Author | Cincura, Carolina | |
Author | Costa, Rubia S. | |
Author | Lima, Clara Monica F. de | |
Author | Oliveira Filho, Jamary | |
Author | Rocha, Paulo Novis | |
Author | Carvalho, Edgar M. | |
Author | Lessa, Marcus M. | |
Access date | 2023-01-27T17:03:26Z | |
Available date | 2023-01-27T17:03:26Z | |
Document date | 2022 | |
Citation | CINCURA, Carolina et al. Assessment of immune and clinical response in patients with mucosal leishmaniasis treated with pentavalent antimony and pentoxifylline. Tropical Medicine and Infectious Disease, v. 7, p. 1-9, 2022. | en_US |
ISSN | 2414-6366 | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/56705 | |
Sponsorship | Ministério da Ciência, Tecnologia e Inovação - Brasil.
Conselho Nacional de Pesquisa (CNPq). | en_US |
Language | eng | en_US |
Publisher | MDPI | en_US |
Rights | open access | en_US |
Subject in Portuguese | Quimiocina CXCL9 | en_US |
Subject in Portuguese | Quimiocina CXCL10 | en_US |
Subject in Portuguese | TNF | en_US |
Subject in Portuguese | IFN-γ | en_US |
Subject in Portuguese | Estágio da doença | en_US |
Subject in Portuguese | Gravidade | en_US |
Subject in Portuguese | Mucosa leishmaniose | en_US |
Subject in Portuguese | Pentoxifilina | en_US |
Subject in Portuguese | Antimônio | en_US |
Title | Assessment of immune and clinical response in patients with mucosal leishmaniasis treated with pentavalent antimony and pentoxifylline | en_US |
Type | Article | en_US |
DOI | 10.3390/tropicalmed7110383 | |
Abstract | Mucosal leishmaniasis (ML) is a severe form of tegumentary leishmaniasis associated with a persistent inflammatory response. High levels of TNF, IFN-γ, CXCL9 and CXCL10 are found in ML patients, and the association of pentoxifylline with antimony is more effective in decreasing the healing time in ML patients when compared to antimony alone. The present study aimed to investigate the existence of a correlation between cytokine and chemokine production and ML severity and evaluate the potential value of cytokine and chemokine production as marker of therapeutic response in ML patients. This prospective study included 86 subjects in an area of endemic Leishmania braziliensis transmission. Patients diagnosed with ML were classified into clinical stages ranging from I to V according to disease severity. TNF, IFN-γ, CXCL9 and CXCL10 levels were quantified in the supernatant of the mononuclear cell cultures by ELISA before and after treatment with antimony alone or antimony plus pentoxifylline. The median TNF level in the group with mild disease (Stages I–II) was 1064 pg/mL (142–3738 pg/mL), while, in the group with moderate or severe disease (Stages III–V), it was 1941 pg/mL (529–5294 pg/mL) (p = 0.008). A direct correlation was observed between ML clinical severity and levels of TNF production (r = 0.44, p = 0.007). Patients who were treated with antimony and pentoxifylline healed significantly faster than those treated with antimony alone (52 vs. 77 days, hazard ratio = 0.60; 95% confidence interval = 0.38–0.95, p = 0.013). Therapeutic failure was higher in the group that received antimony alone (25% vs. 7%; p = 0.041). There was a significant decrease in CXCL9 after therapy of ML in both groups (p = 0.013; p = 0.043). TNF levels are associated with the severity of mucosal diseases, and pentoxifylline associated with antimony should be the recommended therapy for ML in countries where liposomal amphotericin B is not available. | en_US |
Affilliation | Universidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / Universidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Otorrinolaringologia. Unidade Cérvico-Facial. Salvador, BA, Brasil. | en_US |
Affilliation | Universidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. | en_US |
Affilliation | Universidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / Universidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Otorrinolaringologia. Unidade Cérvico-Facial. Salvador, BA, Brasil. | en_US |
Affilliation | Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais. Salvador, BA, Brasil. | en_US |
Affilliation | Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Departamento de Medicina Interna e Apoio Diagnóstico. Salvador, BA, Brasil. | en_US |
Affilliation | Universidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais. Salvador, BA, Brasil. | en_US |
Affilliation | Universidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / Universidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Otorrinolaringologia. Unidade Cérvico-Facial. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Departamento de Cirurgia Experimental e Especialidades Cirúrgicas. Salvador, BA, Brasil. | en_US |
Subject | Chemokine CXCL9 | en_US |
Subject | Chemokine CXCL10 | en_US |
Subject | TNF | en_US |
Subject | IFN-γ | en_US |
Subject | Disease stage | en_US |
Subject | Severity | en_US |
Subject | Mucosal leishmaniasis | en_US |
Subject | Pentoxifylline | en_US |
Subject | Antimony | en_US |
DeCS | Quimiocina CXCL9 | en_US |
DeCS | Quimiocina CXCL10 | en_US |
DeCS | Pentoxifilina | en_US |
DeCS | Antimônio | en_US |
xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar | |