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García M, Ferrer L, Ordeix L. Critically Appraised Topic on Canine Leishmaniosis: Does Treatment with Antimonials and Allopurinol Have the Same Clinical and Clinicopathological Efficacy as Treatment with Miltefosine and Allopurinol, after One Month of Treatment? Vet Sci 2024; 11:231. [PMID: 38921978 DOI: 10.3390/vetsci11060231] [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: 03/19/2024] [Revised: 04/25/2024] [Accepted: 05/18/2024] [Indexed: 06/27/2024] Open
Abstract
The treatment of canine leishmaniosis commonly involves meglumine antimoniate with allopurinol or miltefosine with allopurinol. This study aims to compare the clinical and clinicopathological efficacy at 28-30 days of conventional dosing regimens for both treatments using the critically appraised topic methodology. A comprehensive search across three databases (PubMed, CAB Abstracts, and Web of Science) from March 2004 to September 2023 yielded 16 relevant articles, encompassing 325 ogs treated with meglumine antimoniate and allopurinol, and 273 dogs treated with miltefosine and allopurinol. The findings indicated a significantly higher rate of complete clinical cure in the group treated with meglumine antimoniate and allopurinol. Most dogs in both groups exhibited improvement in clinicopathological alterations after one month of treatment. No significant difference was observed in the number of dogs that showed a negative Leishmania qPCR between the two groups, one month post-treatment. However, quantitative serology results were not commonly reported in the available data and therefore this aspect could not be compared.
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Affiliation(s)
- Marina García
- Departament de Medicina i Cirurgia Animals, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Lluís Ferrer
- Departament de Medicina i Cirurgia Animals, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Laura Ordeix
- Departament de Medicina i Cirurgia Animals, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
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Merino-Goyenechea J, Palacios-Alberti J, Yanes-Martínez T, Martínez-Valladares M, Balaña-Fouce R. Treatment and Healing of Leishmaniasis in a Wolf in Semi-Captivity Regime from an Educational Center of Zamora Province (Spain). Animals (Basel) 2024; 14:1436. [PMID: 38791654 PMCID: PMC11117261 DOI: 10.3390/ani14101436] [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: 04/02/2024] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Leishmaniasis in wild canids is a vector-borne disease caused in Europe by the protozoan parasite Leishmania infantum. To date, there is limited information on clinical signs and laboratory abnormalities in wolves due to leishmaniasis. The current clinical case report described a female Iberian wolf (Canis lupus signatus) housed in semi-captivity conditions at the Centro del Lobo Ibérico "Félix Rodríguez de la Fuente", in Robledo de Sanabria, Zamora (Spain), with an interdigital ulcerous wound at the right forepaw, hyper-gammaglobulinemia, and abnormal liver blood parameters. Definitive serodiagnosis of leishmaniasis was established using antileishmanial serum antibodies and PCR analysis of different biological samples. A gold-standard anti-L. infantum treatment protocol consisting in subcutaneous meglumine antimoniate and oral allopurinol combination was installed. However, the presence of pain at the site of injection due to meglumine antimoniate administration forced its substitution by oral miltefosine. A progressive reduction of the levels of anti-L. infantum serum antibodies and the concentrations of gamma-globulin fraction was detected after antileishmanial treatment as well as a decline of liver GPT. To our knowledge, this is the first case of leishmaniasis diagnosed in a wolf housed in semi-captivity conditions, with the condition subsequently treated and successfully cured.
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Affiliation(s)
- Javier Merino-Goyenechea
- Departamento de Ciencias Biomédicas, Instituto de Biomedicina (IBIOMED), Facultad de Veterinaria, Universidad de León, Campus de Vegazana s/n., 24071 León, Spain;
- Centro del Lobo Ibérico “Félix Rodríguez de la Fuente” Robledo de Sanabria, Puebla de Sanabria, 49393 Zamora, Spain; (J.P.-A.); (T.Y.-M.)
| | - Jesús Palacios-Alberti
- Centro del Lobo Ibérico “Félix Rodríguez de la Fuente” Robledo de Sanabria, Puebla de Sanabria, 49393 Zamora, Spain; (J.P.-A.); (T.Y.-M.)
| | - Tomás Yanes-Martínez
- Centro del Lobo Ibérico “Félix Rodríguez de la Fuente” Robledo de Sanabria, Puebla de Sanabria, 49393 Zamora, Spain; (J.P.-A.); (T.Y.-M.)
| | - María Martínez-Valladares
- Instituto de Ganadería de Montaña (CSIC-Universidad de León), Finca Marzanas, Ctra. León-Grulleros s/n., Grulleros, 24346 León, Spain;
| | - Rafael Balaña-Fouce
- Departamento de Ciencias Biomédicas, Instituto de Biomedicina (IBIOMED), Facultad de Veterinaria, Universidad de León, Campus de Vegazana s/n., 24071 León, Spain;
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Gonçalves G, de Campos MP, Gonçalves AS, Figueiredo FB. Therapeutic success and failure in using miltefosine to treat dogs naturally infected with Leishmania infantum. REVISTA BRASILEIRA DE PARASITOLOGIA VETERINARIA = BRAZILIAN JOURNAL OF VETERINARY PARASITOLOGY : ORGAO OFICIAL DO COLEGIO BRASILEIRO DE PARASITOLOGIA VETERINARIA 2024; 33:e015023. [PMID: 38359300 PMCID: PMC10878695 DOI: 10.1590/s1984-29612024012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/19/2023] [Indexed: 02/17/2024]
Abstract
In urban environments, domestic dogs (Canis familiaris) are a major reservoir for the parasite Leishmania infantum. Miltefosine has been used as the standard treatment for canine visceral leishmaniasis in Brazil. However, therapeutic failures have been reported. In the present study, two dogs (CG03 and CG06) with a diagnosis of infection by L. infantum underwent two cycles of treatment with miltefosine (Milteforan™ - Virbac®). Analyses showed increases in the parasite load of both CG03 and CG06, even after treatment. The clinical score of CG03 dropped from 1 to 0 (after one round of treatment), such that this dog became asymptomatic. CG06 showed clinical worsening, such that its score increased from 1 to 2. After the second therapeutic round, the parasite load in CG03 was found to have decreased, but it was still higher than before drug treatment even though this dog was physically asymptomatic. There was no decrease in the parasite load in CG06 and there was clinical worsening. The clinical response of these dogs to the treatment differed, but the parasite load remained high in both cases, which poses a risk to public health, making it essential take measures to prevent the sandfly vector from accessing the dog.
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Affiliation(s)
- Gustavo Gonçalves
- Laboratório de Biologia Celular, Fiocruz Paraná, Instituto Carlos Chagas, Curitiba, PR, Brasil
| | - Monique Paiva de Campos
- Laboratório de Referência em Leishmaniase, Fiocruz Paraná, Instituto Carlos Chagas, Curitiba, PR, Brasil
| | | | - Fabiano Borges Figueiredo
- Laboratório de Referência em Leishmaniase, Fiocruz Paraná, Instituto Carlos Chagas, Curitiba, PR, Brasil
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Vaz TP, Quaresma PF, Rêgo FD, Souza CB, Fontes G, Gontijo CMF. Clinical and Laboratory Response of Domiciled Dogs with Visceral Leishmaniasis Treated with Miltefosine and Allopurinol. Trop Med Infect Dis 2023; 8:472. [PMID: 37888600 PMCID: PMC10610677 DOI: 10.3390/tropicalmed8100472] [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: 08/29/2023] [Revised: 09/26/2023] [Accepted: 09/30/2023] [Indexed: 10/28/2023] Open
Abstract
Canine visceral leishmaniasis (CVL) remains a significant disease worldwide. In Brazil, its treatment is performed using miltefosine, which has demonstrated promising outcomes in dogs. This study represents the first attempt to treat and monitor dogs with CVL in natural conditions over the course of one year. The dogs were divided into two groups: G1 received miltefosine and allopurinol for 28 days, while G2 received miltefosine for 28 days, followed by allopurinol for one year. The follow-up involved clinical, hematological, and biochemical evaluations, as well as the detection of Leishmania DNA in skin and bone marrow samples. By the end of the follow-up, dogs in G2 exhibited improved staging compared to their initial conditions, whereas those in G1 showed worsened staging. Leishmania DNA in skin and bone marrow decreased between 6 and 12 months after treatment. Our observations indicate that the treatment using miltefosine reduces the detection of the parasite in the skin and bone marrow for up to one year following its administration. The continuous use of allopurinol contributes to control of the disease in dogs. These findings provide valuable insights into the response of dogs treated in natural conditions, offering essential information for veterinarians and public health authorities.
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Affiliation(s)
- Talita Pereira Vaz
- René Rachou Institute (FIOCRUZ/MG), Av. Augusto de Lima, 1715, Barro Preto, Belo Horizonte 30190-009, MG, Brazil; (T.P.V.); (F.D.R.); (C.B.S.)
| | - Patrícia Flávia Quaresma
- Campus Reitor João Davi Ferreira Lima, Federal University of Santa Catarina, Trindade, Florianópolis 88040-900, SC, Brazil;
| | - Felipe Dutra Rêgo
- René Rachou Institute (FIOCRUZ/MG), Av. Augusto de Lima, 1715, Barro Preto, Belo Horizonte 30190-009, MG, Brazil; (T.P.V.); (F.D.R.); (C.B.S.)
| | - Camila Binder Souza
- René Rachou Institute (FIOCRUZ/MG), Av. Augusto de Lima, 1715, Barro Preto, Belo Horizonte 30190-009, MG, Brazil; (T.P.V.); (F.D.R.); (C.B.S.)
| | - Gilberto Fontes
- Campus Centro Oeste, Federal University of São João del Rei (UFSJ), Sebastião Gonçalves Coelho, 400, Divinópolis 35501-296, MG, Brazil;
| | - Célia Maria Ferreira Gontijo
- René Rachou Institute (FIOCRUZ/MG), Av. Augusto de Lima, 1715, Barro Preto, Belo Horizonte 30190-009, MG, Brazil; (T.P.V.); (F.D.R.); (C.B.S.)
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Molina CC, Dias MJ, Domingues TD, Englar RE, Leal RO. Clinical findings and prognostic factors for mortality in hospitalized dogs with leishmaniosis: aretrospective study. Comp Immunol Microbiol Infect Dis 2023; 101:102041. [PMID: 37634471 DOI: 10.1016/j.cimid.2023.102041] [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: 06/20/2023] [Revised: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 08/29/2023]
Abstract
This retrospective study evaluated factors responsible for mortality of dogs hospitalized for Canine Leishmaniosis. Medical records of 31 dogs with leishmaniosis from a Portuguese Veterinary Teaching Hospital were examined between August 2018 and January 2022. Females (n = 18) and pure breed dogs (n = 27) were overrepresented, with higher frequency of Labrador Retriever (n = 4). Median age was 7 years (interquartile range=7). Most had historical findings of lethargy (n = 26) and the commonest clinicopathological abnormality was hypoalbuminemia (n = 26). Eleven dogs were classified as LeishVet stage II, 10 stage III and 10 stage IV. Fourteen dogs (45.2%) died or were euthanized, with azotemia, leukocytosis, stage IV, absence of diagnosis before hospitalization and lack of leishmaniosis specific treatment during hospitalization contributing to mortality. Absence of hypoalbuminemia and stages II/III increased survival. Mean hospitalization length prior to discharge was 5.41days ( ± 1.84) and diarrhea prolonged hospital stay.
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Affiliation(s)
- Carlota Carvalho Molina
- Hospital Escolar Veterinário, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal.
| | - Maria Joana Dias
- Hospital Escolar Veterinário, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal; Centre for Interdisciplinary Research in Animal Health (CIISA) , Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Lisbon, Portugal.
| | | | - Ryane E Englar
- College of Veterinary Medicine, University of Arizona, Oro Valley, USA.
| | - Rodolfo Oliveira Leal
- Hospital Escolar Veterinário, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal; Centre for Interdisciplinary Research in Animal Health (CIISA) , Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Lisbon, Portugal.
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do Carmo Maquiaveli C, da Silva ER, Hild de Jesus B, Oliveira Monteiro CE, Rodrigues Navarro T, Pereira Branco LO, Souza dos Santos I, Figueiredo Reis N, Portugal AB, Mendes Wanderley JL, Borges Farias A, Correia Romeiro N, de Lima EC. Design and Synthesis of New Anthranyl Phenylhydrazides: Antileishmanial Activity and Structure-Activity Relationship. Pharmaceuticals (Basel) 2023; 16:1120. [PMID: 37631035 PMCID: PMC10458276 DOI: 10.3390/ph16081120] [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: 06/29/2023] [Revised: 07/26/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Leishmaniasis is a neglected tropical disease affecting millions of people worldwide. A centenary approach to antimonial-based drugs was first initiated with the synthesis of urea stibamine by Upendranath Brahmachari in 1922. The need for new drug development led to resistance toward antimoniates. New drug development to treat leishmaniasis is urgently needed. In this way, searching for new substances with antileishmanial activity, we synthesized ten anthranyl phenylhydrazide and three quinazolinone derivatives and evaluated them against promastigotes and the intracellular amastigotes of Leishmania amazonensis. Three compounds showed good activity against promastigotes 1b, 1d, and 1g, with IC50 between 1 and 5 μM. These new phenylhydrazides were tested against Leishmania arginase, but they all failed to inhibit this parasite enzyme, as we have shown in a previous study. To explain the possible mechanism of action, we proposed the enzyme PTR1 as a new target for these compounds based on in silico analysis. In conclusion, the new anthranyl hydrazide derivatives can be a promising scaffold for developing new substances against the protozoa parasite.
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Affiliation(s)
- Claudia do Carmo Maquiaveli
- Laboratório de Farmacologia e Bioquímica (LFBq), Departamento de Medicina Veterinária, Universidade de São Paulo Faculdade de Zootecnia e Engenharia de Alimentos, Av. Duque de Caxias Norte 225, Pirassununga 13635-900, SP, Brazil
| | - Edson Roberto da Silva
- Laboratório de Farmacologia e Bioquímica (LFBq), Departamento de Medicina Veterinária, Universidade de São Paulo Faculdade de Zootecnia e Engenharia de Alimentos, Av. Duque de Caxias Norte 225, Pirassununga 13635-900, SP, Brazil
| | - Barbara Hild de Jesus
- Laboratório de Farmacologia e Bioquímica (LFBq), Departamento de Medicina Veterinária, Universidade de São Paulo Faculdade de Zootecnia e Engenharia de Alimentos, Av. Duque de Caxias Norte 225, Pirassununga 13635-900, SP, Brazil
| | - Caio Eduardo Oliveira Monteiro
- Laboratório de Farmacologia e Bioquímica (LFBq), Departamento de Medicina Veterinária, Universidade de São Paulo Faculdade de Zootecnia e Engenharia de Alimentos, Av. Duque de Caxias Norte 225, Pirassununga 13635-900, SP, Brazil
| | - Tiago Rodrigues Navarro
- Laboratório de Catálise e Síntese de Substâncias Bioativas, Instituto Multidisciplinar de Química, CM UFRJ-Macaé, Universidade Federal do Rio de Janeiro, Macaé CEP 27971-525, RJ, Brazil
| | - Luiz Octavio Pereira Branco
- Laboratório de Catálise e Síntese de Substâncias Bioativas, Instituto Multidisciplinar de Química, CM UFRJ-Macaé, Universidade Federal do Rio de Janeiro, Macaé CEP 27971-525, RJ, Brazil
| | - Isabela Souza dos Santos
- Laboratório de Catálise e Síntese de Substâncias Bioativas, Instituto Multidisciplinar de Química, CM UFRJ-Macaé, Universidade Federal do Rio de Janeiro, Macaé CEP 27971-525, RJ, Brazil
| | - Nanashara Figueiredo Reis
- Laboratório de Catálise e Síntese de Substâncias Bioativas, Instituto Multidisciplinar de Química, CM UFRJ-Macaé, Universidade Federal do Rio de Janeiro, Macaé CEP 27971-525, RJ, Brazil
| | - Arieli Bernardo Portugal
- Laboratório de Imunoparasitologia, Instituto de Ciências Médicas, Centro Multidisciplinar UFRJ, Macaé CEP 27979-000, RJ, Brazil
- Programa de Pós Graduação em Biociências e Biotecnologia, Universidade Estadual do Norte Fluminense, Campos dos Goytacazes CEP 28013-602, RJ, Brazil
| | - João Luiz Mendes Wanderley
- Laboratório de Imunoparasitologia, Instituto de Ciências Médicas, Centro Multidisciplinar UFRJ, Macaé CEP 27979-000, RJ, Brazil
| | - André Borges Farias
- Unidad Académica de Yucatán, Instituto de Investigaciones en Matemáticas Aplicadas y en Sistemas, Universidad Nacional Autónoma de México, Mérida 97302, Yucatán, Mexico
- Integrated Laboratory of Scientific Computing (LICC), Federal University of Rio de Janeiro (UFRJ)—Campus Macaé, Aluízio Silva Gomes Avenue 50, Granjas Cavaleiros, Macaé 27930-560, RJ, Brazil
| | - Nelilma Correia Romeiro
- Integrated Laboratory of Scientific Computing (LICC), Federal University of Rio de Janeiro (UFRJ)—Campus Macaé, Aluízio Silva Gomes Avenue 50, Granjas Cavaleiros, Macaé 27930-560, RJ, Brazil
| | - Evanoel Crizanto de Lima
- Laboratório de Catálise e Síntese de Substâncias Bioativas, Instituto Multidisciplinar de Química, CM UFRJ-Macaé, Universidade Federal do Rio de Janeiro, Macaé CEP 27971-525, RJ, Brazil
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Gizzarelli M, Foglia Manzillo V, Inglese A, Montagnaro S, Oliva G. Retrospective Long-Term Evaluation of Miltefosine-Allopurinol Treatment in Canine Leishmaniosis. Pathogens 2023; 12:864. [PMID: 37513711 PMCID: PMC10384837 DOI: 10.3390/pathogens12070864] [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: 05/23/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
Miltefosine-Allopurinol (MIL-AL) combination is reported to be one of the most effective treatments for canine leishmaniosis, thanks to its oral administration and MIL-documented low impact on renal function. However, MIL-AL is considered a second-choice treatment when compared to meglumine-antimoniate-allopurinol combination, mainly due to the risk of earlier relapses. The aim of this study was to evaluate the efficacy of the MIL-AL protocol during a long-term follow-up with an average duration of nine years. Dogs were living in Southern Italy (Puglia, Italy) in an area considered endemic for Canine leishmaniosis (CanL). Inclusion criteria were clinical and/or clinicopathological signs consistent with CanL; positive result to Leishmania quantitative ELISA; and negativity to the most frequent canine vector-borne infections. All dogs received 2 mg/kg MIL for 28 days, and 10 mg/kg AL, BID, for a period varying between 2 and 12 months. Ancillary treatments were allowed according to the clinical condition of the dog. A total clinical score and a total clinicopathological score were calculated at each time point by attributing one point to each sign or alteration present and then by adding all points. Improvement after each treatment was defined by the reduction of at least 50% of the total score. A survival analysis (Kaplan-Meier curve) was performed for quantifying the probability of the events occurring during the study follow-up. The following events were considered: decreased and negative ELISA results; improvement/recovery of the clinical and clinicopathological alterations; and relapse of leishmaniasis. One hundred seventy-three dogs (75f and 98m) were retrospectively included in the study by examining their clinical records since the first diagnosis of CanL. One hundred forty-three (83%) dogs were under five years of age. The mean duration of the follow-up period was 5.4 (±1.1) years with a minimum of 3.2 years and a maximum of 9 years. All dogs received a first treatment of MIL-AL at inclusion; then, during the follow-up course, 30 dogs required a second treatment, 2 dogs required a third treatment and 1 dog required a fourth and a fifth treatment. The mean time interval between the first and the second treatment was 27.2 (±18.3) months. After the first treatment, all dogs had decreased ELISA levels, in an average interval of 2.6 (±1.6) months. One hundred seventy dogs (98%) experienced a clinical improvement (mean time 3.0 ± 4.9 months); 152 (88%) dogs were considered clinically recovered after a mean time of 16.7 ± 13.5 months. A similar trend was observed for clinicopathological alterations; interestingly, proteinuria decreased in most dogs (p < 0.0001-Chi-square for trends). Thirty dogs experienced relapses, the earliest after 4.8 months. The mean time without relapse was 90.4 (±2.5) months. In relapsed dogs, the mean time for clinical improvement after the second treatment was 8.6 (±12.6) months, whereas it was 11.0 (±15.4) months for clinicopathological alterations. Five dogs had limited gastrointestinal side effects associated with MIL treatment. The present study confirms that the MIL-AL protocol can be considered one of the most effective treatments for CanL therapy, mainly for its capacity to provide a long-time clinical improvement in a large majority of treated dogs. As reported in the literature, the clinical stabilization of dogs does not occur immediately after treatment, probably due to the particular pharmacokinetic properties of MIL. The efficacy of MIL-AL decreases in dogs that need more than one treatment, suggesting the necessity to alternate anti-Leishmania drugs for the treatment of relapses. Side effects were transient and slight, even in dogs that required several treatments.
