Parasites, Hosts and Diseases

"leishmaniasis"

Mini Review

Leishmania Vaccines: the Current Situation with Its Promising Aspect for the Future: Rasit Dinc; Korean J Parasitol 2022;60(6):379-391.
Published online December 22, 2022; DOI: https://doi.org/10.3347/kjp.2022.60.6.379

Abstract
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Leishmaniasis is a serious parasitic disease caused by Leishmania spp. transmitted through sandfly bites. This disease is a major public health concern worldwide. It can occur in 3 different clinical forms: cutaneous, mucocutaneous, and visceral Leishmaniasis (CL, MCL, and VL, respectively), caused by different Leishmania spp. Currently, licensed vaccines are unavailable for the treatment of human Leishmaniasis. The treatment and prevention of this disease rely mainly on chemotherapeutics, which are highly toxic and have an increasing resistance problem. The development of a safe, effective, and affordable vaccine for all forms of vector-borne disease is urgently needed to block transmission of the parasite between the host and vector. Immunological mechanisms in the pathogenesis of Leishmaniasis are complex. IL-12-driven Th1-type immune response plays a crucial role in host protection. The essential purpose of vaccination is to establish a protective immune response. To date, numerous vaccine studies have been conducted using live/attenuated/killed parasites, fractionated parasites, subunits, recombinant or DNA technology, delivery systems, and chimeric peptides. Most of these studies were limited to animals. In addition, standardization has not been achieved in these studies due to the differences in the virulence dynamics of the Leishmania spp. and the feasibility of the adjuvants. More studies are needed to develop a safe and effective vaccine, which is the most promising approach against Leishmania infection.

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Original Article

Cutaneous Leishmaniasis Situation and Predicting the Distribution of Phlebotomus papatasi and P. sergenti as Vectors of Leishmaniasis in Ardabil Province, Iran: Ali Khamesipour, Soheila Molaei, Navid Babaei-Pouya, Eslam Moradi-Asl; Korean J Parasitol 2020;58(3):229-236.
Published online June 26, 2020; DOI: https://doi.org/10.3347/kjp.2020.58.3.229

Abstract
PDF

Cutaneous leishmaniosis (CL) is the most common form of leishmaniasis.CL caused by L. major and L. tropica is endemic in 17 provinces of Iran. This study was carried out to elucidate situation of CL in Ardabil province and to predict distribution of Phlebotomus papatasi and Phlebotomus sergenti (Diptera: Psychodidae) as vectors of CL in the region. In this cross-sectional study, data on CL patients were collected from local health centers of Ardabil province, Iran during 2006-2018 to establish a geodatabase using ArcGIS10.3. A total of 20 CL cases were selected randomly and skin samples were collected and analyzed by PCR method. MaxEnt 3.3.3 model was used to determine ecologically suitable niches for the main vectors. A total, 309 CL human cases were reported and the highest incidence rate of disease was occurred in Bilasavar (37/100,000) and Germi (35/100,000). A total of 2,794 sand flies were collected during May to October 2018. The environmentally suitable habitats for P. papatasi and P. sergenti were predicted to be present in northern and central areas of Ardabil province. The most variable that contributed ratio in the modeling were Isothermality and slope factors. Ardabil province is possibly an endemic are for CL. The presence of P. papatasi and P. sergenti justifies local transmission while the vectors of CL are existing in the northern and central areas of the province.

Citations

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Amrollah Azarm, Mona Koosha, Abdolhossein Dalimi, Alireza Zahraie-Ramazani, Amir Ahmad Akhavan, Zahra Saeidi, Mehdi Mohebali, Kamal Azam, Hassan Vatandoost, Mohammad Ali Oshaghi
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Mohammad Kashif, Mohd Waseem, Naidu Subbarao
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Cutaneous leishmaniasis situation analysis in the Islamic Republic of Iran in preparation for an elimination plan
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Brief Communication

A Novel Anti-Microbial Peptide from Pseudomonas, REDLK Induced Growth Inhibition of Leishmania tarentolae Promastigote In Vitro: Yanhui Yu, Panpan Zhao, Lili Cao, Pengtao Gong, Shuxian Yuan, Xinhua Yao, Yanbing Guo, Hang Dong, Weina Jiang; Korean J Parasitol 2020;58(2):173-179.
Published online April 30, 2020; DOI: https://doi.org/10.3347/kjp.2020.58.2.173

Leishmaniasis is a prevalent cause of death and animal morbidity in underdeveloped countries of endemic area. However, there is few vaccine and effective drugs. Antimicrobial peptides are involved in the innate immune response in many organisms and are being developed as novel drugs against parasitic infections. In the present study, we synthesized a 5-amino acid peptide REDLK, which mutated the C-terminus of Pseudomonas exotoxin, to identify its effect on the Leishmania tarentolae. Promastigotes were incubated with different concentration of REDLK peptide, and the viability of parasite was assessed using MTT and Trypan blue dye. Morphologic damage of Leishmania was analyzed by light and electron microscopy. Cellular apoptosis was observed using the annexin V-FITC/PI apoptosis detection kit, mitochondrial membrane potential assay kit and flow cytometry. Our results showed that Leishmania tarentolae was susceptible to REDLK in a dose-dependent manner, disrupt the surface membrane integrity and caused parasite apoptosis. In our study, we demonstrated the leishmanicidal activity of an antimicrobial peptide REDLK from Pseudomonas aeruginosa against Leishmania tarentolae in vitro and present a foundation for further research of anti-leishmanial drugs.

