China
Africa
Explore chapters and articles related to this topic
Leishmaniasis
Published in F. Y. Liew, Vaccination Strategies of Tropical Diseases, 2017
Treatment of leishmaniasis is based on antimony compounds, notably the pentavalent antimonials sodium stibogluconate and N-methylglucamine antimonate, but they have to be injected daily for several weeks and are not effective against cutaneous forms. Second-line drugs include the antimicrobials amphotericin B, pentamidine, metronidazole, and nifurtimox. In general, progress in this field has not been impressive.
Amphotericin B Lipid Complex (ABLC)
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Enhanced distribution of ABLC to macrophages may be of therapeutic benefit to patients with visceral leishmaniasis (VL). In randomized, open-label, dose-ranging studies, short-course treatment with once-daily ABLC (5–15 mg/kg total cumulative dose over 5 days), administered by intravenous infusion, produced high rates of apparent (day 14–19) [93–100%] and definitive (6 months) [79–100%] cures in Indian patients with antimonial-resistant VL (Sundar et al., 1997; Sundar et al., 1998; Sundar et al., 1999; Goldsmith and Perry 2004). ABLC appeared to be as effective as liposomal AmB or the conventional deoxycholate formulation in a randomized, open-label study conducted in India in a mixed population of patients with previously untreated or antimonial-resistant VL (Sundar et al., 2004). In patients with HIV infection and VL, ABLC 3 mg/kg/day for 5 or 10 days appeared to be as effective as meglumine antimonate 20 mg/kg/day for 28 days in a small, randomized pilot study in southern Europe (Laguna et al., 2003). ABLC was generally well tolerated in patients with VL, with infusion-related reactions being the most common adverse events (Goldsmith and Perry, 2004). Finally, in a randomized controlled trial investigating ABLC 3 mg/kg/day every 21 days versus no treatment, the compound showed preventative efficacy as secondary prophylaxis for VL relapse in HIV-infected patients, and was well tolerated (López-Vélez et al., 2004).
Leishmania spp.
Published in Peter M. Lydyard, Michael F. Cole, John Holton, William L. Irving, Nino Porakishvili, Pradhib Venkatesan, Katherine N. Ward, Case Studies in Infectious Disease, 2010
Peter M. Lydyard, Michael F. Cole, John Holton, William L. Irving, Nino Porakishvili, Pradhib Venkatesan, Katherine N. Ward
Simple cutaneous leishmaniasis may be left to self-heal in geographical areas with L. major. Some cutaneous lesions, mucocutaneous disease, and visceral leishmaniasis require treatment. Until recently the mainstay of treatment has been pentavalent antimony compounds. These include sodium stibogluconate and meglumine antimonate. They are administered by intramuscular injection on a daily basis for up to 28 days. The intramuscular injections can be painful and there can be systemic toxicity. Amphotericin B and more recently liposomal amphotericin B represent advances in treatment. However, they require intravenous administration, are also toxic, and are much more expensive, especially liposomal amphotericin B. An oral, tolerable agent is now available for visceral leishmaniasis. Oral miltefosine for 28 days was shown to be equally effective with amphotericin B for visceral leishmaniasis in India. Alternative treatments are very welcome, as about 60% of visceral leishmaniasis infections in Bihar, India are resistant to treatment with pentavalent antimonials.
Pyrrolidine-based 3-deoxysphingosylphosphorylcholine analogs as possible candidates against neglected tropical diseases (NTDs): identification of hit compounds towards development of potential treatment of Leishmania donovani
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2021
Ahmed H. E. Hassan, Trong-Nhat Phan, Seolmin Yoon, Cheol Jung Lee, Hye Rim Jeon, Seung-Hwan Kim, Joo Hwan No, Yong Sup Lee
Out of 53 known Leishmania species, 31 are mammals’ parasites including 20 human’s pathogenic species5. In lieu of the diversity of Leishmania parasites, it might be understandable that there is no available vaccine for protection, yet. Consequently, the development of an effective treatment remains the practically viable option for combating Leishmania infections. The current toolbox of antileishmanial therapeutic agents involves multiple classes of compounds (Figure 1) including antimony-containing compounds; such as meglumine antimonate and sodium stibogluconate, alkyl phospholipids; such as miltefosine, and amidine derivatives such as pentamidine. However, all of these treatments, especially against VL, suffer from tolerability and toxicity drawbacks such as cardiotoxicity, pancreatitis, hepatotoxicity, and nephrotoxicity of antimony-containing compounds; teratogenicity, nephrotoxicity and gastrointestinal effects of miltefosine; and diabetes mellitus; cardiotoxicity; nephrotoxicity or even death because of pentamidine. Furthermore, the emergence of drug resistance to the currently available treatments is a serious challenge threatening current efforts to cure the disease and curb infections. Accordingly, there is a real need for the development of new, less toxic, better tolerated, economic and effective treatments.
The effect of pentavalent antimonial compounds used in the treatment of cutaneous leishmaniasis on hemogram and biochemical parameters
Published in Cutaneous and Ocular Toxicology, 2019
Isa An, Mehmet Harman, Mustafa Esen, Hakim Çelik
Pentavalent antimonials is the most commonly used approach in the treatment of CL, since it produces the most effective results in most of the cases with low rate of recurrence and cosmetically good results in general. Pentavalent antimonials have been the cornerstone of anti-leishmanial treatment since the 1940s. The mechanisms of action of the pentavalent antimonials are not fully known, but they are thought to inhibit ATP synthesis of the parasite. There are two pentavalent antimonials which are therapeutically equivalent. These are meglumine antimonate (MA) and sodium stibogluconate (SSG)2,3,5. These compounds may cause side effects such as muscle and joint pain, fatigue, loss of appetite, nausea, abdominal pain, headache, skin rash and nonspecific ST changes in electrocardiography. Increase in pancreatic enzymes, elevation of transaminases, bone marrow suppression and acute renal failure have also been reported in the literature2,6–9.
Evaluating the effect of oral clarithromycin on acute cutaneous leishmaniasis lesions compared with systemic glucantime
Published in Journal of Dermatological Treatment, 2022
Naghmeh Zabolinejad, Pouran Layegh, Zahra Abbasi Shaye, Maryam Salehi, Somayeh Ghanizadeh
In the thermotherapy method, temperatures of 40–42 °C are used since the parasite is sensitive to temperatures above 37 °C. Nevertheless, this technique does not seem to be a practical approach. Cryotherapy method that uses liquid nitrogen or solid carbon dioxide is an effective method but does not permanently eliminate pigmentation in the tissue cells. In 1946, glucantime or meglumine-antimonate was used to treat leishmaniasis. Today, the two pentavalent antimonial compounds known as sodium stibogluconate and glucantime are the most commonly used drugs in the treatment of this disease. Clinical response to antimonial compounds is due to a decrease in the level of ATP, which is induced by interference with glycolysis and β-oxidation of fatty acids (10–13).