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Affiliation(s)
- Manuela Gizzarelli
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, 80137 Naples, Italy
| | - Valentina Foglia Manzillo
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, 80137 Naples, Italy
| | - Antonio Inglese
- Ambulatorio Veterinario Dr. Antonio Inglese, 74023 Grottaglie, Italy
| | - Serena Montagnaro
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, 80137 Naples, Italy
| | - Gaetano Oliva
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, 80137 Naples, Italy
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Schäfer I, Müller E, Naucke TJ. Ein Update zur Leishmaniose des Hundes: Diagnostik, Therapie und Monitoring. TIERÄRZTLICHE PRAXIS AUSGABE K: KLEINTIERE / HEIMTIERE 2022; 50:431-445. [DOI: 10.1055/a-1970-9590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
ZusammenfassungAufgrund von steigenden Importzahlen von Hunden aus dem Ausland, zunehmendem Reiseverkehr sowie den Veränderungen klimatischer Bedingungen in Europa gewinnen Infektionen mit Leishmania (L.) infantum bei Hunden in Deutschland zunehmend an Bedeutung. Daher sollten auch Hunde aus dem Ausland, die keine klinischen Symptome zeigen, direkt nach Import sowie erneut 6 Monate später auf vektorübertragene Infektionserreger getestet werden. Bei Hunden mit klinischer Symptomatik, die hinweisend auf eine Leishmaniose sind, werden direkte und indirekte Nachweisverfahren sowie eine hämatologische und biochemische Untersuchung unter Einbezug von Serumeiweißelektrophorese sowie Bestimmung des C-reaktiven Proteins empfohlen. Als Leitfaden für die Therapie sowie das Monitoring stehen die LeishVet-Guidelines zur Verfügung. Es stehen leishmanizide und leishmaniostatische Wirkstoffe zur Verfügung, die in first-line, second-line und third-line unterschieden werden. Zur Anpassung der Allopurinol-Dosierung wird der Stufenplan empfohlen. Aufgrund der Veränderung der klimatischen Bedingungen kommt es zu einer Ausbreitung der Habitate von Sandmücken, die als Vektoren der Leishmaniose bekannt sind. Als weitere Infektionsquellen sind Deckakte, transplazentare Infektionen, Bisswunden und Bluttransfusionen beschrieben. Leishmania infantum hat zoonotisches Potential und ist daher auch in Hinblick auf den „One-Health“-Gedanken bedeutend.
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Cavalera MA, Gernone F, Uva A, Donghia R, Zizzadoro C, Zatelli A. Efficacy of domperidone plus renal diet in slowing the progression of chronic kidney disease in dogs with leishmaniosis. Parasit Vectors 2022; 15:397. [PMID: 36316751 PMCID: PMC9620618 DOI: 10.1186/s13071-022-05537-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/06/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) represents the main cause of mortality in dogs with leishmaniosis. Domperidone has recently been reported to improve kidney function in leishmaniotic dogs affected by CKD. Serum symmetric dimethylarginine (sSDMA) has also been shown to be a useful biomarker for earlier detection of decreased kidney function when compared to serum creatinine (sCr). This study aimed to assess the efficacy of domperidone plus renal diet in slowing the progression of nephropathy in leishmaniotic dogs with CKD, evaluating sSDMA and sCr as markers of kidney function. METHODS This study was a therapeutic, prospective, randomized, controlled, 11-month-long field trial. Dogs were recruited if classified as "exposed" to or "infected" with Leishmania infantum and affected by CKD at early stages. After enrolment (T0), dogs were randomized into groups T (treatment) and C (control). All dogs were fed a renal diet and then followed up at 90 (T1), 210 (T2), and 330 (T3) days after inclusion in the study. At T1 and T2, dogs in group T received an oral suspension of domperidone (1 ml/10 kg once a day for up to 28 days). RESULTS Twenty-two dogs (i.e., n = 12 in group T and n = 10 in group C) completed the study. At T0, the entire population of enrolled dogs presented a mean sSDMA value of 16.5 ± 3.4 μg/dl. At T1 (i.e., after 3 months of renal diet), sSDMA was significantly decreased in both groups, with an sSDMA of 13.1 ± 4.4 μg/dl for the entire population involved. From T1 to T3, sSDMA gradually increased in group C, while remaining stable in group T, which continued to show a significantly lower value of sSDMA at T3 than at T0. Regarding sCr, at T0 and T1, the mean values of the entire population of dogs were 1.1 ± 0.3 and 1.0 ± 0.4 mg/dl, respectively, with no statistical differences between groups T and C. In group T, sCr decreased significantly from T0 to T1, while returning at T3 to values similar to T0. CONCLUSIONS In this study, domperidone plus renal diet reduced the progression of kidney disease in leishmaniotic dogs affected by CKD.
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Affiliation(s)
| | - Floriana Gernone
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | - Annamaria Uva
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | - Rossella Donghia
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study” National Institute of Gastroenterology “S. de Bellis” Research Hospital, Bari, Italy
| | - Claudia Zizzadoro
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | - Andrea Zatelli
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
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Effectiveness of an O-Alkyl Hydroxamate in Dogs with Naturally Acquired Canine Leishmaniosis: An Exploratory Clinical Trial. Animals (Basel) 2022; 12:ani12192700. [PMID: 36230441 PMCID: PMC9559384 DOI: 10.3390/ani12192700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/23/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022] Open
Abstract
Canine leishmaniosis is a challenge in veterinary medicine and no drug to date has achieved parasite clearance in dogs. Histone deacetylase inhibitors are a drug class widely used in cancer chemotherapy. We have successfully used O-alkyl hydroxamates (vorinostat derivatives) in the treatment of a laboratory model of visceral leishmaniasis without showing toxicity. In order to test the effectiveness of a particular compound, MTC-305, a parallel-group, randomized, single-centre, exploratory study was designed in naturally infected dogs. In this clinical trial, 18 dogs were allocated into 3 groups and were treated with either meglumine antimoniate (104 mg SbV/kg), MTC-305 (3.75 mg/kg) or a combination of both using a lower MTC-305 dose (1.5 mg/kg) through a subcutaneous route for 2 treatment courses of 30 days, separated by a 30-day rest period. After treatment, a follow-up time of 4 months was established. Parasite burden in bone marrow, lymph node and peripheral blood were quantified through qPCR. Antibody titres were determined through an immunofluorescence antibody test, and cytokine expression values were calculated through RT-qPCR. Treatment safety was evaluated through the assessment of haematological and biochemical parameters in blood, weight, and gastrointestinal alterations. Assessment was carried out before, between and after treatment series. Treatment with MTC-305 was effective at reducing parasite burdens and improving the animals' clinical picture. Dogs treated with this compound did not present significant toxicity signs. These results were superior to those obtained using the reference drug, meglumine antimoniate, in monotherapy. These results would support a broader clinical trial, optimised dosage, and an expanded follow-up stage to confirm the efficacy of this drug.
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11
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A new immunochemotherapy schedule for visceral leishmaniasis in a hamster model. Parasitol Res 2022; 121:2849-2860. [PMID: 35997843 DOI: 10.1007/s00436-022-07628-y] [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: 10/24/2021] [Accepted: 08/12/2022] [Indexed: 10/15/2022]
Abstract
The purpose of the present study was to evaluate the efficacy of the treatment with a recombinant cysteine proteinase from Leishmania, rldccys1, associated with allopurinol or miltefosine on Leishmania (Leishmania) infantum chagasi-infected hamsters. Golden Syrian hamsters infected with L. (L.) infantum chagasi were treated with either miltefosine (46 mg/kg) or allopurinol (460 mg/kg) alone by oral route or associated with rldccys1 (150 µg/hamster) by subcutaneous route for 30 days. Infected hamsters were also treated with miltefosine (46 mg/kg) plus rldccys1 (150 µg/hamster) for 30 days (phase 1) followed by two additional doses of rldccys1 (250 µg/hamster) (phase 2). After the end of treatment, the animals were analyzed for parasite load, body weight, serum levels of immunoglobulins, cytokine expression, and drug toxicity. The data showed a significant decrease of parasite load in infected hamsters treated with allopurinol or miltefosine alone or associated with rldccys1, as well as in those treated with rldccys1 alone. Significantly lower levels of serum IgG were detected in hamsters treated with allopurinol plus rldccys1. The treatment with miltefosine associated with rldccys1 prevented relapse observed in animals treated with miltefosine alone. A significant loss of body weight was detected only in some hamsters treated with miltefosine for 1 month and deprived of this treatment for 15 days. There were no significant differences in transcript expression of IFN-γ and IL-10 in any of treated groups. Neither hepatotoxicity nor nephrotoxicity was observed among controls and treated groups. These findings open perspectives to further explore this immunochemotherapeutic schedule as an alternative for treatment of visceral leishmaniasis.
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12
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Ayres EDCBS, Dias ÁFDLR, Monteiro BRG, Pazzini SS, Barbosa MEC, Silva EBD, Macedo LFDC, Sousa VRF, Dutra V, Nakazato L, Almeida ADBPFD. Clinical and parasitological impact of short-term treatment using miltefosine and allopurinol monotherapy or combination therapy in canine visceral leishmaniasis. REVISTA BRASILEIRA DE PARASITOLOGIA VETERINARIA = BRAZILIAN JOURNAL OF VETERINARY PARASITOLOGY : ORGAO OFICIAL DO COLEGIO BRASILEIRO DE PARASITOLOGIA VETERINARIA 2022; 31:e007222. [PMID: 35920471 DOI: 10.1590/s1984-29612022040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Canine visceral leishmaniasis is an endemic zoonosis in Brazil. Dogs are the main hosts in urban environments. The treatment has gained popularity since the Brazilian government authorized miltefosine for canine treatment. The aim of this study was to investigate the clinical and parasitological impact of short-term treatment with miltefosine and allopurinol, alone and in combination. We evaluated the ability of pharmacotherapy to reduce clinical signs of disease, antibody levels using the indirect fluorescence antibody test (IFAT) and skin parasite load via qPCR after 28 days of treatment. The therapeutic protocols promoted a significant decline in clinical signs and in the skin parasite load in dogs (p < 0.01). We observed a moderate correlation between the skin parasite load and the clinical score in all three treatment groups (r > 0.5) Antibody levels did not decrease in this short period. It was concluded that the treatment with allopurinol reduced the number of parasites in the skin of dogs with visceral leishmaniasis in the short term. However, its efficiency is potentiated when associated with miltefosine.
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Affiliation(s)
- Eveline da Cruz Boa Sorte Ayres
- Laboratório de Leishmanioses, Hospital Veterinário, Faculdade de Medicina Veterinária, Universidade Federal de Mato Grosso - UFMT, Cuiabá, MT, Brasil
| | - Álvaro Felipe de Lima Ruy Dias
- Laboratório de Leishmanioses, Hospital Veterinário, Faculdade de Medicina Veterinária, Universidade Federal de Mato Grosso - UFMT, Cuiabá, MT, Brasil
| | - Bruna Ribeiro Gomes Monteiro
- Laboratório de Leishmanioses, Hospital Veterinário, Faculdade de Medicina Veterinária, Universidade Federal de Mato Grosso - UFMT, Cuiabá, MT, Brasil
| | - Sarah Szimanski Pazzini
- Laboratório de Leishmanioses, Hospital Veterinário, Faculdade de Medicina Veterinária, Universidade Federal de Mato Grosso - UFMT, Cuiabá, MT, Brasil
| | - Mateus Elias Chagas Barbosa
- Laboratório de Estatística. Departamento de Estatística, Instituto de Ciências Exatas e da Terra, Universidade Federal de Mato Grosso - UFMT, Cuiabá, MT, Brasil
| | - Eveliny Barroso da Silva
- Laboratório de Estatística. Departamento de Estatística, Instituto de Ciências Exatas e da Terra, Universidade Federal de Mato Grosso - UFMT, Cuiabá, MT, Brasil
| | - Luis Felipe da Cruz Macedo
- Laboratório de Farmacologia, Faculdade de Medicina, Universidade Federal de Mato Grosso - UFMT, Cuiabá, MT, Brasil
| | - Valéria Régia Franco Sousa
- Laboratório de Leishmanioses, Hospital Veterinário, Faculdade de Medicina Veterinária, Universidade Federal de Mato Grosso - UFMT, Cuiabá, MT, Brasil
| | - Valéria Dutra
- Laboratório de Biologia Molecular, Hospital Veterinário, Faculdade de Medicina Veterinária, Universidade Federal de Mato Grosso - UFMT, Cuiabá, MT, Brasil
| | - Luciano Nakazato
- Laboratório de Biologia Molecular, Hospital Veterinário, Faculdade de Medicina Veterinária, Universidade Federal de Mato Grosso - UFMT, Cuiabá, MT, Brasil
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13
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Morales-Yuste M, Martín-Sánchez J, Corpas-Lopez V. Canine Leishmaniasis: Update on Epidemiology, Diagnosis, Treatment, and Prevention. Vet Sci 2022; 9:vetsci9080387. [PMID: 36006301 PMCID: PMC9416075 DOI: 10.3390/vetsci9080387] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/17/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Dog are the main reservoir of Leishmania infantum, causing canine leishmaniasis, an incurable multisystemic disease that leads to death in symptomatic dogs, when not treated. This parasite causes visceral, cutaneous, and mucosal leishmaniasis in people in the Mediterranean Basin, North Africa, South America, and West Asia. This disease is mostly unknown by veterinarians outside the endemic areas, but the disease is expanding in the Northern Hemisphere due to travel and climate change. New methodologies to study the epidemiology of the disease have found new hosts of leishmaniasis and drawn a completely new picture of the parasite biological cycle. Canine leishmaniasis diagnosis has evolved over the years through the analysis of new samples using novel molecular techniques. Given the neglected nature of leishmaniasis, progress in drug discovery is slow, and the few drugs that reach clinical stages in humans are unlikely to be commercialised for dogs, but several approaches have been developed to support chemotherapy. New-generation vaccines developed during the last decade are now widely used, along with novel prevention strategies. The implications of the epidemiology, diagnosis, treatment, and prevention of canine leishmaniasis are fundamental to public health.
