Publications by authors named "Behnaz Akhoundi"

39 Publications

Identification of immunodominant proteins of Leishmania infantum by immunoproteomics to evaluate a recombinant multi-epitope designed antigen for serodiagnosis of human visceral leishmaniasis.

Exp Parasitol 2021 Mar 9;222:108065. Epub 2021 Jan 9.

Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.

Visceral leishmaniasis (VL) is a protozoan disease caused by Leishmania infantum in the Mediterranean region including Iran. In 95% of cases, the disease can be fatal if not rapidly diagnosed and left untreated. We aimed to identify immunoreactive proteins of L. infantum (Iranian strain), and to design and evaluate a recombinant multi-epitope antigen for serodiagnosis of human VL. To detect the immunoreactive proteins of L. infantum promastigotes, 2DE immunoblotting technique was performed using different pooled sera of VL patients. The candidate immunoreactive proteins were identified using MALDI-TOF/TOF mass spectrophotometry. Among 125 immunoreactive spots detected in 2-DE gels, glucose-regulated protein 78 (GRP78), ubiquitin-conjugating enzyme E2, calreticulin, mitochondrial heat shock 70-related protein 1 (mtHSP70), heat shock protein 70-related protein, i/6 autoantigen-like protein, ATPase beta subunit, and proteasome alpha subunit 5 were identified. The potent epitopes from candidate immunodominant proteins including GRP78, mtHSP70 and ubiquitin-conjugating enzyme E2 were then selected to design a recombinant antigenic protein (GRP-UBI-HSP). The recombinant antigen was evaluated by ELISA and compared to direct agglutination test for detection of anti L. infantum human antibodies. We screened 34 sera of VL patients from endemic areas and 107 sera of individuals without L. infantum infection from non-endemic area of VL. The recombinant protein-based ELISA provided a sensitivity of 70.6% and a specificity of 84.1%. These results showed that GRP78, ubiquitin-conjugating enzyme E2, and mtHSP70 proteins are potential immunodominant targets of the host immune system in response to the parasite and they can be considered as potential candidate markers for diagnosis purposes.
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http://dx.doi.org/10.1016/j.exppara.2021.108065DOI Listing
March 2021

The diagnostic accuracy of direct agglutination test for serodiagnosis of human visceral leishmaniasis: a systematic review with meta-analysis.

BMC Infect Dis 2020 Dec 11;20(1):946. Epub 2020 Dec 11.

Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib St., Tehran, Iran.

Background: Direct agglutination test (DAT) as a simple, accurate and reliable method, has been widely used for serodiagnosis of visceral leishmaniasis (VL) during the last three decades. The present study is a systematic review and meta-analysis to evaluate the diagnostic accuracy of DAT for serodiagnosis of human VL.

Methods: Electronic databases, including MEDLINE (via PubMed), SCOPUS, Web of Science, SID and Mag Iran (two Persian scientific search engines) were searched from December 2004 to April 2019. We determined the pooled sensitivity and specificity rates of DAT for the diagnosis of human VL, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic (ROC) curves parameters across the eligible studies.

Results: Of the 2928 records identified in the mentioned electronic databases and after examining reference lists of articles, 24 articles met inclusion criteria and were enrolled in the systematic review and out of them 20 records qualified for meta-analysis. The pooled sensitivity and specificity rates of DAT was 96% [95% CI, 92-98] and 95% [CI95% 86-99], respectively. The likelihood ratio of a positive test (LR+) was found to be 21 [CI95%, 6.6-66.5] and the likelihood ratio of a negative test (LR-) was found to be 0.04 [(CI95%, 0.02-0.08]. The combined estimate of the diagnostic odds ratio for DAT was high [467 (CI95%, 114-1912]). We found that the summary receiver operating characteristic curve (SROC) is positioned near the upper left corner of the curve and the area under curve (AUC) was 0.98 (95% CI, 0.97 to 0.99).

