Brazil
| | - Gert Lubec
- Department of Neuroproteomics, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Eduardo R. Perez Gonzalez
- Fine Organic Chemistry Lab, School of Sciences and Technology, São Paulo State University (UNESP), Presidente Prudente 19060-080, Brazil
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25
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Kumar P, Kumar P, Singh N, Khajuria S, Patel R, Rajana VK, Mandal D, Velayutham R. Limitations of current chemotherapy and future of nanoformulation-based AmB delivery for visceral leishmaniasis-An updated review. Front Bioeng Biotechnol 2022; 10:1016925. [PMID: 36588956 PMCID: PMC9794769 DOI: 10.3389/fbioe.2022.1016925] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/31/2022] [Indexed: 12/15/2022] Open
Abstract
Visceral leishmaniasis (VL) is the most lethal of all leishmaniasis diseasesand the second most common parasiticdisease after malaria and,still, categorized as a neglected tropical disease (NTD). According to the latest WHO study, >20 Leishmania species spread 0.7-1.0 million new cases of leishmaniasis each year. VL is caused by the genus, Leishmania donovani (LD), which affects between 50,000 and 90,000 people worldwide each year. Lack of new drug development, increasing drug resistance, toxicity and high cost even with the first line of treatmentof Amphotericin B (AmB), demands new formulation for treatment of VLFurther the lack of a vaccine, allowedthe researchers to develop nanofomulation-based AmB for improved delivery. The limitation of AmB is its kidney and liver toxicity which forced the development of costly liposomal AmB (AmBisome) nanoformulation. Success of AmBisome have inspired and attracted a wide range of AmB nanoformulations ranging from polymeric, solid lipid, liposomal/micellar, metallic, macrophage receptor-targetednanoparticles (NP) and even with sophisticated carbon/quantum dot-based AmBnano delivery systems. Notably, NP-based AmB delivery has shown increased efficacy due to increased uptake, on-target delivery and synergistic impact of NP and AmB. In this review, we have discussed the different forms of leishmaniasis disease and their current treatment options with limitations. The discovery, mechanism of action of AmB, clinical status of AmB and improvement with AmBisome over fungizone (AmB-deoxycholate)for VL treatment was further discussed. At last, the development of various AmB nanoformulation was discussed along with its adavantages over traditional chemotherapy-based delivery.
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Affiliation(s)
- Prakash Kumar
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Pawan Kumar
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Nidhi Singh
- National Institute of Pharmaceutical Education and Research, Ahmedabad, India
| | - Salil Khajuria
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Rahul Patel
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Vinod Kumar Rajana
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Debabrata Mandal
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India,*Correspondence: Ravichandiran Velayutham, ; Debabrata Mandal,
| | - Ravichandiran Velayutham
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Hajipur, India,National Institute of Pharmaceutical Education and Research, Kolkata, India,*Correspondence: Ravichandiran Velayutham, ; Debabrata Mandal,
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26
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Cutaneous/Mucocutaneous Leishmaniasis Treatment for Wound Healing: Classical versus New Treatment Approaches. MICROBIOLOGY RESEARCH 2022. [DOI: 10.3390/microbiolres13040059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cutaneous leishmaniasis (CL) and mucocutaneous leishmaniasis (ML) show clinical spectra that can range from a localized lesion (with a spontaneous healing process) to cases that progress to a generalized systemic disease with a risk of death. The treatment of leishmaniasis is complex since most of the available drugs show high toxicity. The development of an effective topical drug formulation for CL and ML treatment offers advantages as it will improve patient’s compliance to the therapy given the possibility for self-administration, as well as overcoming the first pass metabolism and the high costs of currently available alternatives. The most common dosage forms include solid formulations, such as membranes and semi-solid formulations (e.g., ointments, creams, gels, and pastes). Topical treatment has been used as a new route of administration for conventional drugs against leishmaniasis and its combinations, as well as to exploit new substances. In this review, we discuss the advantages and limitations of using topical drug delivery for the treatment of these two forms of leishmaniasis and the relevance of combining this approach with other pharmaceutical dosage forms. Emphasis will also be given to the use of nanomaterials for site-specific delivery.