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14
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Pereira MA, Santos R, Nóbrega C, Mega C, Cruz R, Esteves F, Santos C, Coelho C, Mesquita JR, Vala H, Santos-Gomes G. A Questionnaire-Based Survey on the Long-Term Management of Canine Leishmaniosis by Veterinary Practitioners. Animals (Basel) 2022; 12:ani12060731. [PMID: 35327128 PMCID: PMC8944528 DOI: 10.3390/ani12060731] [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: 01/07/2022] [Revised: 03/04/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Canine Leishmaniosis is a chronic and potentially fatal disease, caused by Leishmania infantum, a zoonotic microorganism. In economically disadvantaged regions, costs associated with long-term patient monitoring may determine that some owners decline veterinary follow-up of their dogs, with potentially severe implications for animal welfare and public health. This online, questionnaire-based survey aimed to assess how Portuguese veterinary practitioners perform long-term patient management and recognize relapses. More than half of the respondents stated that most dog owners declare having financial restraints, which condition the use of diagnostic tests during long-term follow-up. Allopurinol ad aeternum or until disease remission and domperidone were the most prescribed treatment, and relapses were detected by the reappearance or worsening of clinical signs by most veterinary practitioners. The rate of relapse detection was higher in the most economically favored regions, probably because of a lesser constraint on the use of the appropriate diagnostic tests. This study confirms that owner financial restraints negatively influence veterinary follow-up and relapse recognition, potentially compromising clinical decision making and favoring the maintenance of Leishmania infantum infection endemic status in Portugal. Abstract Canine Leishmaniosis (CanL) is a chronic and potentially fatal disease. In economically disadvantaged regions, costs associated with long-term patient monitoring may determine that some owners decline veterinary follow-up of their dogs. This online, questionnaire-based survey aimed to assess how Portuguese veterinary practitioners perform long-term patient monitoring and recognize relapses. More than 50% of respondents reported that 50–100% of dog owners declared financial restraints. Hence, in these circumstances, most veterinary practitioners only performed clinical examination and serology. However, when owners did not declare financial restriction, other tests were additionally performed, such as renal and hepatic profiles, hemogram, serum protein electrophoresis and urine protein creatinine ratio. The mean number of exams performed when owners presented financial restraints was significantly lower than the number of exams performed without economic limitations. Most veterinary practitioners prescribed allopurinol ad aeternum or until disease remission and domperidone. CanL relapses were recognized by more than half of respondents “Always”, through the reappearance or worsening of clinical signs, whereas about a quarter detected an increase in anti-Leishmania antibody levels and identified abnormalities in the serum protein electrophoresis profile. The relapse rate was higher in the Lisbon Metropolitan Area and north, the most economically favored regions of Portugal. This study confirms that owner financial restraints negatively influence veterinary follow-up and relapse recognition, ultimately compromising clinical decision making and favoring the maintenance of Leishmania infantum infection endemicity.
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Affiliation(s)
- Maria A. Pereira
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008 Lisboa, Portugal;
- CERNAS—Research Centre for Natural Resources, Environment and Society, ESAV, Instituto Politécnico de Viseu, 3500-606 Viseu, Portugal
- Correspondence: ; Tel.: +351-232-446-600
| | - Rute Santos
- Polytechnic Institute of Portalegre, 7300-110 Portalegre, Portugal;
- Research Centre for Endogenous Resource Valorization (VALORIZA), 7300-555 Portalegre, Portugal
| | - Carmen Nóbrega
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes e Alto Douro, 5001-801 Vila Real, Portugal
| | - Cristina Mega
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- CERNAS—Research Centre for Natural Resources, Environment and Society, ESAV, Instituto Politécnico de Viseu, 3500-606 Viseu, Portugal
| | - Rita Cruz
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, 4050-091 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
| | - Fernando Esteves
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- CERNAS—Research Centre for Natural Resources, Environment and Society, ESAV, Instituto Politécnico de Viseu, 3500-606 Viseu, Portugal
| | - Carla Santos
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
| | - Catarina Coelho
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- CERNAS—Research Centre for Natural Resources, Environment and Society, ESAV, Instituto Politécnico de Viseu, 3500-606 Viseu, Portugal
| | - João R. Mesquita
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, 4050-091 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- ICBAS—School of Medicine and Biomedical Sciences, Porto University, 4050-313 Porto, Portugal
| | - Helena Vala
- Instituto Politécnico de Viseu, Escola Superior Agrária de Viseu, Campus Politécnico, 3504-510 Viseu, Portugal; (C.N.); (C.M.); (R.C.); (F.E.); (C.S.); (C.C.); (H.V.)
- CERNAS—Research Centre for Natural Resources, Environment and Society, ESAV, Instituto Politécnico de Viseu, 3500-606 Viseu, Portugal
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes e Alto Douro, 5001-801 Vila Real, Portugal
| | - Gabriela Santos-Gomes
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008 Lisboa, Portugal;
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Villanueva-Saz S, Giner J, Marteles D, Verde M, Yzuel A, Riera C, Fisa R, Alcover M, Fernández A. Leishmaniosis caused by Leishmania infantum in ferrets: Update review. Vet Anim Sci 2022; 15:100229. [PMID: 35028486 PMCID: PMC8739881 DOI: 10.1016/j.vas.2021.100229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/16/2021] [Accepted: 12/23/2021] [Indexed: 12/01/2022] Open
Abstract
Leishmaniosis in domestic ferrets (Mustela putorius furo) is a disease caused by Leishmania infantum, a parasite transmitted through the bite of an infected female phlebotomine sand fly. Among vertebrates, the dog is the primary domestic reservoir of the parasite; however, other domestic animals can be implicated such as cats. The first description of a clinical case of leishmaniosis in domestic ferrets was reported recently. As a result, new knowledge has been published including empirically based treatment protocols, confirmatory techniques to detect the presence of the parasite infection and seasonal variation in the antibodies against Leishmania in apparently healthy domestic ferrets. The most common clinical signs observed are enlargement of peripheral lymph nodes and skin lesions such as papular and/or ulcerative dermatitis. Additionally, the most frequent laboratory alterations seen are hyperproteinaemia with hyperglobulinaemia and biochemical analytes alterations depending on the affected tissue. Two different therapeutic protocols have been described to treat domestic ferrets with leishmaniosis: meglumine antimoniate plus allopurinol protocol or miltefosine plus allopurinol protocol. These treatment protocols seemed to be able to control the Leishmania infection, although the presence of xanthinuria could be detected. The susceptibility of domestic ferrets to Leishmania infantum, the clinical picture, treatment of infected animals and prevention are poorly understood, due to the scarcity of recent description in the literature. Different proposed diagnostic algorithms have been included for domestic ferrets with suspected leishmaniosis, clinically healthy domestic ferrets and animals as blood donors. In this sense, the present review provides updated data on scientific knowledge of leishmaniosis in ferrets.
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Affiliation(s)
- Sergio Villanueva-Saz
- Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Spain
- Clinical Immunology Laboratory, Veterinary Faculty, University of Zaragoza, Spain
- Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Spain
| | - Jacobo Giner
- Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Spain
- Menescalia Veterinary Clinic, Ismael Merlo Actor, 5, 46020 Valencia, Spain
| | - Diana Marteles
- Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Spain
| | - Maite Verde
- Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Spain
- Clinical Immunology Laboratory, Veterinary Faculty, University of Zaragoza, Spain
- Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Spain
| | - Andrés Yzuel
- Clinical Immunology Laboratory, Veterinary Faculty, University of Zaragoza, Spain
| | - Cristina Riera
- Departament de Biologia, Salut i Medi Ambient, Facultat de Farmacia, Universitat de Barcelona, Spain
| | - Roser Fisa
- Departament de Biologia, Salut i Medi Ambient, Facultat de Farmacia, Universitat de Barcelona, Spain
| | - Magdalena Alcover
- Departament de Biologia, Salut i Medi Ambient, Facultat de Farmacia, Universitat de Barcelona, Spain
| | - Antonio Fernández
- Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Spain
- Clinical Immunology Laboratory, Veterinary Faculty, University of Zaragoza, Spain
- Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Spain
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Segarra S. Nutritional Modulation of the Immune Response Mediated by Nucleotides in Canine Leishmaniosis. Microorganisms 2021; 9:2601. [PMID: 34946204 PMCID: PMC8703464 DOI: 10.3390/microorganisms9122601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/09/2021] [Accepted: 12/14/2021] [Indexed: 12/24/2022] Open
Abstract
Leishmaniasis is an emerging, uncontrolled, and neglected zoonotic disease. Climate change is contributing to its ongoing global expansion. The dog is the main reservoir; hence the importance of implementing effective treatment, prevention, and control measures in this animal species to protect public health. However, although the standard treatment for canine leishmaniosis (CanL) is effective, it does not provide full parasitological clearance, and side effects and drug resistance have been described. The host's immune system plays a key role in the establishment and evolution of leishmaniasis. Dietary nucleotides modulate the immune response and, given their reported efficacy and safety in sick and clinically healthy Leishmania-infected dogs and because they represent a sustainable option with no associated side effects or resistance, they could be included within the prevention, treatment, and control strategies for leishmaniasis. This article briefly summarizes the scientific literature on CanL management, including unresolved issues, and reviews the scientific evidence on immunomodulatory effects of dietary nucleotides in different animal species. It also proposes a CanL management algorithm, including nucleotides. It is concluded that nutritional modulation of the immune response with nucleotides can contribute to better management of leishmaniasis following a One Health approach, especially in the COVID-19 era.
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Affiliation(s)
- Sergi Segarra
- R&D Bioiberica S.A.U., 08950 Esplugues de Llobregat, Spain
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17
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Gonçalves G, Campos MP, Gonçalves AS, Medeiros LCS, Figueiredo FB. Increased Leishmania infantum resistance to miltefosine and amphotericin B after treatment of a dog with miltefosine and allopurinol. Parasit Vectors 2021; 14:599. [PMID: 34886876 PMCID: PMC8656069 DOI: 10.1186/s13071-021-05100-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/17/2021] [Indexed: 01/14/2023] Open
Abstract
Background Leishmania infantum is the most important etiological agent of visceral leishmaniasis in the Americas and Mediterranean region, and the dog is the main host. Miltefosine was authorized to treat canine leishmaniasis (CanL) in Brazil in 2017, but there is a persistent fear of the emergence of parasites resistant not only to this drug but, through cross-resistance mechanisms, also to meglumine antimoniate and amphotericin B. Additionally, the literature shows that acquisition of resistance is followed by increased parasite fitness, with higher rates of proliferation, infectivity and metacyclogenesis, which are drivers of parasite virulence. In this context, the aim of this study was to analyze the impact of treating a dog with miltefosine and allopurinol on the generation of parasites resistant to miltefosine, amphotericin B and meglumine antimoniate. Methods In vitro susceptibility tests were conducted against miltefosine, amphotericin B and meglumine antimoniate with T0 (parasites isolated from a dog before treatment with miltefosine plus allopurinol), T1 (after 1 course of treatment) and T2 (after 2 courses of treatment) isolates. The rates of cell proliferation, infectivity and metacyclogenesis of the isolates were also evaluated. Results The results indicate a gradual increase in parasite resistance to miltefosine and amphotericin B with increasing the number of treatment courses. An increasing trend in the metacyclogenesis rate of the parasites was also observed as drug resistance increased. Conclusion The data indicates an increased L. infantum resistance to miltefosine and amphotericin B after the treatment of a dog with miltefosine plus allopurinol. Further studies with a larger number of L. infantum strains isolated from dogs with varied immune response profiles and undergoing different treatment regimes, are advocated. Graphical Abstract ![]()
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Affiliation(s)
- Gustavo Gonçalves
- Cell Biology Laboratory, Carlos Chagas Institute, Oswaldo Cruz Foundation (FIOCRUZ), Curitiba, Paraná, 81310-020, Brazil.
| | - Monique Paiva Campos
- Cell Biology Laboratory, Carlos Chagas Institute, Oswaldo Cruz Foundation (FIOCRUZ), Curitiba, Paraná, 81310-020, Brazil
| | | | - Lia Carolina Soares Medeiros
- Cell Biology Laboratory, Carlos Chagas Institute, Oswaldo Cruz Foundation (FIOCRUZ), Curitiba, Paraná, 81310-020, Brazil
| | - Fabiano Borges Figueiredo
- Cell Biology Laboratory, Carlos Chagas Institute, Oswaldo Cruz Foundation (FIOCRUZ), Curitiba, Paraná, 81310-020, Brazil
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18
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Cardoso JMDO, Brito RCFD, Mathias FAS, Reis LES, Vieira JFP, Ostolin TLVDP, Andrade HMD, Ramos GS, Frézard F, Aguiar-Soares RDDO, Roatt BM, Reis AB. Comparative evaluation of meglumine antimoniate encapsulated in a mixture of conventional and PEGylated liposomes and immunotherapy using an anti-canine IL-10 receptor-blocking monoclonal antibody on canine visceral leishmaniasis. Mol Immunol 2021; 141:70-78. [PMID: 34814056 DOI: 10.1016/j.molimm.2021.11.011] [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: 09/08/2021] [Revised: 10/28/2021] [Accepted: 11/13/2021] [Indexed: 10/19/2022]
Abstract
This study compared the therapeutic potential of the chemotherapy using meglumine antimoniate encapsulated in a mixture of conventional and PEGylated liposomes (Nano Sbv) and immunotherapy with anti-canine IL-10 receptor-blocking monoclonal antibody (Anti IL-10R) on canine visceral leishmaniasis (CVL). Twenty mongrel dogs naturally infected by L. infantum, displaying clinical signs of visceral leishmaniasis were randomly divided in two groups. In the first one, nine dogs received six intravenous doses of a mixture of conventional and PEGylated liposomes containing meglumine antimoniate at 6.5 mg Sb/kg/dose. In the second one, eleven dogs received two intramuscular doses of 4 mg of anti-canine IL-10 receptor-blocking monoclonal antibody. The animals were evaluated before (T0) and 30, 90, and 180 days after treatments. Our major results demonstrated that both treatments were able to maintain hematological and biochemical parameters, increase circulating T lymphocytes subpopulations, increase the IFN-γ producing T-CD4 lymphocytes, restore the lymphoproliferative capacity and improve the clinical status. However, although these improvements were observed in the initial post-treatment times, they did not maintain until the end of the experimental follow-up. We believe that the use of booster doses or the association of chemotherapy and immunotherapy (immunochemotherapy) is promising to improve the effectiveness of treating CVL for improving the clinical signs and possibly reducing the parasite burden in dogs infected with Leishmania infantum.
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Affiliation(s)
- Jamille Mirelle de Oliveira Cardoso
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Rory Cristiane Fortes de Brito
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Fernando Augusto Siqueira Mathias
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Levi Eduardo Soares Reis
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - João Filipe Pereira Vieira
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | | | - Hélida Monteiro de Andrade
- Laboratório de Leishmanioses, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Guilherme Santos Ramos
- Laboratório de Biofísica de Sistemas Nanoestruturados, Departamento de Fisiologia e Biofısica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Frédéric Frézard
- Laboratório de Biofísica de Sistemas Nanoestruturados, Departamento de Fisiologia e Biofısica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Bruno Mendes Roatt
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, INCT-DT, Brazil
| | - Alexandre Barbosa Reis
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, INCT-DT, Brazil.
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de Sousa Gonçalves R, de Pinho FA, Dinis-Oliveira RJ, Mendes MO, de Andrade TS, da Silva Solcà M, Larangeira DF, Silvestre R, Barrouin-Melo SM. Nutritional adjuvants with antioxidant properties in the treatment of canine leishmaniasis. Vet Parasitol 2021; 298:109526. [PMID: 34271314 DOI: 10.1016/j.vetpar.2021.109526] [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: 01/04/2021] [Revised: 06/14/2021] [Accepted: 07/05/2021] [Indexed: 01/03/2023]
Abstract
Clinical improvement of dogs treated for canine leishmaniasis (CanL) requires reducing Leishmania infantum loads, which depend on intracellular oxidant compounds to destroy the parasite. However, oxidative species' excess and antioxidants consumption can culminate in oxidative stress, resulting in increased, widespread inflammation. We aimed to evaluate if early or late addition of nutritional adjuvants (NAs) - omega-3 polyunsaturated fatty acids and B vitamins - to anti-Leishmania drugs (ALDs) in the treatment of CanL would be clinically beneficial. For that, serum biomarkers including oxidative stress parameters were analyzed during 12 months in dogs allocated to two treatment groups: (G1) NAs administered from 30 days prior to the beginning of ALDs; and (G2) NAs administered from 61 days after the beginning of ALDs. Both G1 and G2 continued to receive NAs until the 12th month. The ALDs administered were metronidazole associated with ketoconazole (40 days), followed by allopurinol from day 41 until the 12th month. G1 exhibited superior inflammation control, with reduced globulins (p = 0.025), specific anti-Leishmania immunoglobulins (p = 0.016), total protein (p = 0.031), and an increased serum albumin/globulin ratio (p = 0.033), compared to G2. The early use of NAs associated with ALDs is clinically beneficial in treating dogs with CanL.
