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USE OF TOPICAL RSM29 IN COMBINATION WITH INTRAVENOUS MEGLUMINE ANTIMONIATE IN THE TREATMENT OF CUTANEOUS LEISHMANIASIS: A RANDOMIZE D CONTROLLE D TRIAL
Leishmania (Viannia) braziliensis
rSm29
Resposta inflamatória
Terapia
Leishmania (Viannia) braziliensis
rSm29
Inflammatory response
Therapy
Author
Affilliation
Abstract
Background: Cutaneous leishmaniasis (CL) caused by Leishmania (Viannia) braziliensis is associated with an inflammatory response. Granzyme (GzmB) and IL-1β play a key role in the pathology. Meglumine antimoniate (MA) is the first-choice drug for the treatment of CL, but therapy failure is observed in up to 50% of the cases. The protein, rSm29 of Schistosoma mansoni, down-modulates pro-inflammatory cytokine production. We evaluate if the combination of topical rSm29 plus MA increases the cure rate of CL. Methods: In this randomized clinical trial, 91 CL patients were allocated in 3 groups. All cases received MA (20 mg/kg/weight) for 20 days. Group 1 used topical rSm29 (10 µg), group 2 a placebo topically applied, and group 3 received only MA. Results: The cure rate on day 90 was 71% in subjects treated with rSm29 plus MA, and 43% in patients who received MA plus placebo or MA alone (P < 0.05). There was a decrease in GzmB and an increase in IFN-γ (P < 0.05) in supernatants of skin biopsies of the lesions obtained on D7 of therapy (P < 0.05) in patients who received rSm29. Conclusion: rSm29 associated with MA reduces GzmB levels, is more effective than MA alone, and decreases CL healing time.
Keywords in Portuguese
Leishmaniose cutâneaLeishmania (Viannia) braziliensis
rSm29
Resposta inflamatória
Terapia
Keywords
Cutaneous leishmaniasisLeishmania (Viannia) braziliensis
rSm29
Inflammatory response
Therapy
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