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Original Articles

Diagnosis, Treatment and Clinical Features of Cutaneous Leishmaniasis in Saudi Arabia: Yousry A. Hawash, Khadiga A. Ismail, Maha M. Abdel-Wahab, Mahmoud Khalifa; Korean J Parasitol 2018;56(3):229-236.
Published online June 30, 2018; DOI: https://doi.org/10.3347/kjp.2018.56.3.229

Abstract
PDF

Cutaneous leishmaniasis (CL) has been one of the most common parasitic diseases in Saudi Arabia. This study exhibits the clinical features, diagnosis, cytokine profile and treatment of CL patients in Al-Taif province. Ninety CL suspects at a tertiary care general hospital were enrolled in one-year study. Patients were interviewed, clinically-examined, and subjected to laboratory tests: skin scraping smear microscopy, OligoC-TesT commercial PCR (Coris BioConcept) and kinetoplast DNA (kDNA) PCR for Leishmania diagnosis. Interferon-gamma (RayBio; Human IFN-γ) and nitric oxide (NO) levels in patients’ sera were evaluated before treatment with sodium stibogluconate (pentostam) with 20-day intramuscular drug regimen. Positive rates of microscopy, commercial PCR and kDNA PCR were 74.4%, 95.5% and 100%, respectively. Patients came to hospital mostly in winter (45.0%). CL was frequently exhibited in Saudi patients (78.8%), male gender (70.7%), age <20 years (50.0%), rural-dwellers (75.5%) and patients with travel history (86.6%). Lesion was mostly single ulcer (93.3%), occurred in the face (67.7%). Upon pentostam treatment, 85.1% of ulcers showed rapid healing signs. Levels of IFN-γ and NO were significantly higher in the healing than the non-healing cases (P<0.001). The kDNA PCR proved more sensitive than microscopy and OligoC-TesT commercial PCR. Our results open perspectives for IFN-γ use as a biomarker predicting treatment response.

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Evaluation of the biodiversity and distribution of sand flies and tracking of Leishmania major in them in central Iran
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Molecular characterization of Leishmania species from stray dogs and human patients in Saudi Arabia
Abdullah D. Alanazi, Abdulazi S. Alouffi, Mohamed S. Alyousif, Abdulsadah A. Rahi, Magda A. Ali, Hend H. A. M. Abdullah, Fabio A. Brayner, Jairo Alfonso Mendoza-Roldan, Marcos Antonio Bezerra-Santos, Domenico Otranto
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Zafar Rasheed, Ahmed A. Ahmed, Tarek Salem, Mohammed S. Al-Dhubaibi, Ahmad A. Al Robaee, Abdullateef A. Alzolibani
BMC Public Health.2019;[Epub] CrossRef

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15 Web of Science
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Epidemiological Aspects of Cutaneous Leishmaniasis during 2009-2016 in Kashan City, Central Iran: Doroodgar Moein, Doroodgar Masoud, Mahboobi Saeed, Doroodgar Abbas; Korean J Parasitol 2018;56(1):21-24.
Published online February 28, 2018; DOI: https://doi.org/10.3347/kjp.2018.56.1.21

Abstract
PDF

Cutaneous leishmaniasis (CL) can be seen in 2 forms, zoonotic and anthroponotic, in Iran. In this study, epidemiological aspects of CL were studied during an 8-year period (2009-2016) in city of Kashan, central Iran. The demographic and epidemiological data, including age, sex, occupation, number and site of the lesions, treatment regimen, past history of CL, and season of all patients were gathered from the health centers. Descriptive statistics were used to describe features of the study data. Total 2,676 people with CL were identified. The highest annual incidence was estimated to be 182 per 100,000 population in 2009 and the least was in 2016 (47 per 100,000 population). The highest frequency affected age groups were observed in 20-29 year-old patients (20.9%). More than 51% of the patients were under 30 years old. The maximum frequency of the disease, 1,134 (43.3%), was seen in autumn. The most common location of lesions was hands (61.4%). Most of the patients (81.6%) were treated by systemic glucantime regimen. In the city of Kashan, the incidence rate of the CL disease is significantly higher than many other regions of Iran. To reduce the risk of disease, control of reservoir hosts and vectors of disease, and education of individual protection are strongly recommended.

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Residential environment, human behavior and socio-economic status in transmission of cutaneous leishmaniasis in central Iran
Asieh Heidari, Nadia Mohammadi Dashtaki, Sima Mizbani, Mehri Rejali, Mohammad Reza Maracy
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Mehdi Haddadnia, Mahsa Esmaeilifallah, Parisima Badiezadeh, Seyed Mohammad Abtahi
International Journal of Environmental Health Research.2025; : 1. CrossRef
Investigating the Effects of Demographic Factors on the Prevalence of Cutaneous Leishmaniasis in a Focus Area of Northeastern Iran
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Michal Solomon, Inbal Fuchs, Yael Glazer, Eli Schwartz
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Cutaneous leishmaniasis in Iran: A review of epidemiological aspects, with emphasis on molecular findings
Zahra Nasiri, Mohsen Kalantari, Jalal Mohammadi, Salman Daliri, Davood Mehrabani, Kourosh Azizi
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Cutaneous Leishmaniasis Based on Climate Regions in Iran (1998-2021)
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Recombinant C-Reactive Protein: A Potential Candidate for the Treatment of Cutaneous Leishmaniasis of BALB/c Mice Caused by Leishmania major
Seyedeh Noushin Zahedi, Seyed Hossein Hejazi, Maryam Boshtam, Farahnaz Amini, Hossein Fazeli, Mahdieh Sarmadi, Mahsa Rahimi, Hossein Khanahmad
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Gholamreza Motalleb, Hamid MalekRaeesi, Hadi Mirahmadi, Amir Tavakoli Kareshk, Rahmat Solgi
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Spatial epidemiology of cutaneous leishmaniasis in Colombia: socioeconomic and demographic factors associated with a growing epidemic
Andrés M Hernández, Juan D Gutierrez, Yanyu Xiao, Adam J Branscum, Diego F Cuadros
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Cutaneous leishmaniasis in Qasr-e Shirin, a border area in the west of Iran
Yazdan Hamzavi, Naser Nazari, Nahid Khademi, Keivan Hassani, Arezoo Bozorgomid
Veterinary World.2018; : 1692. CrossRef

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22 Web of Science
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Genetic Diversity and Phylogenetic Analysis of the Iranian Leishmania Parasites Based on HSP70 Gene PCR-RFLP and Sequence Analysis: Sara Nemati, Asghar Fazaeli, Homa Hajjaran, Ali Khamesipour, Mohsen Falahati Anbaran, Arezoo Bozorgomid, Fatah Zarei; Korean J Parasitol 2017;55(4):367-374.
Published online August 31, 2017; DOI: https://doi.org/10.3347/kjp.2017.55.4.367