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Affiliation(s)
- Rafaela de Sousa Gonçalves
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia, 40170-110, Salvador, BA, Brazil; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal
| | - Flaviane Alves de Pinho
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia, 40170-110, Salvador, BA, Brazil; Department of Veterinary Anatomy, Pathology and Clinics, School of Veterinary Medicine and Zootechny, Federal University of Bahia, 40170-110, Salvador, BA, Brazil
| | - Ricardo Jorge Dinis-Oliveira
- TOXRUN - Toxicology Research Unit, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, Rua Central de Gandra, 1317, 4585-116, Gandra, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal; UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal
| | - Mariana Oliveira Mendes
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia, 40170-110, Salvador, BA, Brazil
| | - Tiago Sena de Andrade
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia, 40170-110, Salvador, BA, Brazil
| | - Manuela da Silva Solcà
- Department of Preventive Veterinary Medicine and Animal Production of the School of Veterinary Medicine and Zootechny, UFBA, 40170-110, Salvador, Bahia, Brazil
| | - Daniela Farias Larangeira
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia, 40170-110, Salvador, BA, Brazil; Department of Veterinary Anatomy, Pathology and Clinics, School of Veterinary Medicine and Zootechny, Federal University of Bahia, 40170-110, Salvador, BA, Brazil
| | - Ricardo Silvestre
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal; ICVS/3B's Associate Laboratory, 4710-057, Braga, Portugal
| | - Stella Maria Barrouin-Melo
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia, 40170-110, Salvador, BA, Brazil; Department of Veterinary Anatomy, Pathology and Clinics, School of Veterinary Medicine and Zootechny, Federal University of Bahia, 40170-110, Salvador, BA, Brazil.
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de Lana M, Giunchetti RC. Dogs as a Model for Chemotherapy of Chagas Disease and Leishmaniasis. Curr Pharm Des 2021; 27:1741-1756. [PMID: 33371843 DOI: 10.2174/1381612826666201228142703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 10/22/2020] [Accepted: 11/02/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Dogs are natural reservoir of Chagas disease (CD) and leishmaniasis and have been used for studies of these infections as they develop different clinical forms of these diseases similar to humans. OBJECTIVE This article describes publications on the dog model relative to CD and leishmaniasis chemotherapy. METHODS The search of articles was based on PubMed, Scopus and MESH using the keywords: dog, Trypanosoma cruzi, treatment (T. cruzi chemotherapy analysis), Leishmania chagasi, Leishmania infantum, canine visceral leishmaniasis, treatment (Leishmania chemotherapy evaluation). RESULTS Benznidazole and nifurtimox were used as a reference in the treatment of CD and in combination with other compounds. Eleven out of the fifteen studies have authors from the same team, using similar protocols and post-treatment evaluations, which assured more reproducibility and credibility. Twenty leishmaniasis studies, especially on visceral leishmaniasis, presenting at least one parasitological analysis tested in distinct monochemotherapy and polychemotherapy approaches were accessed. Data demonstrated that polychemotherapy was more effective in improving the clinical signs and parasitism control. CONCLUSION The benefits of treatment in terms of reducing or eliminating lesions and/or cardiac dysfunctions were demonstrated at acute and/or chronic phases relative to parasite load and/or the T. cruzi strain resistance to treatment. BZ presented better therapeutic results than the two EBI compounds evaluated. Although treatment of the canine visceral leishmaniasis was not able to induce complete parasite clearance, it can improve clinical recovery. Thus, the dog is a good model for CD and leishmaniasis studies of chemotherapy and may be indicated for pre-clinical trials of new treatments.
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Affiliation(s)
- Marta de Lana
- Programa de Pos-Graduacao em Ciencias Farmaceuticas (CiPHARMA), Escola de Farmacia, Programa Pos-Graduacao em de Ciencias Biologicas, Nucleo de Pesquisas em Ciencias Biologicas (NUPEB), Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG, Brazil
| | - Rodolfo Cordeiro Giunchetti
- Departamento de Morfologia, Instituto de Ciencias Biologicas (ICB), Universidade Federal de Minas Gerais, MG, Brazil
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21
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Monteiro M, Prata S, Cardoso L, Pereira da Fonseca I, Leal RO. Diagnosis and clinical management of canine leishmaniosis by general veterinary practitioners: a questionnaire-based survey in Portugal. Parasit Vectors 2021; 14:306. [PMID: 34099039 PMCID: PMC8182999 DOI: 10.1186/s13071-021-04799-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/20/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Canine leishmaniosis (CanL) can be appropriately managed following international recommendations. However, few studies have assessed the preferred protocols in real-life veterinary practice and whether these are in line with the guidelines. This survey aimed to investigate the current trends in the clinical management of CanL among veterinary practitioners in Portugal, taking into consideration different scenarios of infection/disease and the awareness of and application by veterinary practitioners of the current guidelines. METHODS A questionnaire-based survey was conducted online using an electronic platform. The following topics were surveyed: (i) general characteristics of the responding veterinarian; (ii) the preferred protocols used for the diagnosis, treatment and prevention of CanL, considering different theoretical scenarios of infection/disease; and (iii) the responding veterinarian's current knowledge and application of the existing guidelines on CanL. After internal validation, the survey was distributed online, for 2 months, via Portuguese social network veterinary groups. Data were collected for descriptive analysis. RESULTS Eighty-six replies were obtained. Analysis of the results showed that the preferred diagnostic techniques varied widely according to the theoretical scenario of infection/disease. In general daily practice, serology testing (enzyme-linked immunosorbent assay [ELISA]) was the most used tool (67.4%). The preferred matrices used for PCR test were lymph nodes (62.3%) and/or bone marrow (59.0%). Regarding treatment, for subclinical infection/stage I CanL, 51.2% of the respondents did not prescribe any medical treatment, but 98.8% proceeded with both monitoring and preventive measures. Among those who prescribed a treatment (n = 42), most chose domperidone (47.6%). For the treament of stages IIa, IIb and III CanL, allopurinol/meglumine antimoniate (MA) was chosen by 69.8, 73.3 and 51.2% of respondents, respectively, followed by allopurinol/miltefosine (20.9, 19.8 and 38.4%, respectively). In contrast, dogs with stage IV CanL were mostly treated with allopurinol/miltefosine (48.8%) rather than with allopurinol/MA (23.3%). The use of repellents was the preferred preventive strategy (98.8%). About 93.0% of responders were aware of the existence of guidelines, and most of these veterinarians consulted the guidelines of the LeishVet group and the Canine Leishmaniosis Working Group; however, 31.3% reported that they did not follow any specific recommendations. CONCLUSIONS Of the veterinarians responding to the survey, most reported following international guidelines for the clinical management of CanL. While allopurinol/MA was the preferred therapeutic protocol for the treatment of stages II/III CanL, allopurinol/miltefosine was the first choice for the treatment of stage IV CanL, possibly due to the unpredictable effect of MA on renal function. This study contributes to a better understanding of the trends in practical approaches to the treatment of CanL in Portugal.
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Affiliation(s)
- Marta Monteiro
- Hospital Escolar Veterinário, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
| | - Sara Prata
- Hospital Escolar Veterinário, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
| | - Luís Cardoso
- Department of Veterinary Sciences, and Animal and Veterinary Research Centre (CECAV), University of Trás-Os-Montes e Alto Douro (UTAD), Vila Real, Portugal
| | - Isabel Pereira da Fonseca
- Hospital Escolar Veterinário, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
- Centro de Investigação Interdisciplinar em Sanidade Animal (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal
| | - Rodolfo Oliveira Leal
- Hospital Escolar Veterinário, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal.
- Centro de Investigação Interdisciplinar em Sanidade Animal (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisbon, Portugal.
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Nogueira RA, Lira MGS, Santos SIP, Mondêgo-Oliveira R, Andrade FHED, Sousa EMD, Barbosa DS, Abreu-Silva AL, Carvalho RC. Intense transmission of visceral leishmaniasis in a region of northeastern Brazil: a situation analysis after the discontinuance of a zoonosis control program. ACTA ACUST UNITED AC 2021; 30:e020320. [PMID: 33909834 DOI: 10.1590/s1984-29612021015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 02/04/2021] [Indexed: 11/22/2022]
Abstract
In São Luís, Maranhão, northeastern Brazil, the notification of visceral leishmaniasis (VL) cases intensified in 1982, showing endemic and epidemic patterns. In this city, the Center for Zoonoses Control (CZC) was an organization in charge of the control and prevention of the disease. However, technical and political reasons have led to a significant decline in the periodicity of its activities. Therefore, in this study we evaluated the epidemiological scenario of human visceral leishmaniasis (HVL) and the prevalence of the disease in dogs after the cessation of the CZC activities, covering the period of 2007 to 2016. The seroprevalence of canine leishmaniasis was determined based on clinical and serological profiles. HVL cases were notified using data provided by the Municipal Health Department of São Luís. A seropositivity rate of 45.8% (p = 0.0001) was found among dogs, 54% (p = 0.374) of which were asymptomatic. As for human cases, there were 415 notifications, with an increase in the incidence of the zoonosis observed during the aforementioned period. Thus, it can be inferred that after the control and surveillance activities were curtailed, there was an increase in the number of seropositive animals in circulation, acting as reservoirs of infection for dogs and humans.
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Affiliation(s)
- Ranielly Araujo Nogueira
- Programa de Pós-graduação em Ciências da Saúde, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão - UFMA, São Luís, MA, Brasil
| | - Maria Gabriela Sampaio Lira
- Programa de Pós-graduação em Ciências da Saúde, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão - UFMA, São Luís, MA, Brasil
| | - Sarah Ingrid Pinto Santos
- Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Estadual do Maranhão - UEMA, São Luís, MA, Brasil
| | - Renata Mondêgo-Oliveira
- Programa de Pós-graduação em Biotecnologia (Rede Nordeste de Biotecnologia), Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão - UFMA, São Luís, MA, Brasil
| | - Fábio Henrique Evangelista de Andrade
- Laboratório de Anatomopatologia, Curso de Medicina Veterinária, Centro de Ciências Agrárias, Universidade Estadual do Maranhão - UEMA, São Luís, MA, Brasil
| | | | - David Soeiro Barbosa
- Programa de Pós-graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, MG, Brasil
| | - Ana Lucia Abreu-Silva
- Programa de Pós-graduação em Ciências da Saúde, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão - UFMA, São Luís, MA, Brasil.,Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Estadual do Maranhão - UEMA, São Luís, MA, Brasil
| | - Rafael Cardoso Carvalho
- Programa de Pós-graduação em Ciências da Saúde, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão - UFMA, São Luís, MA, Brasil
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Olías-Molero AI, Fontán-Matilla E, Cuquerella M, Alunda JM. Scientometric analysis of chemotherapy of canine leishmaniasis (2000-2020). Parasit Vectors 2021; 14:36. [PMID: 33422141 PMCID: PMC7796616 DOI: 10.1186/s13071-020-04544-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 12/13/2020] [Indexed: 11/16/2022] Open
Abstract
Background Zoonotic visceral leishmaniasis by Leishmania infantum is a first-order pathology in canine veterinary clinics in endemic areas. Moreover, canine infections are considered the main reservoir for human disease; despite their importance in the control of the disease within a One Health approach, no scientometric study has been published. Aims of the study included analyzing the impact of canine leishmaniasis (CanL) on the scientific literature, drugs or combinations used, trends in the period from 2000 to 2020 and efficacy criteria employed. Methods A Web of Science (WOS)-based analysis of publications on CanL and chemotherapy of the disease in the period 2000–2020 was carried out using a stepwise methodology. Data were analyzed by year, geographical origin, chemical groups, drugs and combinations, and efficacy criteria. Results Reports on CanL (n = 3324) represented < 16% of all publications on leishmaniasis (n = 20,968), and of these around 18% (n = 596) were related to chemotherapy. Publication records on CanL followed the distribution of the infection by L. infantum in endemic areas although Mediterranean countries were overrepresented in the reports on chemotherapy of CanL. Publications on the main antileishmanial drugs used in clinical practice showed a sustained tendency in the period analyzed. Pentavalent antimonials (SbV), alone or in combination with allopurinol, represented > 50% of all publications on chemotherapy of CanL despite the availability of more recently marketed drugs. Conclusions Chemotherapy of CanL still relies on SbV and combinations and to a lesser extent on miltefosine (MIL). Reports on chemotherapy are scarce and mostly publicly funded, and the variability of experimental conditions hampers the direct comparison of the efficacy of drugs, combinations and schedules. The vast majority of reports on efficacy do not include any information on supportive therapy; this reduces the actual value of the studies if intended for the practical management of the disease. Complete reports on the chemotherapy (etiological + symptomatic) would add value to the trials performed.![]()
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Affiliation(s)
- A I Olías-Molero
- Department of Animal Health, Faculty of Veterinary Medicine, University Complutense Madrid, 28040, Madrid, Spain.,Instituto de Investigación Hospital 12 de Octubre, Avda. Andalucía s/n, 28041, Madrid, Spain
| | - E Fontán-Matilla
- Department of Animal Health, Faculty of Veterinary Medicine, University Complutense Madrid, 28040, Madrid, Spain
| | - M Cuquerella
- Department of Animal Health, Faculty of Veterinary Medicine, University Complutense Madrid, 28040, Madrid, Spain.,Instituto de Investigación Hospital 12 de Octubre, Avda. Andalucía s/n, 28041, Madrid, Spain
| | - J M Alunda
- Department of Animal Health, Faculty of Veterinary Medicine, University Complutense Madrid, 28040, Madrid, Spain. .,Instituto de Investigación Hospital 12 de Octubre, Avda. Andalucía s/n, 28041, Madrid, Spain.
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Pessoa-E-Silva R, Trajano-Silva LAM, Vaitkevicius-Antão V, Dos Santos WJT, Magalhães FB, Moura DMN, Nakasone EKN, de Lorena VMB, de Paiva-Cavalcanti M. Immunoprophylactic Potential of a New Recombinant Leishmania infantum Antigen for Canine Visceral Leishmaniasis: An In Vitro Finding. Front Immunol 2021; 11:605044. [PMID: 33488607 PMCID: PMC7819978 DOI: 10.3389/fimmu.2020.605044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/23/2020] [Indexed: 11/13/2022] Open
Abstract
The development and application of safe and effective immunoprophylactic/immunotherapeutic agents against canine visceral leishmaniasis (CanL) have been pointed out as the only means for the real control of the disease. Thus, this study aimed to evaluate the in vitro cellular immune response of dogs, elicited by the new recombinant proteins of Leishmania infantum, Lci10 and Lci13, in order to investigate their potential for vaccinology. Twenty-four dogs were submitted to clinical, parasitological, serological and molecular tests, and then separated into two study groups: 12 infected (InD) and 12 non-infected dogs (NInD), and six of each group were directed for Lci10 and Lci13 evaluation. Peripheral blood mononuclear cells (PBMC) were cultured and stimulated with Lci10 (10 μg/ml) or Lci13 (5 μg/ml), and with L. infantum soluble antigen (LSA) (25 μg/ml) or no stimulus (NS) as controls. Afterwards, the mRNA levels of different cytokines were quantified through qPCR, and Nitric Oxide (NO) production was assessed in the culture supernatants. Significant differences were considered when p ≤ 0.05. The comparative analysis revealed that, in the NInD group, Lci13 promoted a significant increase in the expression of IFN-γ in relation to LSA (p = 0.0362), and the expression of this cytokine in NInD was significantly higher than that presented in the InD (p = 0.0028). A negative expression for TGF-β was obtained in both groups. Lci13 also induced a greater production of NO in relation to the NS sample in the NInD group. No significant differences were observed after stimulation with Lci10. In conclusion, the results suggest a protective role of Lci13 for uninfected animals, thus with a potential for immunoprophylaxis. The results will help to direct the antigen Lci13 for further studies (pre-clinical trials), in order to determine its immunogenicity and reactogenicity effects, as a way to consolidate its real applicability for vaccinology against CanL.
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Iarussi F, Paradies P, Foglia Manzillo V, Gizzarelli M, Caratozzolo MF, Navarro C, Greco B, Rubino GTR, Oliva G, Sasanelli M. Comparison of Two Dosing Regimens of Miltefosine, Both in Combination With Allopurinol, on Clinical and Parasitological Findings of Dogs With Leishmaniosis: A Pilot Study. Front Vet Sci 2021; 7:577395. [PMID: 33381534 PMCID: PMC7767967 DOI: 10.3389/fvets.2020.577395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/19/2020] [Indexed: 11/29/2022] Open
Abstract
Miltefosine (MIL)–allopurinol combination therapy administered at standard dosage is effective to treat canine leishmaniosis, nevertheless for some dogs the digestive tolerance of MIL is not acceptable. This study evaluates an alternative therapeutic protocol by using a modified dosage of MIL to increase its effectiveness and improve the digestive tolerance. Thirty-four Leishmania infantum owned naturally infected dogs were included and monitored for 180 days. The dogs were allocated in two randomized groups: Group X−18 dogs treated with MIL registered dose of 2 mg/kg, oral administration, once daily, for 28 days; Group Y−16 dogs treated with 1.2 mg/kg for 5 days followed by 2.5 mg/kg for 25 days. Both groups were also treated with allopurinol. Digestive tolerance was monitored by adverse events observation. Treatments effectiveness was evaluated by monitoring the reduction of clinical score, the improvement of clinicopathological abnormalities, the reduction of parasitological load by PCR and the number of relapses. 16.6% dogs of group X and 12.5% dogs of group Y showed treatment associated adverse events. The reduction of clinical score was 61.7% for group X and 71.6% for group Y. All dogs showed an improvement of laboratory parameters after treatment. Quantitative PCR showed better results in group Y compared to group X; relapses were only registered in four dogs of group X. The modified protocol demonstrates a better trend of results in term of tolerance, clinical effectiveness, parasitological load reduction and relapses control, suggesting it could be considered for new large-scale studies.
