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Peixoto JF, Gonçalves-Oliveira LF, Souza-Silva F, de Castro Côrtes LM, Finkelstein LC, Dias-Lopes G, Patricio BFDC, Lima CGDS, Rocha HVA, da Silva FDC, Ferreira VF, Pereira BAS, Alves CR. Efficacy of the treatment using a microemulsion loaded with epoxy-α-lapachone in combination with meglumine antimoniate against murine infection by Leishmania (Leishmania) amazonensis. Int J Parasitol Drugs Drug Resist 2024; 24:100525. [PMID: 38359731 PMCID: PMC10875245 DOI: 10.1016/j.ijpddr.2024.100525] [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: 08/31/2023] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
Leishmaniasis is a disease caused by Leishmania spp., affecting millions of people around the world. For decades, its treatment has been based on pentavalent antimonials, which notoriously cause toxic side effects in patients. In this study, epoxy-α-lapachone incorporated into an oil-in-water-type microemulsion (ELAP-ME) and meglumine antimoniate (MA) were assayed in monotherapy and in combination (ELAP-ME/MA) in BALB/c mice infected with Leishmania (Leishmania) amazonensis. In general, there was a reduction in paw lesion size (up to 37% reduction) and decreases of parasite loads in the footpad (∼40%) and lymph nodes (∼31%) of animals treated with ELAP-ME/MA, when compared to the non-treated control groups. Analyses of serum biochemical parameters revealed that the ELAP-ME/MA showed lower renal and hepatic toxicity when compared to MA 2-doses/week monotherapy. These findings indicate that the ELAP-ME/MA combination may be a promising approach for the treatment of cutaneous leishmaniasis.
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Affiliation(s)
- Juliana Figueiredo Peixoto
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas - Avenida Brasil 4365, CEP 21040-900, Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Luiz Filipe Gonçalves-Oliveira
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas - Avenida Brasil 4365, CEP 21040-900, Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Franklin Souza-Silva
- Centro de Desenvolvimento Tecnológico em Saúde, Fundação Oswaldo Cruz - Avenida Brasil, 4365, CEP 21040-900, Manguinhos, Rio de Janeiro, RJ, Brazil; Universidade Iguaçu - Avenida Abílio Augusto Távora 2134, CEP 26260-045, Dom Rodrigo, Nova Iguaçu, RJ, Brazil
| | - Luzia Monteiro de Castro Côrtes
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas - Avenida Brasil 4365, CEP 21040-900, Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Léa Cysne Finkelstein
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Imunoparasitologia - Avenida Brasil 4365, CEP 21040-900, Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Geovane Dias-Lopes
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas - Avenida Brasil 4365, CEP 21040-900, Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Beatriz Ferreira de Carvalho Patricio
- Fundação Oswaldo Cruz, Farmanguinhos, Laboratório de Micro e Nanotecnologia - Avenida Brasil 4036, CEP 21040361, Bonsucesso, Rio de Janeiro, RJ, Brazil; Universidade Federal do Estado do Rio de Janeiro, Instituto Biomédico, Laboratório de Farmacologia - Rua Frei Caneca 94, CEP 20211040, Centro, Rio de Janeiro, RJ, Brazil
| | - Carolina Guimarães de Souza Lima
- Universidade Federal Fluminense, Instituto de Química, Departamento de Química Orgânica - Outeiro de São João Batista s/n, CEP 24020-141, Niterói, RJ, Brazil
| | - Helvécio Vinícius Antunes Rocha
- Universidade Federal do Estado do Rio de Janeiro, Instituto Biomédico, Laboratório de Farmacologia - Rua Frei Caneca 94, CEP 20211040, Centro, Rio de Janeiro, RJ, Brazil
| | - Fernando de Carvalho da Silva
- Universidade Federal Fluminense, Instituto de Química, Departamento de Química Orgânica - Outeiro de São João Batista s/n, CEP 24020-141, Niterói, RJ, Brazil
| | - Vitor Francisco Ferreira
- Universidade Federal Fluminense, Instituto de Química, Departamento de Química Orgânica - Outeiro de São João Batista s/n, CEP 24020-141, Niterói, RJ, Brazil; Universidade Federal Fluminense, Faculdade de Farmácia, Departamento de Tecnologia Farmacêutica - Rua Dr. Mario Vianna 523, Santa Rosa, CEP 24241-002, Niterói, RJ, Brazil
| | - Bernardo Acácio Santini Pereira
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas - Avenida Brasil 4365, CEP 21040-900, Manguinhos, Rio de Janeiro, RJ, Brazil; Universidade Federal Fluminense, Faculdade de Medicina, Departamento de Patologia - Avenida Marquês do Paraná, 303, CEP 24033-900, Centro, Niterói, RJ, Brazil
| | - Carlos Roberto Alves
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas - Avenida Brasil 4365, CEP 21040-900, Manguinhos, Rio de Janeiro, RJ, Brazil.
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2
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Khandibharad S, Singh S. Synthetic biology for combating leishmaniasis. Front Microbiol 2024; 15:1338749. [PMID: 38362504 PMCID: PMC10867266 DOI: 10.3389/fmicb.2024.1338749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/08/2024] [Indexed: 02/17/2024] Open
Abstract
Leishmaniasis is a neglected tropical disease caused by protozoan parasites of the Leishmania genus. Despite the efforts to control and treat the disease, it still remains a major public health problem in many countries. Synthetic biology is a rapidly evolving interdisciplinary field that combines biology, engineering, and computer science to design and construct novel biological systems. In recent years, synthetic biology approaches have shown great promise for developing new and effective strategies to combat leishmaniasis. In this perspective, we summarize the recent advances in the use of synthetic biology for the development of vaccines, diagnostic tools, and novel therapeutics for leishmaniasis.
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Affiliation(s)
| | - Shailza Singh
- Systems Medicine Laboratory, National Centre for Cell Science, Pune, India
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3
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de Araújo SA, Silva CMP, Costa CS, Ferreira CSC, Ribeiro HS, da Silva Lima A, Quintino da Rocha C, Calabrese KDS, Abreu-Silva AL, Almeida-Souza F. Leishmanicidal and immunomodulatory activity of Terminalia catappa in Leishmania amazonensisin vitro infection. Heliyon 2024; 10:e24622. [PMID: 38312642 PMCID: PMC10835263 DOI: 10.1016/j.heliyon.2024.e24622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/24/2023] [Accepted: 01/11/2024] [Indexed: 02/06/2024] Open
Abstract
Leishmaniases are infectious-parasitic diseases that impact public health around the world. Antileishmanial drugs presented toxicity and increase in parasitic resistance. Studies with natural products show an alternative to this effect, and several metabolites have demonstrated potential in the treatment of various diseases. Terminalia catappa is a plant species with promising pharmaceutical properties. The objective of this work was to evaluate the therapeutic potential of extracts and fractions of T. catappa on Leishmania amazonensis and investigate the immunomodulatory mechanisms associated with its action. In anti-Leishmania assays, the ethyl acetate fraction exhibited activity against promastigotes (IC50 86.07 ± 1.09 μg/mL) and low cytotoxicity (CC50 517.70 ± 1.68 μg/mL). The ethyl acetate fraction also inhibited the intracellular parasite (IC50 25.74 ± 1.08 μg/mL) with a selectivity index of 20.11. Treatment with T. catappa ethyl acetate fraction did not alter nitrite production by peritoneal macrophages stimulated with L. amazonensis, although there was a decrease in unstimulated macrophages treated at 50 μg/mL (p = 0.0048). The T. catappa ethyl acetate fraction at 100 μg/mL increased TNF-α levels (p = 0.0238) and downregulated HO-1 (p = 0.0030) and ferritin (p = 0.0002) gene expression in L. amazonensis-stimulated macrophages. Additionally, the total flavonoid and ellagic acid content for ethyl acetate fraction was 13.41 ± 1.86 mg QE/g and 79.25 mg/g, respectively. In conclusion, the T. catappa ethyl acetate fraction showed leishmanicidal activity against different forms of L. amazonensis and displayed immunomodulatory mechanisms, including TNF-α production and expression of pro and antioxidant genes.