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27
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Ghosh S, Kumar V, Verma A, Sharma T, Pradhan D, Selvapandiyan A, Salotra P, Singh R. Genome-wide analysis reveals allelic variation and chromosome copy number variation in paromomycin-resistant Leishmania donovani. Parasitol Res 2022; 121:3121-3132. [PMID: 36056959 DOI: 10.1007/s00436-022-07645-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/24/2022] [Indexed: 11/30/2022]
Abstract
In the absence of adequate diagnosis and treatment, leishmaniasis remains a major public health concern on a global scale. Drug resistance remains a key obstacle in controlling and eliminating visceral leishmaniasis. The therapeutic gap due to lack of target-specific medicine and vaccine can be minimized by obtaining parasite's genomic information. This study compared whole-genome sequence of paromomycin-resistant parasite (K133PMM) developed through in vitro adaptation and selection with sensitive Leishmania clinical isolate (K133WT). We found a large number of upstream and intergenic gene variations in K133PMM. There were 259 single nucleotide polymorphisms (SNPs), 187 insertion-deletion (InDels), and 546 copy number variations (CNVs) identified. Most of the genomic variations were found in the gene's upstream and non-coding regions. Ploidy estimation revealed chromosome 5 in tetrasomy and 6, 9, and 12 in trisomy, uniquely in K133PMM. These contain the genes for protein degradation, parasite motility, autophagy, cell cycle maintenance, and drug efflux membrane transporters. Furthermore, we also observed reduction in ploidy of chromosomes 15, 20, and 23, in the resistant parasite containing mostly the genes for hypothetical proteins and membrane transporters. We chronicled correlated genomic conversion and aneuploidy in parasites and hypothesize that this led to rapid evolutionary changes in response to drug induced pressure, which causes them to become resistant.
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Affiliation(s)
- Sushmita Ghosh
- ICMR-National Institute of Pathology, Safdarjung Hospital Campus, New Delhi, 110029, India.,Department of Molecular Medicine, Jamia Hamdard, New Delhi, 110062, India
| | - Vinay Kumar
- ICMR-National Institute of Pathology, Safdarjung Hospital Campus, New Delhi, 110029, India
| | - Aditya Verma
- ICMR-National Institute of Pathology, Safdarjung Hospital Campus, New Delhi, 110029, India
| | - Tanya Sharma
- ICMR-AIIMS Computational Genomics Centre, Indian Council of Medical Research, New Delhi, 110029, India
| | - Dibyabhaba Pradhan
- ICMR-AIIMS Computational Genomics Centre, Indian Council of Medical Research, New Delhi, 110029, India
| | | | - Poonam Salotra
- ICMR-National Institute of Pathology, Safdarjung Hospital Campus, New Delhi, 110029, India
| | - Ruchi Singh
- ICMR-National Institute of Pathology, Safdarjung Hospital Campus, New Delhi, 110029, India.
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28
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Linse KP, Bogdan C, Haenssle HA, Toberer F. Mucocutaneous Leishmaniasis due to Leishmania infantum Infection. Acta Derm Venereol 2022; 102:adv00748. [DOI: 10.2340/actadv.v102.2321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract is missing (Short communcation)
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29
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Yaich S, Abid H, Toumi S, Fendri B, Chaker H, Agrebi I, Dammak N, Masmoudi M, Masmoudi A, Turki H, Kammoun K, Hmida MB. Leishmaniose cutanée après transplantation rénale : à propos de 7 cas et revue de la littérature. Nephrol Ther 2022; 18:506-511. [DOI: 10.1016/j.nephro.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
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30
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Cárdenas GAP, Travezaño JER, Chavez MSC. Reprint of: Man with severe mucocutaneous leishmaniasis. Dis Mon 2022; 68:101425. [DOI: 10.1016/j.disamonth.2022.101425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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31
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Oranges T, Veraldi S, Granieri G, Fidanzi C, Janowska A, Dini V, Romanelli M. Parasites causing cutaneous wounds: Theory and practice from a dermatological point of view. Acta Trop 2022; 228:106332. [PMID: 35092728 DOI: 10.1016/j.actatropica.2022.106332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 11/27/2022]
Abstract
A wide range of parasites can infest open wounds, or cause wounds due to the effects of the infestation. Parasitic infestations can involve the skin and subcutaneous tissues, with various clinical manifestations. In case of cutaneous wounds related to infestations, protozoa, helminths and arthropods are the main groups of parasites involved and emerging new aspects have been recently reported. Treating the wound correctly is fundamental in these patients in order to reduce the development of pathological scars and prevent complications. In particular, a gentle debridement for devitalized/infested tissue removal, the appropriate use of topical antiseptics and dressings such as hydrogel, hydrocolloids and antimicrobial dressings can be useful to control superinfections, moisture balance, inflammation and to promote edge proliferation.
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Affiliation(s)
- Teresa Oranges
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy; Department of Pediatrics, Dermatology Unit, Meyer Children's University Hospital, Florence, Italy
| | - Stefano Veraldi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giammarco Granieri
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Cristian Fidanzi
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Agata Janowska
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Valentina Dini
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Marco Romanelli
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy.
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32
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Zhuang L, Su J, Tu P. Cutaneous leishmaniasis presenting with painless ulcer on the right forearm: A case report. World J Clin Cases 2022; 10:2301-2306. [PMID: 35321164 PMCID: PMC8895175 DOI: 10.12998/wjcc.v10.i7.2301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/13/2021] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Leishmaniasis includes a range of chronic infections in humans and animals and can be caused by more than 20 species of Leishmania protozoa. The manifestations of leishmaniasis are diverse and dependent on the immune response capacity of the host and the type of Leishmania. In East Asia, leishmaniasis is relatively rare and prone to misdiagnosis and underdiagnosis.