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Affiliation(s)
- Fabrizio Iarussi
- Dipartimento Dell'Emergenza e dei Trapianti di Organi, Sezione Veterinaria, Università Degli Studi "Aldo Moro", Bari, Italy
| | - Paola Paradies
- Dipartimento Dell'Emergenza e dei Trapianti di Organi, Sezione Veterinaria, Università Degli Studi "Aldo Moro", Bari, Italy
| | - Valentina Foglia Manzillo
- Dipartimento di Medicina Veterinaria e Produzioni Animali, Università Degli Studi di Napoli Federico II, Naples, Italy
| | - Manuela Gizzarelli
- Dipartimento di Medicina Veterinaria e Produzioni Animali, Università Degli Studi di Napoli Federico II, Naples, Italy
| | | | | | - Beatrice Greco
- Dipartimento Dell'Emergenza e dei Trapianti di Organi, Sezione Veterinaria, Università Degli Studi "Aldo Moro", Bari, Italy
| | | | - Gaetano Oliva
- Dipartimento di Medicina Veterinaria e Produzioni Animali, Università Degli Studi di Napoli Federico II, Naples, Italy
| | - Mariateresa Sasanelli
- Dipartimento Dell'Emergenza e dei Trapianti di Organi, Sezione Veterinaria, Università Degli Studi "Aldo Moro", Bari, Italy
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Medkour H, Bitam I, Laidoudi Y, Lafri I, Lounas A, Hamidat HK, Mekroud A, Varloud M, Davoust B, Mediannikov O. Potential of Artesunate in the treatment of visceral leishmaniasis in dogs naturally infected by Leishmania infantum: Efficacy evidence from a randomized field trial. PLoS Negl Trop Dis 2020; 14:e0008947. [PMID: 33338041 PMCID: PMC7781483 DOI: 10.1371/journal.pntd.0008947] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/04/2021] [Accepted: 11/03/2020] [Indexed: 12/19/2022] Open
Abstract
Leishmaniasis is among the world’s most neglected diseases. Dogs are the main reservoirs/hosts of Leishmania infantum, causative agent of both canine and human visceral leishmaniosis. Canine leishmaniasis (CanL) represents a public health problem as one of the most prevalent zoonotic diseases worldwide. Current therapeutics present drawbacks; thus, there is a need for more effective, safer, and cheaper drugs. The aim of this study was to evaluate and to compare the efficacy of oral administration of artesunate or meglumine antimoniate/allopurinol in dogs with clinical leishmaniasis. Forty-two dogs with naturally occurring clinical leishmaniasis were included in this open-label, simple randomized positive-control clinical field trial with 6 months of follow-up. Dogs received meglumine antimoniate 100 mg/kg/day and allopurinol 30 mg/kg/day for 28 days (control group, n = 26) or artesunate 25 mg/kg/day for 6 days (test group, n = 16). The animals were evaluated for their clinical evolution, parasite load (by qPCR) and humoral response at different time points: 0, 30, 90, and 180 days after treatment. Data analyses showed a significant improvement in both groups in clinical scores, parasitemia and antibody titers after treatment. Compared to the control group, the artesunate group showed significantly lower clinical score (P = 0.0001), lower parasitemia (P = 0.0001) and antibody titers after 6 months of follow-up. Compared to baseline values, a rapid, significant reduction (P < 0.012) in antibody levels, 2.28- versus 3.04-fold for the control versus artesunate groups, respectively, was observed 30 days after treatment. Antibody levels continued to decrease further in the artesunate group, where 58% of cases became seronegative at the 6-month follow-up. All qPCR-positive dogs were negative after treatment with artesunate, while 14.3% remained positive with the appearance of two new cases in the control group. Artesunate was well tolerated, and no side effects were recorded. Treatment failures were similar in both groups with 27.27% (6/22), including 18.18% (4/22) mortality in the control group, versus 26.66% (4/15), including 13.33% (2/15) mortality in the artesunate group. This is the first report showing the potential of artesunate in the treatment of dogs with clinical leishmaniasis. Artesunate showed higher efficacy than the current first-line treatment for CanL without any adverse effects. It could be a good alternative chemotherapy for CanL, and may be considered for further studies in human leishmaniases. Further clinical trials are needed to confirm these findings, to determine if there are relapses after treatment and if dogs remain infective to sandflies, to define the ideal therapeutic dosage and duration of treatment with artesunate. Canine leishmaniasis (CanL) is a fatal, zoonotic vector-borne disease caused by Leishmania infantum, a common pathogen for both humans and dogs. Most CanL therapeutics are toxic, expensive, or ineffective. Artemisinin and derivatives have recently demonstrated potent antileishmanial activity in vitro and in experimental models. In this study, dogs with clinical leishmaniasis were randomly included in one of the treatment groups: meglumine antimoniate/allopurinol (control) or artesunate (alternative). Dogs were followed up for 6 months for their clinical score, parasitemia and Leishmania antibody levels. Both groups showed improved clinical scores, parasitemia and antibody titers after treatment. After six months of follow-up, treatment success was very similar in both groups, and 72.73% (16/22) of the controls versus 73.34% (11/15) in the artesunate group had clinical improvement. All dogs initially seropositive by PCR became negative after artesunate treatment, while 14.3% remained positive with the appearance of new cases in the control group. Antibody titers decreased rapidly (from day 30) from baseline especially in the artesunate group, where 58% of the dogs converted to seronegative after 6 months. Artesunate could be a good alternative for treatment of leishmaniasis. Additional clinical trials are needed to obtain more data on this drug.
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Affiliation(s)
- Hacène Medkour
- IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
- PADESCA Laboratory, Veterinary Science Institute, University Constantine 1, El Khroub, Algeria
| | - Idir Bitam
- Aix-Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- Superior School of Food Sciences and Food Industries of Algiers, Algeria
| | - Younes Laidoudi
- IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
- PADESCA Laboratory, Veterinary Science Institute, University Constantine 1, El Khroub, Algeria
| | - Ismail Lafri
- Aix-Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- Institute of Veterinary Sciences, University of Blida 1, Algeria
- Laboratory of Biotechnology related to Animal Reproduction (LBRA), University of Blida, Blida, Algeria
| | - Abdelaziz Lounas
- Institute of Veterinary Sciences, University of Blida 1, Algeria
- Laboratory of Biotechnology related to Animal Reproduction (LBRA), University of Blida, Blida, Algeria
| | - Hamza Karim Hamidat
- Department of Biology, Faculty of Sciences, University of Boumerdes, Algeria
| | - Abdeslam Mekroud
- PADESCA Laboratory, Veterinary Science Institute, University Constantine 1, El Khroub, Algeria
| | | | - Bernard Davoust
- IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Oleg Mediannikov
- IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
- * E-mail:
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Miret JA, Moreno J, Nieto J, Carter KC, Mullen AB, Ambros L, Rodríguez C, San Andrés MI, González F. Antileishmanial efficacy and tolerability of combined treatment with non-ionic surfactant vesicle formulations of sodium stibogluconate and paromomycin in dogs. Exp Parasitol 2020; 220:108033. [PMID: 33166530 DOI: 10.1016/j.exppara.2020.108033] [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: 07/08/2020] [Revised: 09/30/2020] [Accepted: 10/28/2020] [Indexed: 10/23/2022]
Abstract
Infection with Leishmania infantum causes the disease visceral leishmaniasis (VL), which is a serious clinical and veterinary problem. The drugs used to treat canine leishmaniasis (CanL) do not cause complete parasite clearance; they can be toxic, and emerging drug resistance in parasite populations limits their clinical utility. Therefore, in this study we have evaluated the toxicity and efficacy of joint treatment with a 1:1 mixture of sodium stibogluconate-NIV (SSG-NIV, 10 mg Sbv/day) and paromomycin-NIV (PMM-NIV, 10 mg PMM/kg/day), given intravenously daily for seven days from day 270 post-infection, to nine-month-old female beagle dogs (n = 6) experimentally infected with Leishmania infantum. Treatment significantly improved the clinical symptoms of VL infection in all the treated dogs, reduced parasite burdens in lymph nodes and bone marrow, and all symptomatic treated dogs, were asymptomatic at 90 days post-treatment. Treatment was associated with a progressive and significant decrease in specific IgG anti-Leishmania antibodies using parasite soluble antigen (p < 0.01) or rK39 (p < 0.01) as the target antigen. In addition, all dogs were classified as parasite negative based on Leishmania nested PCR and quantitative real time PCR tests and as well as an inability to culture of promastigote parasites from lymph nodes and bone marrow tissue samples taken at day 90 post-treatment. However, treatment did not cure the dogs as parasites were detected at 10 months post-treatment, indicating that a different dosing regimen is required to cause long term cure or prevent relapse.
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Affiliation(s)
- Jorge A Miret
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Dr. Cecilio Báez casi Dr. Gaspar Villamayor. Campus UNA, CP 2169, San Lorenzo, Paraguay.
| | - Javier Moreno
- WHO Collaborating Center for Leishmaniasis, Centro Nacional Microbiología, Instituto de Salud Carlos III. Crta, Majadahonda a Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain
| | - Javier Nieto
- WHO Collaborating Center for Leishmaniasis, Centro Nacional Microbiología, Instituto de Salud Carlos III. Crta, Majadahonda a Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain
| | - Katharine C Carter
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Catedral St Glasgow G 4 ORE, Glasgow, United Kingdom
| | - Alexander B Mullen
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Catedral St Glasgow G 4 ORE, Glasgow, United Kingdom
| | - Luis Ambros
- Cátedra de Farmacología, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires. Av. Chorroarin 280, Buenos Aires, Argentina
| | - Casilda Rodríguez
- Cátedra de Farmacología, Facultad de Veterinaria, Universidad Complutense de Madrid, Avenida Puerta del Hierro s/n, Ciudad Universitaria, 28040, Madrid, Spain
| | - Manuel Ignacio San Andrés
- Cátedra de Farmacología, Facultad de Veterinaria, Universidad Complutense de Madrid, Avenida Puerta del Hierro s/n, Ciudad Universitaria, 28040, Madrid, Spain
| | - Fernando González
- Cátedra de Farmacología, Facultad de Veterinaria, Universidad Complutense de Madrid, Avenida Puerta del Hierro s/n, Ciudad Universitaria, 28040, Madrid, Spain
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Roura X, Cortadellas O, Day MJ, Benali SL, Zatelli A. Canine leishmaniosis and kidney disease: Q&A for an overall management in clinical practice. J Small Anim Pract 2020; 62:E1-E19. [PMID: 33107613 DOI: 10.1111/jsap.13237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 12/19/2022]
Affiliation(s)
- X Roura
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
| | - O Cortadellas
- Hospital Clínico Veterinario, Universidad CEU Cardenal Herrera, 46115, Valencia, Spain
| | - M J Day
- School of Veterinary and Life Sciences, Murdoch University, 6150, Murdoch, Australia
| | - S L Benali
- Laboratorio La Vallonea, 20017, Milano, Italy
| | | | - A Zatelli
- Dipartimento di Medicina Veterinaria, Università degli Studi di Bari "Aldo Moro", 70010, Bari, Italy
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Evaluation of Cysteine Protease C of Leishmania donovani in Comparison with Glycoprotein 63 and Elongation Factor 1α for Diagnosis of Human Visceral Leishmaniasis and for Posttreatment Follow-Up Response. J Clin Microbiol 2020; 58:JCM.00213-20. [PMID: 32848039 DOI: 10.1128/jcm.00213-20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/30/2020] [Indexed: 12/21/2022] Open
Abstract
Visceral leishmaniasis (VL) is a threat in many developing countries. Much effort has been put to eliminating this disease, for which serodiagnosis remains the mainstay for VL control programs. New and improved antigens as diagnostic candidates are required, though, as the available antigens fail to demonstrate equal optimum performance in all areas of endemicity. Moreover, these diagnoses are dependent on invasive serum sampling. In the current study, we cloned and expressed Leishmania donovani cysteine protease C (CPC) and evaluated its diagnostic and test-of-cure possibilities by detecting the antibody levels in human serum and urine through ELISA and immunoblot assays. Two immunodominant antigens, recombinant glycoprotein 63 (GP63) and elongation factor 1α (EF1α), identified earlier by our group, were also assessed by employing human serum and urine samples. Of these three antigens in ELISAs, CPC demonstrated the highest sensitivities of 98.15% and 96% positive testing in serum and urine of VL patients, respectively. Moreover, CPC yielded 100% specificity with serum and urine of nonendemic healthy controls compared to GP63 and EF1α. Urine samples were found to be more specific than serum for distinguishing endemic healthy controls and other diseases by means of all three antigens. In all cases, CPC gave the most promising results. Unlike serum, urine tests demonstrated a significant decrease in antibody levels for CPC, GP63, and EF1α after 6 months of treatment. The diagnostic and test-of-cure performances of CPC in the immunoblot assay were found to be better than those of GP63 and EF1α. In conclusion, CPC, followed by GP63 and EF1α, may be utilized as candidates for diagnosis of VL and to assess treatment response.
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Cortez-Maya S, Moreno-Herrera A, Palos I, Rivera G. Old Antiprotozoal Drugs: Are They Still Viable Options for Parasitic Infections or New Options for Other Diseases? Curr Med Chem 2020; 27:5403-5428. [DOI: 10.2174/0929867326666190628163633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 05/31/2019] [Accepted: 06/10/2019] [Indexed: 01/16/2023]
Abstract
Parasitic diseases, caused by helminths (ascariasis, hookworm, trichinosis, and schistosomiasis)
and protozoa (chagas, leishmaniasis, and amebiasis), are considered a serious public
health problem in developing countries. Additionally, there is a limited arsenal of anti-parasitic
drugs in the current pipeline and growing drug resistance. Therefore, there is a clear need for the
discovery and development of new compounds that can compete and replace these drugs that have
been controlling parasitic infections over the last decades. However, this approach is highly resource-
intensive, expensive and time-consuming. Accordingly, a drug repositioning strategy of the
existing drugs or drug-like molecules with known pharmacokinetics and safety profiles is alternatively
being used as a fast approach towards the identification of new treatments. The artemisinins,
mefloquine, tribendimidine, oxantel pamoate and doxycycline for the treatment of helminths, and
posaconazole and hydroxymethylnitrofurazone for the treatment of protozoa are promising candidates.
Therefore, traditional antiprotozoal drugs, which were developed in some cases decades ago,
are a valid solution. Herein, we review the current status of traditional anti-helminthic and antiprotozoal
drugs in terms of drug targets, mode of action, doses, adverse effects, and parasite resistance
to define their suitability for repurposing strategies. Current antiparasitic drugs are not only
still viable for the treatment of helminth and protozoan infections but are also important candidates
for new pharmacological treatments.
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Affiliation(s)
- Sandra Cortez-Maya
- Instituto de Quimica, Universidad Nacional Autonoma de Mexico, Cd. Universitaria, Circuito Exterior, Coyoacan, 04510 Ciudad de Mexico, Mexico
| | - Antonio Moreno-Herrera
- Laboratorio de Biotecnologia Farmaceutica, Centro de Biotecnologia Genomica, Instituto Politecnico Nacional, 88710 Reynosa, Mexico
| | - Isidro Palos
- Unidad AcadEmica Multidisciplinaria Reynosa-Rodhe, Universidad AutOnoma de Tamaulipas, 88710 Reynosa, Mexico
| | - Gildardo Rivera
- Laboratorio de Biotecnologia Farmaceutica, Centro de Biotecnologia Genomica, Instituto Politecnico Nacional, 88710 Reynosa, Mexico
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Pereira MA, Santos R, Oliveira R, Costa L, Prata A, Gonçalves V, Roquette M, Vala H, Santos-Gomes G. Prognostic Factors and Life Expectancy in Canine Leishmaniosis. Vet Sci 2020; 7:vetsci7030128. [PMID: 32899831 PMCID: PMC7559807 DOI: 10.3390/vetsci7030128] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 01/16/2023] Open
Abstract
Canine leishmaniosis (CanL) is a chronic and potentially fatal disease. The prognosis of CanL depends on the severity of the clinical signs and clinicopathological abnormalities presented by the dog at the time of diagnosis. This study aims to estimate the survival time of dogs with CanL, determining the prognostic value of different clinical and clinicopathological parameters. Medical records of 99 dogs diagnosed with CanL in five veterinary centers of the Alentejo region (Portugal) were examined retrospectively. The majority of dogs presented hyperproteinemia, moderate normocytic normochromic anemia, normal blood urea and creatinine levels and were classified as stage 1 according to the International Interest Society (IRIS) guidelines at the time of diagnosis. The severity of anemia, presence of concomitant infectious diseases at the time of diagnosis and the anti-Leishmania therapy were correlated with the survival time. The influence of renal dysfunction was evaluated by Receiver Operating Characteristic (ROC) curve and survival analysis. Survival analysis demonstrated that patients classified as IRIS 1 at the time of diagnosis survived more than four years, in contrast with dogs classified as IRIS 2 that survived around two and half years and dogs classified as IRIS 3-4 that survived around one month. IRIS stage deteriorated during the course of CanL in one third of the dogs and was the principal cause of death or euthanasia in a high proportion of animals. In some cases, dogs did not receive anti-Leishmania treatment or abandoned the veterinary follow-ups, which may have considerable repercussions for animal wellbeing and public health. This study reinforces the value of blood urea and creatinine levels as prognostic factors in CanL.