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Affiliation(s)
- Sandra Alves de Araújo
- Rede Nordeste de Biotecnologia, Universidade Federal do Maranhão, São Luís, 65080-805, Brazil
| | | | | | | | | | - Aldilene da Silva Lima
- Laboratório de Química dos Produtos Naturais, Universidade Federal do Maranhão, 65080-805, São Luís, MA, Brazil
| | - Cláudia Quintino da Rocha
- Laboratório de Química dos Produtos Naturais, Universidade Federal do Maranhão, 65080-805, São Luís, MA, Brazil
| | - Kátia da Silva Calabrese
- Laboratório de Protozoologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, 21041-250, Brazil
| | - Ana Lucia Abreu-Silva
- Rede Nordeste de Biotecnologia, Universidade Federal do Maranhão, São Luís, 65080-805, Brazil
- Universidade Estadual do Maranhão, São Luís, 65055-310, Brazil
- Pós-graduação em Ciência Animal, Universidade Estadual do Maranhão, São Luís, 65055-310, Brazil
| | - Fernando Almeida-Souza
- Universidade Estadual do Maranhão, São Luís, 65055-310, Brazil
- Laboratório de Protozoologia, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, 21041-250, Brazil
- Pós-graduação em Ciência Animal, Universidade Estadual do Maranhão, São Luís, 65055-310, Brazil
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4
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Naz S, Aroosh A, Raza N, Islam A, Fatima A, Ozbel Y, Toz S, Hayat O, Waseem S. Comparative analysis of the severity and progression of cutaneous leishmaniasis caused by Leishmania tropica in untreated and glucantime-treated patients. Acta Trop 2023; 248:107023. [PMID: 37717686 DOI: 10.1016/j.actatropica.2023.107023] [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: 07/07/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/19/2023]
Abstract
Millions of people worldwide are affected by cutaneous leishmaniasis (CL), a disease that has a significant impact on morbidity and mortality. Understanding the immune responses responsible for tissue damage or the process of lesion healing plays a pivotal role in shaping optimal treatment strategies. In this study, we investigated immunological phenotypes for three groups: glucantime treated (n = 30) and untreated (n = 30) CL patients infected with Leishmania tropica (L. tropica), and healthy controls (n = 20). T-lymphocytes (CD4+ and CD8+), and B lymphocytes (CD14+ and CD19+) were isolated using antibody-conjugated microbeads and magnetic field isolation to achieve high purity. A higher significant difference was observed between T-lymphocytes (CD4+ and CD8+), and B-lymphocytes (CD14+ and CD19+) cells in CL-infected groups before and after treatment (p < 0.0001). When compared, there was also a significant difference among T-lymphocytes (CD4+ and CD8+), B lymphocytes (CD14+ and CD19+) p < 0.0001, p < 0.0005, and p < 0.0007, respectively between CL-infected individuals (before and after treatment) to controls. Our findings suggest that an increased proportion of these cells seen in treated patients may mediate healing, while it is also possible that they may contribute to tissue injury. Understanding the immune system and lesion size of CL can help develop immunotherapies and comprehend the evolution of this parasitic disease.
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Affiliation(s)
- Shumaila Naz
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan.
| | - Aiman Aroosh
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Naeem Raza
- Department of Dermatology, Pak Emirates Military Hospital (MH), Rawalpindi, Pakistan
| | - Arshad Islam
- Department of Pathology, Government Lady Reading Hospital Medical Teaching Institution, Peshawar, Pakistan
| | - Anam Fatima
- Department of Medicine, Polyclinic Hospital, Islamabad, Pakistan
| | - Yusuf Ozbel
- Department of Parasitology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Seray Toz
- Department of Parasitology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Obaid Hayat
- Department of Biotechnology, Faculty of Chemical and Life Sciences, Abdul Wali Khan University, Mardan 23200, Pakistan
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5
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Aronson NE, Billick K. Intralesional Antimonial Drug Treatment for Leishmania braziliensis Cutaneous Leishmaniasis: The Knowns and the Unknowns. Clin Infect Dis 2023; 77:583-588. [PMID: 37185765 DOI: 10.1093/cid/ciad248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/28/2023] [Accepted: 04/25/2023] [Indexed: 05/17/2023] Open
Affiliation(s)
- Naomi E Aronson
- Infectious Diseases Division, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Kendall Billick
- Division of Dermatology, University of Toronto, Toronto, Ontario, Canada
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6
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Madusanka RK, Silva H, Karunaweera ND. Treatment of Cutaneous Leishmaniasis and Insights into Species-Specific Responses: A Narrative Review. Infect Dis Ther 2022; 11:695-711. [PMID: 35192172 PMCID: PMC8960542 DOI: 10.1007/s40121-022-00602-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 01/31/2022] [Indexed: 12/16/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a complex skin infection that has imposed a heavy burden on many developing countries and is caused by more than 20 Leishmania species. This disease is predominantly associated with disfiguring scars and major social stigma upon infection. The severity of the disease seemingly depends on many factors including the species of parasite, the host, region of endemicity, socio-economic status and the accessibility to health facilities. Despite myriad studies that have been performed on current and novel therapies, the treatment outcomes of CL remain contentious, possibly because of the knowledge gaps that still exist. The differential responses to the current CL therapies have become a major drawback in disease control, and the dearth of information on critical analyses of outcomes of such studies is a hindrance to the overall understanding. On the basis of currently available literature on treatment outcomes, we discuss the most effective doses, drug susceptibilities/resistance and treatment failures of the Leishmania genus for both monotherapy and combination therapy. This review focuses on the available treatment modalities for CL caused by different Leishmania species, with insights into their species-specific efficacies, which would inform the selection of appropriate drugs for the treatment and control of leishmaniasis.
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Affiliation(s)
| | - Hermali Silva
- Department of Parasitology, Faculty of Medicine, University of Colombo, No. 25, Kynsey Road, Colombo 8, Sri Lanka
| | - Nadira D Karunaweera
- Department of Parasitology, Faculty of Medicine, University of Colombo, No. 25, Kynsey Road, Colombo 8, Sri Lanka.
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7
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Rodrigues LS, Barreto AS, Bomfim LGS, Gomes MC, Ferreira NLC, da Cruz GS, Magalhães LS, de Jesus AR, Palatnik-de-Sousa CB, Corrêa CB, de Almeida RP. Multifunctional, TNF-α and IFN-γ-Secreting CD4 and CD8 T Cells and CD8 High T Cells Are Associated With the Cure of Human Visceral Leishmaniasis. Front Immunol 2021; 12:773983. [PMID: 34777391 PMCID: PMC8581227 DOI: 10.3389/fimmu.2021.773983] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 10/06/2021] [Indexed: 11/30/2022] Open
Abstract
Visceral leishmaniasis (VL) is a chronic and often fatal disease caused by protozoans of the genus Leishmania that affects millions of people worldwide. Patients with symptomatic VL have an impaired anti-Leishmania-specific CD4+ T-cell response, which is reversed after clinical cure. In contrast, the quality of the CD4+ and CD8+ T-cell responses involved in resistance and/or cure of VL relies on the capability of these cells to activate polyfunctional and memory responses, which are associated with the simultaneous production of three cytokines: IFN-γ, IL-2, and TNF-α. Models for the development of CD4 and CD8 T-cell quality in memory and protection to leishmaniasis have been described previously. We aimed to assess the functionality of the T cells involved in the recovery of the immune suppression throughout the VL treatment. Therefore, we cultured peripheral blood mononuclear cells (PBMCs) from VL patients and healthy controls in vitro with soluble Leishmania antigen (SLA). Cell surface markers and intracellular cytokine production were determined on days 7, 14, 21, 30, 60, 90, and 180 after the beginning of chemotherapy. We observed that the frequencies of CD4+TNF-α+IFN-γ+ and the multifunctional CD4+IL-2+TNF-α+IFN-γ+, together with CD4+TNF-α+ and CD4+IFN-γ+ T cells, increased throughout and at the end of the treatment, respectively. In addition, enhanced frequencies of CD8+IL-2+TNF-α+IFN-γ+ and CD8+TNF-α+IFN-γ T cells were also relevant in the healing process. Noteworthy, the frequencies of the CD4+ and CD8 central-memory T cells, which produce IL-2, TNF-α, and IFN-γ and ensure the memory response against parasite reinfection, are significantly enhanced in cured patients. In addition, the subset of the non-functional CD8Low population is predominant in VL untreated patients and decreases along the chemotherapy treatment. In contrast, a CD8High subset increased towards the cure. Furthermore, the cure due to treatment with meglumine antimoniate or with liposomal amphotericin B was associated with the recovery of the T-cell immune responses. We described the evolution and participation of functional T cells during the treatment of patients with VL. Our results disclosed that the clinical improvement of patients is significantly associated with the participation of the CD4+ and CD8+ cytokine-secreting T cells.
