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Fróes LAR, Toma TS, Jachiet M, Rousset L, Poderoso RE, Trindade MAB. Bacterial, fungal and parasitic co-infections in leprosy: A scoping review. PLoS Negl Trop Dis 2023; 17:e0011334. [PMID: 37216331 DOI: 10.1371/journal.pntd.0011334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/24/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND In leprosy patients, the most commonly reported non-viral co-infections are Tuberculosis, Leishmaniasis, Chromoblastomycosis and Helminths. The presence of a secondary infection is believed to increase the likelihood of leprosy reactions. The purpose of this review was to describe the clinical and epidemiological characteristics of the most reported bacterial, fungal, and parasitic co-infections in leprosy. METHODOLOGY/PRINCIPAL FINDINGS Following the PRISMA Extension for Scoping Reviews guidelines, a systematic literature search was conducted by two independent reviewers, resulting in the inclusion of 89 studies. For tuberculosis, a total of 211 cases were identified, with a median age of 36 years and male predominance (82%). Leprosy was the initial infection in 89% of cases, 82% of individuals had multibacillary disease, and 17% developed leprosy reactions. For leishmaniasis, 464 cases were identified, with a median age of 44 years and male predominance (83%). Leprosy was the initial infection in 44% of cases, 76% of individuals presented with multibacillary disease, and 18% developed leprosy reactions. Regarding chromoblastomycosis, we identified 19 cases with a median age of 54 years and male predominance (88%). Leprosy was the primary infection in 66% of cases, 70% of individuals had multibacillary disease, and 35% developed leprosy reactions. Additionally, we found 151 cases of co-infection with leprosy and helminths, with a median age of 43 years and male predominance (68%). Leprosy was the primary infection in 66% of cases, and 76% of individuals presented with multibacillary disease, while the occurrence of leprosy reactions varied from 37% to 81% across studies. CONCLUSION We observed a male-dominated pattern of co-infections among working-age individuals with multibacillary leprosy. Unlike prior studies reporting increased leprosy reactions in chronic viral co-infections, our findings did not indicate any increase among bacterial, fungal, or parasitic co-infections. Rather, co-infections with tuberculosis and leishmaniasis appeared to reduce leprosy reactions.
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Affiliation(s)
| | - Tereza Setsuko Toma
- Núcleo de Evidências, Instituto de Saúde, Secretaria de Estado da Saúde, São Paulo, SP, Brasil
| | - Marie Jachiet
- Service de Dermatologie, Hôpital saint Louis APHP Paris, Université Paris Cité
| | - Laurie Rousset
- Service de Dermatologie, Hôpital saint Louis APHP Paris, Université Paris Cité
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Saini I, Joshi J, Kaur S. Unwelcome prevalence of leishmaniasis with several other infectious diseases. Int Immunopharmacol 2022; 110:109059. [DOI: 10.1016/j.intimp.2022.109059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/12/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022]
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Carvalho AGD, Luz JGG, Steinmann P, Ignotti E. Are the clinical features of leprosy and American tegumentary leishmaniasis worse in patients with both diseases? Rev Inst Med Trop Sao Paulo 2022; 64:e37. [PMID: 35674635 PMCID: PMC9173689 DOI: 10.1590/s1678-9946202264037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 04/26/2022] [Indexed: 08/23/2023] Open
Affiliation(s)
| | | | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Switzerland; University of Basel, Switzerland
| | - Eliane Ignotti
- Universidade Federal de Mato Grosso, Brazil; Universidade do Estado de Mato Grosso, Brazil
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Kariyawasam R, Valencia BM, Lau R, Shao E, Thompson CA, Stevens M, Kincaid L, Del Castillo ALQ, Cruz-Arzapalo LO, Llanos-Cuentas A, Boggild AK. Evaluation of a point-of-care molecular detection device for Leishmania spp. and intercurrent fungal and mycobacterial organisms in Peruvian patients with cutaneous ulcers. Infection 2021; 49:1203-1211. [PMID: 34368941 DOI: 10.1007/s15010-021-01673-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Overlapping clinical features of cutaneous leishmaniasis (CL) with ulcers caused by fungi and mycobacteria necessitate confirmatory diagnostic testing. We evaluated a handheld battery-operated device for detection of CL and common fungal and mycobacterial causes of ulcers. METHODS We validated Palm PCR™ for detection of common ulcerative skin pathogens using ATCC® reference and clinical strains of Leishmania, mycobacteria, and fungi in the lab and field. Amplified products were Sanger sequenced. Performance characteristics were calculated using conventional PCR as a reference standard. RESULTS Palm PCR™ detected 100% of ATCC® strains of Leishmania, fungi, and mycobacteria, with sensitivity and specificity of 90% and 91.7%, respectively. In the field, the sensitivity for detection of Leishmania in patients with suspected CL was 100%. In 61% of CL patients, co-colonization with genera such as Malassezia, Aspergillus, Candida, and Cladosporium was detected. In 50% of CL patients with an inflammatory (secondarily infected) phenotype, detected fungal species had known associations with human cutaneous disease. CONCLUSIONS Palm PCR™ performs comparably to conventional PCR for detection of Leishmania, fungi, and mycobacteria. This work has implications for the diagnostic approach to tropical ulcers, and has the potential to improve field detection of ulcerative pathogens in resource constrained areas.
