Sucessful use of a defined antigen/GM-CSF adjuvant vaccine to treat mucosal leishmaniasis refractory to antimony: a case report

RESUMO

Immunotherapy has been proposed as a method to treat mucosal leishmaniosis for many years, but the approach has been hampered by poor definition and variability of antigens used, and results have been inconclusive. We report here a case of antimonial-refractory mucosal leishmaniasis in a 45 year old male who was treated with three single injections (one per month) with a cocktail of lour Leishmania recombinant antigens selected after documented hyporesponsiveness of the patient to these antigens, plus 50µg of GM-CSF as vaccine adjuvant. Three months after treatment, all lesions had resolved completely and the patient remains without relapse after two years. Side effects of the treatment included only moderate erythema and induration at the injection site after the second and third injections. We conclude that carefully selected microbial antigens and cytokine adjuvant can be sucessful as immunotherapy for patients with antimonial-refractory mucosal leishmaniasis.