Conclusion: Referring to our analysis, we determined that DAT can be considered as a valuable tool for the serodiagnosis of human VL with high sensitivity and specificity. As DAT is a simple, accurate and efficient serological test, it can be recommended for serodiagnosis of human VL particularly in endemic areas.
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http://dx.doi.org/10.1186/s12879-020-05558-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729288PMC
December 2020

Molecular and Seroepidemiological Survey of Visceral Leishmaniasis in Owned Dogs () in New Foci of Rural Areas of Alborz Province, Central Part of Iran: A Cross-Sectional Study in 2017.

J Arthropod Borne Dis 2020 Mar 31;14(1):38-46. Epub 2020 Mar 31.

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Mediterranean form of visceral leishmaniasis (VL) is endemic among some provinces of Iran. The present study was designed to determine the prevalence of canine visceral leishmaniasis (CVL) in the owned dogs of the rural areas of Alborz Province near Tehran as the capital of Iran.

Methods: This study conducted on 303 owned dogs that selected using a stratified random sampling method. The direct agglutination test (DAT) was used to determine the frequency of Vl. The spleen biopsy was taken from the serology-positive dogs for the confirmation of CVL in the suspected dogs. Nested PCR and sequencing methods were used to determine the type of species in the dogs which were parasitological positive.

Results: Overall, the DAT results of 9 dogs (2.97%, CI: 1.57-5.55) showed anti antibodies at titers ≥ 1:320 indicating VL infection. One dog (0.33%, CI 95%: 0.06-1.85) showed clinical signs and symptoms of VL. There was a significant correlation between the positive cases of CVL and rural area (p< 0.001). The was observed in the impression smears that were prepared from spleen biopsy of five the studied dogs. were confirmed in all them using nested-PCR assay. The sequence analysis of all five isolates was 95% similar to .

Conclusion: This study shows that domestic cycle of has been established in rural areas of Alborz province where located near Tehran as capital city of Iran. It is necessary to increase the awareness and monitoring of the disease periodically.
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http://dx.doi.org/10.18502/jad.v14i1.2702DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382694PMC
March 2020

The rK39 Antigen from an Iranian Strain of : Detection of Anti- Antibodies in Humans and Dogs.

Iran J Parasitol 2020 Jan-Mar;15(1):48-56

Department of Medical Genetics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Background: Visceral leishmaniasis (VL) is the most severe form of leishmaniasis in Iran with high mortality rates in the case of inaccurate diagnosis and treatment. This study aimed to prepare and evaluate a new rk39 recombinant antigen from an Iranian strain of for diagnosis of VL in humans and dogs.

Methods: rK39-based enzyme-linked immunosorbent assay (ELISA) was compared with the direct agglutination test (DAT) for the detection of anti antibodies. We screened 84 human sera and 87 dog sera from clinical cases in the endemic area of Meshkin-Shahr, Iran along with 176 sera from healthy controls (collected from 86 humans and 90 dogs) during 2013-2016.

Results: Using the rK39 ELISA, a sensitivity of 85.7% (95% CI, 95-99%) and a specificity of 86.0% (95% CI, 95%-99%) were detected in human sera at a 1:800 (cut-off) titer when DAT-confirmed cases were compared with healthy controls; a sensitivity of 96.6% (95% CI, 95%-99%) and specificity of 94.4% (95% CI, 95%-99%) were found at a 1:80 (cut-off) titer compared with DAT. Kappa analysis indicated agreement between the rK39 ELISA and DAT (0.718) when using human sera at a 1:800 (cut-off) titer as well as (0.910) at a 1:80 (cut-off) titer when using dog sera (<0.05).

Conclusion: New rk39 recombinant antigen from an Iranian strain of seems to be used for diagnosis of VL in humans and dogs. Further extended field studies are recommended.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244836PMC
June 2020

A Comparative Evaluation of Regulatory T Cells Profile among Acute and Chronic Cutaneous Leishmaniasis Using Flow Cytometry.

Iran J Parasitol 2019 Apr-Jun;14(2):190-196

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Cutaneous leishmaniasis (CL) is described as a major health problem in many countries of the world. Regulatory T cells (Tregs) are characterized as one of immunologic indexes. One of the best methods to determine of Tregs percentage is flow cytometry. The aim of this study was determination of the role of Tregs profile among acute and chronic forms of human CL using flow cytometry analysis.