CASE SUMMARY We report a case of a 36-year-old male with cutaneous leishmaniasis. The patient had been misdiagnosed with a bacterial skin infection and was given a dressing change and oral levofloxacin, which proved ineffective. Histopathological examination revealed amastigote (Leishman-Donovan body) in the histocytes, and nucleic acid sequencing proved that the pathogen was Leishmania major. The patient was treated successfully by regional injection of sodium gluconate (600 mg) three times. The ulcer healed and did not recur at 1.5-year follow-up.
CONCLUSION Skin ulcers caused by leishmaniasis are easily misdiagnosed in non-epidemic countries, yet it should not be overlooked.
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Affiliation(s)
- Le Zhuang
- Department of Dermatology, Peking University The First Hospital, Beijing 100034, China
- Department of Dermatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong province, China
| | - Jing Su
- Department of Pathology, School of Basic Medical Sciences, The Third Hospital, Peking University Health Science Center, Beijing 100034, China
| | - Ping Tu
- Department of Dermatology, Peking University The First Hospital, Beijing 100034, China
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Suarez J, Rios M, Estripeaut D, Reina A. Impetigo Leishmaniasis Previously Diagnosed as Crusty Impetigo: A Case Study. Cureus 2022; 14:e22492. [PMID: 35345709 PMCID: PMC8942141 DOI: 10.7759/cureus.22492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/05/2022] Open
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Tas B, Altinel Y. How to predict the diagnosis of cutaneous leishmaniasis in a Non-Endemic Region. Indian J Dermatol 2022; 67:232-238. [DOI: 10.4103/ijd.ijd_452_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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35
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Muthanna A, Malhomme H, Schwartz R, Al-Qubati Y. The clinical phenotypes of cutaneous leishmaniasis in central and Southwest Regions of Yemen. Indian J Dermatol 2022; 67:311. [PMID: 36386068 PMCID: PMC9644748 DOI: 10.4103/ijd.ijd_81_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Cutaneous leishmaniasis (CL) is endemic in Yemen. CL displays a spectrum of typical and atypical morphologies yet understudied in the central and southwest regions of Yemen. Aims and Objectives: To identify the typical and atypical clinical phenotypes of CL in the central and southwest regions of Yemen. Materials and Methods: A survey of 145 patients who visited Prof. Al-Qubati Clinic in Taiz between 2010 and 2015, was conducted. Results: Children and residents of the rural areas were at high risk of exposure to the insect vector. The typical phenotype was single (67%), facial (58%) and ulcerated nodule (35%). Other usual phenotypes were small ulcers (21.4%) and non-ulcerative papules and nodules (21%). Unusual phenotypes constituted 12% of the cohort and included psoriasiform, eczematous, erysipeloid, lupoid, verrucous, large ulcerative, leishmania recidivens, satellite, granulomatous infiltrative and hyperkeratotic plaques. Mucous membrane involvement was evident in 10.6% and was also polymorphic. Conclusion: CL has many morphologic patterns in central and southwest regions of Yemen, some are clinically deceptive.
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Hidalgo-Enríquez JA, Moscona-Nissan A, Zaputt-Cabrera S, Rincón-Ángel LI, Hidalgo-Enríquez AD. Atypical Cutaneous Leishmaniasis Variant. Cureus 2021; 13:e19252. [PMID: 34900453 PMCID: PMC8647779 DOI: 10.7759/cureus.19252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2021] [Indexed: 11/16/2022] Open
Abstract
Leishmaniasis is a complex group of parasitic infectious diseases caused by intracellular protozoa of the genus Leishmania. It is a zoonosis mainly transmitted by the bite of infected female Phlebotomus or Lutzomyia sandflies. Clinical manifestations of leishmaniasis are diverse and can range from asymptomatic presentations to disseminated systemic disease. Cutaneous leishmaniasis is endemic in more than 80 countries in the world, having a predominance in tropical and subtropical regions. Although the majority of cases follow a classic development, an increasing number of new and rare variants of cutaneous leishmaniasis have been reported. These variants should be suspected as a cause of diverse clinical presentations, especially in endemic regions and travelers, being a diagnostic challenge for physicians. We present a case of atypical cutaneous leishmaniasis found as a single verrucous plaque of eight months of evolution in the left posterior thigh of a 35-year-old man, who presented mild pruritus. The patient reported shrimp farming as his main occupational activity and was living in a rural region surrounded by forest on the Pacific coast of Ecuador. On dermatological examination, a single 4 x 5 cm verrucous plaque with irregular borders and a scaly erythematous violaceous aspect was found. Histopathological analysis revealed the presence of lymphohistiocytic inflammatory infiltrate with plasmocytes and granulomatous inflammation. On the Giemsa stain, intracellular amastigotes (Leishman-Donovan bodies) were observed. The treatment consisted of intramuscular meglumine antimoniate, presenting significant improvement on follow-up.
