What's new for 'Trypanosomatids' in PubMed

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Sent on Thursday, 2010 Jul 08
Search kinetoplastids OR kinetoplastid OR Kinetoplastida OR "trypanosoma brucei" OR leishmania OR brucei OR leishmaniasis OR "African trypanosomiasis"
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PubMed Results

Items 1 - 10 of 14

1.	J Glob Infect Dis. 2010 May;2(2):196-7. Sporadic case of visceral leishmaniasis in sikkim, India. Adhikari L, Singh TS, Tsering D, Dhakal OP, Gupta A. Department of Microbiology, Sikkim-Manipal Institute of Medical Sciences, 5 Mile Tadong, Gangtok, Sikkim - 737 102, India.
	PMID: 20606980 [PubMed - in process]

2.	J Glob Infect Dis. 2010 May;2(2):177-85. Leishmaniasis Vaccine: Where are We Today? Kedzierski L. Infection and Immunity Division, Walter+Eliza Hall Institute of Medical Research, Melbourne, Australia. Abstract Leishmaniasis is a disease that ranges in severity from skin lesions to serious disfigurement and fatal systemic infection. WHO has classified the disease as emerging and uncontrolled and estimates that the infection results in two million new cases a year. There are 12 million people currently infected worldwide, and leishmaniasis threatens 350 million people in 88 countries. Current treatment is based on chemotherapy, which relies on a handful of drugs with serious limitations such as high cost, toxicity, difficult route of administration and lack of efficacy in endemic areas. Vaccination remains the best hope for control of all forms of the disease, and the development of a safe, effective and affordable antileishmanial vaccine is a critical global public-health priority. Extensive evidence from studies in animal models indicates that solid protection can be achieved by immunization with defined subunit vaccines or live-attenuated strains of Leishmania. However, to date, no such vaccine is available despite substantial efforts by many laboratories. The major impediment in vaccine design is the translation of data from animal models to human disease, and the transition from the laboratory to the field. Furthermore, a thorough understanding of protective immune responses and generation and maintenance of the immunological memory, the most important and least-studied aspect of antiparasitic vaccine development, during Leishmania infection is needed. This review focuses on recent findings in antileishmania vaccine field and highlights current difficulties facing vaccine development and implementation.
	PMID: 20606974 [PubMed - in process]

3.	J Glob Infect Dis. 2010 May;2(2):167-76. Drug resistance in leishmaniasis. Chakravarty J, Sundar S. Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221 005, India. Abstract The treatment options of leishmaniasis are limited and far from satisfactory. For more than 60 years, treatment of leishmaniasis has centered around pentavalent antimonials (Sb(v)). Widespread misuse has led to the emergence of Sb(v) resistance in the hyperendemic areas of North Bihar. Other antileishmanials could also face the same fate, especially in the anthroponotic cycle. The HIV/ visceral leishmaniasis (VL) coinfected patients are another potential source for the emergence of drug resistance. At present no molecular markers of resistance are available and the only reliable method for monitoring resistance of isolates is the technically demanding in vitro amastigote-macrophage model. As the armametrium of drugs for leishmaniasis is limited, it is important that effective monitoring of drug use and response should be done to prevent the spread of resistance. Regimens of simultaneous or sequential combinations should be seriously considered to limit the emergence of resistance.
	PMID: 20606973 [PubMed - in process]

4.	J Glob Infect Dis. 2010 May;2(2):159-66. Liposomal amphotericin B and leishmaniasis: dose and response. Sundar S, Chakravarty J. Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221 005, India. Abstract Liposomal amphotericin B has been used with increasing frequency to treat visceral leishmaniasis (VL). It is the treatment of choice for immunocompetent patients in the Mediterranean region and the preferred drug for HIV/VL co-infection. Although there is a regional variation in the susceptibility of the parasite a total dose of 20 mg/kg is effective in immunocompetent patients. Randomized clinical trials of liposomal amphotericin B in the treatment and secondary prophylaxis of HIV-VL coinfected patients is urgently needed to optimize treatment in this subset. With the availability of Liposomal amphotericin B at a preferential pricing in the endemic areas, short course combination therapy can become a viable alternative.
	PMID: 20606972 [PubMed - in process]

