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Sadeghi N, Mohebali M, Kakooei Z, Roustazadeh A, Mir H, Abdoli A, Solhjoo K, Shabani M, Shadmand E, Taghipour A. Seroprevalence of visceral leishmaniasis among pregnant women in Jahrom city in Fars province, southern Iran. Parasite Epidemiol Control 2024; 25:e00349. [PMID: 38645673 PMCID: PMC11031800 DOI: 10.1016/j.parepi.2024.e00349] [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: 12/07/2023] [Revised: 02/22/2024] [Accepted: 04/15/2024] [Indexed: 04/23/2024] Open
Abstract
Background Visceral leishmaniasis (VL) is a public health issue in endemic countries with poor sanitation facilities. In this study, the seroprevalence rate and associated risk factors of VL were investigated during September 2020 to February 2021 in pregnant women referred to Ostad Mottahari and Peymanieh hospitals in Jahrom county, Fars province, southern Iran. Material and methods A total of 220 serum samples of pregnant women were assessed for the presence of Anti-Leishmania infantum antibodies by direct agglutination antigen (DAT). The associated risk factors were obtained using questionnaires. Results The overall seroprevalence of VL in pregnant women was 12.72% (28/220). Considering the antibody titer, titer 1:1600 was detected in 23 samples, titer 1:3200 in 4 samples, and titer 1:6400 in one sample. All 5 women with titer >3200 had mild fever. As such, there was a statistically significant difference regarding the age (≥39 years old with p-value: 0.01). Conclusions We recommend an appropriate health education program for pregnant women and serological screening of VL before pregnancy in endemic cities. Moreover, we believed a need for more epidemiological studies for better understand the status of VL in pregnant women.
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Affiliation(s)
- Najmeh Sadeghi
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Mehdi Mohebali
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Kakooei
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abazar Roustazadeh
- Department of Biochemistry and Nutrition, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Advanced Medical Sciences and Technologies, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hamed Mir
- Department of Biochemistry and Nutrition, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Kavous Solhjoo
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Manoochehr Shabani
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Enayatollah Shadmand
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
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Singh-Phulgenda S, Kumar R, Dahal P, Munir A, Rashan S, Chhajed R, Naylor C, Maguire BJ, Siddiqui NA, Harriss E, Rahi M, Alves F, Sundar S, Stepniewska K, Musa A, Guerin PJ, Pandey K. Post-kala-azar dermal leishmaniasis (PKDL) drug efficacy study landscape: A systematic scoping review of clinical trials and observational studies to assess the feasibility of establishing an individual participant-level data (IPD) platform. PLoS Negl Trop Dis 2024; 18:e0011635. [PMID: 38626228 PMCID: PMC11051605 DOI: 10.1371/journal.pntd.0011635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 04/26/2024] [Accepted: 03/27/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Post-kala-azar dermal leishmaniasis (PKDL) is a dermatosis which can occur after successful treatment of visceral leishmaniasis (VL) and is a public health problem in VL endemic areas. We conducted a systematic scoping review to assess the characteristics of published PKDL clinical studies, understand the scope of research and explore the feasibility and value of developing a PKDL individual patient data (IPD) platform. METHODS A systematic review of published literature was conducted to identify PKDL clinical studies by searching the following databases: PubMed, Scopus, Ovid Embase, Web of Science Core Collection, WHO Global Index Medicus, PASCAL, Clinicaltrials.gov, Ovid Global Health, Cochrane Database and CENTRAL, and the WHO International Clinical Trials Registry Platform. Only prospective studies in humans with PKDL diagnosis, treatment, and follow-up measurements between January 1973 and March 2023 were included. Extracted data includes variables on patient characteristics, treatment regimens, diagnostic methods, geographical locations, efficacy endpoints, adverse events and statistical methodology. RESULTS A total of 3,418 records were screened, of which 56 unique studies (n = 2,486 