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37
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Kumari D, Perveen S, Sharma R, Singh K. Advancement in leishmaniasis diagnosis and therapeutics: An update. Eur J Pharmacol 2021; 910:174436. [PMID: 34428435 DOI: 10.1016/j.ejphar.2021.174436] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/10/2021] [Accepted: 08/16/2021] [Indexed: 12/11/2022]
Abstract
Leishmaniasis is regarded as a neglected tropical disease by World Health Organization (WHO) and is ranked next to malaria as the deadliest protozoan disease. The primary causative agents of the disease comprise of diverse leishmanial species sharing clinical features ranging from skin abrasions to lethal infection in the visceral organs. As several Leishmania species are involved in infection, the role of accurate diagnosis becomes pivotal in adding new dimensions to anti-leishmanial therapy. Diagnostic methods must be fast, reliable, easy to perform, highly sensitive, and specific to differentiate among similar parasitic diseases. Herein, we present the conventional and recent approaches impended for the disease diagnosis and their sensitivity, specificity, and clinical application in parasite detection. Furthermore, we have also elaborated various new methods to cure leishmaniasis, which include host-directed therapies, drug repurposing, nanotechnology, and combinational therapy. This review addresses novel techniques and innovations in leishmaniasis, which can aid in unraveling new strategies to fight against the deadly infection.
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Affiliation(s)
- Diksha Kumari
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Summaya Perveen
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Rashmi Sharma
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Kuljit Singh
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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38
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Volpedo G, Huston RH, Holcomb EA, Pacheco-Fernandez T, Gannavaram S, Bhattacharya P, Nakhasi HL, Satoskar AR. From infection to vaccination: reviewing the global burden, history of vaccine development, and recurring challenges in global leishmaniasis protection. Expert Rev Vaccines 2021; 20:1431-1446. [PMID: 34511000 DOI: 10.1080/14760584.2021.1969231] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Leishmaniasis is a major public health problem and the second most lethal parasitic disease in the world due to the lack of effective treatments and vaccines. Even when not lethal, leishmaniasis significantly affects individuals and communities through life-long disabilities, psycho-sociological trauma, poverty, and gender disparity in treatment. AREAS COVERED This review discusses the most relevant and recent research available on Pubmed and GoogleScholar highlighting leishmaniasis' global impact, pathogenesis, treatment options, and lack of effective control strategies. An effective vaccine is necessary to prevent morbidity and mortality, lower health care costs, and reduce the economic burden of leishmaniasis for endemic low- and middle-income countries. Since there are several forms of leishmaniasis, a pan-Leishmania vaccine without geographical restrictions is needed. This review also focuses on recent advances and common challenges in developing prophylactic strategies against leishmaniasis. EXPERT OPINION Despite advances in pre-clinical vaccine research, approval of a human leishmaniasis vaccine still faces major challenges - including manufacturing of candidate vaccines under Good Manufacturing Practices, developing well-designed clinical trials suitable in endemic countries, and defined correlates of protection. In addition, there is a need to explore Challenge Human Infection Model to avoid large trials because of fluctuating incidence and prevalence of leishmanasis.
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Affiliation(s)
- Greta Volpedo
- Departments of Pathology and Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Ryan H Huston
- Departments of Pathology and Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Erin A Holcomb
- Departments of Pathology and Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Thalia Pacheco-Fernandez
- Departments of Pathology and Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Sreenivas Gannavaram
- Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Parna Bhattacharya
- Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Hira L Nakhasi
- Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Abhay R Satoskar
- Departments of Pathology and Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
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Mahender T, Pankaj W, Kumar SP, Ankur V, Kumar SS. Some Scaffolds as Anti-leishmanial Agents: An Review. Mini Rev Med Chem 2021; 22:743-757. [PMID: 34517799 DOI: 10.2174/1389557521666210913115116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/03/2021] [Accepted: 06/06/2021] [Indexed: 11/22/2022]
Abstract
Leishmaniasis is a parasitic infectious neglected tropical disease transmitted to humans by the parasites of Leishmania species. Mainly three types of leishmaniasis cases such as visceral (VL), cutaneous (CL) and mucocutaneous leishmaniasis are usually observed. In many western countries, almost 700,000 to 1million peoples are suffering from leishmaniasis and it is estimated that around 26000 to 65000 deaths occurs annually. For its treatment few drugs are available however none of them are ideal to treat leishmaniasis due to long treatment, discomfort mode of administration, risk of high level toxicity, high resistance against etc. Hence so many patients are unable to take complete treatment due to the high drug resistance. The present review will focus on antileishmanial activity of reported derivatives of betacarboline, chalcone, azole, quinoline, quinazoline, benzimidazole, benzadiazapine, thiaazoles, semicarbazone and hydontoin analogues. We believe that this present study will helpful to researcher to design new antileishmanial agents.
