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Santos JS, Galvão JG, Mendonça MRC, Costa AMB, Silva ARST, Oliveira DS, Santos ADJ, Lira AAM, Scher R, Sales Júnior PA, Pereira VRA, Formiga FR, Nunes RS. Encapsulation of Citrus sinensis essential oil and R-limonene in lipid nanocarriers: A potential strategy for the treatment of leishmaniasis. Int J Pharm 2024; 662:124464. [PMID: 39033939 DOI: 10.1016/j.ijpharm.2024.124464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/23/2024]
Abstract
Leishmaniases, a group of neglected tropical diseases caused by an intracellular parasite of the genus Leishmania, have significant impacts on global health. Current treatment options are limited due to drug resistance, toxicity, and high cost. This study aimed to develop nanostructured lipid carriers (NLCs) for delivering Citrus sinensis essential oil (CSEO) and its main constituent, R-limonene, against leishmaniasis. The influence of surface-modified NLCs using chitosan was also examined. The NLCs were prepared using a warm microemulsion method, and surface modification with chitosan was achieved through electrostatic interaction. These nanocarriers were characterized by differential scanning calorimetry (DSC), X-ray diffraction (XRD), transmission electron microscopy, and dynamic light scattering (DLS). In vitro cytotoxicity was assessed in L929 and RAW 264.7 cells, and leishmanicidal activity was evaluated against promastigote and amastigote forms. The NLCs were spherical, with particle sizes ranging from 97.9 nm to 111.3 nm. Chitosan-coated NLCs had a positive surface charge, with zeta potential values ranging from 45.8 mV to 59.0 mV. Exposure of L929 cells to NLCs resulted in over 70 % cell viability. Conversely, surface modification significantly reduced the viability of promastigotes (93 %) compared to free compounds. Moreover, chitosan-coated NLCs presented a better IC50 against the amastigote forms than uncoated NLCs. Taken together, these findings demonstrate the feasibility of using NLCs to overcome the limitations of current leishmaniasis treatments, warranting further research.
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Affiliation(s)
- Jeferson S Santos
- Departament of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, Sergipe, Brazil.
| | - Juliana G Galvão
- Departament of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, Sergipe, Brazil
| | - Marcos R C Mendonça
- Departament of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, Sergipe, Brazil
| | - Amanda M B Costa
- Departament of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, Sergipe, Brazil
| | - Audrey R S T Silva
- Departament of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, Sergipe, Brazil
| | - Daniela S Oliveira
- Departament of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, Sergipe, Brazil
| | - Adriana de J Santos
- Process Engineering Program, University of Tiradentes (UNIT), Aracaju, SE 49032-490, Brazil
| | - Ana Amélia M Lira
- Departament of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, Sergipe, Brazil
| | - Ricardo Scher
- Departament of Morphology, Federal University of Sergipe, São Cristóovão 49100-000, Sergipe, Brazil
| | | | | | - Fábio Rocha Formiga
- Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (FIOCRUZ), 50670-420 Recife, PE, Brazil; Faculty of Medical Sciences (FCM), University of Pernambuco (UPE), 52171-011 Recife, PE, Brazil
| | - Rogéria S Nunes
- Departament of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, Sergipe, Brazil
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Rai T, Shrestha S, Prajapati S, Bastola A, Parajuli N, Ghimire PG, Bhandari P, Pandey K, Jain M, Matlashewski G, Bras-Goncalves R, Manandhar KD. Leishmania donovani persistence and circulation causing cutaneous leishmaniasis in unusual-foci of Nepal. Sci Rep 2023; 13:12329. [PMID: 37516780 PMCID: PMC10387047 DOI: 10.1038/s41598-023-37458-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/22/2023] [Indexed: 07/31/2023] Open
Abstract
Cutaneous leishmaniasis cases have increased dramatically in recent years in Nepal. The study offers molecular identification of the Leishmania species using 40 patient's aspiration biopsy samples, targeting markers kinetoplast minicircle DNA (kDNA) and internal transcribed spacer-1 (ITS1). Among molecularly diagnosed 22 cutaneous leishmaniasis cases, L. donovani complex was identified in 13 instances and L. major in 9 cases. The ITS1 PCR was positive in 12 of the positive nested- kDNA PCR cases (12/22), confirming L. donovani complex in seven of the cases and L. major in five of the cases. In addition, the study conclude that concurrent occurrence of atypical cutaneous infections caused by L. donovani parasite in 59.1% of cases and typical cutaneous infections caused by L. major parasite in 40.9% of cases. A Phylogentic analaysis showed that the detected L. donovani species present null genetic distances from seven references of L. donovani, but slight differences between ITS1 sequences and not grouped into a significant monophyletic cluster.
