Showing 14 results for Leishmaniasis
Mohammadali Nilforoushzadeh, Seyyed Hossein Hejazi, Hajar Zarkoob, Leila Shirani Bidabadi, Gholam Reza Asghari, Seyyed Mohsen Hosseini, Elaheh Haftbaradaran, Fariba Jaffary,
Volume 1, Issue 2 (6-2010)
Abstract
Background and Aim: There are some reports regading the anti-inflammatory and antimicrobial effect of honey and Nigella sativa and their therapeutic effects in improvement of wound healing. This study was designed to evaluate the efficacy of adding honey and Nigella sativa extract compared to honey alone in patients with cutaneous leishmaniasis receiving intralesional Glucantime.
Methods: In this clinical trial, 150 patients with confirmed cutaneous leishmaniasis were randomly allocated into two groups. One group was treated with topical honey twice daily along with weekly intralesional injection of Glucantime. In the second group, patients were treated with topical honey and 60 % hydroalchoholic Nigella sativa extract instead of honey alone. The patients were treated until complete healing of the ulcer or for maximum of 12 weeks.
Results: At 12 weeks, complete cure was achieved in 61 (81.3%) of patients treated with topical honey and 60 % hydroalchoholic Nigella sativa extract versus 48 (64%) in the second group (P=0.002).
Conclusion: The efficacy of adjunct honey and Nigella sativa extract along with intralesional Glucantime is more than honey alone in increasing complete cure rate and decreasing the residual scar size and the required dose of Glucantime.
Ali Khamesipour, Mahmoud Nateghi Rostami, Hossein Keshavarz, Akram Miramin Mohammadi, Minoo Tasbihi, Seyyedeh Tahereh Shahrestani, Abdolfattah Sarrafnejad,
Volume 1, Issue 3 (9-2010)
Abstract
Background and Aim: The heterogenous population of memory T lymphocytes is distinguished based on surface markers and effector functions such as cytokine secretion. Recently, two subsets of memory T cells are defined by expression of chemokine receptor CCR7 and CD45RA designating as "central memory" T cells (TCM) and "effector memory" T cells (TEM). The objective of this staudy was to evaluate the phenotype and function of these lymphocytes in healed cases of cutaneous leishmaniasis.
Methods: The phenotype of lymphocytes were determined in blood samples of 13 volunteers with history of self healing cutaneous leishmaniasis (HCL) and in 6 healthy controls.
Results: No significant difference was found in memory T cell subsets between HCL volunteers and healthy controls using flow cytometry. However, following sorting of different memory subsets, a significantly higher proliferation was seen in cells of HCL volunteers comparing to the control group. A significantly higher IFN-γ response in TEM and a significantly higher IL-2 response in TCM were observed in cell culture of HCL volunteers comparing controls.
Conclusion: The responses were elicited when the cells were stimulate with SLA in vitro, it is concluded Leishmania-specific TEM and Leishmania-specific TCM subsets exist in HCL volunteers and since the volunteers with history of CL presumed to be protected against reinfection, it seems that both TCM and TEM play role in the protection against Leishmania infection in these individuals.
Ali Khamesipour, Alireza Khatemi, Iraj Sharifi, Mahdie Bahrami, Amir Javadi, Seyyed Ebrahim Eskandari, Alireza Firooz, Alireza Fekri, Mohammad Reza Aflatoonian,
Volume 1, Issue 4 (12-2010)
Abstract
Background and Aim: Treatment of cutaneous leishmaniasis, especially when caused by L. tropica, is challenging. Meglumine antimoniate (Glucantime®) is used as the standard treatment, but multiple injectiond are necessary. The objective of this study was to compare the efficacy of weekly intralesional injections with twice weekly injections of Glucantime for the treatment of anthroponotic cutaneous leishmaniasis (ACL).
Methods: This randomized open clinical trial was conducted, in Bam, Kerman province, Iran. 96 eligible patients according to inclusion and exclusion criteria who were willing to participate were included. The included patients were randomly assigned into two groups, one group treated with weekly intralesional injections of Glucantime® and the other group treated with intralesional Glucantime® twice a week. Type and size of each lesion (induration, ulcer and scar) were recorded weekly. Complete healing was defined as complete re-epithelialization and absence of induration in all lesions and was considered as the primary outcome measure.