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Affiliation(s)
- Thatikayala Mahender
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144401. India
| | - Wadhwa Pankaj
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144401. India
| | - Singh Pankaj Kumar
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Hyderabad 500037. India
| | - Vaidya Ankur
- Pharmacy College Saifai, Uttar Pradesh University of Medical Sciences, Saifai, Etawah (U.P.). India
| | - Sahu Sanjeev Kumar
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144401. India
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40
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de Souza ML, Dos Santos WM, de Sousa ALMD, Ferraz LRDM, da Costa LAG, Silva EO, Rolim Neto PJ. Cutaneous leishmaniasis: new oral therapeutic approaches under development. Int J Dermatol 2021; 61:89-98. [PMID: 34510406 DOI: 10.1111/ijd.15902] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/14/2021] [Accepted: 08/19/2021] [Indexed: 12/19/2022]
Abstract
The World Health Organization (WHO) classifies leishmaniasis as a disease for which the development of new treatments is a priority. Available drugs are not fully effective in all cases; they have parenteral administration and exhibit serious and common adverse effects. The only oral drug available (miltefosine) has shown resistance, is expensive, and is not available in many endemic countries. Thus, the development of an oral medicine may solve many of these issues. Based on that, this review aimed to investigate which therapeutic alternatives have been studied for the development of oral drugs for the treatment of cutaneous leishmaniasis. A literature search for keywords "leishmania and oral" was performed in PubMed and ScienceDirect, considering articles published in the last 5 years. The articles were selected based on the objective of the review. The main problem in the current treatment of leishmaniasis is the administration of injectables, since it requires patients to travel to health centers, hospitalization, and professional administration, conditions that are not adapted to the socioeconomic reality of patients. Therefore, many research studies have evaluated oral alternatives for the treatment of cutaneous leishmaniasis. The main tested approaches were obtaining new molecules, repositioning drugs, and new formulations of old drugs. The prospects are encouraging but still require more in vivo bioavailability and clinical trials.
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Affiliation(s)
- Myla Lôbo de Souza
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
| | - Widson Michael Dos Santos
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
| | - André Luiz Moreira Domingues de Sousa
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
| | - Leslie Raphael de Moura Ferraz
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
| | - Lucas Amadeu Gonzaga da Costa
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
| | - Emerson Oliveira Silva
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
| | - Pedro José Rolim Neto
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
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Montoya AL, Austin VM, Portillo S, Vinales I, Ashmus RA, Estevao I, Jankuru SR, Alraey Y, Al-Salem WS, Acosta-Serrano Á, Almeida IC, Michael K. Reversed Immunoglycomics Identifies α-Galactosyl-Bearing Glycotopes Specific for Leishmania major Infection. JACS AU 2021; 1:1275-1287. [PMID: 34467365 PMCID: PMC8397363 DOI: 10.1021/jacsau.1c00201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Indexed: 06/13/2023]
Abstract
All healthy humans have high levels of natural anti-α-galactosyl (α-Gal) antibodies (elicited by yet uncharacterized glycotopes), which may play important roles in immunoglycomics: (a) potential protection against certain parasitic and viral zoonotic infections; (b) targeting of α-Gal-engineered cancer cells; (c) aiding in tissue repair; and (d) serving as adjuvants in α-Gal-based vaccines. Patients with certain protozoan infections have specific anti-α-Gal antibodies, elicited against parasite-derived α-Gal-bearing glycotopes. These glycotopes, however, remain elusive except for the well-characterized glycotope Galα1,3Galβ1,4GlcNAcα, expressed by Trypanosoma cruzi. The discovery of new parasitic glycotopes is greatly hindered by the enormous structural diversity of cell-surface glycans and the technical challenges of classical immunoglycomics, a top-down approach from cultivated parasites to isolated glycans. Here, we demonstrate that reversed immunoglycomics, a bottom-up approach, can identify parasite species-specific α-Gal-bearing glycotopes by probing synthetic oligosaccharides on neoglycoproteins. This method was tested here seeking to identify as-yet unknown glycotopes specific for Leishmania major, the causative agent of Old-World cutaneous leishmaniasis (OWCL). Neoglycoproteins decorated with synthetic α-Gal-containing oligosaccharides derived from L. major glycoinositolphospholipids served as antigens in a chemiluminescent enzyme-linked immunosorbent assay using sera from OWCL patients and noninfected individuals. Receiver-operating characteristic analysis identified Galpα1,3Galfβ and Galpα1,3Galfβ1,3Manpα glycotopes as diagnostic biomarkers for L. major-caused OWCL, which can distinguish with 100% specificity from heterologous diseases and L. tropica-caused OWCL. These glycotopes could prove useful in the development of rapid α-Gal-based diagnostics and vaccines for OWCL. Furthermore, this method could help unravel cryptic α-Gal-glycotopes of other protozoan parasites and enterobacteria that elicit the natural human anti-α-Gal antibodies.