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Affiliation(s)
- Lorranny Santana Rodrigues
- Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), National Insitute of Science and Technology (INCT), National Council for Scientific and Technological Development (CNPq), Aracaju, Brazil.,Graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil
| | - Aline Silva Barreto
- Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), National Insitute of Science and Technology (INCT), National Council for Scientific and Technological Development (CNPq), Aracaju, Brazil.,Graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil.,Division of Immunology and Molecular Biology Laboratory, University Hospital/Brazilian Hospital Services Company (EBSERH), Federal University of Sergipe, Sergipe, Brazil
| | - Lays Gisele Santos Bomfim
- Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), National Insitute of Science and Technology (INCT), National Council for Scientific and Technological Development (CNPq), Aracaju, Brazil.,Graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil
| | - Marcos Couto Gomes
- Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), National Insitute of Science and Technology (INCT), National Council for Scientific and Technological Development (CNPq), Aracaju, Brazil
| | - Nathalia Luisa Carlos Ferreira
- Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), National Insitute of Science and Technology (INCT), National Council for Scientific and Technological Development (CNPq), Aracaju, Brazil
| | - Geydson Silveira da Cruz
- Graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil.,Division of Immunology and Molecular Biology Laboratory, University Hospital/Brazilian Hospital Services Company (EBSERH), Federal University of Sergipe, Sergipe, Brazil
| | - Lucas Sousa Magalhães
- Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), National Insitute of Science and Technology (INCT), National Council for Scientific and Technological Development (CNPq), Aracaju, Brazil.,Graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil
| | - Amélia Ribeiro de Jesus
- Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), National Insitute of Science and Technology (INCT), National Council for Scientific and Technological Development (CNPq), Aracaju, Brazil.,Graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil.,Division of Immunology and Molecular Biology Laboratory, University Hospital/Brazilian Hospital Services Company (EBSERH), Federal University of Sergipe, Sergipe, Brazil
| | - Clarisa B Palatnik-de-Sousa
- Graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil.,Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Immunology Investigative Institute (III), National Insitute of Science and Technology (INCT), National Council for Scientific and Technological Development (CNPq), Rio de Janeiro, Brazil
| | - Cristiane Bani Corrêa
- Graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil.,Laboratory of Biology and Immunology of Cancer and Leishmania, Department of Morphology, Federal University of Sergipe, São Cristóvão, Brazil
| | - Roque Pacheco de Almeida
- Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), National Insitute of Science and Technology (INCT), National Council for Scientific and Technological Development (CNPq), Aracaju, Brazil.,Graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil.,Division of Immunology and Molecular Biology Laboratory, University Hospital/Brazilian Hospital Services Company (EBSERH), Federal University of Sergipe, Sergipe, Brazil
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8
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Fernández OL, Ramírez LG, Díaz-Varela M, Tacchini-Cottier F, Saravia NG. Neutrophil Activation: Influence of Antimony Tolerant and Susceptible Clinical Strains of L. (V.) panamensis and Meglumine Antimoniate. Front Cell Infect Microbiol 2021; 11:710006. [PMID: 34631596 PMCID: PMC8493214 DOI: 10.3389/fcimb.2021.710006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Emerging evidence indicates that innate host response contributes to the therapeutic effect of antimicrobial medications. Recent studies have shown that Leishmania parasites derived by in vitro selection for resistance to pentavalent antimony (SbV) as meglumine antimoniate (MA) modulate the activation of neutrophils. However, whether modulation of neutrophil activation extends to natural resistance to this antileishmanial drug has not been established. We have evaluated the influence of clinical strains of L. (V.) panamensis having intrinsic tolerance/resistance to SbV, on the inflammatory response of neutrophils during ex vivo exposure to MA. Accordingly, neutrophils obtained from healthy donors were infected with clinical strains that are sensitive (n = 10) or intrinsically tolerant/resistant to SbV (n = 10) and exposed to a concentration approximating the maximal plasma concentration (Cmax) of SbV (32 µg/ml). The activation profile of neutrophils was evaluated as the expression of the surface membrane markers CD66b, CD18, and CD62L by flow cytometry, measurement of reactive oxygen species (ROS) by luminometry, and NET formation using Picogreen to measure dsDNA release and quantification of NETs by confocal microscopy. These parameters of activation were analyzed in relation with parasite susceptibility to SbV and exposure to MA. Here, we show that clinical strains presenting intrinsic tolerance/resistance to SbV induced significantly lower ROS production compared to drug-sensitive clinical strains, both in the presence and in the absence of MA. Likewise, analyses of surface membrane activation markers revealed significantly higher expression of CD62L on cells infected with intrinsically SbV tolerant/resistant L. (V.) panamensis than cells infected with drug-sensitive strains. Expression of other activation markers (CD18 and CD66b) and NET formation were similar for neutrophils infected with SbV sensitive and tolerant clinical strains under the conditions evaluated. Exposure to MA broadly impacted the activation of neutrophils, diminishing NET formation and the expression of CD62L, while augmenting ROS production and CD66b expression, independently of the parasite susceptibility phenotype. These results demonstrated that activation of human neutrophils ex vivo is differentially modulated by infection with clinical strains of L. (V.) panamensis having intrinsic tolerance/resistance to SbV compared to sensitive strains, and by exposure to antimonial drug.
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Affiliation(s)
- Olga Lucía Fernández
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Lady Giovanna Ramírez
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Míriam Díaz-Varela
- Department of Biochemistry, University of Lausanne, Epalinges, Switzerland
| | | | - Nancy Gore Saravia
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
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9
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Siadat AH, Iraji F, Zolfaghari A, Shariat S, Jazi SB. Heat therapy for cutaneous leishmaniasis: A literature Review. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2021; 26:15. [PMID: 34084194 PMCID: PMC8106408 DOI: 10.4103/jrms.jrms_934_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/06/2020] [Accepted: 09/14/2020] [Indexed: 11/09/2022]
Abstract
Cutaneous leishmaniasis (CL) is endemic in many parts of the world with a high economic and health impact. Despite many treatments that have been suggested for this zoonotic infection, there is still no definite therapy for CL. Meglumine antimony compounds are considered as a standard treatment for leishmaniasis, however, these medications have a relatively high side effect profile and not always effective. Physical modalities including cryotherapy, laser, and heat therapy have also been used for this purpose. As a source of heat therapy, different methods have been used including radiofrequency, ultrasound, infrared, exothermic crystallization thermotherapy, and microwave. We reviewed all of the articles in PubMed regarding the use of heat therapy for the treatment of CL up to January 2020. According to our literature review, heat therapy using different sources showed promising results for the treatment of CL that were comparable to meglumine antimony. In addition, heat therapy has very low side effect profiles that are localized to the treatment area suggesting this method as a safe procedure for CL therapy. This study is a brief review of the literature about the effect of heat therapy on the treatment of CL. Performing randomized clinical trials to compare different methods of heat therapy and to compare it with meglumine antimony compounds is recommended.