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Affiliation(s)
| | - Braulio M Valencia
- Instituto de Medicina Tropical "Alexander Von Humboldt", Lima, Peru
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Rachel Lau
- Public Health Ontario Laboratory, Toronto, ON, Canada
| | - Eric Shao
- Department of Microbiology and Immunology, Western University, London, ON, Canada
| | - Courtney A Thompson
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Tropical Disease Unit, Toronto General Hospital, 200 Elizabeth Street, 13EN-218, Toronto, ON, M5G 2C4, Canada
- Markham-Stouffville Hospital, Markham, ON, Canada
| | - Michael Stevens
- Division of Clinical Dermatology and Cutaneous Science, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Leah Kincaid
- Alliance Dermatology Associates, Lawrenceville, NJ, USA
| | | | | | - Alejandro Llanos-Cuentas
- Instituto de Medicina Tropical "Alexander Von Humboldt", Lima, Peru
- Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Andrea K Boggild
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
- Department of Medicine, University of Toronto, Toronto, ON, Canada.
- Tropical Disease Unit, Toronto General Hospital, 200 Elizabeth Street, 13EN-218, Toronto, ON, M5G 2C4, Canada.
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Serological evidence of Toxoplasma gondii infection as potential risk for the development of lepromatous leprosy in an endemic area for both neglected tropical diseases in Brazil. Infect Dis Poverty 2020; 9:19. [PMID: 32051036 PMCID: PMC7017566 DOI: 10.1186/s40249-020-0636-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/03/2020] [Indexed: 11/23/2022] Open
Abstract
Background Mycobacterium leprae and Toxoplasma gondii infections are both neglected tropical diseases highly prevalent in Brazil. Infection with certain parasite species can significantly alter susceptibility to other important pathogens, and/or influence the development of pathology. Here we investigated the possible influence of M. leprae/T. gondii co-parasitism on the manifestation of leprosy and its clinical forms. Methods Participants (n = 291) were recruited in Campos dos Goytacazes city, Rio de Janeiro state, southeast Brazil, from August 2015 to December 2019 and clinically diagnosed for leprosy. Participants were selected based on the presence (patients) or absence (healthy controls) of the leprosy disease. Contacts of patients were also recruited for this study. Serum samples from patients (n = 199) with leprosy, contacts (n = 40) and healthy controls (n = 52) were investigated for levels of IgM and IgG anti-phenolic glycolipid-1 (PGL-1) by ELISA. Additionally, IgG antibody against soluble Toxoplasma antigen (STAg) was measured in sera samples from leprosy patients, contacts and healthy controls for Toxoplasma gondii serology by ELISA. Anti-PGL-1 IgG and IgM levels were compared using one-way ANOVA Kruskal-Wallis or Mann-Whitney, while Spearman test was used to correlate levels of IgG anti-STAg and IgM/IgG anti-PGL-1 from seropositive and seronegative individuals for T. gondii infection. The risk of T. gondii infection for leprosy disease was assessed using Fisher’s test. Results Levels of IgM anti-PGL-1 antibodies were significantly higher in multibacillary (MB) patients compared to paucibacillary (PB) patients (P = 0.0068). Higher IgM and IgG levels anti-PGL-1 were detected in patients with the lepromatous forms. The serologic prevalence for T. gondii infection was 74.9%. We detected increased anti-STAg antibody levels in leprosy patients (79.4%), reaching 88.8% within those with lepromatous form of this disease. The leprosy risk increase in T. gondii seropositive individuals was two-fold (odds ratio [OR] = 2.055; 95% confidence intervals [95% CI]: 1.18–3.51) higher than those seronegative, and considering the lepromatous leprosy risk this increase was even dramatic (OR = 4.33; 95% CI: 1.76–9.69) in T. gondii seropositive individuals. Moreover the leprosy risk in T. gondii seropositive individuals was weakly correlated to the levels of IgG anti-STAg and IgM/IgG anti-PGL-1. Conclusions Altogether, our results suggest that T. gondii infection may exert immunomodulatory properties that influence to the susceptibility of leprosy, mainly on its more severe clinical form. A better understanding of parasite immunomodulation can ultimately contribute to the development of medical applications.