patients) were included in this review. Out of the 56 studies, 36 (64.3%) were from India (1983-2022), 12 (21.4%) from Sudan (1992-2021), 6 (10.7%) were from Bangladesh (1991-2019), and 2 (3.6%) from Nepal (2001-2007). Five (8.9%) studies were published between 1981-1990 (n = 193 patients), 10 (17.9%) between 1991-2000 (n = 230 patients), 10 (17.9%) between 2001-2010 (n = 198 patients), and 31 (55.4%) from 2011 onwards (n = 1,865 patients). Eight (14.3%) were randomised clinical trials, and 48 (85.7%) were non-randomised studies. The median post-treatment follow-up duration was 365 days (range: 90-540 days) in 8 RCTs and 360 days (range: 28-2,373 days) in 48 non-randomised studies. Disease diagnosis was based on clinical criterion in 3 (5.4%) studies, a mixture of clinical and parasitological methods in 47 (83.9%) and was unclear in 6 (10.7%) studies. Major drugs used for treatment were miltefosine (n = 636 patients), liposomal amphotericin B (L-AmB) (n = 508 patients), and antinomy regimens (n = 454 patients). Ten other drug regimens were tested in 270 patients with less than 60 patients per regimen. CONCLUSIONS Our review identified studies with very limited sample size for the three major drugs (miltefosine, L-AmB, and pentavalent antimony), while the number of patients combined across studies suggest that the IPD platform would be valuable. With the support of relevant stakeholders, the global PKDL community and sufficient financing, a PKDL IPD platform can be realised. This will allow for exploration of different aspects of treatment safety and efficacy, which can potentially guide future healthcare decisions and clinical practices.
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Affiliation(s)
- Sauman Singh-Phulgenda
- Infectious Diseases Data Observatory (IDDO), Oxford, United Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Rishikesh Kumar
- ICMR—Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna, Bihar, India
| | - Prabin Dahal
- Infectious Diseases Data Observatory (IDDO), Oxford, United Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Abdalla Munir
- Department of Clinical Pathology and Immunology, Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | - Sumayyah Rashan
- Infectious Diseases Data Observatory (IDDO), Oxford, United Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Rutuja Chhajed
- Infectious Diseases Data Observatory (IDDO), Oxford, United Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Caitlin Naylor
- Infectious Diseases Data Observatory (IDDO), Oxford, United Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Brittany J. Maguire
- Infectious Diseases Data Observatory (IDDO), Oxford, United Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Niyamat Ali Siddiqui
- ICMR—Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna, Bihar, India
| | - Eli Harriss
- The Knowledge Centre, Bodleian Health Care Libraries, University of Oxford, Oxford, United Kingdom
| | - Manju Rahi
- Indian Council of Medical Research (ICMR), New Delhi, India
| | - Fabiana Alves
- Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland
| | - Shyam Sundar
- Infectious Disease Research Laboratory, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Kasia Stepniewska
- Infectious Diseases Data Observatory (IDDO), Oxford, United Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Ahmed Musa
- Department of Clinical Pathology and Immunology, Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | - Philippe J. Guerin
- Infectious Diseases Data Observatory (IDDO), Oxford, United Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Krishna Pandey
- ICMR—Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna, Bihar, India
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Riebenbauer K, Czerny S, Egg M, Urban N, Kinaciyan T, Hampel A, Fidelsberger L, Karlhofer F, Porkert S, Walochnik J, Handisurya A. The changing epidemiology of human leishmaniasis in the non-endemic country of Austria between 2000 to 2021, including a congenital case. PLoS Negl Trop Dis 2024; 18:e0011875. [PMID: 38198499 PMCID: PMC10805284 DOI: 10.1371/journal.pntd.0011875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/23/2024] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Leishmaniasis is caused by infection with intracellular protozoans of the genus Leishmania. Transmission occurs predominantly by the bite of phlebotomine sandflies, other routes, including congenital transmission, are rare. The disease manifests as either cutaneous, visceral or