Abstract
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Despite the broad distribution of leishmaniasis among Iranians and animals across the country, little is known about the genetic characteristics of the causative agents. Applying both HSP70 PCR-RFLP and sequence analyses, this study aimed to evaluate the genetic diversity and phylogenetic relationships among Leishmania spp. isolated from Iranian endemic foci and available reference strains. A total of 36 Leishmania isolates from almost all districts across the country were genetically analyzed for the HSP70 gene using both PCR-RFLP and sequence analysis. The original HSP70 gene sequences were aligned along with homologous Leishmania sequences retrieved from NCBI, and subjected to the phylogenetic analysis. Basic parameters of genetic diversity were also estimated. The HSP70 PCR-RFLP presented 3 different electrophoretic patterns, with no further intraspecific variation, corresponding to 3 Leishmania species available in the country, L. tropica, L. major, and L. infantum. Phylogenetic analyses presented 5 major clades, corresponding to 5 species complexes. Iranian lineages, including L. major, L. tropica, and L. infantum, were distributed among 3 complexes L. major, L. tropica, and L. donovani. However, within the L. major and L. donovani species complexes, the HSP70 phylogeny was not able to distinguish clearly between the L. major and L. turanica isolates, and between the L. infantum, L. donovani, and L. chagasi isolates, respectively. Our results indicated that both HSP70 PCR-RFLP and sequence analyses are medically applicable tools for identification of Leishmania species in Iranian patients. However, the reduced genetic diversity of the target gene makes it inevitable that its phylogeny only resolves the major groups, namely, the species complexes.

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Existing and newly emerging human cutaneous Leishmania isolates in Ethiopia: a systematic review
Abiy Ayele Angelo, Getu Girmay, Dereje Mengesha Berta, Bisrat Birke Teketelew, Elias Chane, Negesse Cherie, Muluneh Assefa, Zufan Yiheyis Abriham, Mebratu Tamir
Discover Medicine.2025;[Epub] CrossRef
Update on the Seroepidemiology of Human Cystic Echinococcosis and Associated Risk Factors in Iran: A Systematic Review and Meta‐Analysis
Nashmin Mohemmi, Mohammad Taghi Khodayari, Seyed Ahmad Karamati, Mohammad Reza Shiee, Hossein Effatpanah, Afshin Davari, Ali Reza Ghorbani, Arezoo Bozorgomid
Health Science Reports.2025;[Epub] CrossRef
Genetic Diversity and Chromosomal Variations in the Iranian Leishmania major Strain: Insights into Pathogenicity and Drug Resistance
Hanieh Sharifian, Anis Khalafiyan, Mahmood Fadaie, Hossein Khanahmad, Zabihollah Shahmoradi, Erfan Zaker, Parisa Mousavi, Nadia Pourmoshir, Azadeh Zolfaghari
Advanced Biomedical Research.2025;[Epub] CrossRef
Genetic diversity and epidemiological insights into cutaneous leishmaniasis in Pakistan: a comprehensive study on clinical manifestations and molecular characterization of Leishmania species
Shumaila Naz, Muhammed Nalcaci, Obaid Hayat, Seray Toz, Azhar Minhas, Shahid Waseem, Yusuf Ozbel
Parasitology Research.2024;[Epub] CrossRef
Assessment of genetic markers for multilocus sequence typing (MLST) of Fasciola isolates from Iran
Naser Nazari, Mohamad Bagher Rokni, Madoka Ichikawa‐Seki, Saber Raeghi, Homa Hajjaran, Shahab Falahi, Yazdan Hamzavi, Peyman Heydarian, Afshin Davari, Keyphobad Ghadiri, Arezoo Bozorgomid
Veterinary Medicine and Science.2023; 9(2): 924. CrossRef
Real‐time impact of COVID‐19 pandemic on cutaneous leishmaniasis case finding and strategic planning, preventive interventions, control and epidemiology in a region with a high burden of cutaneous leishmaniasis and COVID‐19: A cross‐sectional descriptive
Morteza Shams, Ayoub Rashidi, Jasem Mohamadi, Mohamad Moradi, Reza Pakzad, Razi Naserifar, Jahangir Abdi, Fariba Ghelichi, Arezoo Bozorgomid, Nahid Maspi, Azra Kenarkoohi, Yasin Mohammadi, Amir Abdoli, Shahab Falahi
Health Science Reports.2023;[Epub] CrossRef
An overview of the trypanosomatid (Kinetoplastida: Trypanosomatidae) parasites infecting several mammal species in Colombia
Adriana C. Castillo-Castañeda, Luz H. Patiño, Maria Fernanda Zuñiga, Omar Cantillo-Barraza, Martha S. Ayala, Maryi Segura, Jessica Bautista, Plutarco Urbano, Jeiczon Jaimes-Dueñez, Juan David Ramírez
Parasites & Vectors.2022;[Epub] CrossRef
Taxonomy, Population Structure and Genetic Diversity of Iranian Leishmania Strains of Cutaneous and Visceral Leishmaniasis
Sara Nemati, Homa Hajjaran, Soudabeh Heydari, Asghar Fazaeli, Ali Khamesipour, Mohsen Falahati Anbaran, Mehdi Mohebali, Hamed Mirjalali
Acta Parasitologica.2021; 66(4): 1274. CrossRef
The Geographical Distribution of Human Cutaneous and Visceral Leishmania Species Identified by Molecular Methods in Iran: A Systematic Review With Meta-Analysis
Homa Hajjaran, Reza Saberi, Alireza Borjian, Mahdi Fakhar, Seyed Abdollah Hosseini, Sajjad Ghodrati, Mehdi Mohebali
Frontiers in Public Health.2021;[Epub] CrossRef
Development of a Multilocus sequence typing (MLST) scheme for Pan-Leishmania
Juan Jose Lauthier, Paula Ruybal, Paola Andrea Barroso, Yoshihisa Hashiguchi, Jorge Diego Marco, Masataka Korenaga
Acta Tropica.2020; 201: 105189. CrossRef
Isolation and Molecular Identification of Leishmania spp. in Patients With Cutaneous Leishmaniasis in Golestan Province, Iran
Ali Fattahi Bafghi, Gilda Eslami, Oghol Niazjorjani, Farzaneh Mirzaei, Javad Namrodi
International Journal of Epidemiologic Research.2019; 6(1): 8. CrossRef
Description of Leishmania species among dogs and humans in Colombian Visceral Leishmaniasis outbreaks
Giovanny Herrera, Adriana Higuera, Luz Helena Patiño, Martha S. Ayala, Juan David Ramírez
Infection, Genetics and Evolution.2018; 64: 135. CrossRef
Cutaneous leishmaniasis in Qasr-e Shirin, a border area in the west of Iran
Yazdan Hamzavi, Naser Nazari, Nahid Khademi, Keivan Hassani, Arezoo Bozorgomid
Veterinary World.2018; : 1692. CrossRef

