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https://www.arca.fiocruz.br/handle/icict/49860
INFLUENCE OF OBESITY ON CLINICAL MANIFESTATIONS AND RESPONSE TO THERAPY IN CUTANEOUS LEISHMANIASIS CAUSED BY LEISHMANIA BRAZILIENSIS
Leishmania braziliensis
Obesidade
Lesões atípicas
Resposta imune.
Author
Affilliation
Federal University of Bahia. Professor Edgard Santos University Hospital Complex. Immunology Service. Salvador, BA, Brazil / Federal University of Bahia Medical School. Postgraduate Course in Health Sciences, Salvador, BA, Brazil.
Federal University of Bahia. Professor Edgard Santos University Hospital Complex. Immunology Service. Salvador, BA, Brazil / Federal University of Bahia Medical School. Postgraduate Course in Health Sciences, Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil.
Federal University of Bahia Medical School. Postgraduate Course in Health Sciences, Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil.
Federal University of Southern Bahia. Teixeira de Freitas, BA, Brazil.
Federal University of Bahia. Professor Edgard Santos University Hospital Complex. Immunology Service. Salvador, BA, Brazil / Federal University of Bahia Medical School. Postgraduate Course in Health Sciences, Salvador, BA, Brazil.
Federal University of Bahia. Professor Edgard Santos University Hospital Complex. Immunology Service. Salvador, BA, Brazil / Federal University of Bahia Medical School. Postgraduate Course in Health Sciences, Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil.
Federal University of Bahia. Professor Edgard Santos University Hospital Complex. Immunology Service. Salvador, BA, Brazil / Federal University of Bahia Medical School. Postgraduate Course in Health Sciences, Salvador, BA, Brazil.
Federal University of Bahia. Professor Edgard Santos University Hospital Complex. Immunology Service. Salvador, BA, Brazil / Federal University of Bahia Medical School. Postgraduate Course in Health Sciences, Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil.
Federal University of Bahia. Professor Edgard Santos University Hospital Complex. Immunology Service. Salvador, BA, Brazil / Federal University of Bahia Medical School. Postgraduate Course in Health Sciences, Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil.
Federal University of Bahia Medical School. Postgraduate Course in Health Sciences, Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil.
Federal University of Southern Bahia. Teixeira de Freitas, BA, Brazil.
Federal University of Bahia. Professor Edgard Santos University Hospital Complex. Immunology Service. Salvador, BA, Brazil / Federal University of Bahia Medical School. Postgraduate Course in Health Sciences, Salvador, BA, Brazil.
Federal University of Bahia. Professor Edgard Santos University Hospital Complex. Immunology Service. Salvador, BA, Brazil / Federal University of Bahia Medical School. Postgraduate Course in Health Sciences, Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil.
Federal University of Bahia. Professor Edgard Santos University Hospital Complex. Immunology Service. Salvador, BA, Brazil / Federal University of Bahia Medical School. Postgraduate Course in Health Sciences, Salvador, BA, Brazil.
Federal University of Bahia. Professor Edgard Santos University Hospital Complex. Immunology Service. Salvador, BA, Brazil / Federal University of Bahia Medical School. Postgraduate Course in Health Sciences, Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Bahia, Brasil.
Abstract
Background. Cutaneous leishmaniasis (CL) caused by Leishmania braziliensis is characterized by a single ulcer or multiple cutaneous
lesions with raised borders. Cure rates <60% are observed in response to meglumine antimoniate therapy. We investigated
the impact of obesity on CL clinical presentation and therapeutic response.
Methods. A total of 90 age-matched patients with CL were included (30 obese, 30 overweight, and 30 with normal body mass
index [BMI]). CL was diagnosed through documentation of L. braziliensis DNA by polymerase chain reaction or identification of
amastigotes in biopsied skin-lesion samples. Serum cytokine levels were determined by chemiluminescence. Antimony therapy with
Glucantime (Sanofi-Aventis; 20 mg/kg/day) was administered for 20 days.
Results. Obese CL patients may present hypertrophic ulcers rather than typical oval, ulcerated lesions. A direct correlation between
BMI and healing time was noted. After 1 course of antimony, cure was achieved in 73% of patients with normal BMI, 37%
of overweight subjects, yet just 18% of obese CL patients (P < .01). Obese CL cases additionally presented higher leptin levels than
overweight patients or those with normal BMI (P < .05).
Conclusions. Obesity modifies the clinical presentation of CL and host immune response and is associated with greater failure
to therapy.
Keywords in Portuguese
Leishmaniose cutâneaLeishmania braziliensis
Obesidade
Lesões atípicas
Resposta imune.
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