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Affiliation(s)
- Maria Aires Pereira
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, R. da Junqueira 100, 1349-008 Lisbon, Portugal;
- Agrarian School of the Polytechnic Institute of Viseu, Quinta da Alagoa-Estrada de Nelas Ranhados, 3500-606 Viseu, Portugal;
- Correspondence:
| | - Rute Santos
- Polytechnic Institute of Portalegre, Praça do Município 11, 7300-110 Portalegre, Portugal; (R.S.); (R.O.); (L.C.); (M.R.)
- VALORIZA—Research Centre for Endogenous Resource Valorization, Campus Politécnico, 10, 7300-555 Portalegre, Portugal
| | - Ricardo Oliveira
- Polytechnic Institute of Portalegre, Praça do Município 11, 7300-110 Portalegre, Portugal; (R.S.); (R.O.); (L.C.); (M.R.)
- Clilegre-Clínica Veterinária de Portalegre, Rua Martinho Azevedo Coutinho nº 13A e 16A, 7300-817 Portalegre, Portugal
| | - Lina Costa
- Polytechnic Institute of Portalegre, Praça do Município 11, 7300-110 Portalegre, Portugal; (R.S.); (R.O.); (L.C.); (M.R.)
- VALORIZA—Research Centre for Endogenous Resource Valorization, Campus Politécnico, 10, 7300-555 Portalegre, Portugal
| | - Ana Prata
- Vetviana-Consultório Veterinário, Rua Padre Luís António da Cruz 67, 7090-284 Viana do Alentejo, Évora, Portugal;
| | - Vânia Gonçalves
- Centro Veterinário da Vidigueira, Largo Frei António das Chagas 25A, 7960-220 Vidigueira, Beja, Portugal;
| | - Madalena Roquette
- Polytechnic Institute of Portalegre, Praça do Município 11, 7300-110 Portalegre, Portugal; (R.S.); (R.O.); (L.C.); (M.R.)
- VetAlter-Clínica Veterinária, Avenida Padre José Agostinho Rodrigues nº 13, 7440 Alter do Chão, Portalegre, Portugal
| | - Helena Vala
- Agrarian School of the Polytechnic Institute of Viseu, Quinta da Alagoa-Estrada de Nelas Ranhados, 3500-606 Viseu, Portugal;
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
| | - Gabriela Santos-Gomes
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, R. da Junqueira 100, 1349-008 Lisbon, Portugal;
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Dea-Ayuela MA, Segarra S, Serrano DR, Bolás-Fernández F. Nucleotides and AHCC Enhance Th1 Responses In Vitro in Leishmania-Stimulated/Infected Murine Cells. Molecules 2020; 25:molecules25173918. [PMID: 32867338 PMCID: PMC7504588 DOI: 10.3390/molecules25173918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/22/2020] [Accepted: 08/25/2020] [Indexed: 11/16/2022] Open
Abstract
A stronger Th1 (cellular) immune response in canine leishmaniosis (CanL) leads to a better prognosis. Dietary nucleotides plus AHCC® have shown beneficial effects in dogs with clinical leishmaniosis and in clinically healthy Leishmania-infected dogs. The potential leishmanicidal activity of nucleotides and AHCC was assessed by quantifying nitric oxide (NO) production and replication of parasites. Their effects on lymphocyte proliferation were studied with and without soluble Leishmania infantum antigen (SLA) stimulation. Cytokine level variations were assessed using naïve and L. infantum-infected macrophages/lymphocytes cocultures. Promastigotes and amastigotes proliferation and NO macrophage production were not directly affected. Lymphocyte proliferation was significantly enhanced by nucleotides, AHCC, and their combinations only after SLA stimulation. Nucleotides and AHCC significantly increased the production of IL-1β, IL-2, IL-5, IL-9, IL-10, and IL-12 by naïve immune cells. In naïve and L. infantum-infected macrophage/lymphocyte cocultures, nucleotides with or without AHCC led to significant increases in IFN-γ and TNF-α. Given that these cytokines are involved in the effective Th1 immune response against Leishmania parasites, these mechanisms of action could explain the previously reported in vivo clinical efficacy of such combination and further support the use of nucleotides with or without AHCC in the management of CanL patients.
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Affiliation(s)
- María Auxiliadora Dea-Ayuela
- Departamento de Farmacia, Facultad de Ciencias de la Salud, Universidad CEU-Cardenal Herrera, 46113 Moncada, Spain;
| | - Sergi Segarra
- R & D Bioiberica S.A.U., Av. dels Països Catalans 34, 08950 Esplugues de Llobregat, Spain
- Correspondence: ; Tel.: +34-9349-04908
| | - Dolores R. Serrano
- Department of Pharmaceutics and Food Technology, School of Pharmacy, Universidad Complutense de Madrid, Plaza Ramon y Cajal s/n, 28040 Madrid, Spain;
- Instituto Universitario de Farmacia Industrial (IUFI), School of Pharmacy, Universidad Complutense de Madrid, Avenida Complutense, 28040 Madrid, Spain
| | - Francisco Bolás-Fernández
- Departament of Microbiology and Parasitology, School of Pharmacy, Universidad Complutense de Madrid, Plaza Ramon y Cajal s/n, 28040 Madrid, Spain;
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Dias AFDLR, Ayres EDCBS, Maruyama FH, Monteiro BRG, de Freitas MS, de Almeida ADBPF, Mendonça AJ, Sousa VRF. Monitoring of serum and urinary biomarkers during treatment of canine visceral leishmaniasis. Vet World 2020; 13:1620-1626. [PMID: 33061236 PMCID: PMC7522955 DOI: 10.14202/vetworld.2020.1620-1626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/25/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND AIM Canine visceral leishmaniasis (CanL) has a broad spectrum of changes, with kidney disease being considered the main cause of mortality. Thus, this study aimed to monitor serum and urinary biomarkers in response to two short-term treatments for CanL. MATERIALS AND METHODS Thirty dogs with CanL were equally divided into two treatment groups and treated with either miltefosine (Group M) or miltefosine plus allopurinol (Group MA); the groups were evaluated before treatment and after 28 days of treatment. Physical exams were performed and hematimetric, biochemical, and urinary parameters, including urinary biomarkers cystatin C (CisC), lipocalin-2 (NGAL), and microalbuminuria, were measured. RESULTS Both treatments significantly reduced clinical scores (p<0.05), but only the MA group saw a reduction in the clinical-pathological score. The serum albumin and calcium levels increased significantly in the MA and M groups (p<0.05). Proteinuria and urinary density did not decrease significantly after the treatments. With regard to the biomarkers, CisC and microalbuminuria did not have any significant changes; however, NGAL was significantly reduced in the MA group (p<0.05). CONCLUSION Both pharmacotherapeutic protocols promoted clinical and clinical-pathological improvements. In addition, miltefosine plus allopurinol proved to be a safe treatment due to the lack of changes detected in the monitored renal biomarkers. The treatment with miltefosine plus allopurinol proved to be the most effective, with more pronounced beneficial effects for canines with visceral leishmaniasis.
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Affiliation(s)
- Alvaro Felipe de Lima Ruy Dias
- Program of Postgraduate in Veterinary Sciences, Faculty of Veterinary Medicine, Federal University of Mato Grosso, Cuiabá - MT, Brazil
| | - Eveline da Cruz Boa Sorte Ayres
- Program of Postgraduate in Veterinary Sciences, Faculty of Veterinary Medicine, Federal University of Mato Grosso, Cuiabá - MT, Brazil
| | - Fernanda Harumi Maruyama
- Program of Postgraduate in Veterinary Sciences, Faculty of Veterinary Medicine, Federal University of Mato Grosso, Cuiabá - MT, Brazil
| | - Bruna Ribeiro Gomes Monteiro
- Program of Postgraduate in Veterinary Sciences, Faculty of Veterinary Medicine, Federal University of Mato Grosso, Cuiabá - MT, Brazil
| | - Maria Sabrina de Freitas
- Program of Postgraduate in Veterinary Sciences, Faculty of Veterinary Medicine, Federal University of Mato Grosso, Cuiabá - MT, Brazil
| | | | - Adriane Jorge Mendonça
- Veterinary Clinical Pathology Laboratory, Faculty of Veterinary Medicine, Federal University of Mato Grosso, Cuiabá - MT, Brazil
| | - Valéria Régia Franco Sousa
- Program of Postgraduate in Veterinary Sciences, Faculty of Veterinary Medicine, Federal University of Mato Grosso, Cuiabá - MT, Brazil
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Giner J, Villanueva-Saz S, Alcover MM, Riera C, Fisa R, Basurco A, Yzuel A, Trotta M, Fani C, Verde MT, Fernández A. Treatment and follow-up of a domestic ferret (Mustela putorius furo) with clinical leishmaniosis caused by Leishmania infantum. VETERINARY PARASITOLOGY- REGIONAL STUDIES AND REPORTS 2020; 21:100423. [PMID: 32862910 DOI: 10.1016/j.vprsr.2020.100423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/28/2020] [Accepted: 06/07/2020] [Indexed: 01/23/2023]
Abstract
Leishmania infantum infection including treatment and follow up in domestic animals other than dogs and cats has not been described at this moment. This article describes the anti-Leishmania treatment and follow-up of a ferret (Mustela putorius furo) with leishmaniosis. A combined therapeutic protocol established for the patient, not yet approved for ferrets, was a combination of meglumine antimoniate plus allopurinol. A follow-up was established monthly during the first year in order to monitor the health condition of the patient. Six months after commencing allopurinol therapy, xanthine crystalluria was observed in urine sediment with no other urine alterations detected by urine analysis. The ferret worsened progressively with diarrhoea and weight loss after cohabiting with another ferret diagnosed with cryptosporidiosis. Cryptosporidium parvum was isolated in faecal samples from the patient detected by three different methods including Ziehl-Neelsen staining, a qualitative test to detection of C. parvum antigens and finally a specific molecular analysis to characterize the species. To the best of the authors´ knowledge, this is the first report providing information about anti-Leishmania protocol therapy used and follow-up in a domestic ferret with clinical leishmaniosis. Veterinarians practicing in endemic areas should be aware of this infection in ferrets at risk and their susceptibility especially when immunosuppressive conditions are present.
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Affiliation(s)
- Jacobo Giner
- Menescalia Veterinary Clinic, Ismael Merlo Actor, 5, 46020, Valencia, Spain; Clinical Immunology Laboratory, Veterinary Faculty, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain
| | - Sergio Villanueva-Saz
- Clinical Immunology Laboratory, Veterinary Faculty, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain; Department of Pharmacology and Physiology, Veterinary Faculty, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain.
| | - María Magdalena Alcover
- Laboratory of Parasitology, Pharmacy Faculty, University of Barcelona, Avda. Joan XXIII s/n, 08028 Barcelona, Spain
| | - Cristina Riera
- Laboratory of Parasitology, Pharmacy Faculty, University of Barcelona, Avda. Joan XXIII s/n, 08028 Barcelona, Spain
| | - Roser Fisa
- Laboratory of Parasitology, Pharmacy Faculty, University of Barcelona, Avda. Joan XXIII s/n, 08028 Barcelona, Spain
| | - Asier Basurco
- Clinical Immunology Laboratory, Veterinary Faculty, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain; Animal Pathology Department, Veterinary Faculty, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain
| | - Andrés Yzuel
- Clinical Immunology Laboratory, Veterinary Faculty, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain
| | - Michele Trotta
- CD Vet Laboratorio Analisi Veterinarie, Via Ernesto Monaci, 21, 00161 Roma, Rome, Italy
| | - Caterina Fani
- CD Vet Laboratorio Analisi Veterinarie, Via Ernesto Monaci, 21, 00161 Roma, Rome, Italy
| | - María Teresa Verde
- Clinical Immunology Laboratory, Veterinary Faculty, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain; Animal Pathology Department, Veterinary Faculty, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain
| | - Antonio Fernández
- Clinical Immunology Laboratory, Veterinary Faculty, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain; Animal Pathology Department, Veterinary Faculty, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain
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Mathematical Modelling Using Predictive Biomarkers for the Outcome of Canine Leishmaniasis upon Chemotherapy. Microorganisms 2020; 8:microorganisms8050745. [PMID: 32429309 PMCID: PMC7285289 DOI: 10.3390/microorganisms8050745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/05/2020] [Accepted: 05/12/2020] [Indexed: 12/16/2022] Open
Abstract
Prediction parameters of possible outcomes of canine leishmaniasis (CanL) therapy might help with therapeutic decisions and animal health care. Here, we aimed to develop a diagnostic method with predictive value by analyzing two groups of dogs with CanL, those that exhibited a decrease in parasite load upon antiparasitic treatment (group: responders) and those that maintained high parasite load despite the treatment (group: non-responders). The parameters analyzed were parasitic load determined by q-PCR, hemogram, serum biochemistry and immune system-related gene expression signature. A mathematical model was applied to the analysis of these parameters to predict how efficient their response to therapy would be. Responder dogs restored hematological and biochemical parameters to the reference values and exhibited a Th1 cell activation profile with a linear tendency to reach mild clinical alteration stages. Differently, non-responders developed a mixed Th1/Th2 response and exhibited markers of liver and kidney injury. Erythrocyte counts and serum phosphorus were identified as predictive markers of therapeutic response at an early period of assessment of CanL. The results presented in this study are highly encouraging and may represent a new paradigm for future assistance to clinicians to interfere precociously in the therapeutic approach, with a more precise definition in the patient's prognosis.
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Kasabalis D, Chatzis MK, Apostolidis K, Petanides T, Athanasiou LV, Xenoulis PG, Mataragka A, Ikonomopoulos J, Leontides LS, Saridomichelakis MN. A randomized, blinded, controlled clinical trial comparing the efficacy of aminosidine (paromomycin)-allopurinol combination with the efficacy of meglumine antimoniate-allopurinol combination for the treatment of canine leishmaniosis due to Leishmania infantum. Exp Parasitol 2020; 214:107903. [PMID: 32360142 DOI: 10.1016/j.exppara.2020.107903] [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: 10/25/2019] [Revised: 03/09/2020] [Accepted: 04/22/2020] [Indexed: 01/21/2023]
Abstract
The aim of this 6-month, randomized, blinded, controlled clinical trial was to compare the efficacy and safety of aminosidine-allopurinol combination with that of meglumine antimoniate-allopurinol combination for the treatment of leishmaniosis in dogs without stage III or IV chronic kidney disease. Forty client-owned dogs were randomly assigned to group A [n = 20; aminosidine (15 mg/kg, subcutaneously, once daily, for 28 days) and allopurinol (10 mg/kg, per os, twice daily, for 6 months)] or group B [(n = 20; meglumine antimoniate (100 mg/kg SC, once daily, for 28 days) and allopurinol (10 mg/kg, per os, twice daily, for 6 months)]. Clinical and clinicopathological evaluations, parasitic load measurement (lymph node and bone marrow microscopy, bone marrow real-time PCR), specific serology and leishmanin skin test (LST) were performed at baseline (time 1) and after 14 (time 2), 28 (time 3), 60 (time 4) and 180 (time 5) days. Both treatments were safe and resulted in significant clinical and clinicopathological improvement, reduction of parasitic load and of indirect immunofluorescence antibody test (IFAT) titer and induction of positive LST. There was no significant difference between groups with regards to the primary outcome measures of the trial that included the proportion of dogs that presented severe treatment-related side effects, were cured and were parasitologically negative at time 5. However, some (proportion of dogs that presented no clinical signs, no hyperglobulinemia and negative serology at time 5) secondary outcome measures showed significant differences in favor of the meglumine antimoniate-allopurinol treatment arm. Treatment-related death occurred in one dog in each group, while injection site reactions appeared at a similar frequency in both groups. Due to the differences in some secondary outcome measures in association with the low power of this trial, it cannot be definitively concluded that the two treatments are equally effective. Therefore, the aminisodine-allopurinol combination cannot be proposed as a first-line treatment of CanL but rather as a second-line treatment that may be particularly useful to avoid repeated administration of meglumine antimoniate and in countries where the latter is not available or registered.
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Affiliation(s)
- D Kasabalis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, 224 Trikalon Str., GR-43132, Karditsa, Greece; Veterinary Clinic "St. Modestos", Aerodromiou Str. 59A, GR-57013, Thessaloniki, Greece
| | - M K Chatzis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, 224 Trikalon Str., GR-43132, Karditsa, Greece
| | - K Apostolidis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, 224 Trikalon Str., GR-43132, Karditsa, Greece
| | - T Petanides
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, 224 Trikalon Str., GR-43132, Karditsa, Greece
| | - L V Athanasiou
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, 224 Trikalon Str., GR-43132, Karditsa, Greece
| | - P G Xenoulis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, 224 Trikalon Str., GR-43132, Karditsa, Greece
| | - A Mataragka
- Department of Anatomy and Physiology of Farm Animals, Faculty of Animal Science and Aquaculture, Agricultural University of Athens, 75 Iera Odos, Votanikos, GR-11855, Athens, Greece
| | - J Ikonomopoulos
- Department of Anatomy and Physiology of Farm Animals, Faculty of Animal Science and Aquaculture, Agricultural University of Athens, 75 Iera Odos, Votanikos, GR-11855, Athens, Greece
| | - L S Leontides
- Laboratory of Epidemiology, Biostatistics and Animal Health Economics, Faculty of Veterinary Science, University of Thessaly, 224 Trikalon Str., GR-43132, Karditsa, Greece
| | - M N Saridomichelakis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, 224 Trikalon Str., GR-43132, Karditsa, Greece.
