Clinical-therapeutic follow-up of patients with American cutaneous leishmaniasis caused by different Leishmania spp. in Brazil.

Autor: Morais RCS; Aggeu Magalhães Institute, FIOCRUZ-PE, Rego Avenue, University City, Recife-Pernambuco, 50670-420, Brazil. Electronic address: rayanacarla_m@hotmail.com., Melo MGN; Aggeu Magalhães Institute, FIOCRUZ-PE, Rego Avenue, University City, Recife-Pernambuco, 50670-420, Brazil. Electronic address: mariagabriella_melo@hotmail.com., Goes TC; Aggeu Magalhães Institute, FIOCRUZ-PE, Rego Avenue, University City, Recife-Pernambuco, 50670-420, Brazil. Electronic address: taynacgoes@hotmail.com., Pessoa E Silva R; Aggeu Magalhães Institute, FIOCRUZ-PE, Rego Avenue, University City, Recife-Pernambuco, 50670-420, Brazil. Electronic address: romulops12@gmail.com., de Morais RF; Medicine Tropical Foundation - Dr. Heitor Vieira Dourado, Pedro Teixeira Avenue, Dom Pedro, Manaus, Amazonas, 69040-000, Brazil. Electronic address: romulo.morais.rf@gmail.com., Guerra JAO; Medicine Tropical Foundation - Dr. Heitor Vieira Dourado, Pedro Teixeira Avenue, Dom Pedro, Manaus, Amazonas, 69040-000, Brazil. Electronic address: jguerra291@gmail.com., de Brito MEF; Aggeu Magalhães Institute, FIOCRUZ-PE, Rego Avenue, University City, Recife-Pernambuco, 50670-420, Brazil. Electronic address: britomef@cpqam.fiocruz.br., Brandão-Filho SP; Aggeu Magalhães Institute, FIOCRUZ-PE, Rego Avenue, University City, Recife-Pernambuco, 50670-420, Brazil. Electronic address: sinval@cpqam.fiocruz.br., de Paiva Cavalcanti M; Aggeu Magalhães Institute, FIOCRUZ-PE, Rego Avenue, University City, Recife-Pernambuco, 50670-420, Brazil. Electronic address: milena.cavalcanti@fiocruz.br.
Jazyk: angličtina
Zdroj: Experimental parasitology [Exp Parasitol] 2022 Sep; Vol. 240, pp. 108338. Date of Electronic Publication: 2022 Jul 30.
DOI: 10.1016/j.exppara.2022.108338
Abstrakt: American cutaneous leishmaniasis (ACL) may present different clinical manifestations, immune and therapeutic responses, depending on the Leishmania species, as well as inoculum size and factors inherent to the affected individual. Thus, the aim of this study was to carry out clinical-therapeutic follow-up of Brazilian patients with ACL caused by different Leishmania species. Between 2015 and 2018, patients with ACL from Amazonas and Pernambuco states (Brazil) were submitted to blood collection before and after treatment. The qPCR technique was used to quantify the parasite load. To identify the Leishmania species, one of the following techniques was employed: a conventional PCR performed from biopsy or blood DNA, followed by sequencing; or Multilocus Enzyme Electrophoresis from Leishmania isolated from biopsy/aspirated lesion. A total of 10.8% (23/213) of the patients included in positive cases were followed-up. All 23 patients were clinically and epidemiologically compatible with ACL and were also positive in parasitological tests (86.96%), molecular tests (73.91%) or both (60.87%). Seventeen samples collected before treatment and 11 collected after treatment were positive in the qPCR assay, with a mean parasite load (MPL) of 38.33 fg/μL and 11.81 fg/μL, respectively. Eight samples were positive in both collections. Thirteen patients (56.52%) were clinically cured (wound healing). Ten patients (43.47%) were not clinically cured at the time of return with the attending physician. Identification of Leishmania species was carried out in samples from nine patients, and six were identified as L. (Viannia) braziliensis, 2 as L (Viannia) guyanensis and 1 as L (Leishmania) amazonensis. One patient infected with L. guyanensis and other with L. braziliensis were not clinically cured and increased the mean parasite load after treatment. The data obtained from the followed-up patients and the relationship between clinical evolution and the infecting species demonstrate the need to understand its etiology to define the effective therapeutic protocol.
(Published by Elsevier Inc.)
Databáze: MEDLINE
Externí odkaz: