Leishmaniasis

利什曼病
  • 文章类型: Journal Article
    尽管在南美采取了一致的努力,这些疾病继续在流行地区造成重大的发病率和死亡率负担。这项研究旨在分析医院数据并调查登革热的住院率,利什曼病,以及2015年至2022年厄瓜多尔的疟疾。
    分析了2015年至2022年厄瓜多尔国家统计局和人口普查的开放访问数据库。使用每种疾病的特定术语(ICD-10)过滤数据,并使用MicrosoftExcel计算地理分布的描述性统计数据,Stata14.2和Rstudio。
    登革热负担最高,报告病例31616例,其次是疟疾(1316)和利什曼病(283)。从2015年到2022年,Sucumbios省每105名居民的登革热住院率最高(697.2),帕斯塔萨省的疟疾(108.4),以及莫罗纳圣地亚哥省的利什曼病(18.8)。数据的趋势分析显示,登革热略有增加,疟疾和利什曼病的住院率呈轻度下降趋势。
    结果表明,厄瓜多尔的媒介传播疾病控制失败。不幸的是,登革热没有明显减少的趋势,疟疾,和厄瓜多尔的利什曼病。这项研究强调了优化可持续媒介控制计划的必要性,并强调了对疾病发病率和控制措施的持续监测。
    UNASSIGNED: Despite concerted efforts in South America, these diseases continue to pose a significant burden of morbidity and mortality in endemic regions. This study aimed to analyse hospital data and investigate the hospitalisation rates of dengue fever, leishmaniasis, and malaria in Ecuador between 2015 and 2022.
    UNASSIGNED: Open-access databases from the National Institute of Statistics and Censuses of Ecuador between 2015 and 2022 were analysed. Data were filtered using specific terms for each disease (ICD-10), and descriptive statistics of geographical distributions were calculated using Microsoft Excel, Stata 14.2, and Rstudio.
    UNASSIGNED: Dengue had the highest burden, with 31,616 reported cases, followed by malaria (1,316) and leishmaniasis (283). From 2015 to 2022, the highest hospitalisation rate per 105 inhabitants for dengue was observed in Sucumbios province (697.2), for malaria in Pastaza province (108.4), and for leishmaniasis in Morona Santiago province (18.8). The data\'s trend analysis revealed a slight increase in dengue and mild downward trends in hospitalisation for malaria and leishmaniasis.
    UNASSIGNED: The results suggest that vector-borne disease control has failed in Ecuador. Unfortunately, there was no significant trend towards a decrease in dengue, malaria, and leishmaniasis in Ecuador during the years studied. This study highlights the need to optimise sustainable vector control programs and emphasises continuous monitoring of disease incidence and control measures.
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  • 文章类型: Journal Article
    背景:这项研究检查了利什曼病犬主人的经验,他们每天皮下注射锑酸葡甲胺治疗犬。业主认为注射容易,评估了问题的发生以及对主人和狗主人债券的影响。
    方法:使用兽医学院的兽医药局数据库确定了用抗报葡胺治疗利什曼病的犬,乌得勒支大学.向这些狗的主人发送了一份在线问卷,以评估注射的容易程度,问题的发生以及对主人和狗主人债券的影响。
    结果:收到了64名狗主人的回复。大多数受访者(78%)报告说,注射并不困难。据报道,50%和40%的狗在注射部位出现疼痛或结节发展,分别。在44%的狗中报告了多尿。一些业主报告说,注射对他们的心理健康有负面影响(20%),有些人会喜欢更多的兽医支持(11%)。
    结论:一些问题由有限的人回答,他们的回答可能不具有代表性。
    结论:狗主人仍然非常积极地坚持使用葡甲胺抗盐治疗,并愿意自己进行注射。在治疗周期期间需要时的主动支持的可用性可以进一步提高他们对给予注射的接受度和信心。
    BACKGROUND: This study examined the experiences of owners of dogs with leishmaniosis who treated their dogs with daily subcutaneous meglumine antimoniate injections. The owners\' perceived ease of administering the injections, the occurrence of problems and the effects on the owners and on the dog‒owner bond were evaluated.