Methods: This study was conducted on 24 patients referred to Laboratory of Leishmaniasis, Tehran University of Medical Sciences, Tehran, Iran with acute and 14 patients with chronic phases of CL as well as 15 healthy individuals as control group in 2015-2016. After microscopic examination, 2 ml of peripheral blood samples were collected for determining percentage of CD CD CD low Tregs by using flow cytometry method.

Results: Using flow cytometry analysis, the average percentage of Tregs were calculated 5.73, 6.71 and 6.61 for acute, chronic and healthy individuals, respectively. With SPSS software and Scheffe multiple comparison tests, the differences within in these groups are statistically significant (=0.04) and between the acute and chronic group, there was marginally significant with approximately 91% of confidence level (=0.088).

Conclusion: Marginally differences were found significantly among averages of Regulatory T cells, acute and chronic phases of CL. Further comprehensive studies can be needed to verify the role of Tregs in both phases of CL cases.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737365PMC
September 2019

Visceral leishmaniasis (Kala-azar) in Qom Province, Iran: Report of two cases.

F1000Res 2018 31;7:1371. Epub 2018 Aug 31.

Health Center of Qom Province, Qom University of Medical Sciences, Qom, Iran.

Visceral leishmaniasis (VL) is a fatal parasitic zoonotic worldwide disease, which transmits to humans by the infected sand fly bite. The common form of VL in Iran is the Mediterranean type with the causative agent of , whose main reservoirs are stray and domesticated dogs. The disease has several endemic foci in Iran, mostly seen among children under the age of 10, living in rural areas and nomadic tribes. The first cases of Kala-Azar in Qom province, central Iran, were reported in the year 2001, from the villages of Ghahan district. After conducting VL control strategies in the area, no new cases of the disease had been reported until recently. The cases described here are two 2-year-old girls, living in the urban parts of Qom province, one of whom did not have a history of traveling to known endemic areas of the disease. The patients were admitted to hospital in 2016-2017, complaining from recurrent fever with unrecognized reason, associated with decreased appetite and weight loss. Disease follow-up demonstrated anemia and splenomegaly, which led to diagnosis of VL, and both patients are now fully recovered. VL was presumed to be controlled in Qom province but the present cases indicate that possible VL existence remains in the region. Therefore, urgent studies and periodic monitoring are needed to identify potential reservoirs of VL in the area.
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http://dx.doi.org/10.12688/f1000research.15805.3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6593324PMC
November 2019

In vitro and in vivo anti-parasitic activity of biogenic antimony sulfide nanoparticles on Leishmania major (MRHO/IR/75/ER).

Parasitol Res 2019 Sep 5;118(9):2669-2678. Epub 2019 Jul 5.

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

The aims of this study were to produce biogenic antimony sulfide nanoparticles (NPs) using Serratia marcescens (S. marcescens) and investigate the potential anti-leishmanial effects of these NPs on Leishmania major (L. major) (MRHO/IR/75/ER) in both in vitro and in vivo experiments. Biogenic antimony sulfide NPs were synthesized through intracellular biological methods using S. marcescens. The efficiency of various concentrations of antimony sulfide NPs was assessed using in vitro experiments on amastigotes of L. major at various times post-infection. In vivo experiments were carried out in BALB/c mice inoculated subcutaneously with 2 × 10L. major promastigotes (MHROM/IR/75/ER) and treated with antimony sulfide NPs (70 μg/mL, tropically), meglumine antimoniate (glucantime) as positive control and sterile phosphate-buffered saline (PBS, pH 7.4) as vehicle control. Results of in vitro experiments revealed that the anti-leishmanial activity increased when the antimony sulfide NPs concentration increased. The IC50 (50% inhibitory concentration) of antimony sulfide NPs against amastigotes was calculated as 62.5 μg/mL. In in vivo experiments, the average size of lesions significantly decreased to 8.6 ± 2.7 mm in mice inoculated with L. major promastigotes and treated with antimony sulfide NPs, compared with that in the negative control group (P = 0.015). Furthermore, results showed that antimony sulfide NPs significantly decreased the parasite load in the test group, compared with the negative control group (P = 0.001). Various concentrations of antimony sulfide NPs showed a great anti-leishmanial efficiency against L. major (MRHO/IR/75/ER), with the greatest efficiency shown by a concentration of 62.5 μg/mL in in vitro and in vivo experiments.
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http://dx.doi.org/10.1007/s00436-019-06382-yDOI Listing
September 2019

Western Blot Analysis of Antigens in Sera of Patients with Visceral Leishmaniasis.

