Antihelminthic Therapy and Antimony in Cutaneous Leishmaniasis: A Randomized, Double-Blind, Placebo-Controlled Trial in Patients Co-Infected with Helminths and Leishmania braziliensis

Newlove, Tracey; Guimarães, Luiz Henrique; Morgan, Daniel J.; Alcântara, Leda; Glesby, Marshall J.; Carvalho, Edgar M.; Machado, Paulo Roberto Lima

doi:10.4269/ajtmh.2011.10-0423

Cited by 35 publications

(33 citation statements)

References 19 publications

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“…Al-though there was no statistically significant difference, patients who received early anthelmintic treatment took longer to heal their lesions than patients in the untreated group. This study shows that the early introduction of anthelmintic therapy does not improve clinical out-comes in patients coinfected with helminths and L. braziliensis (Newlove et al, 2011). A recent study showed that patients coinfected with intestinal helminths and Leishmania braziliensis had a higher frequency of tegumentary lesions and took longer to heal compared to patients without helminth infection (Azeredo-Coutinho et al, 2016).…”

Section: Introductionmentioning

confidence: 77%

Susceptibility of dendritic cells from individuals with schistosomiasis to infection by Leishmania braziliensis

Lopes

Almeida

Souza

et al. 2018

Molecular Immunology

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Coinfection with leishmaniasis and schistosomiasis has been associated with increased time to healing of cutaneous lesions of leishmaniasis. The objective of this study was to evaluate the effect of Leishmania braziliensis infection on co-cultures of monocyte-derived dendritic cells (MoDCs) with autologous lymphocytes from patients with schistosomiasis and patients with cutaneous leishmaniasis. MoDCs were differentiated from peripheral blood monocytes, isolated by magnetic beads, infected with L. braziliensis, and co-cultured with autologous lymphocytes. Expression of HLA-DR, CD1a, CD83, CD80, CD86, CD40, and the IL-10 receptor (IL-10R) on MoDCs as well as CD28, CD40L, CD25, and CTLA-4 on lymphocytes were evaluated by flow cytometry. The production of the cytokines IL-10, TNF, IL-12p40, and IFN-γ were evaluated by sandwich ELISA of the culture supernatant. The infectivity evaluation was performed by light microscopy after concentration of cells by cytospin and Giemsa staining. It was observed that the frequency of MoDCs expressing CD83, CD80, and CD86 as well as the MFI of HLA-DR were smaller in the group of patients with schistosomiasis compared to the group of patients with leishmaniasis. On the other hand, the frequency of IL-10R on MoDCs was higher in patients with schistosomiasis than in patients with leishmaniasis. CD4+ and CD8+ T lymphocytes from patients with schis-tosomiasis presented a lower frequency of CD28 and a higher frequency of CTLA-4 compared to lymphocytes from patients with leishmaniasis. Levels of IL-10 were higher in the supernatants of co-cultures from individuals with schistosomiasis compared to those with leishmaniasis. However, levels of TNF, IL-12p40, and IFN-γ were lower in the group of individuals with schistosomiasis. Regarding the frequency of MoDCs infected by L. braziliensis after 72 h in culture, it was observed that higher frequencies of cells from patients with schistosomiasis were infected compared to cells from patients with leishmaniasis. It was concluded that MoDCs from patients with schistosomiasis are more likely to be infected by L. braziliensis, possibly due to a lower degree of activation and a regulatory profile.

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Section: Introductionmentioning

confidence: 77%

Susceptibility of dendritic cells from individuals with schistosomiasis to infection by Leishmania braziliensis

Lopes

Almeida

Souza

et al. 2018

Molecular Immunology

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“…infection. However, another study demonstrated that early introduction of anti-helminthic therapy did not improve clinical outcomes in patients co-infected with helminths and L. braziliensis (Newlove et al 2011).…”

Section: Discussionmentioning

confidence: 99%

Schistosoma mansoni antigens alter the cytokine response in vitro during cutaneous leishmaniasis

Bafica

Cardoso

Oliveira

et al. 2011

Mem. Inst. Oswaldo Cruz

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“…17 Sb-unresponsive CL is being seen clinically in the sense that recent cure rates of New World L. (Viannia) CL treated with systemic Sb are surprisingly low for a standard therapy, approximately 50-75%. [18][19][20][21][22] An undecided issue is whether there is a correlation between in vitro and clinical data, whether parasite resistance is the cause of clinical unresponsiveness. For Leishmania tropica from Iran, the mean effective dose (ED50) for parasites from 165 lesions that responded to systemic or ILSb was 4.6 μg/mL, whereas the mean ED50 for parasites from 16 lesions that did not respond was 19 μg/mL.…”

Section: 15mentioning

confidence: 99%

Intralesional Pentamidine: A Novel Therapy for Single Lesions of Bolivian Cutaneous Leishmaniasis

Soto¹,

Paz²,

Rivero³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. A novel therapy, intralesional (IL) pentamidine, was compared to intralesional therapy with antimony (ILSb), a World Health Organization-recommended therapy, for single Bolivian Leishmania braziliensis lesions. In Study 1, 90 patients were randomized equally between three injections of ILSb over 5 days, five injections of ILSb over 11 days, and three injections of IL pentamidine (120 μg/mm 2 lesion area [ILPenta-120-3]) over 5 days. Cure rates at 6 months were 57% for ILSb-3 injections, 73% for ILSb-5 injections, and 72% for ILPenta-120-3 injections. Adverse effects were local irritation and injection-site pain-ILSb (60 patients): mild (25), moderate (4); IL pentamidine (30 patients): mild (4), moderate (3). In Study 2, 60 patients were randomized equally between five injections of ILSb and three injections of a double dose of IL pentamidine (240 μg/mm 2 ). In Study 2, cure rates were 67% for ILSb-5 injections and 73% for ILPenta-240-3. For three IL injections of pentamidine, efficacy was optimized at a dose of 120 μg/mm 2 lesion area. The cure rate of that regimen was similar to that for ILSb-5 injections and nonstatistically larger than that of ILSb-3 injections. IL pentamidine is an attractive alternative to ILSb on the basis of efficacy for Bolivian L. braziliensis, the threat of Sb-resistant parasites, tolerance, and patient convenience of three visits over 5 days.

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Antihelminthic Therapy and Antimony in Cutaneous Leishmaniasis: A Randomized, Double-Blind, Placebo-Controlled Trial in Patients Co-Infected with Helminths and Leishmania braziliensis

Cited by 35 publications

References 19 publications

Susceptibility of dendritic cells from individuals with schistosomiasis to infection by Leishmania braziliensis

Susceptibility of dendritic cells from individuals with schistosomiasis to infection by Leishmania braziliensis

Schistosoma mansoni antigens alter the cytokine response in vitro during cutaneous leishmaniasis

Intralesional Pentamidine: A Novel Therapy for Single Lesions of Bolivian Cutaneous Leishmaniasis

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