    METHODS: Dogs prescribed meglumine antimoniate as a treatment for leishmaniosis were identified using the database of the veterinary pharmacy of the Faculty of Veterinary Medicine, Utrecht University. An online questionnaire was sent to the owners of these dogs to evaluate the perceived ease of administering the injections, the occurrence of problems and the effects on the owner and the dog-owner bond.
    RESULTS: Responses were received from 64 dog owners. Most respondents (78%) reported that administering the injections was not difficult. Pain or the development of nodules at the injection site was reported in 50% and 40% of the dogs, respectively. Polyuria was reported in 44% of the dogs. Some owners reported that administering the injections had a negative impact on their psychological wellbeing (20%), and some would have liked more veterinary support (11%).
    CONCLUSIONS: Some questions were answered by a limited number of people, and their responses may not be representative.
    CONCLUSIONS: Dog owners remain highly motivated to persevere with meglumine antimoniate treatment and are willing to administer the injections themselves. The availability of active support when needed during the therapy cycle may further improve their acceptance of and confidence in giving the injections.
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  • 文章类型: Journal Article
    目的:伊朗是全球皮肤利什曼病(CL)发病率最高的六个国家之一。使用计划模型是一种基于社区的干预措施,以促进预防行为。我们研究的目的是通过社区干预中的母亲培训,评估PRECEDE-PROCEED模型(PPM)在改善儿童与CL相关的预防行为方面的有效性。
    方法:一项基于PPM模型的随机对照试验在伊朗农村地区的168名母亲(干预组(n=84)和对照组(n=84)和10岁儿童中进行。来自7个村地区的母亲被随机分配到干预组(2个村)和对照组(5个村)。干预组接受了一项计划,包括八次90分钟的培训课程和环境干预措施。在这项研究中,我们利用PPM作为框架设计了利什曼病预防行为问卷.两组参与者在基线时(干预前)完成问卷,干预后立即,在2个月的随访中。利用SPSS20进行数据分析,统计学显著性设定为p<0.05。
    结果:与对照组相比,干预组的知识显着增加,有利因素,强化因素,态度,从基线到随访,与皮肤利什曼病相关的预防行为(P<0.001)。在PPM结构的改变中没有观察到显著差异(P>0.05),知识,对照组从干预前到随访的预防行为。
    结论:基于PPM的社区(教育和环境)干预是可行的,可以通过增加母亲的知识和态度以及改变促进和增强因素来改变儿童皮肤利什曼病的预防行为。
    背景:IRCT20160619028529N8.
    OBJECTIVE: Iran ranks among the top six countries globally with a significant incidence of Cutaneous Leishmaniasis (CL). Using planning models is one community-based intervention to promote preventive behaviors. The purpose of our study was to evaluate the effectiveness of the PRECEDE-PROCEED model (PPM) in modifying preventive behaviors related to CL in children through mother training in a community intervention.
    METHODS: A randomized controlled trial based on the PPM model was conducted on 168 mothers (intervention (n = 84) and control group (n = 84) with 10 years old children in the rural areas of Iran. Mothers from 7 village areas were randomly allocated to the intervention (2 village) and control groups (5 village). The intervention group received a program comprising eight 90-minute training sessions and environmental interventions. In this study, we utilized the PPM as a framework to design the questionnaires on Leishmaniosis prevention behavior. Participants in both groups completed the questionnaires at baseline (before the intervention), immediately after the intervention, and at the 2-month follow-up. Analysis of the data was conducted utilizing SPSS20, with statistical significance set at p < 0.05.
    RESULTS: Compared to the control group, the intervention group showed significant increases in knowledge, enabling factors, reinforcing factors, attitude, and preventive behaviors related to Cutaneous Leishmaniasis over time from baseline to follow-up (P < 0.001). No significant differences (P > 0.05) were observed in the alterations of the PPM construct, knowledge, and preventive behaviors within the control group from pre-intervention to follow-up.
    CONCLUSIONS: Community (education and environmental) intervention based on PPM is feasible and acceptable to modify preventive behaviors of Cutaneous Leishmaniasis in children by increasing a mother\'s knowledge and attitude as well as changing enabling and reinforcing factors.
    BACKGROUND: IRCT20160619028529N8.