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Affiliation(s)
- Alba L. Montoya
- Department
of Chemistry and Biochemistry, Border Biomedical Research Center, University of Texas at El Paso, 500 West University Avenue, El Paso, Texas 79968, United States
| | - Victoria M. Austin
- Department
of Vector Biology, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, United
Kingdom
| | - Susana Portillo
- Department
of Biological Sciences, Border Biomedical Research Center, University of Texas at El Paso, 500 West University Avenue, El Paso, Texas 79968, United States
| | - Irodiel Vinales
- Department
of Chemistry and Biochemistry, Border Biomedical Research Center, University of Texas at El Paso, 500 West University Avenue, El Paso, Texas 79968, United States
| | - Roger A. Ashmus
- Department
of Chemistry and Biochemistry, Border Biomedical Research Center, University of Texas at El Paso, 500 West University Avenue, El Paso, Texas 79968, United States
| | - Igor Estevao
- Department
of Biological Sciences, Border Biomedical Research Center, University of Texas at El Paso, 500 West University Avenue, El Paso, Texas 79968, United States
| | - Sohan R. Jankuru
- Department
of Chemistry and Biochemistry, Border Biomedical Research Center, University of Texas at El Paso, 500 West University Avenue, El Paso, Texas 79968, United States
| | - Yasser Alraey
- Department
of Vector Biology, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, United
Kingdom
| | - Waleed S. Al-Salem
- Department
of Vector Biology, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, United
Kingdom
| | - Álvaro Acosta-Serrano
- Department
of Vector Biology, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, United
Kingdom
| | - Igor C. Almeida
- Department
of Biological Sciences, Border Biomedical Research Center, University of Texas at El Paso, 500 West University Avenue, El Paso, Texas 79968, United States
| | - Katja Michael
- Department
of Chemistry and Biochemistry, Border Biomedical Research Center, University of Texas at El Paso, 500 West University Avenue, El Paso, Texas 79968, United States
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42
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Mudugal R, Bains A, Elhence P, Bharti JN. Relapsing erythematous papuloplaque lesions on the forearm of a middle-aged man. Clin Exp Dermatol 2021; 47:209-212. [PMID: 34387883 DOI: 10.1111/ced.14820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 11/28/2022]
Affiliation(s)
- R Mudugal
- Department of, Dermatology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - A Bains
- Department of, Dermatology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - P Elhence
- Department of, Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - J N Bharti
- Department of, Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Meireles PW, de Souza DPB, Rezende MG, Borsodi MPG, de Oliveira DE, da Silva LCRP, de Souza AMT, Viana GM, Rodrigues CR, do Carmo FA, de Sousa VP, Rossi-Bergmann B, Cabral LM. Nanoparticles Loaded with a New Thiourea Derivative: Development and In vitro Evaluation Against Leishmania amazonensis. Curr Drug Deliv 2021; 17:694-702. [PMID: 32621717 DOI: 10.2174/1567201817666200704132348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/27/2019] [Accepted: 02/13/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Leishmaniasis is a neglected tropical disease caused by protozoa of the genus Leishmania. Current treatments are restricted to a small number of drugs that display both severe side effects and a potential for parasites to develop resistance. A new N-(3,4-methylenedioxyphenyl)-N'- (2-phenethyl) thiourea compound (thiourea 1) has shown promising in vitro activity against Leishmania amazonensis with an IC50 of 54.14 μM for promastigotes and an IC50 of 70 μM for amastigotes. OBJECTIVE To develop a formulation of thiourea 1 as an oral treatment for leishmaniasis, it was incorporated into Nanoparticles (NPs), a proven approach to provide long-acting drug delivery systems. METHODS Poly (D,L-Lactic-co-Glycolic Acid) (PLGA) polymeric NPs containing thiourea 1 were obtained through a nanoprecipitation methodology associated with solvent evaporation. The NPs containing thiourea 1 were characterized for Encapsulation Efficiency (EE%), reaction yield (% w/w), surface charge, particle size and morphology by Transmission Electron Microscopy (TEM). RESULTS NPs with thiourea 1 showed an improved in vitro leishmanicidal activity with a reduction in its cytotoxicity against macrophages (CC50>100 μg/mL) while preserving its IC50 against intracellular amastigotes (1.46 ± 0.09 μg/mL). This represents a parasite Selectivity Index (SI) of 68.49, which is a marked advancement from the reference drug pentamidine (SI = 30.14). CONCLUSION The results suggest that the incorporation into NPs potentiated the therapeutic effect of thiourea 1, most likely by improving the selective delivery of the drug to the phagocytic cells that are targeted for infection by L. amazonensis. This work reinforces the importance of nanotechnology in the acquisition of new therapeutic alternatives for oral treatments.