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Affiliation(s)
- Amir Hossein Siadat
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Iraji
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Zolfaghari
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sheila Shariat
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Safoura Bokaie Jazi
- Department of Dermatology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Valentim Silva JR, de Barros NB, Aragão Macedo SR, Ferreira ADS, Moreira Dill LS, Zanchi FB, do Nascimento JR, Fernandes do Nascimento FR, Lourenzoni MR, de Azevedo Calderon L, Soares AM, Nicolete R. A natural cell-penetrating nanopeptide combined with pentavalent antimonial as experimental therapy against cutaneous leishmaniasis. Exp Parasitol 2020; 217:107934. [PMID: 32698075 DOI: 10.1016/j.exppara.2020.107934] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/22/2020] [Accepted: 06/02/2020] [Indexed: 10/23/2022]
Abstract
The inadequacy of available treatments for leishmaniasis has presented up to 40% therapeutic failure. This fact suggests an urgency in the discovery of new drugs or alternative approaches for treating this disease. The objective of this study was to evaluate the antileishmanial activity of combined therapy between crotamine (CTA) from Crotalus durissus terrificus and the pentavalent antimonial Glucantime® (GLU). The assays were in vitro performed measuring the inhibition of Leishmania amazonensis amastigotes, followed by the evaluation of cellular production of cytokines and nitrites. After that, analytical methods were performed in order to characterize the molecules involved in the study by Mass Spectrometry, molecular affinity through an in silico assay and Surface Plasmon Resonance. In vivo experiments with BALB/c mice were performed by analyzing parasitemia, lesion size and immunological mediators. In the in vitro experiments, the pharmacological association improved the inhibition of the amastigotes, modulated the production of cytokines and nitric oxide. The therapy improved the effectiveness of the GLU, demonstrating a decreased parasitemia in the infected tissues. Altogether, the results suggest that the combined approach with CTA and GLU may be a promising alternative for the treatment of cutaneous leishmaniasis.
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Affiliation(s)
- João Rafael Valentim Silva
- Laboratório de Biotecnologia Aplicada à Saúde, Fundação Oswaldo Cruz - Rondônia, Porto Velho, RO, Brazil; Physical Education Department of Federal University of Rondônia (UNIR), Porto Velho, RO, Brazil; Physical Education Department of University Center UNINORTE, Rio Branco, AC, Brazil
| | - Neuza Biguinati de Barros
- Laboratório de Biotecnologia Aplicada à Saúde, Fundação Oswaldo Cruz - Rondônia, Porto Velho, RO, Brazil
| | - Sharon Rose Aragão Macedo
- Laboratório de Biotecnologia Aplicada à Saúde, Fundação Oswaldo Cruz - Rondônia, Porto Velho, RO, Brazil; Centro de Estudos de Biomoléculas Aplicadas à Saúde (CEBio), Fundação Oswaldo Cruz, Fiocruz - Rondônia e Universidade Federal de Rondônia (UNIR), Porto Velho, RO, Brazil
| | - Amália Dos Santos Ferreira
- Laboratório de Biotecnologia Aplicada à Saúde, Fundação Oswaldo Cruz - Rondônia, Porto Velho, RO, Brazil
| | - Leandro Soares Moreira Dill
- Centro de Estudos de Biomoléculas Aplicadas à Saúde (CEBio), Fundação Oswaldo Cruz, Fiocruz - Rondônia e Universidade Federal de Rondônia (UNIR), Porto Velho, RO, Brazil
| | - Fernando Berton Zanchi
- Centro de Estudos de Biomoléculas Aplicadas à Saúde (CEBio), Fundação Oswaldo Cruz, Fiocruz - Rondônia e Universidade Federal de Rondônia (UNIR), Porto Velho, RO, Brazil
| | - Johnny Ramos do Nascimento
- Laboratory of Immunophysiology, Department of Pathology, Center for Biological and Health Sciences, Federal University of Maranhão (UFMA), São Luís, MA, Brazil
| | - Flávia Raquel Fernandes do Nascimento
- Laboratory of Immunophysiology, Department of Pathology, Center for Biological and Health Sciences, Federal University of Maranhão (UFMA), São Luís, MA, Brazil
| | | | - Leonardo de Azevedo Calderon
- Centro de Estudos de Biomoléculas Aplicadas à Saúde (CEBio), Fundação Oswaldo Cruz, Fiocruz - Rondônia e Universidade Federal de Rondônia (UNIR), Porto Velho, RO, Brazil
| | - Andreimar Martins Soares
- Centro de Estudos de Biomoléculas Aplicadas à Saúde (CEBio), Fundação Oswaldo Cruz, Fiocruz - Rondônia e Universidade Federal de Rondônia (UNIR), Porto Velho, RO, Brazil; eCentro Universitário São Lucas (UniSL), Porto Velho, RO, Brazil
| | - Roberto Nicolete
- Laboratório de Biotecnologia Aplicada à Saúde, Fundação Oswaldo Cruz - Rondônia, Porto Velho, RO, Brazil; Fundação Oswaldo Cruz (Fiocruz Ceará), Eusébio, CE, Brazil.
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11
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Amorim EADS, de França ÁA, Pereira VRA, Brelaz-de-Castro MCA. IL-1 family and Cutaneous Leishmaniasis: A poorly understood relationship. Cytokine Growth Factor Rev 2020; 57:85-92. [PMID: 32540132 DOI: 10.1016/j.cytogfr.2020.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/04/2020] [Indexed: 01/02/2023]
Abstract
The cytokines of the interleukin (IL) -1 family act in the initiation of an effective immune response in Leishmania infection, represented mainly by the T helper 1 (Th1) profile, in addition to being associated with disease exacerbation and controversial contributions in the Th2 responses. The family also includes members who self-regulate inflammation, such as antagonists and anti-inflammatory cytokines, most of which have not yet been studied in Cutaneous Leishmaniasis (CL) in humans. Here we summarize findings about what is known so far about the role of these cytokines in mice, the main study model, and in humans. We reinforce the importance of studies of these cytokines as new targets in the context of CL.
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Affiliation(s)
- Ester Alves da Silva Amorim
- Federal University of Pernambuco (UFPE), Academic Center of Vitória (CAV), Rua do Alto do Reservatório s/n, Bela Vista, Vitória de Santo Antão, Pernambuco, PE, 55608-680, Brazil; Oswaldo Cruz Pernambuco Foundation (Fiocruz/PE), Department of Immunology, Av. Moraes Rego, s/n - Cidade Universitária, 50670-420, Recife, Pernambuco, Brazil.
| | - Áquila Alcântara de França
- Federal University of Pernambuco (UFPE), Academic Center of Vitória (CAV), Rua do Alto do Reservatório s/n, Bela Vista, Vitória de Santo Antão, Pernambuco, PE, 55608-680, Brazil; Oswaldo Cruz Pernambuco Foundation (Fiocruz/PE), Department of Immunology, Av. Moraes Rego, s/n - Cidade Universitária, 50670-420, Recife, Pernambuco, Brazil.
| | - Valéria Rêgo Alves Pereira
- Oswaldo Cruz Pernambuco Foundation (Fiocruz/PE), Department of Immunology, Av. Moraes Rego, s/n - Cidade Universitária, 50670-420, Recife, Pernambuco, Brazil.
| | - Maria Carolina Accioly Brelaz-de-Castro
- Federal University of Pernambuco (UFPE), Academic Center of Vitória (CAV), Rua do Alto do Reservatório s/n, Bela Vista, Vitória de Santo Antão, Pernambuco, PE, 55608-680, Brazil; Oswaldo Cruz Pernambuco Foundation (Fiocruz/PE), Department of Immunology, Av. Moraes Rego, s/n - Cidade Universitária, 50670-420, Recife, Pernambuco, Brazil.