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Montoya A, Gálvez R, Checa R, Sarquis J, Plaza A, Barrera JP, Marino V, Miró G. Latest trends in L. infantum infection in dogs in Spain, Part II: current clinical management and control according to a national survey of veterinary practitioners. Parasit Vectors 2020; 13:205. [PMID: 32317018 PMCID: PMC7175573 DOI: 10.1186/s13071-020-04080-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/10/2020] [Indexed: 12/17/2022] Open
Abstract
Background Canine leishmaniosis (CanL) is a parasitic zoonotic disease, endemic in the Mediterranean basin including Spain. While knowledge about CanL, its management, treatment, prevention and control mounts, it remains unclear whether all clinical veterinarians follow the same international recommendations, such as those of the LeishVet group. This study was thus designed to assess recent trends in the clinical management of CanL in veterinary clinics across Spain through a questionnaire-based survey. Results were compared with those of a prior national multicenter questionnaire administered by our research team in 2005. Methods A questionnaire consisting of 28 questions about CanL was developed using Google Forms and distributed by email to 1428 veterinary clinics in Spain. Questions were designed to obtain data on common clinical signs, techniques and complementary exams used to diagnose the disease, and on its monitoring, treatment and control measures. Data were collected in a database for statistical analysis. Results Completed questionnaires were returned by 295 clinics. Compared to the situation in 2005, responses indicate that clinical signs of CanL have not changed significantly, cutaneous lesions being still the most prevalent sign observed by practitioners. Quantitative serological techniques are considered an adequate approach to diagnosis, provided their results are supported by the findings of a thorough physical exam, as well as complementary tests (complete blood count, biochemical profile, plasma protein electrophoretogram and complete urinalysis). Treatment protocols and check-ups follow international recommendations. Finally, a multimodal approach is being endorsed to adequately control CanL including preventive measures such as annual serological check-ups and the combination of repellents and vaccines. Additionally, owners are being better informed about CanL by veterinarians, which translates to the improved control of this zoonosis. Conclusions The clinical management of CanL has recently undergone significant changes owing to improvements in clinical knowledge of the disease, more unified international criteria, improved diagnostic techniques and their adequate interpretation, as well as a greater awareness of the disease transmitted to owners.![]()
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Affiliation(s)
- Ana Montoya
- Grupo de investigación Epicontrol-Carnívoros, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Rosa Gálvez
- Grupo de investigación Epicontrol-Carnívoros, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Rocío Checa
- Grupo de investigación Epicontrol-Carnívoros, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Juliana Sarquis
- Grupo de investigación Epicontrol-Carnívoros, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Alexandra Plaza
- Grupo de investigación Epicontrol-Carnívoros, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan Pedro Barrera
- Grupo de investigación Epicontrol-Carnívoros, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Valentina Marino
- Grupo de investigación Epicontrol-Carnívoros, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Guadalupe Miró
- Grupo de investigación Epicontrol-Carnívoros, Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain.
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Santos MF, Alexandre-Pires G, Pereira MA, Marques CS, Gomes J, Correia J, Duarte A, Gomes L, Rodrigues AV, Basso A, Reisinho A, Meireles J, Santos-Mateus D, Brito MTV, Tavares L, Santos-Gomes GM, da Fonseca IP. Meglumine Antimoniate and Miltefosine Combined With Allopurinol Sustain Pro-inflammatory Immune Environments During Canine Leishmaniosis Treatment. Front Vet Sci 2019; 6:362. [PMID: 31681815 PMCID: PMC6813190 DOI: 10.3389/fvets.2019.00362] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 10/01/2019] [Indexed: 01/11/2023] Open
Abstract
Canine leishmaniosis (CanL) caused by Leishmania infantum is a zoonotic disease of global concern. Antileishmanial drug therapies commonly used to treat sick dogs improve their clinical condition, although when discontinued relapses can occur. Thus, the current study aims to evaluate the effect of CanL treatments in peripheral blood, lymph node, and bone marrow cytokine profile associated with clinical recovery. Two groups of six dogs diagnosed with CanL were treated with miltefosine combined with allopurinol and meglumine antimoniate combined with allopurinol (MT+A and MG+A), respectively. At diagnosis and after treatment, during a 3-month follow-up, clinical signs, hematological and biochemical parameters, urinalysis results and antileishmanial antibody titers were registered. Furthermore, peripheral blood, popliteal lymph node, and bone marrow samples were collected to assess the gene expression of IL-2, IL-4, IL-5, IL-10, IL-12, TNF-α, TGF-β, and IFN-γ by qPCR. In parallel, were also evaluated samples obtained from five healthy dogs. Both treatment protocols promoted the remission of clinical signs as well as normalization of hematological and biochemical parameters and urinalysis values. Antileishmanial antibodies returned to non-significant titers in all dogs. Sick dogs showed a generalized upregulation of IFN-γ and downregulation of IL-2, IL-4, and TGF-β, while gene expression of IL-12, TNF-α, IL-5, and IL-10 varied between groups and according to evaluated tissue. A trend to the normalization of cytokine gene expression was induced by both miltefosine and meglumine antimoniate combined therapies. However, IFN-γ gene expression was still up-regulated in the three evaluated tissues. Furthermore, the effect of treatment in the gene expression of cytokines that were not significantly changed by infection, indicates that miltefosine and meglumine antimoniate combined therapy directly affects cytokine generation. Both combined therapies are effective in CanL treatment, leading to sustained pro-inflammatory immune environments that can compromise parasite survival and favor dogs' clinical cure. In the current study, anti-inflammatory and regulatory cytokines do not seem to play a prominent role in CanL or during clinical recovery.
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Affiliation(s)
- Marcos Ferreira Santos
- Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, Lisboa, Portugal
| | - Graça Alexandre-Pires
- Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, Lisboa, Portugal
| | - Maria A Pereira
- GHTM-Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisbon (UNL), Lisbon, Portugal
| | - Cátia S Marques
- Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, Lisboa, Portugal
| | - Joana Gomes
- Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, Lisboa, Portugal
| | - Jorge Correia
- Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, Lisboa, Portugal
| | - Ana Duarte
- Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, Lisboa, Portugal
| | - Lídia Gomes
- Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, Lisboa, Portugal
| | - Armanda V Rodrigues
- GHTM-Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisbon (UNL), Lisbon, Portugal
| | - Alexandra Basso
- Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, Lisboa, Portugal
| | - Ana Reisinho
- Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, Lisboa, Portugal
| | - José Meireles
- Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, Lisboa, Portugal
| | - David Santos-Mateus
- GHTM-Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisbon (UNL), Lisbon, Portugal
| | - Maria Teresa Villa Brito
- Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, Lisboa, Portugal
| | - Luís Tavares
- Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, Lisboa, Portugal
| | - Gabriela M Santos-Gomes
- GHTM-Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisbon (UNL), Lisbon, Portugal
| | - Isabel Pereira da Fonseca
- Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, Lisboa, Portugal
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Kasabalis D, Chatzis MK, Apostolidis K, Xenoulis PG, Buono A, Petanides T, Leontides LS, Polizopoulou ZS, Steiner JM, Suchodolski JS, Saridomichelakis MN. Evaluation of nephrotoxicity and ototoxicity of aminosidine (paromomycin)-allopurinol combination in dogs with leishmaniosis due to Leishmania infantum: A randomized, blinded, controlled study. Exp Parasitol 2019; 206:107768. [PMID: 31539540 DOI: 10.1016/j.exppara.2019.107768] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/30/2019] [Accepted: 09/16/2019] [Indexed: 12/13/2022]
Abstract
Canine leishmaniosis due to Leishmania infantum is a widespread zoonotic disease. Although aminosidine can be an effective treatment, current therapeutic recommendations do not advocate its use, mainly due to concerns regarding the potential nephrotoxicity and ototoxicity of this drug. The aim of this randomized, blinded, controlled study was to evaluate the nephrotoxicity and ototoxicity of aminosidine-allopurinol combination and compare it with that of meglumine antimonate-allopurinol combination in non-azotemic dogs with leishmaniosis. Forty dogs with leishmaniosis were randomly assigned to be treated with either aminosidine at 15 mg/kg, subcutaneously, once daily for 28 days (group A) or with meglumine antimonate at 100 mg/kg, subcutaneously, once daily for 28 days (group B). In addition to either drug, dogs in both groups were administered allopurinol at 10 mg/kg per os twice daily for 2 months. Kidney function was evaluated through measurement of serum creatinine, urea nitrogen, inorganic phosphorus, and cystatin-c concentrations and complete urinalysis, including protein-to-creatinine ratio, at baseline and after 14, 28, and 60 days from the beginning of the treatment. At the same time points, vestibular and auditory functions were evaluated through neurological examination and brainstem auditory evoked response (BAER) recordings of wave I, wave V, inter-wave I-V latencies, and minimum hearing thresholds. None of the dogs developed clinicopathological evidence of kidney disease during the study. Serum creatinine concentration increased >0.3 mg/dl over baseline in 2 dogs in group A and in 5 dogs in group B. Parameters of kidney function were not significantly different or were improved compared to baseline and the only difference between the two groups was the lower concentration of serum creatinine in group A. None of the dogs developed peripheral vestibular syndrome or hearing impairment. At the end of the study, parameters of auditory function were not significantly different or were improved compared to baseline and there were no differences between the two groups. The results of this study show that the nephrotoxicity and ototoxicity of aminosidine, when administered to non-azotemic dogs with leishmaniosis at 15 mg/kg subcutaneously once daily for 28 days along with allopurinol, is minimal and does not differ from that of meglumine antimonate.
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Affiliation(s)
- D Kasabalis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Trikalon Str. 224, GR-43132, Karditsa, Greece; Veterinary Clinic St. Modestos, Aerodromiou Str. 59A, GR-57013, Thessaloniki, Greece
| | - M K Chatzis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Trikalon Str. 224, GR-43132, Karditsa, Greece
| | - K Apostolidis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Trikalon Str. 224, GR-43132, Karditsa, Greece
| | - P G Xenoulis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Trikalon Str. 224, GR-43132, Karditsa, Greece
| | - A Buono
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, College Station, TX, 77843-4474, USA
| | - T Petanides
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Trikalon Str. 224, GR-43132, Karditsa, Greece
| | - L S Leontides
- Laboratory of Epidemiology, Biostatistics and Animal Health Economics, Faculty of Veterinary Science, University of Thessaly, Trikalon Str. 224, GR-43132, Karditsa, Greece
| | - Z S Polizopoulou
- Diagnostic Laboratory, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, St. Voutira Str. 11, GR-54627, Thessaloniki, Greece
| | - J M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, College Station, TX, 77843-4474, USA
| | - J S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, College Station, TX, 77843-4474, USA
| | - M N Saridomichelakis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Trikalon Str. 224, GR-43132, Karditsa, Greece.
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Daza González M, Fragío Arnold C, Fermín Rodríguez M, Checa R, Montoya A, Portero Fuentes M, Rupérez Noguer C, Martínez Subiela S, Cerón J, Miró G. Effect of two treatments on changes in serum acute phase protein concentrations in dogs with clinical leishmaniosis. Vet J 2019; 245:22-28. [DOI: 10.1016/j.tvjl.2018.12.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 11/24/2022]
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Dos Santos Nogueira F, Avino VC, Galvis-Ovallos F, Pereira-Chioccola VL, Moreira MAB, Romariz APPL, Molla LM, Menz I. Use of miltefosine to treat canine visceral leishmaniasis caused by Leishmania infantum in Brazil. Parasit Vectors 2019; 12:79. [PMID: 30736866 PMCID: PMC6368741 DOI: 10.1186/s13071-019-3323-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/28/2019] [Indexed: 12/25/2022] Open
Abstract
Background Visceral leishmaniasis (VL) is an infectious disease with a variety of clinical signs. The main form of parasite transmission to humans and other mammalian hosts is through the bite of infected arthropod females with Lutzomyia longipalpis serving as the main vector in the Americas. Dogs are the main urban domestic reservoirs of the parasite and the main source of vector infection due to their high prevalence in endemic areas and the large number of parasites in the skin of infected animals. Although miltefosine has been used in Europe since 2002 for treatment of VL infected dogs, in the Americas the treatment of dogs has not been recommended. Therefore, this study aimed to evaluate efficacy of miltefosine observing a reduction of clinical signs in infected dogs and the infectiveness to the vector by Leishmania (L.) infantum. Methods To our knowledge, this is the first controlled study using qPCR and xenodiagnosis to evaluate the efficacy of miltefosine (Milteforan®, Virbac) as a single treatment in Brazil. Thirty-five adult dogs with canine visceral leishmaniasis (CVL), confirmed by clinical and laboratory tests, were included in this study. They received miltefosine at a dose of 2 mg/kg every 24 h for 28 days. The dogs were observed over a three-month period, during which clinical evaluations based on a scoring system were conducted at pre-established times. Parasite load was assessed by cytology and real-time polymerase chain reaction (qPCR). Transmissibility to the vector was evaluated by xenodiagnosis. Results At the end of the period, the following were observed: (i) the remission of clinical signs with a reduction in clinical scores for 94.2% of the animals; (ii) a statistically significant reduction (98.7%) in parasitic load by qPCR; and (iii) a reduction in infectivity to sand flies. After treatment, 74.2% of the animals remained or had become non-infectious. Conclusions Our study indicates that the use of miltefosine administered orally for 4 weeks contributes to a clinical improvement and reduction in infectivity of dogs to L. infantum.
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Affiliation(s)
| | - Valdir Carlos Avino
- Departamento de Assuntos Regulatórios e Desenvolvimento da Virbac Brasil, São Paulo, Brazil
| | - Fredy Galvis-Ovallos
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Saúde Pública, Universidade São Paulo, São Paulo, Brazil
| | | | | | | | - Leticia M Molla
- Departamento de Assuntos Regulatórios e Desenvolvimento da Virbac Brasil, São Paulo, Brazil
| | - Ingrid Menz
- Ingrid Menz Self-employed Veterinarian, São Paulo, Campinas, Brazil.
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Bruno B, Romano A, Zanatta R, Spina S, Mignone W, Ingravalle F, Barzanti P, Ceccarelli L, Goria M. Serum indirect immunofluorescence assay and real-time PCR results in dogs affected by Leishmania infantum: evaluation before and after treatment at different clinical stages. J Vet Diagn Invest 2019; 31:222-227. [PMID: 30636530 DOI: 10.1177/1040638718824140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We compared results of a serum immunofluorescence assay (IFA) and lymph node quantitative PCR (qPCR) in dogs classified as exposed, infected, or sick because of leishmaniasis. We also determined how IFA or qPCR results changed in response to treatment and reflected different clinical and clinicopathologic improvement of dogs. We included 108 dogs in our retrospective study: 12 exposed, 25 infected, and 71 sick, as classified according to Canine Leishmaniasis Working Group standards. Between-group comparison showed higher IFA values ( p < 0.01) for sick dogs; qPCR values were higher for sick than infected dogs ( p < 0.01). A novel clinical and clinicopathologic score was created and applied to 50 sick dogs. Using this score, 41 were reclassified as partially recovered (PR) within 3 mo, and 37 as totally recovered (TR) 3-6 mo after presentation. Statistically significant differences in IFA values were found between the sick and TR dogs ( p < 0.01), but not between sick and PR dogs ( p = 0.98). During follow-up, qPCR revealed a progressive decrease in parasite load, with a statistically significant difference in sick versus PR ( p < 0.01), sick versus TR ( p < 0.01), and PR versus TR ( p < 0.01) dogs. A decrease of 1 point in the clinical score corresponded to 1.3 Leishmania/μL qPCR decrease ( p < 0.01) and decrease of 1:42 in IFA ( p < 0.01). Our findings confirm that the clinical status of dogs affected by leishmaniasis is closely related to parasite load and antibody level, both before and after treatment.
