A single-group trial of end-stage patients with anthroponotic cutaneous leishmaniasis: Levamisole in combination with Glucantime in field and laboratory models
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu časopisecké články
PubMed
30583021
DOI
10.1016/j.micpath.2018.12.040
PII: S0882-4010(18)31549-3
Knihovny.cz E-zdroje
- Klíčová slova
- Cutaneous leishmaniasis, End-stage patients, Glucantime, Levamisole, Treatment,
- MeSH
- antiprotozoální látky farmakologie terapeutické užití MeSH
- buněčné linie účinky léků MeSH
- chronická nemoc terapie MeSH
- dítě MeSH
- dospělí MeSH
- fixní kombinace léků MeSH
- interleukin-10 metabolismus MeSH
- interleukin-12 - podjednotka p40 metabolismus MeSH
- kombinovaná farmakoterapie MeSH
- Leishmania tropica účinky léků patogenita MeSH
- leishmanióza kožní farmakoterapie MeSH
- levamisol aplikace a dávkování farmakologie terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- makrofágy účinky léků MeSH
- meglumin antimoniát aplikace a dávkování farmakologie terapeutické užití MeSH
- mladiství MeSH
- mladý dospělý MeSH
- myši MeSH
- senioři MeSH
- synthasa oxidu dusnatého, typ II metabolismus MeSH
- TNF-alfa metabolismus MeSH
- transformující růstový faktor beta metabolismus MeSH
- viabilita buněk účinky léků MeSH
- výsledek terapie MeSH
- zvířata MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- myši MeSH
- senioři MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antiprotozoální látky MeSH
- fixní kombinace léků MeSH
- IL10 protein, human MeSH Prohlížeč
- interleukin-10 MeSH
- interleukin-12 - podjednotka p40 MeSH
- levamisol MeSH
- meglumin antimoniát MeSH
- NOS2 protein, human MeSH Prohlížeč
- synthasa oxidu dusnatého, typ II MeSH
- TNF-alfa MeSH
- transformující růstový faktor beta MeSH
Currently, there is no satisfactory treatment modality available for cutaneous leishmaniasis (CL). The major objective of the present study was to explore the effect of immunomodulator-levamisole in combination with Glucantime in end-stage unresponsive patients with anthroponotic CL (ACL). Twenty end-stage unresponsive patients with ACL were identified for participation in this single-group trial study. Simultaneously, each patient was received a combination of levamisole pills along with Glucantime during the remedy course. Several in vitro complementary experiments were performed to evaluate the mode of action of levamisole and Glucantime alone and in combination using a macrophage model, in vitro MTT assay, flow cytometry and quantitative real time PCR (qPCR). Overall, 75% of the patients showed complete clinical cure, 10% partially improved and the remaining (15%) had underlying chronic diseases demonstrated no response to the treatment regimen. In in vitro studies, there was no cytotoxic effect associated with these drugs in the range of our experiments. The findings by the flow cytometric analysis represented that the highest apoptotic values corresponded to the drugs combination (32.23%) at 200 μg/ml concentration. Finally, the gene expression level of IL-12 p40, iNOS and TNF-α promoted while the level of IL-10 and TGF-β genes reduced as anticipated. The findings clearly indicated that the combination of levamisole and Glucantime should be considered in end-stage unresponsive patients with ACL who have not responded to basic treatments. The immunomodulatory role of levamisole in mounting immune system as documented by the in vitro experiments and further substantiated by this single-group trail study was highlighted.
Dadbin Health Clinic Kerman University of Medical Sciences Kerman Iran
Department of Dermatology Kerman University of Medical Sciences Kerman Iran
Department of Medical Parasitology and Mycology Kerman University of Medical Sciences Kerman Iran
Leishmaniasis Research Center Kerman University of Medical Sciences Kerman Iran
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