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  • 文章类型: Journal Article
    利什曼原虫,异种锥虫寄生虫,是利什曼病的病原体,目前分为四个亚属:利什曼病,Viannia,Sauroleishmania,和最近描述的蒙迪尼亚,由六个物种组成,分布在世界各地,感染人类和/或动物。这些寄生虫感染各种哺乳动物物种,也引起严重的人类疾病,但他们的水库是未知的。因此,需要适当的实验室模型才能对蒙迪尼亚寄生虫进行适当的研究。在这项复杂的研究中,我们比较了五种Mundinia物种的实验性感染(L.Enriettii,L.宏观,L.Chancei,L.Orientalis,和三种啮齿动物中的四种马氏乳球菌):BALB/c小鼠,中国仓鼠(Cricetulusgriseus)和草原旅鼠(Laguruslagurus)。将培养物来源的寄生虫皮内接种到耳膜中,并监测感染进展20周,当动物的组织和器官筛选利什曼原虫的存在和数量时。在感染后第5、10、15和20周进行了假血球病的异种诊断,以测试整个实验中动物的传染性。BALB/c小鼠没有出现感染迹象,对沙蝇没有感染,虽然中国仓鼠和草原旅鼠被证明对所有五种蒙迪尼亚物种敏感,表现出从无症状到内脏的广泛疾病体征。与中国仓鼠相比,Mundinia在草原旅鼠中引起的感染率明显更高,因此,草原旅鼠对沙蝇更具传染性:在所有测试组中,它们在感染后第5周至第20周具有传染性。总之,我们发现了两种啮齿动物,中国仓鼠(Cricetulusgriseus)和草原旅鼠(Laguruslagurus),作为Mundinia实验室模型的候选人,可以对这些神秘的寄生虫进行详细研究。此外,草原旅鼠中所有Mundinia物种的长期生存及其对媒介的传染性支持以下假设:某些啮齿动物有可能成为Mundinia的水库宿主。
    Leishmania, the dixenous trypanosomatid parasites, are the causative agents of leishmaniasis currently divided into four subgenera: Leishmania, Viannia, Sauroleishmania, and the recently described Mundinia, consisting of six species distributed sporadically all over the world infecting humans and/or animals. These parasites infect various mammalian species and also cause serious human diseases, but their reservoirs are unknown. Thus, adequate laboratory models are needed to enable proper research of Mundinia parasites. In this complex study, we compared experimental infections of five Mundinia species (L. enriettii, L. macropodum, L. chancei, L. orientalis, and four strains of L. martiniquensis) in three rodent species: BALB/c mouse, Chinese hamster (Cricetulus griseus) and steppe lemming (Lagurus lagurus). Culture-derived parasites were inoculated intradermally into the ear pinnae and progress of infection was monitored for 20 weeks, when the tissues and organs of animals were screened for the presence and quantity of Leishmania. Xenodiagnoses with Phlebotomus duboscqi were performed at weeks 5, 10, 15 and 20 post-infection to test the infectiousness of the animals throughout the experiment. BALB/c mice showed no signs of infection and were not infectious to sand flies, while Chinese hamsters and steppe lemmings proved susceptible to all five species of Mundinia tested, showing a wide spectrum of disease signs ranging from asymptomatic to visceral. Mundinia induced significantly higher infection rates in steppe lemmings compared to Chinese hamsters, and consequently steppe lemmings were more infectious to sand flies: In all groups tested, they were infectious from the 5th to the 20th week post infection. In conclusion, we identified two rodent species, Chinese hamster (Cricetulus griseus) and steppe lemming (Lagurus lagurus), as candidates for laboratory models for Mundinia allowing detailed studies of these enigmatic parasites. Furthermore, the long-term survival of all Mundinia species in steppe lemmings and their infectiousness to vectors support the hypothesis that some rodents have the potential to serve as reservoir hosts for Mundinia.
