Madusanka Rajamanthrilage Kasun, Silva Hermali, Karunaweera Nadira D
Department of Parasitology, Faculty of Medicine, University of Colombo, No. 25, Kynsey Road, Colombo 8, Sri Lanka.
Infect Dis Ther. 2022 Apr;11(2):695-711. doi: 10.1007/s40121-022-00602-2. Epub 2022 Feb 22.
Cutaneous leishmaniasis (CL) is a complex skin infection that has imposed a heavy burden on many developing countries and is caused by more than 20 Leishmania species. This disease is predominantly associated with disfiguring scars and major social stigma upon infection. The severity of the disease seemingly depends on many factors including the species of parasite, the host, region of endemicity, socio-economic status and the accessibility to health facilities. Despite myriad studies that have been performed on current and novel therapies, the treatment outcomes of CL remain contentious, possibly because of the knowledge gaps that still exist. The differential responses to the current CL therapies have become a major drawback in disease control, and the dearth of information on critical analyses of outcomes of such studies is a hindrance to the overall understanding. On the basis of currently available literature on treatment outcomes, we discuss the most effective doses, drug susceptibilities/resistance and treatment failures of the Leishmania genus for both monotherapy and combination therapy. This review focuses on the available treatment modalities for CL caused by different Leishmania species, with insights into their species-specific efficacies, which would inform the selection of appropriate drugs for the treatment and control of leishmaniasis.
皮肤利什曼病(CL)是一种复杂的皮肤感染疾病,给许多发展中国家带来了沉重负担,它由20多种利什曼原虫引起。这种疾病主要与感染后造成毁容的疤痕和严重的社会耻辱感相关。该疾病的严重程度似乎取决于许多因素,包括寄生虫种类、宿主、流行地区、社会经济地位以及获得医疗设施的难易程度。尽管针对现有和新型疗法已经开展了大量研究,但CL的治疗效果仍然存在争议,这可能是因为仍然存在知识空白。目前CL疗法的不同反应已成为疾病控制的主要障碍,而缺乏对此类研究结果的批判性分析信息则阻碍了整体认识。基于目前关于治疗效果的现有文献,我们讨论了利什曼原虫属在单药治疗和联合治疗中的最有效剂量、药物敏感性/耐药性以及治疗失败情况。本综述重点关注由不同利什曼原虫种类引起的CL的现有治疗方式,并深入探讨其种属特异性疗效,这将为选择治疗和控制利什曼病的合适药物提供参考。
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