mucosal/mucocutaneous leishmaniasis. In recent years, changes in the epidemiological pattern have been reported from Europe. PRINCIPAL FINDINGS A total of 311 new and 29 published leishmaniasis cases occurring between 01/01/2000 and 12/31/2021 in Austria were collected and analyzed. These encompassed 146 cutaneous (CL), 14 visceral (VL), 4 mucosal, and 3 cases with concurrent VL and CL. In addition, asymptomatic infections, comprising 11 unspecified cases with Leishmania DNA detectable only in the blood and 162 cases with anti-Leishmania antibodies were reported. Particularly since 2016, the incidence of leishmaniasis has steadily risen, mainly attributable to increasing numbers of CL and cases with positive serology against Leishmania species, whereas the incidence of VL has slowly decreased. Analysis revealed that a shift in the causative species spectrum had occurred and that a substantial number of CL cases were caused by members of the Leishmania donovani/infantum complex. Simultaneous occurrence of VL and CL was identified in immunocompromised individuals, but also in a not yet reported case of an immunocompetent child after vertical transmission. CONCLUSIONS The incidence of leishmaniasis has risen in the recent years. The numbers are anticipated to keep rising due to increasing human mobility, including travel and forced migration, growing reservoir host populations as well as expansion and dispersal of vector species caused by climate and habitat changes, urbanization and globalization. Hence, elevated awareness for the disease, including possible transmission in previously non-endemic regions and non-vector transmission modes, support of sandfly surveillance efforts and implementation and establishment of public health interventions in a One Health approach are pivotal in the global efforts to control and reduce leishmaniasis.
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Affiliation(s)
| | - Stefan Czerny
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Maximilian Egg
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Nikolaus Urban
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Tamar Kinaciyan
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Amélie Hampel
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Luise Fidelsberger
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Franz Karlhofer
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Stefanie Porkert
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Julia Walochnik
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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4
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Affiliation(s)
- Nitin Bansal
- Infectious Diseases, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi-110085, India
| | - Ankur Jain
- Clinical Haematology, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi-110029, India
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5
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O'Grady N, McManus D, Briggs N, Azar MM, Topal J, Davis MW. Dosing implications for liposomal amphotericin B in pregnancy. Pharmacotherapy 2023; 43:452-462. [PMID: 36862037 DOI: 10.1002/phar.2784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 03/03/2023]
Abstract
Liposomal amphotericin B (LAmB) is used in the treatment of opportunistic fungal and parasitic infections, including leishmaniasis. Given its lack of known teratogenicity in pregnancy, LAmB is a preferred agent for treatment for these patients. However, significant gaps remain in determining optimal dosing regimens for LAmB in pregnancy. We describe the use of LAmB for a pregnant patient with mucocutaneous leishmaniasis (MCL) using a dosing strategy of 5 mg/kg/day for days 1-7 using ideal body weight followed by 4 mg/kg weekly using adjusted body weight. We reviewed the literature for LAmB dosing strategies, particularly dosing weight, in pregnancy. Of the 143 cases identified in 17 studies, only one reported a dosing weight, in which ideal body weight was used. Five Infectious Diseases Society of America guidelines in total discussed the use of amphotericin B in pregnancy but no guidelines included recommendations for dosing weight. This review describes our experience in using ideal body weight for dosing LAmB in pregnancy for the treatment of MCL. Use of ideal body weight may minimize risk of adverse effects to the fetus compared to the use of total body weight while maintaining efficacy for treatment of MCL in pregnancy.