Iran J Parasitol 2019 Jan-Mar;14(1):10-19

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Visceral leishmaniasis (VL) is endemic in the northwest and south of Iran. Untreated cases of VL could cause death. The aim of the present study was to evaluate the diagnostic performance of western blotting to detect a specific immunodominant proteins pattern for infection using human sera infected with VL.

Methods: We studied a panel of 122 cryopreserved human serum samples from the leishmaniasis Research Laboratory, Tehran University of Medical Sciences, Tehran, Iran from 2010 to 2017.Serum samples were collected from visceral (Group I, n: 43) and cutaneous leishmaniasis (CL) (Group II, n: 8) patients, healthy individuals from endemic (Group III, n: 13) and non-endemic (Group IV, n: 16) areas for VL, and patients with other infectious diseases (Group V, n: 42). Total antigens were prepared from the Iranian strain of promastigote form.

Results: In western blotting method, 34 protein bands of 14 to 163 kDa were recognized using the sera of VL patients. The polypeptide fractions with the highest frequency including 29, 51, and 62 kDa fractions were detected using 81.4%, 79%, and 81.4% of the sera, respectively. These bands were not detected using the sera of the negative control. Moreover, 19-23, 27, 31-35, 143-163, and 109 kDa fractions were detected specifically using the sera of the patients with VL.

Conclusion: This technique could be a primary step for further exploration of VL immunodominant antigens for cloning (or any technique) further investigations for future planning.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6511593PMC
May 2019

High resolution melting analysis as an accurate method for identifying in canine serum samples.

J Vector Borne Dis 2018 Oct-Dec;55(4):315-320

Department of Medical Parasitology and Mycology, School of Public Health, Tehran, Iran.

Background & Objectives: Leishmania (L.) infantum is the principal agent of visceral leishmaniasis (VL) in the Mediterranean and American regions. So far different molecular methods including high resolution melting (HRM) analysis have been developed for detecting and identifying L. infantum infection. HRM assay is an automted molecular method which detects and identifies different genus and species of infectious agents. This study aimed to diagnose and identify Leishmania infection caused by L. infantum species using real-time PCR coupled with HRM assay in the serum samples in comparison with anti-L. infantum antibodies obtained using direct agglutination test (DAT), in domestic and wild canines of northeastern Iran.

Methods: Serum samples of 15 foxes, 14 jackals, seven domestic dogs and three wolves were collected in some villages around Shirvan and Bojnourd districts from the northeast regions of Iran during 2014-15. Initially, all the collected serum samples were tested by DAT for the detection of anti-L. infantum antibodies. Afterwards, genomic DNA was extracted from the samples and tested by real-time PCR-HRM analysis targeting hsp70, ITS1 and gp63 genes. The level of agreement between DAT and HRM assay were analysed statistically.

Results: Out of the 39 serum samples, eight showed anti-L. infantum antibodies at titre 1: 80 while only one of them showed anti-L. infantum antibodies at titre 1 : 160. All the nine seropositive samples showed positive results with HRM analysis. Additionally, three DAT negative serum samples were also found positive in the HRM technique. Altogether, 12 out of the 39 DNA samples showed positive results in HRM analysis. Among the three gene sequences used, gp63 was best for separation and identification of species.

Interpretation & Conclusion: HRM analysis targeting hsp70, ITS1 and gp63 genes can be used as a highly sensitive technique for the screening and early detection of L. infantum infection in the wild and domestic canines. It has higher accuracy than DAT and allows detection and discrimination of different Leishmania species responsible for the Leishmaniases.
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http://dx.doi.org/10.4103/0972-9062.256568DOI Listing
July 2019

Seroepidemiological study on visceral leishmaniasis in an endemic focus of central Iran during 2017.