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12
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Kämink S, Abdi A, Kamau C, Ashraf S, Ansari MA, Qureshi NA, Schallig H, Grobusch MP, Fernhout J, Ritmeijer K. Failure of an Innovative Low-Cost, Noninvasive Thermotherapy Device for Treating Cutaneous Leishmaniasis Caused by Leishmania tropica in Pakistan. Am J Trop Med Hyg 2020; 101:1373-1379. [PMID: 31595864 PMCID: PMC6896852 DOI: 10.4269/ajtmh.19-0430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Cutaneous leishmaniasis (CL), a neglected parasitic skin disease, is endemic in Pakistan, where Leishmania tropica and Leishmania major are the causative protozoan species. Standard treatment with antimonial injections is long, painful, and costly; has toxic side effects; and is not always available in public hospitals. Small pilot studies have previously evaluated a low-cost and noninvasive hand-held exothermic crystallization thermotherapy for cutaneous leishmaniasis (HECT-CL) device. We aimed to further establish the effectiveness, safety, and feasibility of HECT-CL in L. tropica. In a prospective observational study, patients with parasitological confirmation of CL were treated using the HECT-CL heat pack for 3 minutes with an initial temperature of 52–53°C for 7 consecutive days. Dried blood spot samples were taken for species identification by polymerase chain reaction (PCR). Effectiveness was assessed by using medical photographs and measurements of the lesion size at baseline and subsequent follow-up visits, for up to 180 days. We intended to enroll 317 patients. The HECT-CL treatment was easy to apply and well tolerated. Species identification demonstrated the presence of L. tropica. Interim analysis of 56 patients showed a failure rate of 91% at follow-up (median 45 days after treatment, interquartile range 30–60 days). Enrollment of patients was prematurely suspended because of futility. This study showed a high failure rate for HECT-CL thermotherapy in this setting. Leishmania tropica is known to be less sensitive to antileishmanial drugs, more temperature-resistant, and spontaneous healing is slower than that in L. major. More research is needed to identify low-cost, effective, and more patient-friendly treatment for L. tropica.
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Affiliation(s)
- Suzette Kämink
- Department of Infectious Diseases, Amsterdam University Medical Centers, Center of Tropical Medicine and Travel Medicine, University of Amsterdam, Amsterdam, The Netherlands.,Médecins Sans Frontières, Quetta, Pakistan
| | - Ahmed Abdi
- Médecins Sans Frontières, Quetta, Pakistan
| | - Charity Kamau
- Médecins Sans Frontières, Amsterdam, The Netherlands
| | - Shakil Ashraf
- Mohtama Shaheed Benazir Bhutto Hospital, Quetta, Pakistan
| | | | - Naveeda Akhtar Qureshi
- Department of Animal Sciences, Parasitology Laboratory, Quaid-i-Azam University, Islamabad, Pakistan
| | - Henk Schallig
- Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Martin P Grobusch
- Department of Infectious Diseases, Amsterdam University Medical Centers, Center of Tropical Medicine and Travel Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Jena Fernhout
- Médecins Sans Frontières, Amsterdam, The Netherlands
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Profiles of Local and Systemic Inflammation in the Outcome of Treatment of Human Cutaneous Leishmaniasis Caused by Leishmania ( Viannia). Infect Immun 2020; 88:IAI.00764-19. [PMID: 31818959 DOI: 10.1128/iai.00764-19] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 11/26/2019] [Indexed: 02/08/2023] Open
Abstract
The immune mechanisms that contribute to the efficacy of treatment of cutaneous leishmaniasis (CL) are not fully understood. The aim of this study was to define immune correlates of the outcome of treatment of CL caused by Leishmania (Viannia) species during standard of care treatment with pentavalent antimonials. We conducted a comparative expression profiling of immune response genes in peripheral blood mononuclear cells (PBMCs) and lesion biopsy specimens obtained from CL patients before and at the end of treatment (EoT) with meglumine antimoniate. The ex vivo response of PBMCs to L (V) panamensis partially reflected that of lesion microenvironments. Significant downregulation of gene expression profiles consistent with local innate immune responses (monocyte and neutrophil activation and chemoattractant molecules) was observed at EoT in biopsy specimens of patients who cured (n = 8), compared to those from patients with treatment failure (n = 8). Among differentially expressed genes, pretreatment expression of CCL2 was significantly predictive of the therapeutic response (receiver operating characteristic [ROC] curve, area under the curve [AUC] = 0.82, P = 0.02). Polymorphisms in regulatory regions of the CCL2 promoter were analyzed in a pilot cohort of DNA samples from CL patients (cures, n = 20, and treatment failure, n = 20), showing putative association of polymorphisms rs13900(C/T) and rs2857656(G/C) with treatment outcome. Our data indicate that dampening gene expression profiles of monocyte and neutrophil activation characterize clinical cure after treatment of CL, supporting participation of parasite-sustained inflammation or deregulated innate immune responses in treatment failure.
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Egui A, Ledesma D, Pérez-Antón E, Montoya A, Gómez I, Robledo SM, Infante JJ, Vélez ID, López MC, Thomas MC. Phenotypic and Functional Profiles of Antigen-Specific CD4 + and CD8 + T Cells Associated With Infection Control in Patients With Cutaneous Leishmaniasis. Front Cell Infect Microbiol 2018; 8:393. [PMID: 30510917 PMCID: PMC6252334 DOI: 10.3389/fcimb.2018.00393] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 10/19/2018] [Indexed: 01/03/2023] Open
Abstract
The host immunological response is a key factor determining the pathogenesis of cutaneous leishmaniasis. It is known that a Th1 cellular response is associated with infection control and that antigen-specific memory T cells are necessary for the development of a rapid and strong protective cellular response. The present manuscript reports the analysis of the functional and phenotypic profiles of antigen-specific CD4+ and CD8+ T cells from patients cured of cutaneous leishmaniasis (CL), patients with an active process of cutaneous leishmaniasis, asymptomatic individuals with a positive Montenegro test and healthy donors (HD). Peripheral blood mononuclear cells (PBMCs) from the patients exhibited a lymphoproliferative capacity after stimulation with total soluble protein from either Leishmania panamensis (SLpA) or Leishmania infantum (SLiA) or with a recombinant paraflagellar rod protein-1 (rPFR1). Higher frequencies of antigen-specific TNAIVE cells, mainly following stimulation with rPFR1, were observed in asymptomatic and cured patients than in patients with active cutaneous leishmaniasis, while T cells from patients with active cutaneous leishmaniasis showed a higher percentage of effector memory T cells (TEM for CD4+ T cells and TEMRA for CD8+ T cells). The amount of antigen-specific CD57+/CD8+ TEMRA cells in patients with active cutaneous leishmaniasis was higher than that in cured patients and asymptomatic subjects. Regarding functionality, a more robust multifunctional CD8+ T cell response was detected in cured patients than in those with active cutaneous leishmaniasis. Moreover, cured patients showed a significant increase in the frequency of cells expressing a Th1-type cytotoxic production profile (IFN-γ+/granzyme-B/+perforin+). Patients with an active leishmaniosis process had a significantly higher frequency of CD8+ T cells expressing the inhibitory CD160 and 2B4 receptors than did cured patients. The expression profile observed in cured patients could be indicative of an imbalance toward a CD8+ Th1 response, which could be associated with infection control; consequently, the determination of this profile could be a useful tool for facilitating the clinical follow-up of patients with cutaneous leishmaniasis. The results also suggest a possible exhaustion process of CD8+ T cells associated with the evolution of Leishmania infection.