5.	J Glob Infect Dis. 2010 May;2(2):151-8. Treatment of visceral leishmaniasis. Moore EM, Lockwood DN. Hospital for Tropical Diseases, University College London Hospital. Abstract The available treatment options for visceral leishmaniasis (VL) have problems relating to efficacy, adverse effects and cost, making treatment a complex issue. We review the evidence relating to the different methods of treatment in relation to - efficacy and toxicity of the drugs in different areas of the world; ability to monitor side effects, length of treatment; ability of patients to pay for and stay safe during treatment, ability of the healthcare services to give intramuscular, intravenous or oral therapy; the sex and child-bearing potential of the patient and the immune status of the patient. The high mortality of untreated/ poorly treated VL infection makes the decisions paramount, but a unified and coordinated response by each area is likely to be more effective and informative to future policies than an ad hoc response. For patients in resource-rich countries, liposomal amphotericin B appears to be the optimal treatment. In South Asia, miltefosine is being used; the combination of single dose liposomal amphotericin B and short course miltefosine looks encouraging but has the problem of potential reproductive toxicities in females. In Africa, the evidence to switch from SSG is not yet compelling. The need to monitor and plan for evolving drug failure, secondary to leishmania parasite resistance, is paramount. With a few drugs the options may be limited; however, we await key ongoing trials in both Africa and India to explore the effects of combination treatment. If safe and reliable combinations are revealed by the ongoing studies, it is far from clear as to whether this will avoid leishmania parasite resistance. The development of new drugs to add to the armamentarium is paramount. Lessons can be learnt from the management of diseases such as tuberculosis and malaria in terms of planning the switch to combination treatment. As important as establishing the best choice for specific antileishmanial agent is ensuring treatment centers, which can best manage the problems encountered during treatment, specifically malnutrition, bleeding, intercurrent infections, drug side effects and detecting and treating underlying immunosuppression.
	PMID: 20606971 [PubMed - in process]

6.	J Glob Infect Dis. 2010 May;2(2):147-50. Treatment strategies for mucocutaneous leishmaniasis. Palumbo E. Department of Pediatric, Hospital of Sondrio, Italy. Abstract Mucocutaneous is an infection caused by a single celled parasite transmitted by sand fly bites. There are about 20 species of Leishmania that may cause mucocutaneous leishmaniasis. Some Leishmania species are closely linked to humans and are therefore found in cities (L. tropica) whereas some others are more traditionally associated with animal species and therefore considered zoonoses (L. major). The evidence for optimal treatment of mucocutaneous leishmaniasis is patchy. Although the cutaneous form of the disease is often self-limiting, it does result in significant scarring and can spread to more invasive, mucocutaneous disease. Therefore, treatment may be considered to prevent these complications. Drugs for systemic and topical treatment are presented and discussed with regard to their application, use and adverse effects.
	PMID: 20606970 [PubMed - in process]

7.	J Glob Infect Dis. 2010 May;2(2):135-46. Immunological perspectives of leishmaniasis. Nylén S, Gautam S. Department of Microbiology Tumor and Cell biology, Karolinska Institutet, Stockholm, Sweden. Abstract Leishmania parasites have been widely used in experimental models to understand generation, maintenance and failure of immune responses underlying resistance and susceptibility to infection. The clinical outcomes of Leishmania infection depend on the infecting species and the immune status of the host. Noticeably most people exposed Leishmania never develop overt disease. Understanding the immunological events that result in failure or successful control of the parasites is fundamental to both design and evaluation of vaccines and therapies against the leishmaniases. Recent studies visualizing immune response to Leishmania major in the skin have given new insights into the different immune cells acting as hosts the parasite during different stage of infection. Control of Leishmania infection and disease progression has been associated with generation of T-helper (Th) 1 and Th2 responses respectively. Though still valid in several aspects, the Th1/Th2 paradigm is an oversimplification in need of revision. Th2 polarization has never explained severity of human leishmanial disease and a number of other T-cell subsets, including regulatory T- and Th17- cells, have important roles in susceptibility and resistance of both experimental and human leishmanial disease. This review gives an updated overview of immunological response considered to be of importance in protection, susceptibility, disease progression and cure of leishmaniasis, with a special emphasis on human diseases.
	PMID: 20606969 [PubMed - in process]