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13 Web of Science
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Clinico-Epidemiological Patterns of Cutaneous Leishmaniasis Patients Attending the Anuradhapura Teaching Hospital, Sri Lanka: Lahiru Sandaruwan Galgamuwa, Buthsiri Sumanasena, Lalani Yatawara, Susiji Wickramasinghe, Devika Iddawela; Korean J Parasitol 2017;55(1):1-7.
Published online February 28, 2017; DOI: https://doi.org/10.3347/kjp.2017.55.1.1

Abstract
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Cutaneous leishmaniasis (CL) caused by Leishmania donovani is an endemic vector-borne disease in Sri Lanka. Over 2,500 cases have been reported since 2000 and the number of CL cases has dramatically increased annually. Total 57 clinically suspected CL patients attending the dermatology clinic in Anuradhapura Teaching Hospital were recruited from January to June 2015. Slit skin smears and skin biopsies were taken from each of the subjects. Clinical and epidemiological data were obtained using interviewer administered questionnaire. Forty-three (75.4%) patients among 57 were confirmed positive for L. donovani. The majority of infected patients was males (P=0.005), and the most affected age group was 21-40 years. Soldiers in security forces, farmers, and housewives were identified as high risk groups. The presence of scrub jungles around the residence or places of occupation (P=0.003), the presence of sandflies (P=0.021), and working outsides more than 6 hr per day (P=0.001) were significantly associated with CL. The number of lesions ranged from 1-3, and the majority (76%) of the patients had a single lesion. Upper and lower extremities were the prominent places of lesions, while the wet type of lesions were more prevalent in females (P=0.022). A nodular-ulcerative type lesion was common in both sexes. The presence of sandflies, scrub jungles, and outdoor activities contributed to spread of Leishmania parasites in an endemic pattern. Implementation of vector control programs together with health education with regard to transmission and prevention of CL are necessary to control the spread of this infection.

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Evaluation of IgG anti-L. tropica antibody response as a biomarker for cutaneous leishmaniasis using ELISA in endemic regions of Pakistan
Bashair Sheikh Pervez, Arshad Islam, Azhar Minhas, Yusuf Ozbel, Seray Toz, Shahid Waseem, Obaid Hayat, Shumaila Naz
Journal of Microbiological Methods.2026; 240: 107340. CrossRef
Immunohistochemical Characterisation of Innate Immune Cellular Responses in Cutaneous Leishmaniasis Caused by Leishmania donovani
Hasna Riyal, Nilakshi Samaranayake, Priyani Amarathunga, Deepani Munidasa, Nadira Karunaweera
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Wasia Ullah, Adil Khan, Sadaf Niaz, Maged A Al-Garadi, Nasreen Nasreen, Ayman A Swelum, Mourad Ben Said
Transactions of The Royal Society of Tropical Medicine and Hygiene.2024; 118(4): 273. CrossRef
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Hasara Nuwangi, Lisa Dikomitis, Kosala Gayan Weerakoon, Suneth Buddhika Agampodi, Thilini Chanchala Agampodi, Alberto Novaes Ramos
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Tharaka Wijerathna, Krishan Wickramasinghe, Nayana Gunathilaka, Asela Perera, Sujeewa Bandara
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Mahdi Al-Dhafiri, Abdulmohsen Alhajri, Zahraa Ali Alwayel, Jasmine Ahmed Alturaiki, Shaima Ali Bu Izran, Fatimah Ahmed Alhammad, Ryhana Mohammed Aljumaiah
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Aisha Khan, Rawan Sajid, Shaista Gul, Ashiq Hussain, Mohammad Tahir Zehri, Shumaila Naz, Sami Simsek, Shahid Waseem, Muhammad Sohail Afzal, Syed Kamran Ul Hassan Naqvi, Muhammad Qasim, Haroon Ahmed
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Acta Tropica.2020; 206: 105434. CrossRef
Socioeconomic, demographic and landscape factors associated with cutaneous leishmaniasis in Kurunegala District, Sri Lanka
Tharaka Wijerathna, Nayana Gunathilaka, Kithsiri Gunawardena, Wasana Rodrigo
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Nayana Gunathilaka, Saveen Semege, Nishantha Pathirana, Nuwani Manamperi, Lahiru Udayanga, Harshima Wijesinghe, Prasad Premaratne, Deepika Fernando
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Clinical, parasitological and molecular profiles of Cutaneous Leishmaniasis and its associated factors among clinically suspected patients attending Borumeda Hospital, North-East Ethiopia
Habtye Bisetegn, Ayalew Jejaw Zeleke, Endalamaw Gadisa, Girma Shumie, Demekech Damte, Tiruework Fenta, Sinkinesh Behaksra, Abebe Genetu Bayih, Fabiano Oliveira
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Diagnosing Cutaneous leishmaniasis using Fluorescencein SituHybridization: the Sri Lankan Perspective
Thilini Dilhara Jayasena Kaluarachchi, Manjula Manoji Weerasekera, Andrew J. McBain, Shalindra Ranasinghe, Renu Wickremasinghe, Surangi Yasawardene, Nisal Jayanetti, Rajitha Wickremasinghe
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Ekadashi Rajni, BC Ghiya, Sarman Singh, Prem Shankar, Taruna Swami, DeepikaSingh Jadon, SR Negi, Manisha Malik, PK Khatri
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Evidence for Seroprevalence in Human Localized Cutaneous Leishmaniasis Caused byLeishmania donovaniin Sri Lanka
Yamuna Deepani Siriwardana, Bhagya Deepachandi, Samantha Ranasinghe, Preethi Soysa, Nadira Karunaweera
BioMed Research International.2018; 2018: 1. CrossRef
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Devika Iddawela, Sanura Malinda Pallegoda Vithana, Dhilma Atapattu, Lanka Wijekoon
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Annals of Dermatology.2018; 30(5): 575. CrossRef
Cutaneous leishmaniasis in Qasr-e Shirin, a border area in the west of Iran
Yazdan Hamzavi, Naser Nazari, Nahid Khademi, Keivan Hassani, Arezoo Bozorgomid
Veterinary World.2018; : 1692. CrossRef

