Visceral leishmaniasis and leishmaniasis-HIV coinfection: comparative study

Coutinho, João Victor Soares Coriolano; Santos, Fabiana Silva dos; Ribeiro, Rosângela do Socorro Pereira; Oliveira, Iara Brito Bucar; Dantas, Victória Bezerra; Santos, Ana Barbara Feliciano Souza; Tauhata, Jéssyca Rodrigues

doi:10.1590/0037-8682-0193-2017

Cited by 34 publications

(18 citation statements)

References 8 publications

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“…Despite being a neglected tropical disease associated with poverty, VL has gathered significant attention recently due to its association with acquired immunodeficiency syndrome (AIDS). In its non-endemic foci, VL is a common co-infection with AIDS where up to 70% of adult leishmaniasis cases have been reported to be related with human immunodeficiency virus (HIV) [4].…”

Section: Introductionmentioning

confidence: 99%

Cinnamomum cassia exhibits antileishmanial activity against Leishmania donovani infection in vitro and in vivo

et al. 2019

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Background There is a pressing need for drug discovery against visceral leishmaniasis, a life-threatening protozoal infection, as the available chemotherapy is antiquated and not bereft of side effects. Plants as alternate drug resources has rewarded mankind in the past and aimed in this direction, we investigated the antileishmanial potential of Cinnamomum cassia . Methodology Dichloromethane, ethanolic and aqueous fractions of C . cassia bark, prepared by sequential extraction, were appraised for their anti-promastigote activity along with apoptosis-inducing potential. The most potent, C . cassia dichloromethane fraction (CBD) was evaluated for anti-amastigote efficacy in infected macrophages and nitric oxide (NO) production studied. The in vivo antileishmanial efficacy was assessed in L . donovani infected BALB/c mice and hamsters and various correlates of host protective immunity ascertained. Toxicity profile of CBD was investigated in vitro against peritoneal macrophages and in vivo via alterations in liver and kidney functions. The plant secondary metabolites present in CBD were identified by gas chromatography-mass spectroscopy (GC-MS). Principal findings CBD displayed significant anti-promastigote activity with 50% inhibitory concentration (IC 50 ) of 33.6 μg ml -1 that was mediated via apoptosis. This was evidenced by mitochondrial membrane depolarization, increased proportion of cells in sub-G 0 -G 1 phase, ROS production, PS externalization and DNA fragmentation (TUNEL assay). CBD also inhibited intracellular amastigote proliferation (IC 50 14.06 μg ml -1 ) independent of NO production. The in vivo protection achieved was 80.91% (liver) and 82.92% (spleen) in mice and 75.61% (liver) and 78.93% (spleen) in hamsters indicating its profound therapeutic efficacy. CBD exhibited direct antileishmanial activity, as it did not specifically induce a T helper type (Th)-1-polarized mileu in cured hosts. This was evidenced by insignificant modulation of NO production, lymphoproliferation, DTH (delayed type hypersensitivity), serum IgG2a and IgG1 levels and production of Th2 cytokines (IL-4 and IL-10) along with restoration of pro-inflammatory Th1 cytokines (INF-γ, IL-12p70) to the normal range. CBD was devoid of any toxicity in vitro as well as in vivo . The chemical constituents, cinnamaldehyde and its derivatives present in CBD may have imparted the observed antileishmanial effect. Conclusions Our study hi...

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Section: Introductionmentioning

confidence: 99%

Cinnamomum cassia exhibits antileishmanial activity against Leishmania donovani infection in vitro and in vivo

et al. 2019

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“…Indeed, in Rondonópolis , a high occurrence of patients with VL/HIV coinfection (9.9%) was found, a higher percentage than the one recently reported in Brazil, where the overall percentage of coinfection was approximately 8.5% in 2013 28 . This is probably related to the increasing AIDS detection rate that has recently been observed in the municipality 29 , and in other medium and small cities located in North and Central-Western Brazil 30 , 31 . Thus, this pattern of occurrence of the HIV infection along with the urbanization of VL provided the geographical juxtaposition of both diseases 4 , 30 .…”