Results: A total of 48 patients completed the study complete cure was seen in 24 of 27 (89%) patients who received weekly intralesional MA with a mean duration of healing equals to 70±10 days. Complete cure was seen in 24 of 31 (77%) patients who received intralesional MA twice a week, the mean duration of healing in the latter group was 58±5 days. There was no significant difference between the two groups (P=0.23).
Conclusion: It seems that the efficacy of intralesional injections of Glucantime® once a week is similar to efficacy of twice a week Glucantime® injections.
Ali Khamesipour, Mohammad Hossein Ghoorchi, Alireza Khatami, Seyed Ebrahim Eskandari, Amir Javadi, Hamed Zartab, Maryam Sarraf-Yazdy, Alireza Firooz,
Volume 2, Issue 1 (3-2011)
Abstract
Background and Aim: Cutaneous leishmaniasis (CL) is endemic in Iran, where it is one of the most important health problems. Both anthroponotic CL (ACL) caused by L. tropica and zoonotic CL (ZCL) caused by L. major are reported. Antimoniate derivatives as the standard therapy for CL need multiple injections and are not easy to tolerate for the patients. This study was conducted in Mashhad to compare the efficacy of weekly versus twice a week intralesional injections of meglumine antimoniate (MA) in the treatment of ACL.
Methods: This randomised controlled trial was performed during 2006 to 2008 in Mashhad, Iran. Using computerized sequence of random numbers, participants were randomly allocated in the two arms of the study: one receiving weekly and the other receiving twice-a-week intralesional injections of MA. The lesion size, induration and healing rate were assessed, recorded and compared. Healing was defined as complete re-epithelialisation and disappearance of induration.
Results: A total of 252 suspected CL patients with 372 lesions were screened. 82 parasitologically proven cases with 121 lesions caused by L. tropica were included and 74 patients with 113 lesions completed the study. At 12th week after initiation of treatment, complete healing was observed in 38 out of 44 lesions (86.4%) in the group which received weekly intralesional MA injection. The median time-to-heal in this group was 36 days (95% confidence interval [CI]: 32.0-39.9). Complete healing was recorded in 60 out of 69 lesions (86.9%) in the group which received twice a week intralesional injections of MA with a median time-to-heal of 25 days (95% CI: 20.9-29.1). While no significant difference was observed between the two groups in terms of complete healing rate (P=0.999), time-to-heal was significantly different between the 2 groups (P=0.003).
Conclusion: It seems that the effectiveness of twice-weekly intralesional injections of MA is similar to once-weekly regimen while the former regimen causes more rapid healing of lesions.
Mohammad Saatchi, Hamid Salehinia, Salman Khazaei, Mahdi Mohammadian, Abdollah Mohammadian-Hafshejani,
Volume 6, Issue 2 (7-2015)
Abstract
Background and Aim: The aim of this study was to investigate various aspects of the treatment in patients with cutaneous leishmaniasis in Iran in the first half of 2014.
Methods: This cross sectional study was conducted on the existing data of 3684 patients with cutaneous leishmaniasis, whom were registered at the Disease Management Center of the Iranian Ministry of Health in the first half of 2014. Version 11 of Stata was used for statistical analysis and the level of significance was considered equals to 0.05.
Results: Of 3684 patients entered into the study (%55.1) were male and the mean age of the patients was 27±18 years. More than 34% of patients were treated with intralesional injections of meglumine antimoniate (MA) and 25% of patients recieved systemic MA injections. There were statistically significant correlations between the size and number of the lesions and the chosen treatment regimen (P<0.001). Thirty-five percent of patients treated with systemic MA between 7 to 10 days and 43.3% of patients recieved intralesional MA injections for 5 to 8 weeks.
Conclusion: More than %99 of patients fully recovered without complication or treatment failure. It seems that Iranian patients suffered milder CL in comparison with some other coutries.