8.	J Glob Infect Dis. 2010 May;2(2):127-34. The biology and control of leishmaniasis vectors. Claborn DM. Department of Nursing, Missouri State University, Springfield, MO, USA. Abstract Vector control remains a key component of many anti-leishmaniasis programs and probably will remain so until an effective vaccine becomes available. Technologies similar to those used for control of adult mosquitoes, specifically interior residual sprays and insecticide-treated nets, are currently at the forefront as disease control measures. This article provides a review of literature on the biology and control of sand fly vectors of leishmaniasis in the context of changing disease risks and the realities of modern vector control. The Literature Retrieval System of the Armed Forces Pest Management Board, Washington, DC, was the primary search engine used to review the literature.
	PMID: 20606968 [PubMed - in process]

9.	J Glob Infect Dis. 2010 May;2(2):124-6. A current perspective on leishmaniasis. Clem A. Department of Global Health, MDC 56 College of Public Health, 12901 Bruce B Downs Blvd, Tampa, USA. Abstract There are many challenges facing the successful control and eradication of cutaneous and visceral leishmaniasis. Leishmaniasis is still endemic in many poverty stricken and war torn areas. Through the use of an extensive literature review, this article examined the global disease burden of cutaneous and visceral leishmaniasis. Surveillance and control measures for leishmaniasis being used by the World Health Organization were also discussed in this article. Finally, potential new treatments and possible vaccines for leishmaniasis were reviewed in this article.
	PMID: 20606967 [PubMed - in process]

10.	J Glob Infect Dis. 2010 May;2(2):95-100. Searching for cutaneous leishmaniasis in tribals from kerala, India. S M S, T S A, R J, K V, Philip RR, Paul N. Department of Dermatology and Venereology, Government Medical College, Thiruvananthapuram, India. Abstract BACKGROUND: In India, indigenous cases of cutaneous leishmaniasis (CL) are mainly confined to the northwestern region. But now, more and more case reports are coming in from other parts of India. In January 2009, a 26-year-old lady residing in a forest area in Thiruvananthapuram district of Kerala State presented with bluish red nodules on her upper extremities, of six months duration, which was clinically more in favor of cutaneous leishmaniasis. She had never gone out of the district of Thiruvananthapuram in her life. AIM: To investigate whether the patient hails from a new endemic focus of cutaneous leishmaniasis. SETTING AND DESIGN: An epidemiological investigation in the form of a survey was carried out in March 2009 by a multidisciplinary team among 63 persons residing in the Mele Aamala and Aayiramkala forest tribal settlements in Kuttichal Panchayat of Thiruvananthapuram district. MATERIAL AND METHODS: History taking and clinical examination of 38 persons in the area with special consideration to skin lesions was undertaken. Microbiological and histopathological examination of the skin lesions was done. Breeding places of sand fly and possible reservoirs of Leishmania were also simultaneously investigated. STATISTICAL ANALYSIS USED: The data obtained was tabulated as frequency and percentage. Chi-square test was done to find out the statistical significance of differences in distributions. RESULTS: Out of the 38 persons examined, active lesions were found in 12 persons and six had healed lesions. Tissue samples were obtained from seven out of the 12 suspected cases. Four of them showed Leishman Donovan (LD) bodies in tissue smears. Out of the cultures taken from three patients, one showed promastigote forms in Novy McNeal Nicolle (NNN) medium. Histopathological study was done in five patients and two patients had LD bodies, one had epithelioid cell granuloma and the other two had mixed infiltrate with predominantly macrophages. All the three investigations were carried out in three patients and out of them one showed positivity in all the three investigations and the rest two were positive in tissue smear and histopathological examination. Sandflies collected from the area gave an indirect evidence of its role in the disease transmission in the area. CONCLUSION: The clinical, microbiological and histopathological evaluation of the skin lesions was consistent with cutaneous leishmaniasis. But none of the patients gave history of travel outside the district before the onset of the disease and no one had newly moved into this area within the last two years. So this may be considered as probably a new focus of cutaneous leishmaniasis.
	PMID: 20606960 [PubMed - in process]