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Vernal S, Bueno-Filho R, Gomes CM, Roselino AM. Clinico-immunological spectrum of American tegumentary leishmaniasis and leprosy coinfection: A case series in Southeastern Brazil. Rev Soc Bras Med Trop 2019; 52:e20180172. [PMID: 30994795 DOI: 10.1590/0037-8682-0172-2018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 12/05/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION American tegumentary leishmaniasis (ATL) and leprosy share common areas of prevalence, but reports of coinfection are scarce. METHODS We report a series of 9 ATL-leprosy cases and discuss the association. An integrative diagram to analyze the clinico-immunological features of coinfection with both diseases. RESULTS Nine patients with leishmaniasis (5 cutaneous, 3 mucocutaneous, 1 disseminated case) exhibited concurrent infection with distinct clinical forms of leprosy. Our diagram-based analysis evidenced a divergent clinico-immunological spectrum for each disease in 8 out of 9 cases. CONCLUSIONS The spectrum of ATL-leprosy comorbidity suggests that the host has a specific immune response against each pathogen.
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Affiliation(s)
- Sebastian Vernal
- Divisão de Dermatologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Roberto Bueno-Filho
- Divisão de Dermatologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Ciro Martins Gomes
- Departamento de Dermatologia, Universidade de Brasília, Brasília, DF, Brasil
| | - Ana Maria Roselino
- Divisão de Dermatologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Martínez DY, Verdonck K, Kaye PM, Adaui V, Polman K, Llanos-Cuentas A, Dujardin JC, Boelaert M. Tegumentary leishmaniasis and coinfections other than HIV. PLoS Negl Trop Dis 2018; 12:e0006125. [PMID: 29494584 PMCID: PMC5832191 DOI: 10.1371/journal.pntd.0006125] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Tegumentary leishmaniasis (TL) is a disease of skin and/or mucosal tissues caused by Leishmania parasites. TL patients may concurrently carry other pathogens, which may influence the clinical outcome of TL. METHODOLOGY AND PRINCIPAL FINDINGS This review focuses on the frequency of TL coinfections in human populations, interactions between Leishmania and other pathogens in animal models and human subjects, and implications of TL coinfections for clinical practice. For the purpose of this review, TL is defined as all forms of cutaneous (localised, disseminated, or diffuse) and mucocutaneous leishmaniasis. Human immunodeficiency virus (HIV) coinfection, superinfection with skin bacteria, and skin manifestations of visceral leishmaniasis are not included. We searched MEDLINE and other databases and included 73 records: 21 experimental studies in animals and 52 studies about human subjects (mainly cross-sectional and case studies). Several reports describe the frequency of Trypanosoma cruzi coinfection in TL patients in Argentina (about 41%) and the frequency of helminthiasis in TL patients in Brazil (15% to 88%). Different hypotheses have been explored about mechanisms of interaction between different microorganisms, but no clear answers emerge. Such interactions may involve innate immunity coupled with regulatory networks that affect quality and quantity of acquired immune responses. Diagnostic problems may occur when concurrent infections cause similar lesions (e.g., TL and leprosy), when different pathogens are present in the same lesions (e.g., Leishmania and Sporothrix schenckii), or when similarities between phylogenetically close pathogens affect accuracy of diagnostic tests (e.g., serology for leishmaniasis and Chagas disease). Some coinfections (e.g., helminthiasis) appear to reduce the effectiveness of antileishmanial treatment, and drug combinations may cause cumulative adverse effects. CONCLUSIONS AND SIGNIFICANCE In patients with TL, coinfection is frequent, it can lead to diagnostic errors and delays, and it can influence the effectiveness and safety of treatment. More research is needed to unravel how coinfections interfere with the pathogenesis of TL.