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Affiliation(s)
- Tinmaya Rai
- Central Department of Biotechnology, Tribhuvan University, Kirtipur, Kathmandu, 44600, Nepal
| | - Srijan Shrestha
- Central Department of Biotechnology, Tribhuvan University, Kirtipur, Kathmandu, 44600, Nepal
| | - Sabita Prajapati
- Central Department of Biotechnology, Tribhuvan University, Kirtipur, Kathmandu, 44600, Nepal
| | - Anup Bastola
- Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, 44600, Nepal
| | | | | | | | - Kishor Pandey
- Central Department of Zoology, Tribhuvan University, Kirtipur, Kathmandu, 44600, Nepal
| | - Manju Jain
- Department of Biochemistry, Central University of Punjab, Bathinda, Punjab, 151401, India
| | - Greg Matlashewski
- Department of Microbiology and Immunology, McGill University, Montreal, QC, H3A 0G4, Canada
| | | | - Krishna Das Manandhar
- Central Department of Biotechnology, Tribhuvan University, Kirtipur, Kathmandu, 44600, Nepal.
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Parajuli N, Prajapati B. Use of mobile tele-dermatology in managing cutaneous leishmaniasis from a remote district of Nepal during the COVID 19 pandemic: A case series. Trop Doct 2023; 53:158-160. [PMID: 36344234 PMCID: PMC9643109 DOI: 10.1177/00494755221136910] [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: 11/09/2022]
Abstract
With the invent of smart phones, tele-dermatology has become a cheap and cost-effective medium to provide medical services to rural population. Its usefulness is more prominently noted during the COVID 19 pandemic and much more in countries with difficult terrain with limited specialist health providers. Cutaneous leishmaniasis (CL) is a neglected tropical disease which may cause significant disability if treatment is delayed. Here, we discuss three cases of CL from a remote district by use of tele-dermatology during the pandemic lockdown.
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Affiliation(s)
- Niraj Parajuli
- Assistant Professor/ Senior Consultant
Dermatologist, Department of dermatology and venereology, National Academy of
Medical Sciences, Bir Hospital, Kathmandu, Nepal,Niraj Parajuli, Assistant Professor/ Senior
Consultant Dermatologist, Department of dermatology and venereology, National
Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
| | - Bigyan Prajapati
- Consultant General Physician, Kalikot
District Hospital, Kalikot district, Nepal
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Sikorska K, Gesing M, Olszański R, Roszko-Wysokińska A, Szostakowska B, Van Damme-Ostapowicz K. Misdiagnosis and inappropriate treatment of cutaneous leishmaniasis: a case report. Trop Dis Travel Med Vaccines 2022; 8:18. [PMID: 35909173 PMCID: PMC9341103 DOI: 10.1186/s40794-022-00175-5] [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: 03/31/2022] [Accepted: 06/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background Leishmaniasis is a widespread disease in tropical and subtropical countries, except for Australia and Oceania. In Poland, tourists, migrants and travellers from leishmaniasis-endemic countries may carry Leishmania. Case presentation We present a case of undiagnosed cutaneous leishmaniasis in a patient who received many weeks of inadequate antibiotic treatment. Ulceration in the right submandibular region was thought to be a purulent complication after laser surgery. Six weeks before the ulcer developed, the patient had visited the jungle (Guatemala). Cutaneous leishmaniasis was finally diagnosed after nine months based on a proper history and a polymerase chain reaction (PCR) assay. Treatment with antimony derivatives was administered. After three months, the ulcer healed but left a scar. Conclusion A lack of knowledge about tropical diseases among doctors and an incomplete medical history were the reasons for many weeks of erroneous treatment of cutaneous leishmaniasis with antibiotics. This is the first reported case of cutaneous leishmaniasis misdiagnosed as a complication after an aesthetic medical procedure.
