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皮肤利什曼病治疗无反应性的决定因素:聚焦于由……引起的人源性形式

Determinants of Unresponsiveness to Treatment in Cutaneous Leishmaniasis: A Focus on Anthroponotic Form Due to .

作者信息

Bamorovat Mehdi, Sharifi Iraj, Tavakoli Oliaee Razieh, Jafarzadeh Abdollah, Khosravi Ahmad

机构信息

Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Department of Immunology, Medical School, Kerman University of Medical Sciences, Kerman, Iran.

出版信息

Front Microbiol. 2021 Jun 1;12:638957. doi: 10.3389/fmicb.2021.638957. eCollection 2021.

Abstract

Cutaneous leishmaniasis (CL) is a curable disease; however, due to various risk factors, unresponsiveness to CL treatments is inevitable. The treatment of CL has been firmly correlated with multiple determinants, such as demographical, clinical, and environmental factors, the host's immune response, poor treatment adherence, the parasite's genetic make-up, and RNA virus. This study primarily focuses on the risk factors associated with different therapeutic outcomes following meglumine antimoniate (MA; Glucantime) treatment and policy approaches to prevent unresponsiveness in CL patients with a focus on anthroponotic form (ACL). Findings suggest that effective preventive and therapeutic measures should be more vigorously implemented, particularly in endemic areas. Accordingly, extensive training is essential to monitor drug unresponsiveness regularly, especially in tropical regions where the disease is prevalent. Since humans are the fundamental reservoir host of ACL due to , prompt detection, early diagnosis, and timely and effective treatment could help control this disease. Furthermore, major challenges and gaps remain: efficacious vaccine, new tools, and expert staff are crucial before CL can be definitively controlled.

摘要

皮肤利什曼病(CL)是一种可治愈的疾病;然而,由于各种风险因素,对CL治疗无反应是不可避免的。CL的治疗与多种决定因素密切相关,如人口统计学、临床和环境因素、宿主的免疫反应、治疗依从性差、寄生虫的基因构成以及RNA病毒。本研究主要关注葡甲胺锑酸盐(MA;葡糖酸锑钠)治疗后不同治疗结果相关的风险因素以及预防CL患者(尤其是人源性皮肤利什曼病[ACL])无反应的政策方法。研究结果表明,应更有力地实施有效的预防和治疗措施,特别是在流行地区。因此,进行广泛培训对于定期监测药物无反应至关重要,尤其是在该疾病流行的热带地区。由于人类是ACL的主要储存宿主,及时检测、早期诊断以及及时有效的治疗有助于控制这种疾病。此外,主要挑战和差距仍然存在:在CL得到明确控制之前,有效的疫苗、新工具和专业人员至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b620/8203913/8a3cda504bee/fmicb-12-638957-g001.jpg

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