Fatemeh Kavoosi, Davoud Shojaeizadeh,
Volume 6, Issue 4 (1-2016)
Abstract
Background and Aim: Lack of information on how to protect and prevent cutaneos leishmaniasis plays an important role in the susceptibility to the disease. Therefore, preventive measures will be effective if the parents have awareness about the disease. This study was aimed to invetigate the effects of educational interventions on mother’s knowledge and attitude towards cutaneous leishmaniasis.
Methods: In this quasi-experimental study, 120 married women who were 15 years of age or older and were referred to Ab-o-Bargh Health Center in Mashhad were recruited. The participants were divided into three groups: participation in an educational lecture, participation in an educational group discussion session, and a control, non-intervention group. A researcher-developed questionnaire including questions on demographic data, and developed knowledge and attitude towards cutaneous leishmaniasis were used for data gathering. The evaluation of educational intervention effects were assessed before, immediately after the interventions, and one month after the educational interventions.
Results: Before the intervention, there was no significant difference in the mean of awareness scores between the three groups (P=0.71). However, there was a significant difference in awareness scores between the three groups immediately after the intervention. The observed scores did not change significantly after one month (P=0.001). Also, there was there was a significant difference in the rate of attitude score towards cutaneous leishmaniasis after the intervention between three groups (P=0.001).
Conclusion: Individual and group educational interventions regarding cutaneous leishmaniasis were effective to increase the knowledge and improve the attitude of the participants towards the disease. We recommend to apply effective educational interventions like group discussions to improve the mothers' knowledge and their insights about cutaneous leishmaniasis.
Rezvan Amiri, Maryam Khalili, Alireza Fekri, Mehrdad Farokhnia, Mahin Aflatoonian,
Volume 6, Issue 4 (1-2016)
Abstract
Leishmaniasis is a group of diseases which is caused by an intracellular protozoal infection. It is the third most common opportunistic infectious disease in HIV positive patients worldwide. In this article, we present a 30-year-old women who was a known case of HIV/AIDS infection and developed multiple papules and nodules as on her face, arm and shoulder with diagnoses of diffuse cutaneous leishmaniasis. PCR was performed for determination of parasites species and Leishmania tropica was identified as the causative agent. The patient was treated with parenteral amphotericine B and topical neosomal paromomycin for 3 weeks and all lesions healed without scaring.
She discontinued her anti-retroviral therapy a few months later and the lesions recurred. Finally, she died due to sepsis and pulmonary emboli.
Morteza Akbari, Anis Askari Zadeh, Kayvan Sadri, Mehrdad Iranshahi, Mahmoud Reza Jaafari, Ali Khamesipour, Ali Badiee,
Volume 8, Issue 4 (1-2018)
Abstract
Background and Aim: Curcumin possesses diverse pharmacologic effects including anti-inflammatory, antioxidant, antiproliferative and antiangiogenic activities. The aim of this study was to develop liposomal formulation of curcumin and evaluate the leishmanial effects of its topical use against L. major in vitro and in vivo.
Methods: Nanoliposomes containing 1, 2 or 3% curumin were prepared by fusion method and characterized for their size, morphology and stability. The in vitro efficacy of liposomal form of Curcumin against promastigotes and amastigotes form of L. major was also evaluated. Moreover, the leishmanial effect of formulations was evaluated in infected BALB/c mice. The lesions were treated topically by different formulations twice a day, for 4 weeks. During this time and 4 weeks after treatment, lesions size was measured every week. The level of splenic parasite burdens was investigated in week 4 after parasite inoculation.
Results: Curcumin showed no leishmanicidal effect against live promasigotes and amastigotes in culture media. There was no significant difference between treated and control animals regarding lesion size and splenic parasite burden.
Conclusion: The results of this study showed that nanoliposomes containing curcumin in topical form has no significant leishmanicidal effect in vitro and in vivo against
L. major.
Behnaz Shojaedin Givi, Ali Khamesipour, Hossein Naderimanesh,
Volume 10, Issue 2 (8-2019)
Abstract
Background and Aim: Drug delivery through the microneedle array has been considered as an easy and non-invasive method in recent years. The purpose of this study was to design and construct an array of biodegradable polymeric microneedles containing Amphotericin-B to introduce this system and its use in the treatment of cutaneous lesions caused by Leishmania major parasite inoculation as a model in skin infections.