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S. I. C, Julio AP, De Souza W, A. M. P. Editorial: Understanding anti-trypanosomatid immune responses: The key to developing protective strategies against them. Front Immunol 2022; 13:993315. [PMID: 36211393 PMCID: PMC9535140 DOI: 10.3389/fimmu.2022.993315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Cazorla S. I.
- Centro de Referencia para Lactobacilos – CERELA (CONICET), Tucumán, Argentina
- Cátedra de Inmunología, Facultad de Bioquímica, Química y Farmacia, Universidad Nacional de Tucumán, Tucumán, Argentina
- *Correspondence: Cazorla S. I.,
| | - Alonso-Padilla Julio
- Instituto Salud Global de Barcelona (ISGlobal), Barcelona, Spain
- CIBERINFEC, ISCIII—CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - W. De Souza
- Instituto de Biofísica Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- CMABio, Universidade do Estado do Amazonas-UEA, Manaus, Amazonas, Brazil
| | - Padilla A. M.
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, United States
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Thakur L, Madaan P, Jain A, Shankar V, Negi A, Chauhan SB, Sundar S, Singh OP, Jain M. An Insight Into Systemic Immune Response in Leishmania donovani Mediated Atypical Cutaneous Leishmaniasis in the New Endemic State of Himachal Pradesh, India. Front Immunol 2022; 12:765684. [PMID: 35087516 PMCID: PMC8787830 DOI: 10.3389/fimmu.2021.765684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/16/2021] [Indexed: 11/26/2022] Open
Abstract
Leishmaniasis continues to afflict known and newer endemic sites despite global efforts towards its control and elimination. In this regard, the emergence of newer endemic sites with unusual disease formats is recognized wherein Leishmania donovani complex classically known to cause visceral disease is demonstrated to cause cutaneous manifestation. In this context, atypical cutaneous leishmaniasis (CL) cases caused by L. donovani genetic variants from the newer endemic state of Himachal Pradesh (HP) in India are beginning to be understood in terms of parasite determinants. The atypical CL manifestation further needs to be explored to define host immune correlates with a possible role in driving the unusual disease progression. In the given study, we performed comprehensive systemic-immune profiling of the atypical CL patients from the study area in HP, India, in comparison with the classical visceral leishmaniasis (VL) patients from the northeast region of India. The systemic immune response was studied using ELISA-based assessment of Th1, Th2, Th17, Treg, and Th22 specific plasma cytokine expression pattern and parasite-specific total serum IgG/IgG subclasses. The specified immune correlates are known to exhibit heterogeneous association with the different infecting parasite species, infection load, and co-lateral host immunopathology in classical CL and VL. In the atypical CL patient group, altered expression of IL-10 emerged as the key finding that could potentially fine-tune the Th1/Th17/Th22 effector cytokine axis towards a localized cutaneous manifestation. A reduced expression of IL-10 along with a high IFN-γ/IL-10 ratio as a readout of effective parasite killing defined atypical cutaneous outcome. In contrast, high circulatory IL-10 levels and a depressed IFN-γ/IL-10 ratio were seen in classical VL patients in line with an ineffective parasite-killing cytokine response. Overall, the study highlights new knowledge on host immune correlates in terms of cytokine expression pattern and IgG subclasses that underline atypical disease manifestation such that L. donovani, a generally visceralizing parasite species cause skin localized cutaneous lesions.