11,345 View
231 Download
24 Web of Science
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Case Report

Cutaneous Leishmaniasis of the Eyelids: A Case Series with Molecular Identification and Literature Review: Iraj Mohammadpour, Mohammad Hossein Motazedian, Farhad Handjani, Gholam Reza Hatam; Korean J Parasitol 2016;54(6):787-792.
Published online December 31, 2016; DOI: https://doi.org/10.3347/kjp.2016.54.6.787

Abstract
PDF

Cutaneous leishmaniasis (CL) is a protozoan disease which is endemic in Iran. It is transmitted by the Phlebotomus sand fly. The eyelid is rarely involved possibly because the movement of the lids impedes the sand fly from biting the skin in this region. Here, we report 6 rare cases of eyelid CL. The patients were diagnosed by skin scraping, culture, and PCR from the lesions. Skin scraping examination showed Leishmania spp. amastigotes in the cytoplasm of macrophages. Culture examination was positive for Leishmania spp. PCR was positive for Leishmania major and Leishmania tropica. The lesions were disguised as basal cell carcinoma, chalazion, hordeolum, and impetigo. The patients were treated with intramuscular meglumine antimoniate (20 mg/kg/day) for at least 3 weeks. They showed a dramatic response, and the lesions almost completely disappeared. We emphasized the importance of clinical and diagnostic features of lesions, characterized the phylogenetic relationship of isolated parasites, and reviewed the literature on ocular leishmaniasis.

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PLOS Neglected Tropical Diseases.2017; 11(10): e0005957. CrossRef

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Original Articles

Visceral Leishmaniasis in Rural Areas of Alborz Province of Iran and Implication to Health Policy: Aliehsan Heidari, Mehdi Mohebali, Kourosh Kabir, Hojatallah Barati, Yousef Soultani, Hossein Keshavarz, Behnaz Akhoundi, Homa Hajjaran, Hosein Reisi; Korean J Parasitol 2015;53(4):379-383.
Published online August 25, 2015; DOI: https://doi.org/10.3347/kjp.2015.53.4.379

Abstract
PDF

Visceral leishmaniasis (VL) or kala-azar mainly affects children in endemic areas. This study was conducted to determine the seroprevalence of VL using direct agglutination test (DAT) in children living in rural districts of Alborz Province located 30 km from Tehran capital city of Iran. Multi-stage cluster random sampling was applied. Blood samples were randomly collected from 1,007 children under 10 years of age in the clusters. A total of 37 (3.7%) of the studied population showed anti-Leishmania infantum antibodies with titers of ≥1:800. There was a significant association between positive sera and various parts of the rural areas of Alborz Province (P<0.002). Two children with anti-Leishmania infantum antibodies titers of ≥1:3,200 indicated kala-azar clinical features and treated with anti-leishmaniasis drugs in pediatric hospital. The findings of this study indicated that Leishmania infection is prevalent in rural areas of Alborz Province. Therefore, it is necessary to increase the awareness and alertness among physicians and public health managers, particularly in high-risk rural areas of the province in Iran.

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Antileishmanial and Cytotoxic Effects of Essential Oil and Methanolic Extract of Myrtus communis L.: Hossein Mahmoudvand, Fatemeh Ezzatkhah, Fariba Sharififar, Iraj Sharifi, Ebrahim Saedi Dezaki; Korean J Parasitol 2015;53(1):21-27.
Published online February 27, 2015; DOI: https://doi.org/10.3347/kjp.2015.53.1.21

Abstract
PDF

Plants used for traditional medicine contain a wide range of substances that can be used to treat various diseases such as infectious diseases. The present study was designed to evaluate the antileishmanial effects of the essential oil and methanolic extract of Myrtus communis against Leishmania tropica on an in vitro model. Antileishmanial effects of essential oil and methanolic extract of M. communis on promastigote forms and their cytotoxic activities against J774 cells were evaluated using MTT assay for 72 hr. In addition, their leishmanicidal activity against amastigote forms was determined in a macrophage model, for 72 hr. Findings showed that the main components of essential oil were α-pinene (24.7%), 1,8-cineole (19.6%), and linalool (12.6%). Findings demonstrated that M. communis, particularly its essential oil, significantly (P<0.05) inhibited the growth rate of promastigote and amastigote forms of L. tropica based on a dose-dependent response. The IC50 values for essential oil and methanolic extract was 8.4 and 28.9 μg/ml against promastigotes, respectively. These values were 11.6 and 40.8 μg/ml against amastigote forms, respectively. Glucantime as control drug also revealed IC₅₀ values of 88.3 and 44.6 μg/ml for promastigotes and amastigotes of L. tropica, respectively. The in vitro assay demonstrated no significant cytotoxicity in J774 cells. However, essential oil indicated a more cytotoxic effect as compared with the methanolic extract of M. communis. The findings of the present study demonstrated that M. communis might be a natural source for production of a new leishmanicidal agent.

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Case Reports

Visceral Leishmaniasis without Fever in an 11-Month-Old Infant: a Rare Clinical Feature of Kala-azar: Shirin Sayyahfar, Shahla Ansari, Mehdi Mohebali, Babak Behnam; Korean J Parasitol 2014;52(2):189-191.
Published online April 18, 2014; DOI: https://doi.org/10.3347/kjp.2014.52.2.189

Abstract
PDF

Visceral leishmaniasis or kala-azar is an endemic parasitic disease in some parts of the world which is characterized by fever, splenomegaly, and pancytopenia in most of the cases. Herein we report an 11 month-old male infant with diagnosis of kala-azar who presented with pallor, hepatosplenomegaly, failure to gain weight, and no history of fever. Surprisingly, fever started after beginning of meglumine antimoniate treatment in this patient. As far as we are aware of, this is a rare presentation of visceral leishmaniasis. Therefore, clinicians especially in endemic areas are highly recommended to include kala-azar among differential diagnosis of unexplained anemia without fever to prevent misdiagnosis of this potentially fatal, but treatable condition.