Methods: In this study, microneedles were fabricated by three-step molding method, which included master mold making, polymeric matrix that blending of polyvinyl pyrrolidine and methacrylic acid and finally casting.
Results: The identification of Amphotericin-B in polymeric microscopic compositions was investigated by absorption and emission spectroscopy. Also, the mechanical strength of microneedles, which confirms their ability to penetrate the skin, was investigated by a transducer.
Conclusion: In this study, the design and fabrication of a skin-permeable polymeric microneedle array with biodegradability and biocompatibility characteristics in physiological environment was performed. Using the properties of designed needles, loading of Amphotericin-B was used for the treatment of leishmaniasis and skin fungal infections.
Akram Miraminmohammadi, Minoo Tasbihi, Seyedebrahim Eskandari, Maryam Ahmadi,
Volume 12, Issue 4 (2-2022)
Abstract
Leishmaniasis is a neglected disease caused by different Leishmania species and transmitted by various sand flies. Iran is endemic to both visceral and cutaneous form of the diseases. The aim of this study was to investigate the epidemiological factors of leishmaniasis in patients referred to the Center for Research and Training Skin Disease and Leprosy from 1399-1400. The present study is a cross-sectional study in which every patient with suspected cutaneous leishmaniasis lesion(s) referred to the center during 1399-1400 were included. The results showed a higher number of patients with leishmaniasis are in the age group of 10 to 19 years. Among the mentioned jobs, a higher percentage was assigned to housewives in the affected women and workers in the affected men. According to the results, autumn is the most common season for cutaneous leishmaniasis. The average time from beginning to the diagnosis of leishmaniasis was 1.5-3 months and most patients showed a history of traveling to rural areas. The number of wet type lesions were higher than dry type and most of the lesions were in the hands. Most cases were reported from Isfahan province.
Seyedebrahim Eskandari, Ali Khamesipour, Alireza Firooz, Minoo Tasbihi, Akram Miraminmohammadi, Khadijeh Tavakoli, Maryam Ahmadi,
Volume 13, Issue 2 (8-2022)
Abstract
Background and Aim: Leishmaniasis is a parasitic disease transmitted by sandflies and is one of the endemic diseases of Iran. With the spread of the Covid-19 epidemic worldwide, the virus will interface with endemic infectious diseases in different regions. In this study, coronavirus disease was evaluated in patients with a history of leishmaniasis referred to the Center of Research and Training in Skin Diseases and Leprosy.
Methods: A total of 91 patients with a history of leishmaniasis were studied for possible SARS-CoV-2 infection. The number of patients referred to the Center of Research and Training in Skin Diseases and Leprosy during the coronavirus epidemic was also compared with the same period before the epidemic
Results: A total of 60% of patients with leishmaniasis
did not report coronavirus disease. Twenty-one percent of cases had a mild corona disease, 13% had a moderate and 3% had severe corona disease. Only a single death was reported in corona patients with a history of cutaneous leishmaniasis. The number of referrals before the beginning of the corona epidemic was twice as high as during the epidemic.
Conclusion: In these participants, mortality and side effects of COVID-19 were significantly less reported. However, further studies are needed to evaluate the immune system and cutaneous leishmaniasis protection against COVID-19. Various factors can be effective in reducing patients during the epidemic, including not going to medical centers, reducing the number of trips, and observance of health issues.
Minoo Tasbihi, Akram Miraminmohammadi, Ali Khamesipour, Seyedebrahim Eskandari, Alireza Firooz, Saman Ahmadnasrollahi,
Volume 14, Issue 2 (8-2023)
Abstract
Background and Aim: Cutaneous leishmaniasis is one of the most important health problems in Iran. There is still no effective vaccine available against human leishmaniasis and current treatment is based on chemotherapy. Conventional drugs are toxic and expensive, and drug resistance has caused the search for new treatments. Tofacitinib is a Janus kinase inhibitor that disturbs the signaling pathway of several cytokines in the immune system. The aim of this study was to evalute the effect of topical tofacitinib 2% ointment in healing cutaneous leishmaniasis in Balb/C mice.