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Affiliation(s)
- Adriana Egui
- Molecular Biology Department, Instituto de Parasitología y Biomedicina "López Neyra", Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - Darién Ledesma
- Molecular Biology Department, Instituto de Parasitología y Biomedicina "López Neyra", Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - Elena Pérez-Antón
- Molecular Biology Department, Instituto de Parasitología y Biomedicina "López Neyra", Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - Andrés Montoya
- Programa de Estudio y Control de Enfermedades Tropicales, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Inmaculada Gómez
- Molecular Biology Department, Instituto de Parasitología y Biomedicina "López Neyra", Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - Sara María Robledo
- Programa de Estudio y Control de Enfermedades Tropicales, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan José Infante
- Bionaturis Group, Bioorganic Research and Services, S.A., Jerez de la Frontera, Spain
| | - Ivan Darío Vélez
- Programa de Estudio y Control de Enfermedades Tropicales, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Manuel C López
- Molecular Biology Department, Instituto de Parasitología y Biomedicina "López Neyra", Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - M Carmen Thomas
- Molecular Biology Department, Instituto de Parasitología y Biomedicina "López Neyra", Consejo Superior de Investigaciones Científicas, Granada, Spain
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Montoya A, Yepes L, Bedoya A, Henao R, Delgado G, Vélez ID, Robledo SM. Transforming Growth Factor Beta (TGFβ1) and Epidermal Growth Factor (EGF) as Biomarkers of Leishmania (V) braziliensis Infection and Early Therapeutic Response in Cutaneous Leishmaniasis: Studies in Hamsters. Front Cell Infect Microbiol 2018; 8:350. [PMID: 30333964 PMCID: PMC6176012 DOI: 10.3389/fcimb.2018.00350] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 09/13/2018] [Indexed: 12/19/2022] Open
Abstract
Introduction: In cutaneous leishmaniasis, the host immune response is responsible for the development of skin injuries but also for resolution of the disease especially after antileishmanial therapy. The immune factors that participate in the regulation of inflammation, remodeling of the extracellular matrix, cell proliferation and differentiation may constitute biomarkers of diseases or response to treatment. In this work, we analyzed the production of the growth factors EGF, TGFβ1, PDGF, and FGF during the infection by Leishmania parasites, the development of the injuries and the early response to treatment. Methodology: Golden hamsters were infected with L. (V) braziliensis. The growth factors were detected in skin scrapings and biopsies every 2 weeks after infected and then at day 7 of treatment with different drug candidates by RT-qPCR. The parasitic load was also quantified by RT-qPCR in skin biopsies sampled at the end of the study. Results: The infection by L. (V) braziliensis induced the expression of all the growth factors at day 15 of infection. One month after infection, EGF and TGFβ1 were expressed in all hamsters with inverse ratio. While the EGF and FGF levels decreased between day 15 and 30 of infection, the TGFβ1 increased and the PGDF levels did not change. The relative expression of EGF and TGFβ1 increased notably after treatment. However, the increase of EGF was associated with clinical cure while the increase of TGFβ1 was associated with failure to treatment. The amount of parasites in the cutaneous lesion at the end of the study decreased according to the clinical outcome, being lower in the group of cured hamsters and higher in the group of hamsters that had a failure to the treatment. Conclusions: A differential profile of growth factor expression occurred during the infection and response to treatment. Higher induction of TGFβ1 was associated with active disease while the higher levels of EGF are associated with adequate response to treatment. The inversely EGF/TGFβ1 ratio may be an effective biomarker to identify establishment of Leishmania infection and early therapeutic response, respectively. However, further studies are needed to validate the utility of the proposed biomarkers in field conditions.
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Affiliation(s)
- Andrés Montoya
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Lina Yepes
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Alexander Bedoya
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Raúl Henao
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Gabriela Delgado
- Grupo de Investigación en Inmunotoxicología, Departamento de Farmacia, Facultad de Ciencias, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Iván D Vélez
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Sara M Robledo
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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Gois BM, Peixoto RF, Maciel BLL, Gomes JAS, de Azevedo FLAA, Veras RC, de Medeiros IA, de Lima Grisi TCS, de Araújo DAM, do Amaral IPG, Keesen TSL. Dual immune effect of iNKT cells considering human cutaneous and visceral leishmaniasis: An example of cell plasticity according to different disease scenarios. Scand J Immunol 2018; 87:e12668. [PMID: 29701883 DOI: 10.1111/sji.12668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/19/2018] [Indexed: 01/08/2023]
Abstract
Although the semi-invariant natural killer T cells (iNKT) are a small subpopulation of cells in the peripheral blood, they are presumed to play a role in early stages of infection against various pathogens, including protozoa. This work investigates the activation status and cytokine profile of iNKT cells during human Leishmania infantum and Leishmania braziliensis infection. We studied iNKT cells in patients with symptomatic active visceral leishmaniasis (AVL) (n = 8), patients with symptomatic active cutaneous leishmaniasis (ACL) (n = 13), negative endemic controls (NEC) (n = 6) and non-endemic controls (NonEC) (n = 6), with and without total Leishmania antigen stimulus (TLA). The number of iNKT cells in the peripheral blood of patients with ACL and AVL unaltered in relation to control groups. Moreover, the iNKT cells from ACL showed a hyperactivation profile compared to patients with AVL. Additionally, TLA induced IFN-gamma production in iNKT cells from patients with ACL, while in iNKT of patients with AVL, TLA induced a decrease in this cytokine. Higher IL-17 and IL-10 production by iNKT cells from patients with ACL were also observed compared to all other groups. There were no changes in iNKT IL-10-producing cells in AVL after TLA stimulation. However, TLA induced increase in IL-10 in iNKT cells in patients with ACL. These findings suggest that, although iNKT cells showed distinct profiles in patients with ACL and AVL, they play a dual role in immune modulation in both Leishmania infections.
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Affiliation(s)
- B M Gois
- Department of Cellular and Molecular Biology, Federal University of Paraiba, João Pessoa, Paraíba, Brazil
| | - R F Peixoto
- Department of Cellular and Molecular Biology, Federal University of Paraiba, João Pessoa, Paraíba, Brazil
| | - B L L Maciel
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - J A S Gomes
- Department of Morphology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - F L A A de Azevedo
- Research Institute for Drugs and Medicines, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | - R C Veras
- Research Institute for Drugs and Medicines, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | - I A de Medeiros
- Research Institute for Drugs and Medicines, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | - T C S de Lima Grisi
- Department of Biotechnology, Federal University of Paraiba, João Pessoa, Paraíba, Brazil
| | - D A M de Araújo
- Department of Biotechnology, Federal University of Paraiba, João Pessoa, Paraíba, Brazil
| | - I P G do Amaral
- Department of Cellular and Molecular Biology, Federal University of Paraiba, João Pessoa, Paraíba, Brazil
| | - T S L Keesen
- Department of Cellular and Molecular Biology, Federal University of Paraiba, João Pessoa, Paraíba, Brazil
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Conceição-Silva F, Leite-Silva J, Morgado FN. The Binomial Parasite-Host Immunity in the Healing Process and in Reactivation of Human Tegumentary Leishmaniasis. Front Microbiol 2018; 9:1308. [PMID: 29971054 PMCID: PMC6018218 DOI: 10.3389/fmicb.2018.01308] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/29/2018] [Indexed: 01/09/2023] Open
Abstract
Leishmaniasis is a vector-borne infectious disease caused by different species of protozoa from the Leishmania genus. Classically, the disease can be classified into two main clinical forms: Visceral (VL) and Tegumentary (TL) leishmaniasis. TL is a skin/mucosal granulomatous disease that manifests mainly as cutaneous localized or disseminated ulcers, papules diffusely distributed, mucosal lesions or atypical lesions. Once the etiology of the infection is confirmed, treatment can take place, and different drugs can be administered. It has already been shown that, even when the scar is clinically evident, inflammation is still present in the native tissue, and the decrease of the inflammatory process occurs slowly during the 1st years after clinical healing. The maintenance of residual parasites in the scar tissue is also well documented. Therefore, it is no longer a surprise that, under some circumstances, therapeutic failure and/or lesion reactivation occurs. All over the years, an impressive amount of data on relapses, treatment resistance and lesion reactivation after healing has been collected, and several factors have been pointed out as having a role in the process. Different factors such as Leishmania species, parasite variability, Leishmania RNA virus 1, parasite load, parasite persistence, age, nutritional status, gender, co-morbidities, co-infection, pregnancy, immunosuppression, lesion duration, number and localization of lesions, drug metabolism, irregular treatment and individual host cellular immune response were described and discussed in the present review. Unfortunately, despite this amount of information, a conclusive understanding remains under construction. In addition, multifactorial influence cannot be discarded. In this context, knowing why leishmaniasis has been difficult to treat and control can help the development of new approaches, such as drugs and immunotherapy in order to improve healing maintenance. In this sense, we would like to highlight some of the findings that may influence the course of Leishmania infection and the therapeutic response, with an emphasis on TL.
