Travi Bruno L, Miró Guadalupe
University of Texas Medical Branch, Department of Internal Medicine - Division of Infectious Diseases, Galveston, Texas, USA.
Universidad Complutense de Madrid, Veterinary Faculty, Animal Health Department, Madrid, Spain.
Mem Inst Oswaldo Cruz. 2018 Oct 18;113(11):e180301. doi: 10.1590/0074-02760180301.
A pivotal strategy to decrease the risk of visceral leishmaniasis in humans is to control the infection and disease progression in dogs, the domestic reservoir of Leishmania infantum (L. chagasi). Immunotherapy is a viable approach to treat sick dogs because cell-mediated immunity is the principal defense mechanism against L. infantum. Domperidone is an immune-stimulatory drug increasingly used in veterinary medicine as a prophylactic or immunotherapeutic agent. Domperidone treatment has shown to prevent overt disease or improve the clinical condition of infected dogs. However, veterinarians should be aware of the potential cardiotoxicity of domperidone when given together with drugs that inhibit CYP450s liver enzymes or those that prolong the QT interval. On the other hand, learning whether domperidone treatment significantly decreases dog infectivity to sand fly vectors is of capital importance since this result should have a palpable impact on the infection risk of humans living in regions endemic for visceral leishmaniasis.
降低人类内脏利什曼病风险的关键策略是控制犬类（婴儿利什曼原虫（恰加斯利什曼原虫）的家养宿主）的感染和疾病进展。免疫疗法是治疗患病犬类的一种可行方法，因为细胞介导的免疫是抵抗婴儿利什曼原虫的主要防御机制。多潘立酮是一种免疫刺激药物，在兽医学中越来越多地用作预防或免疫治疗剂。多潘立酮治疗已显示可预防明显疾病或改善感染犬的临床状况。然而，兽医在将多潘立酮与抑制CYP450s肝酶的药物或延长QT间期的药物合用时，应意识到多潘立酮的潜在心脏毒性。另一方面，了解多潘立酮治疗是否能显著降低犬类对沙蝇媒介的传染性至关重要，因为这一结果应会对生活在内脏利什曼病流行地区的人类感染风险产生明显影响。