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Affiliation(s)
- Barbara Bruno
- Department of Veterinary Science (Bruno, Zanatta), University of Turin, Torino, Italy.,Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Torino, Italy (Romano, Spina, Mignone, Ingravalle, Barzanti, Ceccarelli, Goria)
| | - Angelo Romano
- Department of Veterinary Science (Bruno, Zanatta), University of Turin, Torino, Italy.,Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Torino, Italy (Romano, Spina, Mignone, Ingravalle, Barzanti, Ceccarelli, Goria)
| | - Renato Zanatta
- Department of Veterinary Science (Bruno, Zanatta), University of Turin, Torino, Italy.,Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Torino, Italy (Romano, Spina, Mignone, Ingravalle, Barzanti, Ceccarelli, Goria)
| | - Simona Spina
- Department of Veterinary Science (Bruno, Zanatta), University of Turin, Torino, Italy.,Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Torino, Italy (Romano, Spina, Mignone, Ingravalle, Barzanti, Ceccarelli, Goria)
| | - Walter Mignone
- Department of Veterinary Science (Bruno, Zanatta), University of Turin, Torino, Italy.,Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Torino, Italy (Romano, Spina, Mignone, Ingravalle, Barzanti, Ceccarelli, Goria)
| | - Francesco Ingravalle
- Department of Veterinary Science (Bruno, Zanatta), University of Turin, Torino, Italy.,Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Torino, Italy (Romano, Spina, Mignone, Ingravalle, Barzanti, Ceccarelli, Goria)
| | - Paola Barzanti
- Department of Veterinary Science (Bruno, Zanatta), University of Turin, Torino, Italy.,Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Torino, Italy (Romano, Spina, Mignone, Ingravalle, Barzanti, Ceccarelli, Goria)
| | - Lara Ceccarelli
- Department of Veterinary Science (Bruno, Zanatta), University of Turin, Torino, Italy.,Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Torino, Italy (Romano, Spina, Mignone, Ingravalle, Barzanti, Ceccarelli, Goria)
| | - Maria Goria
- Department of Veterinary Science (Bruno, Zanatta), University of Turin, Torino, Italy.,Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Torino, Italy (Romano, Spina, Mignone, Ingravalle, Barzanti, Ceccarelli, Goria)
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43
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Leal RO, Pereira H, Cartaxeiro C, Delgado E, Peleteiro MDC, Pereira da Fonseca I. Granulomatous rhinitis secondary to feline leishmaniosis: report of an unusual presentation and therapeutic complications. JFMS Open Rep 2018; 4:2055116918811374. [PMID: 30450219 PMCID: PMC6236491 DOI: 10.1177/2055116918811374] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Case summary A 12-year-old male neutered domestic shorthair cat underwent rhinoscopy due to inspiratory dyspnoea and stertor. Rhinoscopy showed signs of chronic rhinitis and a multinodular nasopharyngeal mucosa. A marked infiltrate of macrophages that contained intracellular parasitic forms morphologically compatible with Leishmania amastigotes were observed on histopathological examination of nasal and nasopharyngeal biopsies. PCR from nasal tissue was positive for Leishmania infantum DNA, confirming the diagnosis of granulomatous rhinitis secondary to this parasite. Two eyelid nodules were identified 2 weeks later. Fine-needle aspiration revealed Leishmania amastigotes within macrophages and in the background. Allopurinol therapy was started, but 5 days later the cat developed dermatological signs compatible with a cutaneous adverse drug reaction. The drug was discontinued and meglumine antimoniate prescribed. Twenty-five days later, the cat presented with acute kidney injury and meglumine antimoniate was discontinued. Despite clinical improvement after fluid therapy, mild azotaemia persisted. The cat was subsequently treated with nucleotides and active hexose correlated compounds (N-AHCC). Four months later upper respiratory signs were exacerbated. A relapse of granulomatous rhinitis was suspected and miltefosine therapy started. Chronic kidney disease (CKD) worsened during miltefosine treatment, having improved under fluid therapy. Since then, the cat has been treated with N-AHCC and renal diet and at the time of writing shows stable CKD with no recurrence of respiratory signs. Relevance and novel information This case describes Leishmania infantum as a cause of granulomatous rhinitis in a cat without cutaneous lesions, reporting the alternative use of N-AHCC and miltefosine when allopurinol seemed to have induced a cutaneous rash and there was acute kidney injury (AKI) after meglumine antimoniate therapy.
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Affiliation(s)
- Rodolfo Oliveira Leal
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal.,Veterinary School Hospital - Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Hugo Pereira
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal.,Veterinary School Hospital - Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Clara Cartaxeiro
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Esmeralda Delgado
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal.,Veterinary School Hospital - Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Maria da Conceição Peleteiro
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Isabel Pereira da Fonseca
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
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44
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Travi BL, Miró G. Use of domperidone in canine visceral leishmaniasis: gaps in veterinary knowledge and epidemiological implications. Mem Inst Oswaldo Cruz 2018; 113:e180301. [PMID: 30365645 PMCID: PMC6193371 DOI: 10.1590/0074-02760180301] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 10/02/2018] [Indexed: 01/08/2023] Open
Abstract
A pivotal strategy to decrease the risk of visceral leishmaniasis in humans is to control the infection and disease progression in dogs, the domestic reservoir of Leishmania infantum (L. chagasi). Immunotherapy is a viable approach to treat sick dogs because cell-mediated immunity is the principal defense mechanism against L. infantum. Domperidone is an immune-stimulatory drug increasingly used in veterinary medicine as a prophylactic or immunotherapeutic agent. Domperidone treatment has shown to prevent overt disease or improve the clinical condition of infected dogs. However, veterinarians should be aware of the potential cardiotoxicity of domperidone when given together with drugs that inhibit CYP450s liver enzymes or those that prolong the QT interval. On the other hand, learning whether domperidone treatment significantly decreases dog infectivity to sand fly vectors is of capital importance since this result should have a palpable impact on the infection risk of humans living in regions endemic for visceral leishmaniasis.
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Affiliation(s)
- Bruno L Travi
- University of Texas Medical Branch, Department of Internal Medicine - Division of Infectious Diseases, Galveston, Texas, USA
| | - Guadalupe Miró
- Universidad Complutense de Madrid, Veterinary Faculty, Animal Health Department, Madrid, Spain
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45
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Maia C, Campino L. Biomarkers Associated With Leishmania infantum Exposure, Infection, and Disease in Dogs. Front Cell Infect Microbiol 2018; 8:302. [PMID: 30237985 PMCID: PMC6136405 DOI: 10.3389/fcimb.2018.00302] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 08/07/2018] [Indexed: 12/11/2022] Open
Abstract
Canine leishmaniosis (CanL) is a vector-borne disease caused by the protozoan Leishmania (Leishmania) infantum species [syn. L. (L.) infantum chagasi species in the Americas] which is transmitted by the bite of a female phlebotomine sand fly. This parasitosis is endemic and affect millions of dogs in Asia, the Americas and the Mediterranean basin. Domestic dogs are the main hosts and the main reservoir hosts for human zoonotic leishmaniosis. The outcome of infection is a consequence of intricate interactions between the protozoan and the immunological and genetic background of the host. Clinical manifestations can range from subclinical infection to very severe disease. Early detection of infected dogs, their close surveillance and treatment are essential to control the dissemination of the parasite among other dogs, being also a pivotal element for the control of human zoonotic leishmaniosis. Hence, the identification of biomarkers for the confirmation of Leishmania infection, disease and determination of an appropriate treatment would represent an important tool to assist clinicians in diagnosis, monitoring and in giving a realistic prognosis to subclinical infected and sick dogs. Here, we review the recent advances in the identification of Leishmania infantum biomarkers, focusing on those related to parasite exposure, susceptibility to infection and disease development. Markers related to the pathogenesis of the disease and to monitoring the evolution of leishmaniosis and treatment outcome are also summarized. Data emphasizes the complexity of parasite-host interactions and that a single biomarker cannot be used alone for CanL diagnosis or prognosis. Nevertheless, results are encouraging and future research to explore the potential clinical application of biomarkers is warranted.
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Affiliation(s)
- Carla Maia
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
| | - Lenea Campino
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
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46
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Sinergism between alkaloids piperine and capsaicin with meglumine antimoniate against Leishmania infantum. Exp Parasitol 2018; 188:79-82. [DOI: 10.1016/j.exppara.2018.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 03/28/2018] [Accepted: 04/02/2018] [Indexed: 11/23/2022]
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47
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Canine Leishmaniasis: An Overview of the Current Status and Strategies for Control. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3296893. [PMID: 29789784 PMCID: PMC5896350 DOI: 10.1155/2018/3296893] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 02/18/2018] [Indexed: 02/02/2023]
Abstract
Canine leishmaniasis (CanL) is a vector-borne disease caused by Leishmania infantum and is transmitted by female phlebotomine sand flies primarily between animals and secondarily to humans. The course of infection may be different from one individual dog to another, ranging from spontaneous cure to acute evolution that leads to death, if proper management and therapy are not adopted. A parasitological cure is rarely achieved and clinical recurrences in CanL are frequent. Vaccination associated with the use of topical insecticides is undoubtedly the most effective form of prevention and control of the disease. In order to integrate the most important scientific knowledge of the literature in one objective publication, this review proposes a short overview of the main points of CanL.
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48
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Segarra S, Miró G, Montoya A, Pardo-Marín L, Teichenné J, Ferrer L, Cerón JJ. Prevention of disease progression in Leishmania infantum-infected dogs with dietary nucleotides and active hexose correlated compound. Parasit Vectors 2018; 11:103. [PMID: 29467015 PMCID: PMC5822671 DOI: 10.1186/s13071-018-2705-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 02/12/2018] [Indexed: 12/14/2022] Open
Abstract
Background The prevalence of Leishmania infantum infection in clinically healthy dogs can be several times higher than that of clinical disease in endemic areas. Although treatment is not recommended in dogs with subclinical infection, these animals should be managed to prevent disease progression and parasite transmission to human beings or to other dogs. Dietary nucleotides and active hexose correlated compound (AHCC) have been shown to modulate the immune response. A recent study in dogs with clinical leishmaniosis receiving an initial 28-day course of methylglucamine antimoniate showed that six-month administration of a dietary supplement containing nucleotides plus AHCC achieves similar efficacy to allopurinol. Since the type of immune response plays a key role in the evolution of patients with leishmaniosis, the present study was aimed at evaluating the preventive effect of this supplement in avoiding or delaying disease progression in clinically healthy Leishmania-infected dogs. Methods Forty-six dogs were included in this multicenter, randomized, double-blind, placebo-controlled trial. Dogs received once-daily oral administration of a placebo or a dietary supplement containing nucleotides plus AHCC. Disease progression was monitored throughout the study in both groups. At 0, 60, 180 and 365 days of treatment, clinical signs were evaluated using a validated clinical scoring system, and several analytes were measured from blood, urine, and bone marrow samples. Results During the study, a significantly lower (P = 0.047) proportion of dogs changed their clinical status and became sick in the supplement group (3/20; 15%), compared to the placebo group (10/22; 45.5%). ELISA-determined antibody titers were significantly reduced compared to baseline at all time points with the supplement (P < 0.01), but not with the placebo. The mean clinical score of disease severity was significantly lower in the supplement group after 180 days (P = 0.014). No significant differences were observed for the other parameters. The dietary supplement was well tolerated. Conclusions Oral administration of nucleotides plus AHCC for 365 days in clinically healthy L. infantum-infected dogs is safe, allows a significant reduction in anti-Leishmania antibodies, and leads to a lower disease progression rate, hence exerting a preventive effect.
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Affiliation(s)
- Sergi Segarra
- R&D Bioiberica S.A.U, pl. Francesc Macià 7, 08029, Barcelona, Spain.
| | - Guadalupe Miró
- Department of Animal Health, Veterinary Faculty, Universidad Complutense de Madrid, Avda. Puerta de Hierro s/n, 28040, Madrid, Spain
| | - Ana Montoya
- Department of Animal Health, Veterinary Faculty, Universidad Complutense de Madrid, Avda. Puerta de Hierro s/n, 28040, Madrid, Spain
| | - Luis Pardo-Marín
- Interlab-UMU, Campus de Excelencia "Mare Nostrum", University of Murcia, Campus Espinardo, 30071, Murcia, Spain
| | - Joan Teichenné
- Eurecat - Health and Nutrition Unit, TECNIO, CEICS, av. Universitat 1, 43204, Reus, Spain
| | - Lluís Ferrer
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA, 01536, USA
| | - José Joaquín Cerón
- Interlab-UMU, Campus de Excelencia "Mare Nostrum", University of Murcia, Campus Espinardo, 30071, Murcia, Spain
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Corpas-López V, Merino-Espinosa G, Acedo-Sánchez C, Díaz-Sáez V, Navarro-Moll MC, Morillas-Márquez F, Martín-Sánchez J. Effectiveness of the sesquiterpene (-)-α-bisabolol in dogs with naturally acquired canine leishmaniosis: an exploratory clinical trial. Vet Res Commun 2018; 42:121-130. [PMID: 29453596 DOI: 10.1007/s11259-018-9714-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 02/11/2018] [Indexed: 11/28/2022]
Abstract
The use of natural products is a promising approach for treating visceral leishmaniosis. (-)-α-Bisabolol is a sesquiterpene that have been proved active in vivo on Leishmania infantum-infected mice without showing toxicity. A single-centre, parallel-group, randomized, exploratory study was designed to assess its efficacy in a canine leishmaniosis model involving naturally infected dogs. In this clinical trial, 12 dogs were allocated into two groups and were treated with either meglumine antimoniate (100 mg/kg) through subcutaneous route or (-)-α-bisabolol (30 mg/kg) through oral route for two treatment series of 30 days, separated by a 30-day interval. A 4-month follow-up period was established as well. Parasite loads in bone marrow, lymph node and blood were estimated through quantitative PCR. Antibody titres were determined through immunofluorescence antibody test and cytokine expression values were estimated through real-time reverse transcription-PCR. Treatment safety was assessed through the evaluation of weight, gastrointestinal alterations and hematological and biochemical parameters in blood. Analyses were performed before and after treatment, and after a 4-months follow-up period. Treatment with the sesquiterpene was effective at decreasing parasite loads and increasing gamma-interferon expression level. Dogs treated with (-)-α-bisabolol did not show any toxicity sign. These results were better than those obtained using the reference drug, meglumine antimoniate. The natural compound seemed to induce a Th1 immune response that led to parasitological and clinical improvement without showing any safety issue, suggesting a high potential for the treatment of canine and human visceral leishmaniosis.
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Affiliation(s)
- V Corpas-López
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, Granada, 18011, Spain.
| | - G Merino-Espinosa
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, Granada, 18011, Spain
| | - C Acedo-Sánchez
- ANLAVE Laboratorio de Análisis Veterinario, Avenida de Pulianas 15, 18013, Granada, Spain
| | - V Díaz-Sáez
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, Granada, 18011, Spain
| | - M C Navarro-Moll
- Departamento de Farmacología, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, Granada, 18011, Spain
| | - F Morillas-Márquez
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, Granada, 18011, Spain
| | - J Martín-Sánchez
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, Granada, 18011, Spain.
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50
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Segarra S, Miró G, Montoya A, Pardo-Marín L, Boqué N, Ferrer L, Cerón J. Randomized, allopurinol-controlled trial of the effects of dietary nucleotides and active hexose correlated compound in the treatment of canine leishmaniosis. Vet Parasitol 2017; 239:50-56. [PMID: 28495197 DOI: 10.1016/j.vetpar.2017.04.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 03/24/2017] [Accepted: 04/11/2017] [Indexed: 12/27/2022]
Abstract
First-line treatment for canine leishmaniosis (CanL) is N-methylglucamine antimoniate (MGA) combined with allopurinol. However, in some dogs allopurinol may induce hyperxanthinuria leading to urolithiasis. Moreover, allopurinol resistance has recently been described in Leishmania infantum isolates from treated dogs with a relapse of the disease. Alternative treatments are thus needed. Since the type of host immune response strongly influences CanL progression and prognosis, dogs could benefit from treatments targeted at modulating such response, such as nucleotides and active hexose correlated compound (AHCC). The aim of this study was to evaluate the effects of an oral combination of nucleotides and AHCC in dogs with clinical leishmaniosis. Sixty-nine dogs with naturally-occurring clinical leishmaniosis were included in this multicenter, open-label, positively-controlled clinical trial and randomized to receive 10mg/kg allopurinol PO BID (allopurinol group) or 17mg/kg AHCC plus 32mg/kg nucleotides PO SID (supplement group) for 180 days. All dogs were also given 50mg/kg MGA SC BID during the first 28 days. At the time points 0, 30, and 180 days of the trial, dogs underwent a clinical examination, and blood, urine, and bone marrow samples were submitted for analytical tests. Final data analyses (allopurinol group: n=29; supplement group: n=24) revealed a significant improvement in both groups in clinical scores and ELISA-determined antibody titers after treatment. However, the supplement group showed a significantly lower clinical score (P=0.005) and significantly higher antibody titers (P=0.032) after 180 days, compared to the allopurinol group. RT-PCR parasite loads were reduced in groups (mean±SD supplement: 0.38±0.56 vs 5.23±18.9; allopurinol: 0.45±1.47 vs 3.09±8.36 parasites/ng of DNA), but there were no significant differences over time or between groups. During the study, 12 dogs in the allopurinol group developed xanthinuria (41%) compared to no dogs (0%) in the supplement group (P=0.000). Both treatments led to significantly increased CD4+/CD8+ ratio, and improvements in protein electrophoretic pattern and acute phase response. In conclusion, 6-month oral treatment with nucleotides and AHCC in addition to MGA showed similar efficacy to the current first-line treatment for CanL, without producing xanthinuria. This combination could be a good alternative to MGA-allopurinol combination treatment for CanL, especially for dogs suffering allopurinol-related adverse events.
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Affiliation(s)
- Sergi Segarra
- R&D Animal Health Bioiberica S.A.U., Pça. Francesc Macià 7, 08029 Barcelona, Spain.
| | - Guadalupe Miró
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain.
| | - Ana Montoya
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain.
| | - Luis Pardo-Marín
- Interlab-UMU, Campus de Excelencia "Mare Nostrum", University of Murcia, Campus Espinardo, 30071 Murcia, Spain.
| | - Noemí Boqué
- Centre Tecnològic de Nutrició i Salut (CTNS), TECNIO, CEICS, Avinguda Universitat 1, 43204 Reus, Spain.
| | - Lluis Ferrer
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA 01536, USA.
| | - José Cerón
- Interlab-UMU, Campus de Excelencia "Mare Nostrum", University of Murcia, Campus Espinardo, 30071 Murcia, Spain.
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