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  • 文章类型: Journal Article
    内脏利什曼病(VL),由各种利什曼原虫物种引起的第二种被忽视的热带病,由于治疗选择有限和缺乏疫苗,因此提出了重大的公共卫生挑战。负责内脏利什曼病的特工,在印度也被称为“黑热病”,是多诺瓦尼利什曼尼亚.这项研究的重点是L.donovaniMinichromosome维持10(LdMcm10),DNA复制机制中的关键蛋白质,作为利什曼原虫治疗的潜在治疗靶点,使用计算机和体外方法。我们使用了生物信息学工具,分子对接,和分子动力学模拟来预测针对靶蛋白的潜在抑制剂。研究表明,目标蛋白在宿主中缺乏同源物,强调其作为药物靶标的潜力。使用PyRx软件针对LdMcm10筛选来自DrugBank数据库的配体。前三个化合物,即苏拉明,vapreotide,和pasireotide,展现最佳对接得分,通过分子动力学模拟和体外分析进行了进一步的研究。观察到的结构动力学表明,LdMcm10-配体复合物在整个300ns模拟期间保持一致的结合,在他们的骨干最小的变化。这些发现表明,这三种化合物有望成为开发抗利什曼病新药的潜在先导化合物。体外实验还证明了苏拉明的剂量依赖性降低。vapreotide,和pasireotide,计算的IC50值提供了其抗利什曼原虫疗效的定量指标。该研究提供了对LdMcm10作为药物靶标的全面了解,并为进一步的研究和临床探索奠定了基础。最终推进利什曼病治疗的药物发现策略。
    Visceral Leishmaniasis (VL), the second neglected tropical disease caused by various Leishmania species, presents a significant public health challenge due to limited treatment options and the absence of vaccines. The agent responsible for visceral leishmaniasis, also referred to as \"black fever\" in India, is Leishmania donovani. This study focuses on L. donovani Minichromosome maintenance 10 (LdMcm10), a crucial protein in the DNA replication machinery, as a potential therapeutic target in Leishmania therapy using in silico and in vitro approaches. We employed bioinformatics tools, molecular docking, and molecular dynamics simulations to predict potential inhibitors against the target protein. The research revealed that the target protein lacks homologues in the host, emphasizing its potential as a drug target. Ligands from the DrugBank database were screened against LdMcm10 using PyRx software. The top three compounds, namely suramin, vapreotide, and pasireotide, exhibiting the best docking scores, underwent further investigation through molecular dynamic simulation and in vitro analysis. The observed structural dynamics suggested that LdMcm10-ligand complexes maintained consistent binding throughout the 300 ns simulation period, with minimal variations in their backbone. These findings suggest that these three compounds hold promise as potential lead compounds for developing new drugs against leishmaniasis. In vitro experiments also demonstrated a dose-dependent reduction in L. donovani viability for suramin, vapreotide, and pasireotide, with computed IC50 values providing quantitative metrics of their anti-leishmanial efficacy. The research offers a comprehensive understanding of LdMcm10 as a drug target and provides a foundation for further investigations and clinical exploration, ultimately advancing drug discovery strategies for leishmaniasis treatment.
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  • 文章类型: Journal Article
    尽管许多尝试治疗利什曼病,有必要采取新的方法来减轻疾病负担。在一些研究中,Perovskiaabrotanoides(Brazambel)对利什曼原虫寄生虫具有显着的作用。本研究旨在研究巴豆提取物外用制剂对皮肤利什曼病的影响。
    在这项随机对照临床试验中,皮肤利什曼病患者被分为实验组(n=18)和对照组(n=18).两组均接受病灶内的锑酸葡甲胺(Glucantime®)。实验组还每天一次接受5%Brazambel提取物软膏。干预持续至病变完全愈合(再上皮化)最长8周。临床反应,定义为完全反应(上皮再生>75%),部分反应(上皮再生50%-75%),或治疗失败(上皮再生<50%),进行组间比较。
    实验组(第4周:64.44±25.13;第8周:83.85±11.54)的再上皮形成百分比高于对照组(第4周:53.97±25.88;第8周:76.27±21.67);但是,差异无统计学意义(分别为P=0.252和0.494).此外,在完全愈合率方面,实验组和对照组之间没有显着差异(88.9%vs.72.2%,分别)。
    使用巴豆提取物5%局部制剂不影响皮肤利什曼病的愈合。
    UNASSIGNED: Despite many attempts to treat leishmaniasis, new approaches are necessary to reduce the burden of disease. Perovskia abrotanoides (Brazambel) has shown significant effects against Leishmania parasites in some studies. This study aimed to investigate the effects of P. abrotanoides extract topical formulation on cutaneous leishmaniasis.