Methods: This experimental study was performed using tofacitinib and glucantim drugs in 40 female Balb/C mice. The metacyclic form of promastigote of Leishmania major standard strain (MRHO/IR/75/ER) was injected into the footpad of the mice, the mice were divided into 4 treatment groups: tofacitinib, glucantim, tofacitinib-glucantim and control without treatment. The treatment period was 28 days. The footpad thickness of all groups was measured at the end of each week.
Results: After the end of the treatment in the groups treated with tofacitinib, a significant decrease in the size of lesion and the footpad thickness was observed compared to the control group without treatment (P<0.01).
Conclusion: It seems that tofacitinib ointment accelerates lesion healing in Balb/C mice and has worked similarly to standard glucantim treatment. Ointment can be a better option for leishmaniasis treatment and due to its ease of use and no need for painful injections it can be considered as an option for the treatment of patients with cutaneous leishmaniasis.
Maryam Mirahmad, Nasim Tootoonchi, Pooria Asili, Hamidreza Mahmoudi, Kambiz Kamyab, Mohammad Mahdavi, Faezeh Khorasanizadeh, Maryam Daneshpajooh,
Volume 15, Issue 2 (8-2024)
Abstract
Background and Aim: The most prevalent form of leishmaniasis is cutaneous leishmaniasis (CL), which manifests as a single ulcerative or nodular lesion that usually heals on its own. The aims of this study were to investigate the histopathologic and clinical features of CL patients.
Methods: This cross-sectional study was accomplished on 70 CL patients that referred to Razi dermatology hospital in Iran, over a five-year period from 2016 to 2020. Included patients were those who were diagnosed clinically suspected patients whom their disease was confirmed through histopathology examination.
Results: The age of patients ranged from 2 to 76 years with a mean of 42.26 ± 20.86 years. The majority of patients were men (54.3%). The plaque form lesions were the most frequent type (64.3%). Respecting lesion site, face, and upper limbs were more frequent with the abundances of 47.1% and 34.3%, respectively. All of the patients had evidence of cellulitis on ultrasound. The most prevalent change of epidermis was hyperkeratosis (42.8%). Regarding dermal histopathologic changes, infiltration of lymphocytes (61.4%), plasma cells (58.6%), and histiocytes (48.6%), as well as granuloma formation (54.3%) and leishman body presence (54.3%) were the dominant changes. Some patients had atypical forms of CL as six of them had lupoid cutaneous leishmaniasis (LCL) and five had sporotrichoid cutaneous leishmaniasis (SCL).
Conclusion: In this study, men and those who were in middle age were more susceptible to be infected, so it suggests considering them particularly in the preventive programs. Moreover, histopathological findings of CL, including LCL and SCL, are presented. These findings may be beneficial for dermatologists and dermatopathologists to differentiate them from other cutaneous diseases.
Homa Hatefi Minaei, Ali Khamesipour, Alireza Firooz, Akram Miraminmohammadi, Seyedebrahim Eskandari, Shahla Mirazizi, Minoo Tasbihi,
Volume 15, Issue 4 (2-2025)
Abstract
Background and Aim: Leishmaniasis is difficult to control and is not cost-effective in endemic areas. Antimony toxic compounds is the drug of choice, which drug resistance is increasing. Animal studies showed that interferon-gamma deficiency impairs the recovery of leishmaniasis. In this study, the therapeutic effects of subcutaneous injection of recombinant gamma interferon on leishmaniasis lesions in Balb/ C mice were evaluated.
Methods: 40 Balb/ C mice were infected with Leishmania major. After developing lesions, the therapeutic effects of interferon gamma alone or in combination with glucantime were investigated. Also, the standard treatment of glucantime and the control group without treatment were evaluated for comparison.
Results: The treatment groups (glucantime, gamma interferon, and gamma interferon-glucantime) had a significant difference (P<0.01) in terms of reduction in the footpad thickness compared to the control group. There was no significant difference in the mortality rate in the groups receiving gamma interferon and the group receiving standard glucantime treatment.
Conclusion: It seems that gamma interferon was effective in treating cutaneous leishmaniasis lesions in Balb/c mice alone and in combination with standard treatment and can be considered as an alternative treatment.