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Affiliation(s)
- Paloma Wetler Meireles
- Department of Drugs and Pharmaceutics, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Dandara Paiva Barroso de Souza
- Department of Drugs and Pharmaceutics, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marianne Grilo Rezende
- Department of Drugs and Pharmaceutics, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | | | - Gil Mendes Viana
- Department of Drugs and Pharmaceutics, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos Rangel Rodrigues
- Department of Drugs and Pharmaceutics, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flavia Almada do Carmo
- Department of Drugs and Pharmaceutics, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Valeria Pereira de Sousa
- Department of Drugs and Pharmaceutics, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bartira Rossi-Bergmann
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucio Mendes Cabral
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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da Silva W, da Rocha Torres N, de Melo Agripino J, da Silva VHF, de Souza ACA, Ribeiro IC, de Oliveira TA, de Souza LA, Andrade LKR, de Moraes JVB, Diogo MA, de Castro RB, Polêto MD, Afonso LCC, Fietto JLR. ENTPDases from Pathogenic Trypanosomatids and Purinergic Signaling: Shedding Light towards Biotechnological Applications. Curr Top Med Chem 2021; 21:213-226. [PMID: 33019932 DOI: 10.2174/1568026620666201005125146] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/27/2020] [Accepted: 08/24/2020] [Indexed: 11/22/2022]
Abstract
ENTPDases are enzymes known for hydrolyzing extracellular nucleotides and playing an essential role in controlling the nucleotide signaling via nucleotide/purinergic receptors P2. Moreover, ENTPDases, together with Ecto-5´-nucleotidase activity, affect the adenosine signaling via P1 receptors. These signals control many biological processes, including the immune system. In this context, ATP is considered as a trigger to inflammatory signaling, while adenosine (Ado) induces anti-inflammatory response. The trypanosomatids Leishmania and Trypanosoma cruzi, pathogenic agents of Leishmaniasis and Chagas Disease, respectively, have their own ENTPDases named "TpENTPDases," which can affect the nucleotide signaling, adhesion and infection, in order to favor the parasite. Besides, TpENTPDases are essential for the parasite nutrition, since the Purine De Novo synthesis pathway is absent in them, which makes these pathogens dependent on the intake of purines and nucleopurines for the Salvage Pathway, in which TpENTPDases also take place. Here, we review information regarding TpNTPDases, including their known biological roles and their effect on the purinergic signaling. We also highlight the roles of these enzymes in parasite infection and their biotechnological applications, while pointing to future developments.
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Affiliation(s)
- Walmir da Silva
- Departamento de Bioquimica e Biologia Molecular, Universidade Federal de Vicosa, Vicosa, Minas Gerais, Brazil
| | - Nancy da Rocha Torres
- Departamento de Biologia Geral, Universidade Federal de Vicosa, Vicosa, Minas Gerais, Brazil
| | - Joice de Melo Agripino
- Departamento de Bioquimica e Biologia Molecular, Universidade Federal de Vicosa, Vicosa, Minas Gerais, Brazil
| | | | - Anna Cláudia Alves de Souza
- Departamento de Bioquimica e Biologia Molecular, Universidade Federal de Vicosa, Vicosa, Minas Gerais, Brazil
| | - Isadora Cunha Ribeiro
- Departamento de Bioquimica e Biologia Molecular, Universidade Federal de Vicosa, Vicosa, Minas Gerais, Brazil
| | | | - Luciana Angelo de Souza
- Departamento de Biologia Geral, Universidade Federal de Vicosa, Vicosa, Minas Gerais, Brazil
| | | | | | - Marcel Arruda Diogo
- Departamento de Bioquimica e Biologia Molecular, Universidade Federal de Vicosa, Vicosa, Minas Gerais, Brazil
| | - Raíssa Barbosa de Castro
- Departamento de Bioquimica e Biologia Molecular, Universidade Federal de Vicosa, Vicosa, Minas Gerais, Brazil
| | - Marcelo Depolo Polêto
- Departamento de Biologia Geral, Universidade Federal de Vicosa, Vicosa, Minas Gerais, Brazil
| | - Luis Carlos Crocco Afonso
- Nucleo de Pesquisa em Ciencias Biologicas (NUPEB), Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Juliana Lopes Rangel Fietto
- Departamento de Bioquimica e Biologia Molecular, Universidade Federal de Vicosa, Vicosa, Minas Gerais, Brazil
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45
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Matos AL, Figueiredo C, Alves F, Pereira N, Gonçalo M. Mucocutaneous leishmaniasis complicating systemic lupus erythematosus and responding to high dose amphotericin B. J Eur Acad Dermatol Venereol 2021; 35:e756-e758. [PMID: 34057771 DOI: 10.1111/jdv.17423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/27/2021] [Indexed: 11/29/2022]
Affiliation(s)
- A L Matos
- Dermatology Department, Coimbra University Hospital Centre, Coimbra, Portugal
| | - C Figueiredo
- Dermatology Department, Coimbra University Hospital Centre, Coimbra, Portugal
| | - F Alves
- Dermatology Department, Coimbra University Hospital Centre, Coimbra, Portugal
| | - N Pereira
- Dermatology Department, Cova da Beira University Hospital Centre, Covilhã, Portugal
| | - M Gonçalo
- Dermatology Department, Coimbra University Hospital Centre, Coimbra, Portugal.,Dermatology Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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46
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Rojas‐Jaimes J, Hugo Rojas‐Figueroa V, Corcuera R, Arenas J, García‐Reynoso J. Wegener's granulomatosis and differential diagnosis of mucosal leishmaniasis. Clin Case Rep 2021; 9:e04280. [PMID: 34194788 PMCID: PMC8222648 DOI: 10.1002/ccr3.4280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/11/2021] [Accepted: 04/26/2021] [Indexed: 11/06/2022] Open
Abstract
Granulomatosis with polyangiitis with nasal septal perforation can be confused with infectious diseases such as mucosal leishmaniasis, so these cases warrant an in-depth study in order to provide the correct treatment. Among the main characteristics to consider to define a Wegener's granulomatosis as opposed to an infectious disease are vasculitis, lymphadenopathy, and sinusopathy.