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Affiliation(s)
- Dalila Y. Martínez
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Kristien Verdonck
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Paul M. Kaye
- Centre for Immunology and Infection, Department of Biology and Hull York Medical School, University of York, York, United Kingdom
| | - Vanessa Adaui
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Katja Polman
- Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Alejandro Llanos-Cuentas
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jean-Claude Dujardin
- Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
- Department of Biomedical Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | - Marleen Boelaert
- Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
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Soto LA, Caballero N, Fuentes LR, Muñoz PT, Gómez Echevarría JR, López MP, Bornay Llinares FJ, Stanford JL, Stanford CA, Donoghue HD. Leprosy Associated with Atypical Cutaneous Leishmaniasis in Nicaragua and Honduras. Am J Trop Med Hyg 2017; 97:1103-1110. [PMID: 29031287 PMCID: PMC5637581 DOI: 10.4269/ajtmh.16-0622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 07/17/2017] [Indexed: 11/07/2022] Open
Abstract
In Central America, few cases of leprosy have been reported, but the disease may be unrecognized. Diagnosis is based on clinical criteria and histology. Preliminary field work in Nicaragua and Honduras found patients, including many children, with skin lesions clinically suggestive of atypical cutaneous leishmaniasis or indeterminate leprosy. Histology could not distinguish these diseases although acid-fast organisms were visible in a few biopsies. Lesions healed after standard antimicrobial therapy for leprosy. In the present study, patients, family members, and other community members were skin-tested and provided nasal swabs and blood samples. Biopsies were taken from a subgroup of patients with clinical signs of infection. Two laboratories analyzed samples, using local in-house techniques. Mycobacterium leprae, Leishmania spp. and Leishmania infantum were detected using polymerase chain reactions. Mycobacterium leprae DNA was detected in blood samples and nasal swabs, including some cases where leprosy was not clinically suspected. Leishmania spp. were also detected in blood and nasal swabs. Most biopsies contained Leishmania DNA and coinfection of Leishmania spp. with M. leprae occurred in 33% of cases. Mycobacterium leprae DNA was also detected and sequenced from Nicaraguan and Honduran environmental samples. In conclusion, leprosy and leishmaniasis are present in both regions, and leprosy appears to be widespread. The nature of any relationship between these two pathogens and the epidemiology of these infections need to be elucidated.
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Affiliation(s)
- Lucrecia Acosta Soto
- Sanatorio Fontilles, Alicante, Spain
- Universidad Miguel Hernández de Elche, Alicante, Spain
| | | | | | | | | | | | | | - John L. Stanford
- University College London, London, United Kingdom
- Catriona Hargreaves Charitable Trust, Mill House, Claygate, Kent, United Kingdom
| | - Cynthia A. Stanford
- Catriona Hargreaves Charitable Trust, Mill House, Claygate, Kent, United Kingdom
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Differential mucosal IL-10-induced immunoregulation of innate immune responses occurs in influenza infected infants/toddlers and adults. Immunol Cell Biol 2016; 95:252-260. [PMID: 27629065 DOI: 10.1038/icb.2016.91] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 08/23/2016] [Accepted: 09/07/2016] [Indexed: 01/17/2023]
Abstract
Young children (<5 years of age but especially those <2-year old) exhibit high rates of morbidity and frequently require hospitalizations due to complications from respiratory viral infections. This is also a population for which we understand less about how their unique level of immunological maturation affects their antiviral immune responses. However, we do know from prior studies that their T cells appear to apoptose in the lungs owing to limited interferon (IFN)γ autocrine signaling during infection. To begin to further understand additional limits, we utilized an infant/toddler murine model infected with influenza virus with an adult comparator. In our model, young mice exhibited lower interleukin (IL)-10+IFNγ+ co-producing CD4 T cells infiltrating the lungs that paralleled with a failed switch from an innate to adaptive immune response at the mid infection stage. Specifically, limited co-IL-10 production correlated with a lack of influenza-specific antibodies and subsequent complement receptor signaling (complement receptor type-1 related gene Y (CCRY)/p65) to the lung infiltrating CD4 T cells therefore limiting their IKAROs upregulation. Thus, limited IL-10 production appeared to diminish signaling to lung macrophages to stop accumulating late into infection. Taken together, our results suggest a novel role for complement mediated signaling in CD4 T cells with respect to IL-10 co-production. Furthermore, a subsequent failure to shift from the unfocused innate immune response to the specific adaptive responses may be a principle cause in the enhanced morbidity common in respiratory viral infection of young children.