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Affiliation(s)
- Niamh O'Grady
- Department of Pharmacy, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Dayna McManus
- Department of Pharmacy, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Neima Briggs
- Department of Internal Medicine, Infectious Disease Section, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Marwan M Azar
- Department of Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jeffrey Topal
- Department of Internal Medicine, Infectious Disease Section, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Matthew W Davis
- Department of Pharmacy, Yale-New Haven Hospital, New Haven, Connecticut, USA
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6
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Sedaghatmanesh K, Khazan H, Akhoundi B, Khazaei S, Kakooei Z, Mohebali M. Seroprevalence of Visceral Leishmaniasis in Children Up To 12 Years Old of Rural Areas from Kermanshah Province, Western Part of Iran. IRANIAN JOURNAL OF PARASITOLOGY 2023; 18:85-92. [PMID: 37197081 PMCID: PMC10183451 DOI: 10.18502/ijpa.v18i1.12384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/19/2022] [Indexed: 05/19/2023]
Abstract
Background After the earthquake in 2017 a few new cases of visceral leishmaniasis (VL) were reported from SarPol-e-Zahab district of Kermanshah Province, western part of Iran. This study was conducted to determine the seroprevalence in Kermanshah Province. Methods This descriptive cross-sectional study was conducted on children up to 12 years of age from SarPol-e-Zahab County, Kermanshah Province, western part of Iran in 2021. For each individual, a questionnaire including age, sex, clinical features, history of the disease, and contact with canines as reservoir hosts of VL were completed, separately. To determine VL seroprevalence, blood samples were collected from the children and after centrifugation, the sera samples were separated and tested using Direct Agglutination Test (DAT) for detection of anti-L. infantum antibodies. Statistical analyses were performed using SPSS16. Results Totally, 13 persons were seropositive; 7 samples with titer 1:800, 3 samples had 1:1600, 2 samples had 1:3200 and 1 sample had 1:6400. None of the seropositive cases had a history of kala-azar. There was no significant difference between males and females at titers of anti-Leishmania specific antibodies. Conclusion L. infantum infection is being circulated with low prevalence in children up to 12 years old from SarPol-e-Zahab County but it is necessary that the surveillance system is regularly monitored among physicians and public health managers in the studied areas.
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Affiliation(s)
- Kaveh Sedaghatmanesh
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hooshang Khazan
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behnaz Akhoundi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sasan Khazaei
- Department of Parasitology and Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Zahra Kakooei
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Zoonosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
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7
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Briggs N, Wei BM, Ahuja C, Baker C, Foppiano Palacios C, Lee E, O’Grady N, Singanamala S, Singh K, Bandaranayake TD, Cohen JM, Damsky W, Davis MW, Mejia R, Nelson CA, Topal JE, Azar MM. Mucocutaneous Leishmaniasis in a Pregnant Immigrant. Open Forum Infect Dis 2022; 9:ofac360. [PMID: 35928503 PMCID: PMC9345408 DOI: 10.1093/ofid/ofac360] [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: 07/01/2022] [Accepted: 07/20/2022] [Indexed: 01/05/2023] Open
Abstract
Cutaneous leishmaniasis is a parasitic infection that causes significant maternal morbidity, and even fetal mortality, during pregnancy, yet there are limited therapeutic options. Here, we report a case of leishmaniasis in a pregnant immigrant with exuberant mucocutaneous lesions with favorable response to liposomal amphotericin B.
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Affiliation(s)
- Neima Briggs
- Correspondence: Neima Briggs, MD, PhD, Yale School of Medicine, PO Box 208022, New Haven, CT 06520-8022, USA ()
| | - Brian M Wei
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Chaarushi Ahuja
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Catherine Baker
- Department of Pharmacy Services, Yale New Haven Hospital, New Haven, Connecticut, USA
| | - Carlo Foppiano Palacios
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Emily Lee
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Niamh O’Grady
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Santhi Singanamala
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Katelyn Singh
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Thilinie D Bandaranayake
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jeffrey M Cohen
- Department of Pharmacy Services, Yale New Haven Hospital, New Haven, Connecticut, USA
| | - William Damsky
- Department of Pharmacy Services, Yale New Haven Hospital, New Haven, Connecticut, USA
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Matthew W Davis
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Rojelio Mejia
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Caroline A Nelson
- Department of Pharmacy Services, Yale New Haven Hospital, New Haven, Connecticut, USA
| | - Jeffrey E Topal
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Marwan M Azar