    UNASSIGNED: In this randomized controlled clinical trial, patients with cutaneous leishmaniasis were assigned to experimental (n = 18) and control (n = 18) groups. Both groups received intralesional meglumine antimoniate (Glucantime®). The experimental group also received 5% Brazambel extract ointment once a day. The interventions continued until the complete healing of the lesions (reepithelialization) for a maximum of 8 weeks. The clinical response, defined as complete response (reepithelialization >75%), partial response (reepithelialization 50%-75%), or treatment failure (reepithelialization <50%), was compared between the groups.
    UNASSIGNED: The percentage of reepithelialization in the experimental group (4th week: 64.44 ± 25.13; 8th week: 83.85 ± 11.54) was higher than the control group (4th week: 53.97 ± 25.88; 8th week: 76.27 ± 21.67); however, the differences were not statistically significant (P = 0.252 and 0.494, respectively). Moreover, there was no significant difference between the experimental and control groups regarding the rate of complete healing (88.9% vs. 72.2%, respectively).
    UNASSIGNED: The use of P. abrotanoides extract 5% topical formulation does not affect the healing of cutaneous leishmaniasis.
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  • 文章类型: Journal Article
    Partheniumhysterophorphus植物具有多样化的化学特征和巨大的生物活性潜力。它表现出优异的药理特性,如抗癌,抗炎,抗疟疾,杀微生物,和抗锥虫。本研究旨在评估从heserophorus中分离出的脱水parthenin的抗利什曼虫潜力和毒理学安全性。Anydroparthenin是从P的叶子中提取的,并通过对1H的详细分析进行表征,13CNMR,和HRMS。基于染料的体外和离体测定证实,脱水parthenin可显着抑制利什曼原虫的前精子和阿马斯蒂根虫形式。细胞毒性实验和溶血实验均显示其无毒性质和安全指数在10至15的范围内。Further,各种机理分析表明,失氢酯导致氧化应激的产生,细胞内ATP耗竭,形态学和线粒体膜电位的改变,细胞内脂体的形成,和酸性囊泡,最终导致寄生虫死亡。作为一种双重目标方法,计算研究和固醇定量测定证实,无氢子酯抑制利什曼原虫寄生虫中参与麦角甾醇生物合成的甾醇C-24甲基转移酶和甾醇14-α脱甲基酶蛋白。这些结果表明,失水parthenin可能是一种有前途的抗利什曼菌分子,可以作为一种新的治疗利什曼病的治疗策略。
    Parthenium hysterophorus plant has a diverse chemical profile and immense bioactive potential. It exhibits excellent pharmacological properties such as anti-cancer, anti-inflammatory, anti-malarial, microbicidal, and anti-trypanosomal. The present study aims to evaluate the anti-leishmanial potential and toxicological safety of anhydroparthenin isolated from P. hysterophorus. Anydroparthenin was extracted from the leaves of P. hysterophorus and characterized through detailed analysis of 1H, 13C NMR, and HRMS. Dye-based in vitro and ex vivo assays confirmed that anhydroparthenin significantly inhibited both promastigote and amastigote forms of the Leishmania donovani parasites. Both the cytotoxicity experiment and hemolytic assay revealed its non-toxic nature and safety index in the range of 10 to 15. Further, various mechanistic assays suggested that anhydroparthenin led to the generation of oxidative stress, intracellular ATP depletion, alterations in morphology and mitochondrial membrane potential, formation of intracellular lipid bodies, and acidic vesicles, ultimately leading to parasite death. As a dual targeting approach, computational studies and sterol quantification assays confirmed that anhydroparthenin inhibits the Sterol C-24 methyl transferase and Sterol 14-α demethylase proteins involved in the ergosterol biosynthesis in Leishmania parasites. These results suggest that anhydroparthenin could be a promising anti-leishmanial molecule and can be developed as a novel therapeutic stratagem against leishmaniasis.
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  • 文章类型: Journal Article
    皮肤利什曼病(CL)是年轻人群中媒介传播疾病的主要原因之一。为了评估环境健康因素与CL发病率的关系,在伊朗东北部进行了一项病例对照研究.
