Akbari Maryam, Oryan Ahmad, Hatam Gholamreza
Department of Parasitology, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran.
Immunol Lett. 2021 May;233:80-86. doi: 10.1016/j.imlet.2021.03.011. Epub 2021 Mar 23.
Leishmaniasis caused by various species of protozoan transmitted by sand fly vectors occurs as a spectrum of clinical features including cutaneous, mucocutaneous and visceral forms. It is a geographically distributed parasitic disease and a major public health problem in the world. The clinical syndromes are highly variable depending on the parasite species, host genetics, vectors and environment. To date, there is no effective vaccine and traditional treatments are toxic, expensive with long administration duration and many adverse side effects and/or drug resistance. Instead of treatments based on chemotherapy, certain strategies aim to recover leishmaniasis and reduce the parasitic burden. Immunotherapy has focused on the induction of effective immune response to rapidly control the disease. Recent studies have indicated that a single dose of a suitable therapeutic vaccine induces a quick and lasting recovery in patients. Immunotherapy reduces the toxicity of drug and the emergence of resistance dramatically. It could be an effective addition to chemotherapy with a safe and potent drug compared with monotherapy, resulting in a prophylactic and therapeutic cure of leishmaniasis. This review has focused on treatment of leishmaniasis with particular emphasis on immunotherapy as an alternative to conventional drug treatment.
由白蛉传播的各种原生动物引起的利什曼病,其临床表现多样,包括皮肤型、黏膜皮肤型和内脏型。它是一种具有地理分布的寄生虫病,也是世界上一个主要的公共卫生问题。临床综合征因寄生虫种类、宿主遗传学、传播媒介和环境的不同而有很大差异。迄今为止,尚无有效的疫苗,传统治疗方法有毒性、费用高、给药时间长且有许多不良副作用和/或耐药性。除了基于化疗的治疗方法外,某些策略旨在治愈利什曼病并减轻寄生虫负担。免疫疗法专注于诱导有效的免疫反应以迅速控制疾病。最近的研究表明,单剂量合适的治疗性疫苗可使患者迅速并持久康复。免疫疗法可显著降低药物毒性和耐药性的出现。与单一疗法相比,它与一种安全有效的药物联合使用可能是化疗的有效补充,从而实现利什曼病的预防和治疗性治愈。本综述重点关注利什曼病的治疗,特别强调免疫疗法作为传统药物治疗的替代方法。