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An Autochthonous Case of Canine Visceral Leishmaniasis in Korea: Dong Ha Bhang, Ul Soo Choi, Hyun Jeong Kim, Kyoung-Oh Cho, Sung-Shik Shin, Hee-Jeong Youn, Cheol-Yong Hwang, Hwa-Young Youn; Korean J Parasitol 2013;51(5):545-549.
Published online October 31, 2013; DOI: https://doi.org/10.3347/kjp.2013.51.5.545

Abstract
PDF

A 12-year-old spayed female mixed-bred dog presented with nasal bleeding of 2 days duration and a skin nodule in the left flank. No abnormalities were found in coagulation profiles and blood pressure. Cytological evaluation of the nodule revealed numerous characteristic round organisms having a nucleus and a bar within macrophages and in the background, consistent with leishmaniasis. In vitro culture was unsuccessful but PCR of the nodular aspirate identified the organisms as Leishmania infantum, and the final diagnosis was canine leishmaniasis. No history of travel to endemic countries was noted. Because the dog had received a blood transfusion 2 years before the illness, serological screening tests were performed in all donor dogs of the commercial blood bank using the commercial Leishmania ELISA test kit, and there were no positive results. Additional 113 dogs with hyperglobulinemia from Seoul were also screened with the same kits but no positive results were obtained. To the best of the author's knowledge this is the first autochthonous case of canine leishmaniasis in Korea.

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Original Article

An Epidemiological Study of Cutaneous Leishmaniasis in Al-Jabal Al-Gharbi, Libya: Manal Z. M. Abdellatif, Khamis El-Mabrouk, Ashraf A. Ewis; Korean J Parasitol 2013;51(1):75-84.
Published online February 18, 2013; DOI: https://doi.org/10.3347/kjp.2013.51.1.75

Abstract
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Cutaneous leishmaniasis (CL) is an endemic parasitic infection in the Mediterranean region, including Libya and its Al-jabal Al-gharbi province. We aimed at studying the occupational relevance as well as other epidemiological aspects of CL. We investigated 140 CL cases who attended at Gharyan outpatient polyclinic during a period of 6 months in 2009. CL infection was clinically diagnosed and confirmed by demonstration of Leishmania parasites on smears from lesions. Our findings showed that males were more affected than females (P=0.04), and people above 10-years were more affected than younger ones (P=0.0001). A significant percent of CL cases belonged to Al-Kawasem subprovince (P=0.0001). Farm-related activities were the most frequent occupations among CL cases (P=0.04). In addition to farm workers, housewives and students are at risk groups since they are engaged at farm activities. Moreover, those who have occupations that require staying outdoors for a part of night, e.g., policemen, are also at risk. Compared to children, adult CL patients had multiple lesions (P=0.001) that were more prevalent in their upper and lower extremities than the face (P=0.0001). We conclude that CL is a major health problem in Al-jabal Al-gharbi province of Libya. The presence of rodents and sandflies makes it a suitable environment for Leishmania to spread in an endemic epidemiological pattern. Being engaged in farming activities or outdoor occupations increases the risk of infection. Various clinical patterns of CL suggest the presence of more than 1 species of Leishmania at Al-jabal Al-gharbi province. We propose that the 2 species responsible for CL in this area are L. major and L. tropica. Further investigations to identify the leishmanial species responsible for CL at Al-jabal Al-gharbi together with adoption of preventive and control programs are needed.

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Case Reports

Visceral Leishmaniasis Mimicking Autoimmune Hepatitis, Primary Biliary Cirrhosis, and Systemic Lupus Erythematosus Overlap: Ozlem Guzel Tunccan, Abdurrahman Tufan, G?l?in Telli, Nalan Aky?rek, Merve Pamuk?uo?lu, G?ldal Yılmaz, Kenan Hızel; Korean J Parasitol 2012;50(2):133-136.
Published online May 24, 2012; DOI: https://doi.org/10.3347/kjp.2012.50.2.133

Abstract
PDF

Visceral leishmaniasis (VL) is a life-threatening infection caused by Leishmania species. In addition to typical clinical findings as fever, hepatosplenomegaly, and cachexia, VL is associated with autoimmune phenomena. To date, VL mimicking or exacerbating various autoimmune diseases have been described, including systemic lupus erythematosus (SLE), rheumatoid arthritis, and autoimmune hepatitis (AIH). Herein, we presented a patient with VL who had overlapping clinical features with SLE, AIH, as well as antimitochondrial antibody (AMA-M2) positive primary biliary cirrhosis.

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A Case of Post Kala-Azar Dermal Leishmaniasis in India: Kalpalata Tripathy, Aparijita Misra, Rabinarayn Mallik, Debiprasad Misra, Niranjan Rout, Jayshree Rath; Korean J Parasitol 2010;48(3):245-246.
Published online September 15, 2010; DOI: https://doi.org/10.3347/kjp.2010.48.3.245

Abstract
PDF

Post kala-azar dermal leishmaniasis (PKDL) is a rare disease. This is a solitary case report from Orissa, India. We describe a case of PKDL in a 55-year-old male who presented with multiple nodular lesions over face, trunk, and extremities. The patient had been to an endemic area of kala-azar and had a previous history of leishmaniasis. Fine needle aspiration cytology samples from skin nodules revealed Leishmania amastigotes.