    这项研究是在2020-2021年期间根据三级转诊中心的个人和家庭数据进行的。病例为通过PCR方法诊断为CL的患者;在患者亲属中选择对照,信息是从健康登记系统获得的。1871个科目的人口和社会经济数据,包括年龄,性别,家庭信息和环境健康因素。在各种条件下具有环境因素的多变量模型和CL分别通过单变量和混合多条件逻辑回归拟合。
    参与者包括617例(平均[SD]年龄,13.62[13.72]岁;58.20%男性)和1264名对照(平均[SD]年龄,16.45[15.44]岁;50.40%男性)。结果表明,与地表水相比,井水水源的使用与CL显着相关(比值比[OR]=0.204;95CI,0.13-0.33;P<0.001)。泥泞的房子,毁坏的建筑物或荒地和死水,房屋附近的运河和河流也与CL相关(OR=3.85;95CI,1.66-8.89;P=.002;OR=2.47;95CI,1.76-3.47;P<.001)。此外,发现松树的存在是一个危险因素(OR=3.25;95CI,2.12-4.99;P<.001),废物收集系统的使用也是如此(OR=4.43;95CI,3.32-7.51;P<.001)。
    与房屋相关的环境因素与CL显著相关,并且可能代表CL疾病的可改变的危险因素。
    UNASSIGNED: Cutaneous leishmaniasis (CL) is one of the main causes of vector-born diseases in younger population. To evaluate the association of environmental health factors on the odds of CL incidence, a case-control study was conducted in northeastern Iran.
    UNASSIGNED: This study was conducted within 2020-2021 based on individual and household data from a tertiary referral center. Cases were patients diagnosed with CL by PCR method; controls were selected among the patients\' relatives, and information was obtained from a health registry system. Demographic and socioeconomic data of 1871 subjects, included age, sex, household information and environmental health factors. Multivariable models with environmental factors in various conditions and CL were separately fit by univariate and mixed multiple unconditional logistic regression.
    UNASSIGNED: Participants included 617 cases (mean [SD] age, 13.62[13.72] years; 58.20% male) and 1264 controls (mean [SD] age, 16.45[15.44] years; 50.40% male). Results revealed that the use of well-water sources compared to surface water is significantly associated with CL (odds ratio [OR]=0.204; 95%CI, 0.13-0.33;P<0.001). Muddy houses, ruined buildings or wastelands and stagnant water, canals and rivers near the houses were also associated with CL (OR=3.85; 95%CI, 1.66-8.89; P=.002; OR=2.47; 95%CI, 1.76-3.47; P<.001). Besides, existence of pine tree was found to be a risk factor (OR=3.25; 95%CI, 2.12-4.99; P<.001) and similarly for the use of waste collection system (OR=4.43; 95%CI, 3.32-7.51; P<.001).
    UNASSIGNED: Environmental factors related to houses were significantly associated with CL and may represent the modifiable risk factors of CL disease.
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  • 文章类型: Journal Article
    目的:本研究旨在研究局部脂质体克拉霉素联合抗蒙酸葡甲胺(Glucoantime®)对皮肤利什曼病(CL)病变的影响。方法:这个飞行员,随机化,对CL病变患者进行了双盲临床试验.患者被随机分为两组:第一组接受脂质体克拉霉素联合葡聚糖多糖28天,而第二组接受了葡聚糖和安慰剂。之后,患者在治疗开始后1.5、3和6个月进行随访,并评估恢复时间,硬结,和病变的大小。结果:将60例CL病变患者分为两个单独的组,每组30人,并进行检查。组内分析显示,克拉霉素组的恢复时间为26.65±5.12天,而在安慰剂组,为32.84±24.43,统计学上无统计学意义(p=0.18)。两组在第一次和最后一次随访中的病变大小比较均减少:克拉霉素组(p=0.006)为7.73±4.31至0.48±0.50,安慰剂组(p=0.03)为5.47±5.83至0.76±0.88。此外,与安慰剂组相比,干预组的病灶大小显著减小(p=0.02).在克拉霉素组中观察到可识别的硬结减少(2.60±0.77至1.0±0.00)。没有报告可归因于克拉霉素的不良反应。结论:脂质体克拉霉素联合全身葡聚糖对减少利什曼病的病灶大小具有明显的有益作用。建议对更大的人群进行进一步的研究。系统审查注册:https://www。irct.ir/trial/46611。