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Affiliation(s)
- Fatima Conceição-Silva
- Laboratory of Immunoparasitology, Oswaldo Cruz Institute (Fiocruz), Rio de Janeiro, Brazil
| | - Jessica Leite-Silva
- Laboratory of Immunoparasitology, Oswaldo Cruz Institute (Fiocruz), Rio de Janeiro, Brazil
| | - Fernanda N. Morgado
- Laboratory of Leishmaniasis Research, Oswaldo Cruz Institute (Fiocruz), Rio de Janeiro, Brazil
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18
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Gonçalves SVCB, Costa CHN. Treatment of cutaneous leishmaniasis with thermotherapy in Brazil: an efficacy and safety study. An Bras Dermatol 2018; 93:347-355. [PMID: 29924242 PMCID: PMC6001097 DOI: 10.1590/abd1806-4841.20186415] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 03/19/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Pentavalent antimonials remain as the standard drugs in the treatment of cutaneous leishmaniosis. The high cost, difficult administration, long treatment time, toxicity and increasing morbidity are factors that limit the use of these drugs. OBJECTIVES To describe the response to radiofrequency thermotherapy in the treatment of localized cutaneous leishmaniasis in Brazil, and to evaluate its safety and tolerability. METHODS We conducted a non-comparative open trial with a total of 15 patients confirmed to have cutaneous leishmaniasis on parasitological examination. A single radiofrequency thermotherapy session at 50ºC for 30 seconds was applied to the lesion and its edges. In patients with more than one lesion, only the largest one was treated initially. If after 30 days there was no evidence of healing, the smaller lesion was also treated with thermotherapy. Clinical cure was defined as visible healing for three months after treatment. The patients were followed-up for six months and there was no follow-up loss. RESULTS Of all 23 lesions, only two evolved to complete healing without the need of treatment. Of 21 lesions, 18 (85.7%) achieved full healing. The main observed side effects were itching, burning sensation, pain and blisters. STUDY LIMITATIONS Sample with a small number of patients and short follow-up. CONCLUSION Thermotherapy can be considered a therapeutic alternative in localized cutaneous leishmaniasis, especially in cases of single cutaneous lesions and with formal contraindications to conventional treatment with pentavalent antimonials.
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Azami M, Ranjkesh Adermanabadi V, Khanahmad H, Mohaghegh MA, Zaherinejad E, Aghaei M, Jalali A, Hejazi SH. Immunology and Genetic of Leishmania infantum: The Role of Endonuclease G in the Apoptosis. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:36. [PMID: 29887904 PMCID: PMC5961285 DOI: 10.4103/jrms.jrms_705_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 01/13/2018] [Accepted: 01/31/2018] [Indexed: 12/13/2022]
Abstract
Leishmania infantum is the causative agent of infantile visceral leishmaniasis (VL) in the Mediterranean region. Despite developing protective responses, the disease progresses due to many of factors. These include the action of suppressive cytokines, exhaustion of specific T cells, loss of lymphoid tissue, and defective humoral response. Genetic changes that occur inside the genome of alienated or parasite cells, along with immune responses, play an important role in controlling or progressing the disease. Proapoptotic proteins such as Smac/DIABLO, EndoG, AIF (apoptosis-inducing factor), and cytochrome C are effective in apoptosis. EndoG is a mitochondrion-specific nuclease that translocates to the nucleus during apoptosis. Once released from mitochondria, endoG cleaves chromatin DNA into nucleosomal fragments independently of caspases. Therefore, endoG represents a caspase-independent apoptotic pathway initiated from the mitochondria. A comprehensive understanding of the immune and genetic events that occur during VL is very important for designing immunotherapy strategies and developing effective vaccines for disease prevention. In this review which explained the immunological responses and also the important factors that can contribute to parasite apoptosis and are used in subsequent studies as a target for the preparation of drugs or recombinant vaccines against parasites are briefly reviewed.
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Affiliation(s)
- Mehdi Azami
- Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Hossein Khanahmad
- Department of Molecular Biology and Genetics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ali Mohaghegh
- Department of Laboratory Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Ebtesam Zaherinejad
- School of Pharmacy, Department of Health Sciences, Curtin University of Technology, Bentley Campus, Australia
| | - Maryam Aghaei
- Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akram Jalali
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Hossein Hejazi
- Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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20
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Iborra S, Solana JC, Requena JM, Soto M. Vaccine candidates against leishmania under current research. Expert Rev Vaccines 2018; 17:323-334. [PMID: 29589966 DOI: 10.1080/14760584.2018.1459191] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The search for vaccines to prevent human leishmaniasis is an active field of investigation aimed to prevent the devastating effects of this family of diseases on human health. The design and commercialization of several vaccines against canine leishmaniasis is a hopeful advance toward the achievement of a human vaccine. AREAS COVERED This review includes a summary of the most relevant immunological aspects accompanying leishmaniasis in natural hosts as well as a description of the latest advances in the multiple strategies that are being followed to develop leishmanial prophylactic vaccines. We have combined citations of the latest specialized reviews with research articles presenting the most recent results. EXPERT COMMENTARY Achieving safe, effective, durable and low-cost prophylactic vaccines against leishmaniasis is still a major challenge. These vaccines should control not only parasite progression, but also the accompanying pathology, which results from an imbalanced interaction between the infectious agent and the human host immune system. Different strategies for development of vaccines are currently under investigation. They range from the use of live non-pathogenic vectors to the employment of subunit vaccines combined with adjuvants and/or delivery systems inducing cell-mediated immunity.
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Affiliation(s)
- Salvador Iborra
- a Department of Vascular Biology and Inflammation Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Immunobiology of Inflammation Laboratory , Madrid , Spain.,b School of Medicine , Universidad Complutense de Madrid , Madrid , Spain
| | - José Carlos Solana
- c Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular, Nicolás Cabrera 1 , Universidad Autónoma de Madrid , Madrid , Spain
| | - José María Requena
- c Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular, Nicolás Cabrera 1 , Universidad Autónoma de Madrid , Madrid , Spain
| | - Manuel Soto
- c Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Departamento de Biología Molecular, Nicolás Cabrera 1 , Universidad Autónoma de Madrid , Madrid , Spain
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21
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The successful use of radiofrequency-induced heat therapy for cutaneous leishmaniasis: a review. Parasitology 2018. [DOI: 10.1017/s0031182018000124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARYThe present gold standard of the treatment of cutaneous leishmaniasis (CL) is pentavalent antimonials either sodium stibogluconate (Pentostam) or meglumine antimoniate (Glucantime), These drugs are quite toxic. They are given by injection and usually administered intramuscularly or intravenously for three weeks or intralesionally for seven or more weeks. That is why the successful introduction of radiofrequency-induced heat therapy using a Thermomed™ 1.8 instrument administered in a single application, with minimal toxic effects, is so important for the treatment of CL.