Section: Discussionmentioning

confidence: 91%

Visceral leishmaniasis in a Brazilian endemic area: an overview of occurrence, HIV coinfection and lethality

Luz

Naves

Carvalho

et al. 2018

Rev. Inst. Med. trop. S. Paulo

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The Brazilian municipality of Rondonópolis, Mato Grosso State, represents an important visceral leishmaniasis (VL) endemic area. This study described epidemiological and clinical aspects of the occurrence, VL/HIV coinfection and lethality related to VL in Rondonópolis. Data from autochthonous cases reported between 2011 and 2016 were obtained from official information systems. During this period, 81 autochthonous cases were reported, with decreasing incidence through 2016. Contrastingly, the lethality rate was 8.6% overall, but varied widely, reaching a peak (20%) in 2016. Almost 10% of patients had VL/HIVcoinfection. The occurrence of VL prevailed among men (56.8%), brown-skinned (49.4%), urban residents (92.6%), aged 0-4 years (33.3%). Housewives or retired (29.6%) were the most affected occupational groups. Lower age was the main difference among the total VL cases and those who were coinfected or died. Clinically, fever, weakness and splenomegaly were more frequent among all VL cases and VL/HIV coinfected individuals. Bacterial infections (p=0.001) and bleeding (p<0.001) were associated with death due to VL. Pentavalent antimonial and liposomal amphotericin B were the first choices for treatment among all VL cases (71.6%) and those who died (71.4%), respectively. VL/HIV patients were equally treated with both drugs. These findings may support control measures and demonstrate the need for further investigations.

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“…In addition, hepatosplenomegaly and fever occur less frequently, while gastrointestinal symptoms are more frequent in the coinfected. 12 , 18 Hemorrhagic phenomena occurs in almost a third of the patients, as lymph-node enlargement is also observed in the coinfected. 19 When coinfected patients present to clinical settings with amastigotes in unusual sites (gastrointestinal and oral mucosa, skin, pleura, pericardium, lymph nodes, Kaposi’s sarcoma lesions, and the respiratory tract), atypical manifestations are frequently observed.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Visceral leishmaniasis and HIV coinfection: current perspectives

Lindoso¹,

Moreira²,

Cunha³

et al. 2018

HIV

112

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Visceral leishmaniasis (VL) is caused by Leishmania donovani and Leishmania infantum. The burden of VL is concentrated in tropical and subtropical areas; however, HIV infection has spread VL over a hyperendemic area. Several outcomes are observed as a result of VL–HIV coinfection. Impacts are observed in immunopathogenesis, clinical manifestation, diagnosis, and therapeutic response. Concerning clinical manifestation, typical and unusual manifestation has been observed during active VL in HIV-infected patient, as well as alteration in immunoresponse, inducing greater immunosuppression by low CD4 T-lymphocyte count or even by induction of immunoactivation, with cell senescence. Serological diagnosis of VL in the HIV-infected is poor, due to low humoral response, characterized by antibody production, so parasitological methods are more recommended. Another important and even more challenging point is the definition of the best therapeutic regimen for VL in HIV-coinfected patients, because in this population there is greater failure and consequently higher mortality. The challenge of better understanding immunopathogenesis in order to obtain more effective therapies is one of the crucial points to be developed. The combination of drugs and the use of secondary prophylaxis associated with highly active antiretroviral therapy may be the best tool for treatment of HIV coinfection. Some derivatives from natural sources have action against Leishmania; however, studies have been limited to in vitro evaluation, without clinical trials.

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Visceral leishmaniasis and leishmaniasis-HIV coinfection: comparative study

Cited by 34 publications

References 8 publications

Cinnamomum cassia exhibits antileishmanial activity against Leishmania donovani infection in vitro and in vivo

Cinnamomum cassia exhibits antileishmanial activity against Leishmania donovani infection in vitro and in vivo

Visceral leishmaniasis in a Brazilian endemic area: an overview of occurrence, HIV coinfection and lethality

Visceral leishmaniasis and HIV coinfection: current perspectives

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