    Aim: This study aimed to investigate the effects of topical liposomal clarithromycin in combination with meglumine antimoniate (Glucantime®) on cutaneous leishmaniasis (CL) lesions. Methods: This pilot, randomized, double-blinded clinical trial was conducted on patients with CL lesions. Patients were randomly assigned to two groups: the first group received liposomal clarithromycin in combination with Glucantime for 28 days, while the second group received Glucantime and a placebo. Afterward, patients were followed up at 1.5, 3, and 6 months after treatment initiation and were evaluated for recovery time, induration, and size of the lesions. Results: Sixty patients with CL lesions were divided into two separate groups with 30 members each and were examined. Within-group analysis revealed that recovery time in the clarithromycin group was 26.65 ± 5.12 days, while in the placebo group, it was 32.84 ± 24.43, which was statistically insignificant (p = 0.18). Lesion size comparison in the first and last follow-ups reduced in both groups: 7.73 ± 4.31 to 0.48 ± 0.50 in the clarithromycin group (p = 0.006) and 5.47 ± 5.83 to 0.76 ± 0.88 in the placebo group (p = 0.03). Moreover, the size of lesions in the intervention group was significantly reduced compared to that in the placebo group (p = 0.02). Recognizable induration reduction was observed in the clarithromycin group (2.60 ± 0.77 to 1.0 ± 0.00). No adverse effects attributable to clarithromycin were reported. Conclusion: The administration of liposomal clarithromycin in combination with systemic Glucantime had a significant beneficial effect on reducing lesion size in leishmaniasis. Further studies on larger populations are recommended. Systematic Review Registration: https://www.irct.ir/trial/46611.
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  • 文章类型: Journal Article
    利什曼病是由20种利什曼原虫引起的,在流行地区影响数百万人。现有的治疗方法不足以有效控制疾病,引起严重的副作用并最终导致耐药性,迫切需要发现新的治疗分子。基于分子靶标的药物发现,目标是一个确定的分子基因,蛋白质或机制,是新疗法的理论驱动方法。人类从膳食来源获得必需氨基酸如苏氨酸,而利什曼原虫是从头合成的。苏氨酸生物合成途径的酶,因此,包括将L-高丝氨酸转化为正磷酸高丝氨酸的限速高丝氨酸激酶(HSK)是理论驱动疗法的有吸引力的靶标。HSK在人类中的缺失及其在多尼利什曼原虫中的存在增加了利用HSK作为抗利什曼原虫治疗开发的分子靶标的机会。在这项研究中,我们利用基于结构的高通量药物发现(SBDD),随后进行生化验证,并从Maybridge化学文库中鉴定出两种潜在的抑制剂(RH00038和S02587),靶向L.donovaniHSK。这两种抑制剂有效地诱导了利什曼原虫donovani的死亡在两个阶段的阿马斯蒂戈特和前乳突。其中一种对寄生虫具有特异性,是标准治疗分子的两倍。
    Leishmaniasis is caused by ∼20 species of Leishmania that affects millions in endemic areas. Available therapies are not sufficient to effectively control the disease, cause severe side effects and eventually lead to drug resistance, making the discovery of novel therapeutic molecules an immediate need. Molecular target-based drug discovery, where the target is a defined molecular gene, protein or a mechanism, is a rationale driven approach for novel therapeutics. Humans obtain the essential amino acid such as threonine from dietary sources, while Leishmania synthesize it de-novo. Enzymes of the threonine biosynthesis pathway, including the rate limiting Homoserine kinase (HSK) which converts L-homoserine into ortho-phospho homoserine are thus attractive targets for rationale driven therapy. The absence of HSK in humans and its presence in Leishmania donovani enhances the opportunity to exploit HSK as a molecular target for anti-leishmanials therapeutic development. In this study, we utilize structure-based high throughput drug discovery (SBDD), followed by biochemical validation and identified two potential inhibitors (RH00038 and S02587) from Maybridge chemical library that targets L. donovani HSK. These two inhibitors effectively induced the mortality of Leishmania donovani in both amastigote and promastigote stages, with one of them being specific to parasite and twice as effective as the standard therapeutic molecule.
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