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AKHZARI S, REZVAN H, ZOLHAVARIEH M. Expression of Pro-inflammatory Genes in Lesions and Neutrophils during Leishmania major Infection in BALB/c Mice. IRANIAN JOURNAL OF PARASITOLOGY 2016; 11:534-541. [PMID: 28127365 PMCID: PMC5251182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Leishmaniasis is a worldwide disease prevalent in tropical and sub-tropical countries in the world. Characterization of inflammatory responses produced in cutaneous leishmaniasis has not yet been completed. METHODS The specific primers were designed for ten pro-inflammatory genes including CCL4, CCL3, TNF-α, IL-1α, IL-12P35, IL-12P40, CCL5, CCR5, IL-1β and IFN- γ and their expression were assessed and compared using RT-PCR in the lesion and peripheral blood neutrophils in Leishmania infected BALB/c mice. RESULTS None of the pro-inflammatory genes was expressed in the healthy tissue and except IFN-γ others were down-regulated by the parasite in the lesion in untreated mice. In mice treated with anti-Leishmanial drugs, the expression of the pro-inflammatory genes restarted. The figure of pro-inflammatory gene expression in neutrophils was different was from the lesions in treated and untreated mice. CONCLUSION Leishmania is capable to suppress the expression of pro-inflammatory genes in the lesions but not in neutrophils. The expression of TNF-α in the lesions and down-regulation of IL-1β in neutrophils could be accounted as an indication for healing of cutaneous leishmaniasis. The results open a new window on characterization of Leishmania lesions and clarifying the role of neutrophils in Leishmania infections.
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Affiliation(s)
- Soheyla AKHZARI
- Dept. of Laboratory Sciences, School of Veterinary Sciences, Bu-Ali Sina University, Hamadan, Iran
| | - Hossein REZVAN
- Dept. of Laboratory Sciences, School of Veterinary Sciences, Bu-Ali Sina University, Hamadan, Iran,Correspondence
| | - Masoud ZOLHAVARIEH
- Dept. of Laboratory Sciences, School of Veterinary Sciences, Bu-Ali Sina University, Hamadan, Iran, Dept. of Clinical Sciences, Faculty of Para-Veterinary Sciences, Bu-Ali Sina University, Hamedan, Iran
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Daulatabad D, Singal A, Dhawan A, Pandhi D, Sharma S. Mucocutaneous leishmaniasis caused byLeishmania donovaniinfection in an Indian man. Int J Dermatol 2014; 54:680-4. [DOI: 10.1111/ijd.12748] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 04/07/2014] [Accepted: 04/19/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Deepashree Daulatabad
- Department of Dermatology and Sexually Transmitted Diseases; University College of Medical Sciences and Guru Teg Bahadur Hospital; University of Delhi; Delhi India
| | - Archana Singal
- Department of Dermatology and Sexually Transmitted Diseases; University College of Medical Sciences and Guru Teg Bahadur Hospital; University of Delhi; Delhi India
| | - Amit Dhawan
- Department of Dermatology and Sexually Transmitted Diseases; University College of Medical Sciences and Guru Teg Bahadur Hospital; University of Delhi; Delhi India
| | - Deepika Pandhi
- Department of Dermatology and Sexually Transmitted Diseases; University College of Medical Sciences and Guru Teg Bahadur Hospital; University of Delhi; Delhi India
| | - Sonal Sharma
- Department of Pathology; University College of Medical Sciences and Guru Teg Bahadur Hospital; University of Delhi; Delhi India
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Current World Literature. Curr Opin Rheumatol 2013; 25:275-83. [DOI: 10.1097/bor.0b013e32835eb755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hartley MA, Kohl K, Ronet C, Fasel N. The therapeutic potential of immune cross-talk in leishmaniasis. Clin Microbiol Infect 2013; 19:119-30. [DOI: 10.1111/1469-0691.12095] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 10/31/2012] [Accepted: 11/01/2012] [Indexed: 11/30/2022]
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