A single-group trial of end-stage patients with anthroponotic cutaneous leishmaniasis: Levamisole in combination with Glucantime in field and laboratory models
Language English Country England, Great Britain Media print-electronic
Document type Journal Article
PubMed
30583021
DOI
10.1016/j.micpath.2018.12.040
PII: S0882-4010(18)31549-3
Knihovny.cz E-resources
- Keywords
- Cutaneous leishmaniasis, End-stage patients, Glucantime, Levamisole, Treatment,
- MeSH
- Antiprotozoal Agents pharmacology therapeutic use MeSH
- Cell Line drug effects MeSH
- Chronic Disease therapy MeSH
- Child MeSH
- Adult MeSH
- Drug Combinations MeSH
- Interleukin-10 metabolism MeSH
- Interleukin-12 Subunit p40 metabolism MeSH
- Drug Therapy, Combination MeSH
- Leishmania tropica drug effects pathogenicity MeSH
- Leishmaniasis, Cutaneous drug therapy MeSH
- Levamisole administration & dosage pharmacology therapeutic use MeSH
- Middle Aged MeSH
- Humans MeSH
- Macrophages drug effects MeSH
- Meglumine Antimoniate administration & dosage pharmacology therapeutic use MeSH
- Adolescent MeSH
- Young Adult MeSH
- Mice MeSH
- Aged MeSH
- Nitric Oxide Synthase Type II metabolism MeSH
- Tumor Necrosis Factor-alpha metabolism MeSH
- Transforming Growth Factor beta metabolism MeSH
- Cell Survival drug effects MeSH
- Treatment Outcome MeSH
- Animals MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Mice MeSH
- Aged MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Antiprotozoal Agents MeSH
- Drug Combinations MeSH
- IL10 protein, human MeSH Browser
- Interleukin-10 MeSH
- Interleukin-12 Subunit p40 MeSH
- Levamisole MeSH
- Meglumine Antimoniate MeSH
- NOS2 protein, human MeSH Browser
- Nitric Oxide Synthase Type II MeSH
- Tumor Necrosis Factor-alpha MeSH
- Transforming Growth Factor 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
References provided by Crossref.org