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Fine‐needle sampling provides appreciable diagnostic yield in lesions of post kala azar dermal leishmaniasis: Analysis of four cases from North Eastern India
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Diagnostic Cytopathology.2014; 42(6): 525. CrossRef

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Original Article

A Novel Organotellurium Compound (RT-01) as a New Antileishmanial Agent: Camila B?rbara Cantalupo Lima, Wagner Welber Arrais-Silva, Rodrigo Luiz Oliveira Rodrigues Cunha, Selma Giorgio; Korean J Parasitol 2009;47(3):213-218.
Published online August 28, 2009; DOI: https://doi.org/10.3347/kjp.2009.47.3.213

Abstract
PDF

Leishmaniasis is a neglected disease and endemic in developing countries. A lack of adequate and definitive chemotherapeutic agents to fight against this infection has led to the investigation of numerous compounds. The aim of this study was to investigate the effect of RT-01, an organotellurane compound presenting biological activities, in 2 experimental systems against Leishmania amazonensis. The in vitro system consisted of promastigotes and amastigotes forms of the parasite, and the in vivo system consisted of L. amazonensis infected BALB/c mice, an extremely susceptible mouse strain. The compound proved to be toxic against promastigotes and amastigotes. The study also showed that treatment with RT-01 produces an effect similar to that treatment with the reference antimonial drug, Glucantime, in L. amazonensis infected mice. The best results were obtained following RT-01 intralesional administration (720 ?g/kg/day); mice showed significant delay in the development of cutaneous lesions and decreased numbers of parasites obtained from the lesions. Significant differences in tissue pathology consisted mainly of no expressive accumulation of inflammatory cells and well-preserved structures in the skin tissue of RT-01-treated mice compared with expressive infiltration of infected cells replacing the skin tissue in lesions of untreated mice. These findings highlight the fact that the apparent potency of organotellurane compounds, together with their relatively simple structure, may represent a new avenue for the development of novel drugs to combat parasitic diseases.

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Brief Communication

Distribution Frequency of Pathogenic Bacteria Isolated from Cutaneus Leishmaniasis Lesions: Hengameh Ziaei, Giti Sadeghian, SH Hejazi; Korean J Parasitol 2008;46(3):191-193.
Published online September 20, 2008; DOI: https://doi.org/10.3347/kjp.2008.46.3.191

Abstract
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Cutaneous leishmaniasis (CL) is a parasitic disease characterized by single or multiple ulcerations. Secondary bacterial infections are one of the complications that can increase the tissue destruction and the resulting scar. To better determine the incidence of real secondary bacterial infections in CL, we designed the current study. This was a cross-sectional study performed in Skin Diseases and Leishmaniasis Research Centre, Isfahan, Iran. A total of 1,255 patients with confirmed CL enrolled in the study. Sterile swaps were achieved for ulcer exudates and scraping was used for non-ulcerated lesions. All samples were transferred to tryptic soy broth medium. After 24 hr of incubation at 37℃ they were transferred to eosin methylene blue agar (EMB) and blood agar. Laboratory tests were used to determine the species of bacteria. Among 1,255 confirmed CL patients, 274 (21.8%) had positive cultures for secondary bacterial infections. The bacteria isolated from the lesions were Staphylococcus aureus in 190 cases (69.3%), coagulase negative Staphylococcus in 63 cases (23.0%), E. coli in 10 cases (3.6%), Proteus sp. in 6 cases (2.2%), and Klebsiella sp. in 5 cases (1.9%). The results show that the overall incidence of secondary bacterial infections in the lesions of CL was 21.8%, considerably high. The incidence of secondary bacterial infections was significantly higher in ulcerated lesions compared with non-ulcerated lesions.

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Case Report

Successful Treatment of Lupoid Cutaneous Leishmaniasis with Glucantime and Topical Trichloroacetic Acid (A Case Report): Mohamad Ali Nilforoushzadeh, Giti Sadeghian, Fariba Jaffary, Hengameh Ziaei, Liela Shirani-Bidabad, Parvin Mahzoni; Korean J Parasitol 2008;46(3):175-177.
Published online September 20, 2008; DOI: https://doi.org/10.3347/kjp.2008.46.3.175

Abstract
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Lupoid leishmaniasis is a unique form of cutaneous leishmaniasis characterized by unusual clinical features and a chronic relapsing course, mostly caused by infection with Leishmania tropica. In this clinical form, 1-2 yr after healing of the acute lesion, new papules and nodules appear at the margin of the remaining scar. Herein, we describe a case of this clinical form that was resistant to 2 courses of treatments: systemic glucantime and then a combination therapy with allopurinol and systemic glucantime. However, marked improvement was seen after a combination therapy with topical trichloroacetic acid solution (50%) and systemic glucantime, and there were no signs of recurrence after 1 yr of follow-up.

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Original Articles

Protective effect of lectin from Synadenium carinatum on Leishmania amazonensis infection in BALB/c mice: Sandra R. Afonso-Cardoso, Fl?vio H. Rodrigues, M?rcio A.B. Gomes, Adriano G. Silva, Ademir Rocha, Aparecida H.B. Guimar?es, Ign?s Candeloro, S?lvio Favoreto, Marcelo S. Ferreira, Maria A. de Souza; Korean J Parasitol 2007;45(4):255-266.
Published online December 20, 2007; DOI: https://doi.org/10.3347/kjp.2007.45.4.255

Abstract
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The protective effect of the Synadenium carinatum latex lectin (ScLL), and the possibility of using it as an adjuvant in murine model of vaccination against American cutaneous leishmaniasis, were evaluated. BALB/c mice were immunized with the lectin ScLL (10, 50, 100 ?g/animal) separately or in association with the soluble Leishmania amazonensis antigen (SLA). After a challenge infection with 10⁶ promastigotes, the injury progression was monitored weekly by measuring the footpad swelling for 10 weeks. ScLL appeared to be capable of conferring partial protection to the animals, being most evident when ScLL was used in concentrations of 50 and 100 ?g/animal. Also the parasite load in the interior of macrophages showed significant reduction (61.7%) when compared to the control group. With regard to the cellular response, ScLL 50 and 100 ?g/animal stimulated the delayed-type hypersensitivity (DTH) reaction significantly (P < 0.05) higher than SLA or SLA plus ScLL 10 weeks after the challenge infection. The detection of high levels of IgG2a and the expression of mRNA cytokines, such as IFN-γ, IL-12, and TNF-α (Th1 profiles), corroborated the protective role of this lectin against cutaneous leishmaniasis. This is the first report of the ScLL effect on leishmaniasis and shows a promising role for ScLL to be explored in other experimental models for treatment of leishmaniasis.

