Visceral leishmaniasis: what are the needs for diagnosis, treatment and control?

Abstract

Visceral leishmaniasis (VL) is a systemic protozoan disease that is transmitted by phlebotomine sandflies. Poor and neglected populations in East Africa and the Indian sub-continent are particularly affected. Early and accurate diagnosis and treatment remain key components of VL control. In addition to improved diagnostic tests, accurate and simple tests are needed to identify treatment failures. Miltefosine, paromomycin and liposomal amphotericin B are gradually replacing pentavalent antimonials and conventional amphotericin B as the preferred treatments in some regions, but in other areas these drugs are still being evaluated in both mono- and combination therapies. New diagnostic tools and new treatment strategies will only have an impact if they are made widely available to patients.

Inhibition of receptor tyrosine kinases restores immunocompetence and improves immune-dependent chemotherapy against experimental leishmaniasis in mice

“…Visceral leishmaniasis (VL), caused by the protozoan parasites Leishmania donovani and L. infantum, is one of the most important of the neglected tropical diseases, with approximately 500,000 new cases and 70,000 deaths reported per annum (7,8). Pentavalent antimonial drugs remain a first-line therapy for VL in most parts of the world, although increasing drug resistance now limits their use in India.…”

Cyanobacteria, Lyngbya aestuarii and Aphanothece bullosa as antifungal and antileishmanial drug resources

“…Fungi, as a major disease causing agent, were realized after 1980, especially among the immunocompromised and other serious diseases [31] . Among other diseases of concern to scientists, leishmaniasis is caused by species of related genus of Leishmania [32][33][34] . There are limitations with regards to antifungal and antileishmanial drugs because of their price and side effects [35] .…”

Toxicity of betulin derivatives and in vitro effect on promastigotes and amastigotes of Leishmania infantum and L. donovani

“…All the compounds assayed were able to reduce the multiplication of intracellular amastigotes of Leishmania as compared with the uninfected control cultures (Table 4). In the subgroup of simple betulin derivatives (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), only four compounds (1, 2, 6 and 12) were tested against intracellular L. infantum and L. donovani amastigotes. Betulin 1 showed best activity (49.3 and 42.8%, respectively), whereas rest of the compounds showed similar or decreased activity.…”

“…The need to explore new treatments is therefore recognized as a leading priority for research on leishmaniasis. [10][11][12][13] Betulin (lup-20(29)-ene-3b,28-diol) is a pentacyclic triterpene widely distributed in nature. The outer bark of the birch (Betula sp) is particularly rich in this substance, which, depending on the species, may represent more than 25% of the bark by weight.…”