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Affiliation(s)
| | | | | | - José Arenas
- Surgical Pathology Service at Hospital Guillermo Almenara IrigoyenLimaPerú
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47
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Abadías-Granado I, Diago A, Cerro PA, Palma-Ruiz AM, Gilaberte Y. Cutaneous and Mucocutaneous Leishmaniasis. ACTAS DERMO-SIFILIOGRAFICAS 2021:S1578-2190(21)00171-2. [PMID: 34045157 DOI: 10.1016/j.adengl.2021.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/13/2021] [Indexed: 02/07/2023] Open
Abstract
Leishmaniasis is a chronic disease caused by flagellate protozoa of the genus Leishmania. It is a global disease, but most cases are seen in South America, the Mediterranean, and some areas of Asia and Africa. The 3 main types of leishmaniasis are cutaneous (the most common), mucocutaneous, and visceral (the most severe). Visceral leishmaniasis is also known as kala-azar. Leishmaniasis is diagnosed by demonstrating the presence of Leishmania amastigotes in clinical specimens using direct microscopic examination or molecular analysis. Various treatments exist, although the evidence supporting the options available for cutaneous leishmaniasis is weak. Both the classical presentation of leishmaniasis and our management of the disease have changed in recent decades because of acquired immune deficiency caused by conditions such as human immunodeficiency infection or the use of tumor necrosis factor inhibitors.
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Affiliation(s)
- I Abadías-Granado
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, Spain.
| | - A Diago
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - P A Cerro
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - A M Palma-Ruiz
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Y Gilaberte
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, Spain
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48
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Cohen SR, Espinoza C, Valverde Muñoz K. Cutaneous Leishmaniasis in an Immunocompromised Pediatric Patient With Acute Lymphoblastic Leukemia. Cureus 2021; 13:e14203. [PMID: 33954062 PMCID: PMC8089125 DOI: 10.7759/cureus.14203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Leishmaniasis is a protozoan disease caused by the parasite Leishmania. It is most common in developing countries. Its clinical presentation varies depending on several factors such as patient's immunity. Cutaneous leishmaniasis is one of the main types of leishmaniasis, it is known to be a great mimicker. When seen in immunodeficient populations, such as patients with acute lymphoblastic leukemia, it may present more aggressively and its diagnosis is challenging. We present a case of a five-year-old male with a history of acute lymphoblastic leukemia undergoing chemotherapy who developed papules evolving into ulcerated nodules on his left lower extremity. An initial smear for leishmaniasis was negative, the disease evolved and spread in an ascending fashion, while efforts were made finding a diagnosis. One-month later the smear was repeated and positive for leishmaniasis. Subsequently, therapy with Meglumine antimoniate was prescribed. The lesions healed with atrophic scarring without complications. Cutaneous leishmaniasis diagnostic methods are not standardized, limitations such as interpreter's expertise and patient's immunity state may play a role in delaying the diagnosis.
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49
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Nasri J, Cajacob L, Wirz E, Ruf MT, Blum J, Mühleisen B, Navarini AA, Maul LV. Pre-ulcerative leishmaniasis mimicking chilblains in a returning traveller from Southern Europe. J Eur Acad Dermatol Venereol 2021; 35:e503-e505. [PMID: 33735478 DOI: 10.1111/jdv.17233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 01/15/2021] [Accepted: 03/08/2021] [Indexed: 11/29/2022]
Affiliation(s)
- J Nasri
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - L Cajacob
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - E Wirz
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - M-T Ruf
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - J Blum
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - B Mühleisen
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - A A Navarini
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - L V Maul
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
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50
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Lesiones cutáneas en un mundo globalizado. Enferm Infecc Microbiol Clin 2021; 39:151-152. [DOI: 10.1016/j.eimc.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/08/2020] [Accepted: 06/15/2020] [Indexed: 11/22/2022]
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