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Affiliation(s)
- Lovlesh Thakur
- Department of Zoology, Central University of Punjab, Bathinda, India
| | - Priyanka Madaan
- Department of Biochemistry, Central University of Punjab, Bathinda, India
| | - Aklank Jain
- Department of Zoology, Central University of Punjab, Bathinda, India
| | - Vinay Shankar
- Department of Dermatology, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, India
| | - Ajeet Negi
- Department of Dermatology, Indira Gandhi Medical College, Shimla, India
| | - Shashi Bhushan Chauhan
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Shyam Sundar
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Om Prakash Singh
- Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Manju Jain
- Department of Biochemistry, Central University of Punjab, Bathinda, India
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Pandey K, Bastola A, Haiyan G, Pyakurel UR, Pandey BD, Dumre SP. Emergence of cutaneous leishmaniasis in Nepal. Trop Med Health 2021; 49:72. [PMID: 34503578 PMCID: PMC8428101 DOI: 10.1186/s41182-021-00359-3] [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: 07/08/2021] [Accepted: 08/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is endemic in 70 countries worldwide. Nepal is considered non-endemic for CL and hence the control program is targeted to visceral leishmaniasis (VL) only. Here, we report the emergence of CL cases in different parts of Nepal. METHODS We analyzed the CL and VL cases reported to Epidemiology and Diseases Control Division (EDCD), Ministry of Health and Population, Nepal through District Health Information System 2 (DHIS-2) and Early Warning and Reporting System (EWRS) during the past 4 years (2016-2019). Any laboratory-confirmed case was included in the study. Demographic and clinical details of each patient were transcribed into Excel sheets, verified with the case report forms and analyzed. RESULTS VL has been reported in Nepal since 1980, but CL was reported very recently. From 2016 to 2019, 42 CL cases were reported from 26 different hospitals to EDCD which had been diagnosed on the basis of clinical presentation, and laboratory findings (demonstration of amastigotes in Giemsa-stained smears and rK39 test results). Majority of the patients (31.0%, 13/42) visited to the hospital within 1-6 months of onset of lesions. Facial region (38.1%, 16/42) was the common place where lesions were found ompared to other exposed parts of the body. CL was successfully treated with miltefosine for 28 days. The majority of CL patients did not have history of travel outside the endemic areas and there was no report of sandfly from these areas. CONCLUSION These evidences highlight that the Government of Nepal need to pay more efforts on CL and include it in differential diagnosis by clinicians, and plan for an active surveillance when the country is targeting leishmaniasis elimination by the year 2025 with the decreasing number of VL cases.
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Affiliation(s)
- Kishor Pandey
- Central Department of Zoology, Tribhuvan University, Kathmandu, Nepal.
| | - Anup Bastola
- Sukraraj Tropical and Infectious Diseases Hospital, Kathmandu, Nepal
| | - Gong Haiyan
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, China
| | | | - Basu Dev Pandey
- Epidemiology and Diseases Control Division, Kathmandu, Nepal
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Nepal S. Case Report: An Atypical Erysipeloid Presentation of Cutaneous Leishmaniasis from the Hilly Region of Nepal. Am J Trop Med Hyg 2021; 105:134-137. [PMID: 33970883 DOI: 10.4269/ajtmh.20-0595] [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: 06/05/2020] [Accepted: 03/16/2021] [Indexed: 11/07/2022] Open
Abstract
Cutaneous leishmaniasis, which is the most common form of leishmaniasis, classically presents as small erythematous papules and nodules that develop into ulcers with indurated, raised outer borders. However, lesions of cutaneous leishmaniasis can have pleomorphic and atypical presentations. The erysipeloid form is one of the rare, atypical presentations of cutaneous leishmaniasis. Reported is a case of a 58-year-old man from the hilly region of Nepal who presented with an atypical erythematous and edematous plaque over the left antecubital fossa. Cutaneous leishmaniasis was not considered as an initial diagnosis because of the atypical appearance of the lesion as well as his residence in the hilly region of Nepal. The diagnosis was made after detection of amastigotes on histopathological examination of a cutaneous biopsy specimen. There was complete regression of the lesion after treatment with oral miltefosine followed by oral fluconazole. Clinicians should be aware of atypical presentations of cutaneous leishmaniasis and it should be considered in the differential diagnosis, regardless of the presentation or geographic location.
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