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22
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Saheki MN, Lyra MR, Bedoya-Pacheco SJ, Antônio LDF, Pimentel MIF, Salgueiro MDM, Vasconcellos ÉDCFE, Passos SRL, dos Santos GPL, Ribeiro MN, Fagundes A, Madeira MDF, Mouta-Confort E, Marzochi MCDA, Valete-Rosalino CM, Schubach ADO. Low versus high dose of antimony for American cutaneous leishmaniasis: A randomized controlled blind non-inferiority trial in Rio de Janeiro, Brazil. PLoS One 2017; 12:e0178592. [PMID: 28558061 PMCID: PMC5448803 DOI: 10.1371/journal.pone.0178592] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/12/2017] [Indexed: 11/18/2022] Open
Abstract
Background Although high dose of antimony is the mainstay for treatment of American cutaneous leishmaniasis (ACL), ongoing major concerns remain over its toxicity. Whether or not low dose antimony regimens provide non-inferior effectiveness and lower toxicity has long been a question of dispute. Methods A single-blind, non-inferiority, randomized controlled trial was conducted comparing high dose with low dose of antimony in subjects with ACL treated at a referral center in Rio de Janeiro, an endemic area of Leishmania (Viannia) braziliensis transmission. The primary outcome was clinical cure at 360 days of follow-up in the modified-intention-to-treat (mITT) and per-protocol (PP) populations. Non-inferiority margin was 15%. Secondary objectives included occurrence of epithelialization, adverse events and drug discontinuations. This study was registered in ClinicalTrials.gov: NCT01301924. Results Overall, 72 patients were randomly assigned to one of the two treatment arms during October 2008 to July 2014. In mITT, clinical cure was observed in 77.8% of subjects in the low dose antimony group and 94.4% in the high dose antimony group after one series of treatment (risk difference 16.7%; 90% CI, 3.7–29.7). The results were confirmed in PP analysis, with 77.8% of subjects with clinical cure in the low dose antimony group and 97.1% in the high dose antimony group (risk difference 19.4%; 90% CI, 7.1–31.7). The upper limit of the confidence interval exceeded the 15% threshold and was also above zero supporting the hypothesis that low dose is inferior to high dose of antimony after one series of treatment. Nevertheless, more major adverse events, a greater number of adverse events and major adverse events per subject, and more drug discontinuations were observed in the high dose antimony group (all p<0.05). Interestingly, of all the subjects who were originally allocated to the low dose antimony group and were followed up after clinical failure, 85.7% achieved cure after a further treatment with local therapy or low dose of antimony. Conclusions Compared with high dose, low dose of antimony was inferior at the pre-specified margin after one series of treatment of ACL, but was associated with a significantly lower toxicity. While high dose of antimony should remain the standard treatment for ACL, low dose antimony treatment might be preferred when toxicity is a primary concern.
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Affiliation(s)
- Mauricio Naoto Saheki
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
- * E-mail:
| | - Marcelo Rosandiski Lyra
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Sandro Javier Bedoya-Pacheco
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
- Department of Epidemiology and Quantitative Methods in Health, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Liliane de Fátima Antônio
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Maria Inês Fernandes Pimentel
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Mariza de Matos Salgueiro
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Érica de Camargo Ferreira e Vasconcellos
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Sonia Regina Lambert Passos
- Clinical Epidemiology Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Ginelza Peres Lima dos Santos
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Madelon Novato Ribeiro
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Aline Fagundes
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Maria de Fátima Madeira
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Eliame Mouta-Confort
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Mauro Célio de Almeida Marzochi
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
| | - Cláudia Maria Valete-Rosalino
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
- Department of Otorhinolaryngology and Ophthalmology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Armando de Oliveira Schubach
- Laboratory for Leishmaniasis Surveillance, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro State, Brazil
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Possible Interrelationship of Inflammatory Cells in Dry Type Cutaneous Leishmaniasis. IRANIAN JOURNAL OF PATHOLOGY 2017; 12. [PMID: 29515633 PMCID: PMC5831067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND & OBJECTIVE There is a complicated interaction between leishmaniasis and the host immune cells, and also between the host immune cells. These interactions have fundamental effects on the outcome of the disease.The current study aimed at characterizing the number, distribution, co-localization, and interrelation of 4 types of inflammatory cells in different clinical forms of dry-type cutaneous leishmaniasis (CL). METHODS Thirty-nine cases of CL were studied. The cases were classified clinically as 14 cases of acute leishmaniasis with indurated papules, nodules, and plaques with central crust formation < 2 years, 7 cases of chronic type with non-healing lesions > 2 years, and 12 cases of lupoid leishmaniasis with characteristic papules around previous scars of CL > 2 years. Paraffin-embedded blocks were stained with hematoxylin and eosin (H&E) and also stained immunohistochemically for CD4, CD8, CD68, and CD1a. RESULTS In acute CL, there was a significant correlation between CD68+ macrophages and CD1a+ epidermal dendritic cells (DCs); the population of CD68+ macrophages and CD1a+ epidermal DCs increased in parallel.In lupoid CL, there was a significant correlation between CD1a+ epidermal DCs, and CD1a+ dermal DCs and population of CD1a+ epidermal DCs; the number of CD1a+ dermal DCs increased in parallel. CONCLUSIONS The result of the current study could be used as a baseline to design and study the new targeted therapy of synergistic effects of macrophages and DCs to phagocytizing leishmania bodies; and/or suggestion planning of individualizing setup of vaccine by autologous interaction of macrophages and DC in CL.
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De Luca PM, Macedo ABB. Cutaneous Leishmaniasis Vaccination: A Matter of Quality. Front Immunol 2016; 7:151. [PMID: 27148270 PMCID: PMC4838622 DOI: 10.3389/fimmu.2016.00151] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 04/07/2016] [Indexed: 11/25/2022] Open
Abstract
There have been exhaustive efforts to develop an efficient vaccine against leishmaniasis. Factors like host and parasite genetic characteristics, virulence, epidemiological scenarios, and, mainly, diverse immune responses triggered by Leishmania species make the achievement of this aim a complex task. It is already clear that the induction of a Th1, pro-inflammatory response, is important in the protection against Leishmania infection. However, many questions must still be answered to fully understand Leishmania immunopathology, especially regarding Leishmania-specific Th1 response induction, regulation, and persistence. A large number of Leishmania antigens able to induce pro-inflammatory response have been selected so far, but none of them demonstrated efficiency in protection assays. A possible explanation is that CD4 T cells display marked heterogeneity at a single-cell level especially regarding the production of Th1-defining cytokines and multifunctionality. It has been established in the literature that Th1 cells undergo a differentiation process, which can generate cells with diverse phenotypes and survival capabilities. Despite that, only a few studies evaluate this heterogenic response and the amount of multifunctional CD4 T cells induced by Leishmania vaccine candidates, missing what can be a crucial point in defining a correlate of protection after vaccination. Moreover, most of the knowledge involving the development of cutaneous leishmaniasis (CL) vaccines comes from the mouse model of infection with Leishmania major, which cannot be fully applied to New World Leishmaniasis. For this reason, the immune response triggered by infection with New World Leishmania species, as well as vaccine candidates, need further studies. In this review, we will reinforce the importance of evaluating the quality of immune response against Leishmania, using a multiparametric analysis in order to understand better this complex host-parasite interaction, discussing the differences in the responses triggered by different New World Leishmania species, as well as the impact on the development of an effective vaccine against CL.
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Affiliation(s)
- Paula Mello De Luca
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz, FIOCRUZ , Rio de Janeiro , Brazil
| | - Amanda Beatriz Barreto Macedo
- Department of Pathology, Division of Microbiology and Immunology, University of Utah School of Medicine , Salt Lake City, UT , USA
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Differential Recruitment of Dendritic Cells Subsets to Lymph Nodes Correlates with a Protective or Permissive T-Cell Response during Leishmania (Viannia) Braziliensis or Leishmania (Leishmania) Amazonensis Infection. Mediators Inflamm 2016; 2016:7068287. [PMID: 27073297 PMCID: PMC4814687 DOI: 10.1155/2016/7068287] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 01/22/2016] [Accepted: 02/16/2016] [Indexed: 01/25/2023] Open
Abstract
Leishmania (L.) amazonensis (La) and L. (V.) braziliensis (Lb) are responsible for a large clinical and immunopathological spectrum in human disease; while La may be responsible for anergic disease, Lb infection leads to cellular hypersensitivity. To better understand the dichotomy in the immune response caused by these Leishmania species, we evaluated subsets of dendritic cells (DCs) and T lymphocyte in draining lymph nodes during the course of La and Lb infection in BALB/c mice. Our results demonstrated a high involvement of DCs in La infection, which was characterized by the greater accumulation of Langerhans cells (LCs); conversely, Lb infection led to an increase in dermal DCs (dDCs) throughout the infection. Considering the T lymphocyte response, an increase of effector, activated, and memory CD4+ T-cells was observed in Lb infection. Interleukin- (IL-) 4- and IL-10-producing CD4+and CD8+ T-cells were present in both La and Lb infection; however, interferon- (IFN-) γ-producing CD4+and CD8+ T-cells were detected only in Lb infection. The results suggest that during Lb infection, the dDCs were the predominant subset of DCs that in turn was associated with the development of Th1 immune response; in contrast La infection was associated with a preferential accumulation of LCs and total blockage of the development of Th1 immune response.
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