Leishmania (Viannia) braziliensis is the main species causing cutaneous leishmaniasis in the Federal District of Brazil

The first autochthonous case of American cutaneous leishmaniasis was reported in the Federal District in 1980, and the species involved in this type of leishmaniasis was unknown. This study aimed to identify the species that causes the disease in the Federal District and to investigate its clinical and epidemiological aspects. Between 2000 and 2007, 71 autochthonous cases of leishmaniasis were reported in the Federal District. Leishmania species were identified by means of direct immunofluorescence reactions using monoclonal antibodies and restriction fragment length polymorphism. The species of 40 (56.33%) out of 71 samples were identified. Thirty-six (90%) were identified as Leishmania (Viannia) braziliensis and four (10%) were identified as Leishmania (Leishmania) amazonensis. In this area, the disease had clinical and epidemiological characteristics similar to those found in other Brazilian regions.

DNA identification of Leishmania (Viannia) braziliensis in human saliva from a patient with American cutaneous leishmaniasis

This study aims to report the amplification of the DNA of Leishmania (V.) braziliensis, using polymerase chain reaction, obtained from the saliva of a patient with American cutaneous leishmaniasis who did not present any lesion in the oral mucosa. Amplification produced fragments of 103 bp, an estimated size employing Leishmania (V.) braziliensis primers (b1 e b2). The present results revealed, for the first time, that the in vitro amplification of Leishmania DNA using samples from the salivary fluid of a patient with American cutaneous leishmaniasis is possible. However, more studies are required with a larger number of participants to evaluate the usefulness of saliva as a non-invasive sample for PCR. The development of such non-invasive technique is necessary for the diagnosis of many diseases in the future, especially infectious and parasitic ones.

Inefficacy of the association N-methyl glucamine and topical miltefosine in the treatment of experimental cutaneous leishmaniasis by Leishmania (Leishmania) amazonensis

Pentavalent antimonial (SbV) is the first treatment for cutaneous leishmaniasis (CL). Other drugs present similar side effects and higher cost. Oral miltefosine is effective to treat kala-azar. The aim of the present study was to compare the efficacy of glucamine (SbV) plus topical miltefosine with glucamine in the treatment of CL. Eighty isogenic C57BL/6 mice were inoculated with Leishmania (Leishmania) amazonensis and divided into two groups: one group was treated with SbV associated with miltefosine, and the other group received SbV plus saline solution. Groups were evaluated according to the diameter of the inoculated foot pad, the culture, and the parasite count using the limiting dilution assay. There was not statistical difference. The efficacy of glucamine in CL treatment did not increase when associated with topical miltefosine.(AU)

Use of Cavia porcellus (Guinea Pigs) as an experimental model for Leishmania (Viannia) braziliensis

Laboratory animals are fundamental to study immunological aspects and the efficacy of new drugs to treat leishmaniasis. However, we do not have practical and good animal models to study leishmaniasis caused by Leishmania (Viannia) braziliensis - L(V)b. In this study, thirty-two experimental animals (Cavia porcellus) were injected in the hind foot with 3x105 promastigote forms of L(V)b. The animals were followed for eight weeks. None of the experimental animals developed lesions or presented the parasite in any of the tests performed (histopathological exam, smears, culture, inoculation in hamsters, and polymerase chain reaction)

Avaliação da tolerância e nefrotoxicidade do antimonial pentavalente administrado na dose de 40 mg Sb V/kg/dia, de 12/12 h, por 30 dias na forma cutâneo-mucosa de leishmaniose / The evaluation of the tolerance and nephrotoxicity of pentavalent antimony administered in a dose of 40 mg Sb V/kg/day, 12/12 hr, for 30 days in the mucocutaneous form of leishmaniasis

Foi avaliada a função renal de 11 pacientes com leishmaniose cutâneo-mucosa tratados com antimonial pentavalente na dose de 40mg SbV/kg/dia aplicada de 12/12 horas, em esquema contínuo, durante trinta dias. No estudo, um paciente apresentou insuficiência renal reversível e dois desenvolveram alterações enzimáticas hepáticas e eletrocardiográficas sendo o esquema terapêutico interrompido. Nos demais pacientes observou-se efeitos nefrotóxicos tais como diminuição da taxa de filtração glomerular, diminuição da capacidade de concentração urinária, avaliada por um jejum hídrico de 16 horas e aumento na fração de excreção de sódio. No exame do sedimento urinário observou-se um aumento no número de leucócitos e cilindros. Os resultados encontrados neste estudo sugerem que o tratamento com antimonial pentavalente na dose de 40mg SbV/kg/dia foi menos tolerado em virtude de seus efeitos tóxicos, não parecendo apresentar índice de cura superior ao esquema atualmente preconizado de 20mg SbV/kg/dia.

The renal function of eleven patients with mucocutaneous leishmaniasis was analyzed in a prospective study realized at the School Hospital of University of Brasília. The patients were treated with doses of 40 mg/kg/day of pentavalent antimony (Sb V), in a continuous scheme during thirty days. In this study three patients were excluded, one patient with reversible renal failure and two patients with hepatic and cardiac malfunctions. In the other eight patients, severe nephrotoxic effects were observed, like reduction of glomerular filtration rate, reduction of the urinary concentration capacity, evaluated by a sixteen hours hydric fasting and an increase of sodium fractional excretion. An increase in the number of leucocytes and cylinders were observed at the urinary sediment exam. Finally, the results shows that the treatment with pentavalent antimony in doses of 40 mg Sb/kg/day was less tolerated on account of its renal toxic effects. This scheme seems not be superior than the currently preconized scheme of 20 mg of Sb V/kg/day during 30 days.

Insuficiência renal aguda em leishmaniose tegumentar americana tratada com a associaçäo glucantime e alopurinol / Acute renal insufficiency in mucocutaneous leismaniasis reated with glucantime and allopurinol

Os autores apresentam um caso de leishmaniose tegumentar americana causada por Leishmânia viannia brasiliensis que de um grupo de seis pacientes tratados com a associaçäo glucantime e alopurinol desenvolveu quadro de nefrite intersticial aguda acompanhado de exantema cutâneo. Questionam se näo houve potencializaçäo na interaçäo das drogas com relaçäo ao efeito desejável

Resultado do tratamento da leishmaniose tegumentar com benzonidazol. / Results of the treatment of cutaneous leishmaniasis with benzonidazole

Foi realizado um breve ensaio terapeutico com benzonidazol (Rochagan), em seis pacientes portadores de leishmaniose tegumentar com lesoes apenas cutaneas. A droga foi usada na dose diaria de 7mg/kg/dia, em duas tomadas, durante 60 dias. Dos seis pacientes, quatro permanecerem com as lesoes abertas, apesar da terapeutica, revelando apenas uma discreta melhora inicial, pelo exame histopatologico.O 2o caso teve a lesao inicial de braco esquerdo cicatrizada, mas apareceu nova lesao em outro local. Apenas um caso teve cura clinica embora a histopatologia tivesse revelado infiltrado linfocitario residual. Concluiu-se que o benzonidazol nao e eficaz no tratamento da leishmaniose