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Viscerotropic growth pattern of Leishmania tropica in BALB/c mice is suggestive of a murine model for human viscerotropic leishmaniasis: Hamid Mahmoudzadeh-Niknam, Simin Sadat Kiaei, Davood Iravani; Korean J Parasitol 2007;45(4):247-253.
Published online December 20, 2007; DOI: https://doi.org/10.3347/kjp.2007.45.4.247

Abstract
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Leishmania (L.) tropica is a causative agent of cutaneous leishmaniasis, and occasionally of visceral or viscerotropic leishmaniasis in humans. Murine models of Leishmania infection have been proven to be useful for elucidation of mechanisms for pathogenesis and immunity in leishmaniasis. The aim of this study was to establish a murine model for human viscerotropic leishmaniasis, and the growth pattern of L. tropica was studied in different tissues of BALB/c mice in order to find out whether the parasite visceralizes in this murine model. L. major was used as a control as this species is known to cause a progressive infection in BALB/c mice. L. tropica or L. major was injected into the footpad of mice, and thickness of footpad, parasite loads in different tissues, and the weight of the spleen and lymph node were determined at different intervals. Results showed that L. tropica visceralizes to the spleen and grows there while its growth is controlled in footpad tissues. Dissemination of L. tropica to visceral organs in BALB/c mice was similar to the growth patterns of this parasite in human viscerotropic leishmaniasis. The BALB/c model of L. tropica infection may be considered as a good experimental model for human diseases.

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Leishmania tropica infection, in comparison to Leishmania major, induces lower delayed type hypersensitivity in BALB/c mice: Hamid Mahmoudzadeh-Niknam, Simin Sadat Kiaei, Davood Iravani; Korean J Parasitol 2007;45(2):103-109.
Published online June 20, 2007; DOI: https://doi.org/10.3347/kjp.2007.45.2.103

Abstract
PDF

Leishmania tropica and L. major are etiologic agents of human cutaneous leishmaniasis. Delayed type hypersensitivity (DTH) is an immunologic response that has been frequently used as a correlate for protection against or sensitization to leishmania antigen. In BALB/c mice, L. tropica infection results in non-ulcerating disease, whereas L. major infection results in destructive lesions. In order to clarify the immunologic mechanisms of these 2 different outcomes, we compared the ability of these 2 leishmania species in induction of DTH response in this murine model. BALB/c mice were infected with L. major or L. tropica, and disease evolution and DTH responses were determined. The results show that the primary L. major infection can exacerbate the secondary L. major infection and is associated with DTH response. Higher doses of the primary L. major infection result in more disease exacerbation of the secondary L. major infection as well as higher DTH response. L. tropica infection induces lower DTH responses than L. major. We have previously reported that the primary L. tropica infection induces partial protection against the secondary L. major infection in BALB/c mice. Induction of lower DTH response by L. tropica suggests that the protection induced against L. major by prior L. tropica infection may be due to suppression of DTH response.

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Childhood cutaneous leishmaniasis: report of 117 cases from Iran: Safar Ali Talari, Rezvan Talaei, Gholamreza Shajari, Zarichehr Vakili, Abbas Taghaviardakani; Korean J Parasitol 2006;44(4):355-360.
Published online December 20, 2006; DOI: https://doi.org/10.3347/kjp.2006.44.4.355

Abstract
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Cutaneous leishmaniasis (CL), due to Leishmania major, is endemic in different parts of Iran and has long been recognized in most provinces of Iran. This study was conducted to determine the prevalence of childhood leishmaniasis in 3 areas at the southeast of Kashan. A descriptive study was carried out on all children referred to central laboratories during a 3-year period. Initial information including age, sex, sites of ulcer on the body, number of lesions, address, and the place of the disease was obtained. The study gathered 117 children, and the results showed a prevalence of 7.2% in patients with lesions among the population and 4.2% of people displayed lesion and scar. The ages of subjects were from 6 to 15 years (average 9.75 years). The boy: girl ratio was 1.2. All of our patients lived in an endemic area. The face was affected in 47.0% of cases. The encountered forms of leishmaniasis are as follows: papulonodular 27.4%, ulcer 60.7%, sporotrichoid 6%, impetiginous 2.5%, and erysipeloid 3.4%. Treatment with intramuscular meglumine antimoniate 20-30 mg/kg/day was done for 93 patients. Meglumine antimoniate treatment was tolerated with no side effects. All leishmaniasis lesions healed within an average period of 2-14 months. Hyperpigmented scars were formed in 25.6% of the patients, atrophic scars in 4.3%, and hypopigmented scars were in 3.4%, respectively. The findings of this study indicate increased prevalence of CL in the villages at the area of Kashan and Aran-Bidgol. The clinical finding patterns belonged to different endemic strains of L. major in Isfahan, which indicates the possible transmission of infection from Isfahan to this area.

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Identification of novel Leishmania major antigens that elicit IgG2a response in resistant and susceptible mice: Mohammad Reza Mohammadi, Majid Zeinali, Sussan K. Ardestani, Amina Kariminia; Korean J Parasitol 2006;44(1):43-48.
Published online March 20, 2006; DOI: https://doi.org/10.3347/kjp.2006.44.1.43

Abstract
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Experimental murine models with high, intermediate and low levels of genetically based susceptibility to Leishmania major infection reproduce almost entire spectrum of clinical manifestations of the human disease. There are increasing non-comparative studies on immune responses against isolated antigens of L. major in different murine strains. The aim of the present study was to find out whether there is an antigen that can induce protective immune response in resistant and susceptible murine strains. To do that, crude antigenic extract of procyclic and metacyclic promastigotes of L. major was prepared and subjected to SDS-PAGE electrophoresis. Western-blotting was used to search for antigen(s) capable of raising high antibody level of IgG2a versus IgG1 in the sera of both infected resistant and susceptible strains. Two novel antigens from metacyclic promastigotes of L. major (140 and 152 kDa) were potentially able to induce specific dominant IgG2a responses in BALB/c and C57BL/6 mice. The 2 antigens also reacted with IgG antibody of cutaneous leishmaniasis patients. We confirm that 140 and 152 kDa proteins of L. major promastigotes are inducing IgG production in mice and humans.

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