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
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8
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Khosravi A, Sharifi I, Tavakkoli H, Molaakbari E, Bahraminegad S, Salarkia E, Seyedi F, Keyhani A, Salari Z, Sharifi F, Bamorovat M, Afgar A, Dabiri S. Cytotoxicity of Amphotericin B and AmBisome: In Silico and In Vivo Evaluation Employing the Chick Embryo Model. Front Pharmacol 2022; 13:860598. [PMID: 35754489 PMCID: PMC9214246 DOI: 10.3389/fphar.2022.860598] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/26/2022] [Indexed: 11/18/2022] Open
Abstract
Leishmaniasis has been identified as a significant disease in tropical and subtropical regions of the world, with Iran being one of the disease-endemic areas. Various treatments have been applied for this disease, and amphotericin B (Amp B) is the second line of treatment. Side effects of this drug have been reported in various organs. The present study investigated the effects of different types of Amp B on fetal organs using in silico and in vivo assays (chicken embryos). In vivo analysis was done by checking pathological changes, angiogenesis, and apoptosis alterations on eggs treated by Amp B and AmBisome. In silico approach was employed to predict the affinity of Amp B and AmBisome to the vascular endothelial growth factor A (VEGF-A), its receptor (KDR1), apoptotic-regulator proteins (Bcl-2-associated X protein (Bax), B-cell lymphoma (Bcl-2), and Caspase-8. The ADME-toxicity prediction reveals that AmBisome possesses a superior pharmacological effect to Amp B. The best result of all the dockings in the Molegro Virtual Docker (MVD) was obtained between Bax, Bcl-2, Caspase-8, KDR1, and VEGF-A targets. Due to the lower Egap (HOMO–LUMO) of AmBisome, the chemical reactivity of AmBisome was higher than that of Amp B. In vivo analysis showed that embryos that received Amp B exhibited less vascular density than AmBisome. Amp B alone significantly increased the expression of apoptosis and decreased angiogenesis genes compared to AmBisome. The histopathology analysis of the treated embryos showed a reduction in the blood vessel collapse and an increase in degenerative and apoptotic–necrotic changes in the embryonic tissues. Overall, the results suggest the potential benefits of AmBisome over Amp B, which might be a better treatment strategy to treat leishmaniasis during pregnancy.
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Affiliation(s)
- Ahmad Khosravi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Hadi Tavakkoli
- Department of Clinical Science, School of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Elaheh Molaakbari
- Department of Chemistry, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Sina Bahraminegad
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ehsan Salarkia
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Seyedi
- Department of Anatomy, School of Medicine, Jiroft University of Medical, Sciences, Jiroft, Iran
| | - Alireza Keyhani
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Zohreh Salari
- Obstetrics and Gynecology Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Sharifi
- Research Center of Tropical and Infectious Diseases Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Bamorovat
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Afgar
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahriar Dabiri
- Afzalipour School of Medicine and Pathology and Stem Cells Research Center, Kerman University of Medical Sciences, Kerman, Iran
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9
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Singh-Phulgenda S, Rashan S, Harriss E, Dahal P, Naylor C, Brack M, Guerin PJ, Maguire BJ. Infectious diseases data observatory (IDDO) visceral leishmaniasis library of clinical therapeutic studies: A protocol for a living systematic review of clinical studies. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.17739.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Introduction: Visceral leishmaniasis (VL) is a vector-borne disease caused by protozoan parasites of the genus Leishmania. The disease is endemic in parts of South Asia, East Africa, South America and the Mediterranean region, with an estimated 50,000 to 90,000 cases occurring annually. A living systematic review of existing scientific literature is proposed to identify clinical drug efficacy studies against VL, conducted following the Preferred Reporting Items for Systematic-Reviews and Meta-Analyses (PRISMA) guidelines. Methods and analysis: The proposed living systematic review builds on a previous systematic review first carried out in 2016, and the current protocol is designed to capture any published or registered VL clinical study from Nov-2021 onwards. The following databases will be searched by a medical librarian: PubMed, Ovid Embase, Scopus, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, clinicaltrials.gov, WHO ICTRP, as well as IMEMR, IMSEAR, and LILACS from the WHO Global Index Medicus. The systematic review will consider both randomised and non-randomised interventional studies, including single-armed studies. Ethics and dissemination: A database of eligible studies, including study characteristics, is openly available (https://www.iddo.org/tool/vl-surveyor) and will be continually updated every six months. All findings will be published in a peer-reviewed journal. PROSPERO registration: CRD42021284622 (29/11/2021)
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