J Parasit Dis 2019 Mar 10;43(1):22-27. Epub 2018 Nov 10.

1Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Visceral leishmaniasis (VL) is a serious parasitic disease that occurs in some areas of Iran as endemic and sporadic forms. Qom province in central Iran is one of the endemic foci of VL, which is an important issue due to existence of local population density, foreign travelers and resided migrants. This descriptive cross-sectional study that was conducted with the aim of evaluating seroprevalence of VL in the studied area. The research considers various risk factors like immigration and tourism for planning prevention and disease control programs. Random cluster sample selection applied and 960 blood samples collected from children up to 12 years of age. The samples were taken from 22 villages in four clusters, during 2017. A questionnaire was given to each individual after obtaining parental consent. All collected sera assessed by Direct Agglutination Test to detect anti- antibodies. The antibody titers of ≥ 1:3200, accompanied by clinical symptoms, considered as VL disease. Eventually, 3 (0.3%) cases showed anti- antibodies with titers of ≥ 1:1600, while 2 of them (0.2%) had antibody titers of 1:3200 with no clinical manifestations. In order to investigate the increase of antibody, resampling performed after 2-3 weeks in which no antibody rising observed. The findings indicate that distribution pattern of VL is changing from endemic to sporadic form in rural areas of Qom province. Therefore, it is necessary to continue the surveillance by public health centers besides conducting further studies on VL reservoirs and vectors with the aim of VL control in the area.
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http://dx.doi.org/10.1007/s12639-018-1049-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6423186PMC
March 2019

Antimicrobial activity of an antimicrobial peptide against amastigote forms of .

Vet Res Forum 2018 15;9(4):323-328. Epub 2018 Dec 15.

Zoonosis Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Zoonotic cutaneous leishmaniasis caused by is a most common type of vector-borne disease in Iran. The pentavalent antimonial drugs have been used in the treatment of cutaneous leishmaniasis for a long time, but drug resistance and some of serious side effects have been reported. Thus, discovery and development of new therapeutic candidates are needed. The CM11 peptide is one of these peptides that its anti-bacterial activity has been proven. This peptide is a short cecropin-melittin hybrid peptide obtained through a sequence combination approach. The aim of this study was to evaluate anti-leishmanial activity of CM11 peptide against amastigote forms of . In this study, amastigote forms of Iranian strain of (MRHO/IR/75/ER) were cultured in the presence of different concentrations of meglumine antimoniate (Glucantime) to find the most appropriate concentration of Glucantime against amastigotes. Then, the anti-leishmanial activities of various concentrations of CM11 peptide (8, 16, 32 and 64 µM) were evaluated for 24, 48 and 72 hr by DAPI staining. In addition, MTT assay was used to determine the cytotoxic effects of CM11 peptide on murine fibroblast cell line. The results showed that CM11 peptide has antimicrobial activity against Iranian isolate of in the laboratory conditions. It seems that the CM11 peptide has significant potential to be used as a new anti-leishmanial agent.
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http://dx.doi.org/10.30466/vrf.2018.33107DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346494PMC
December 2018

Investigation of the antimicrobial activity of a short cationic peptide against promastigote and amastigote forms of Leishmania major (MHRO/IR/75/ER): An in vitro study.

Exp Parasitol 2019 Jan 26;196:48-54. Epub 2018 Nov 26.

Zoonosis Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Cutaneous leishmaniasis is one of the most endemic global health problems in many countries all around the world. Pentavalent antimonial drugs constitute the first line of leishmaniasis treatment; however, resistance to these drugs is a serious problem. Therefore, new therapies with new modes of action are urgently needed. In the current study, we examined antimicrobial activity of CM11 hybrid peptide (WKLFKKILKVL-NH2) against promastigote and amastigote forms of L. major (MHRO/IR/75/ER). In vitro anti-leishmanial activity was identified against L. major by parasite viability and metabolic activity after exposure to different peptide concentration. In the presentt study, we demostrated that different concentrations of CM11 result in dose dependent growth inhibition of Leishmania promastigotes. Furthermore, we demostrated that CM11 peptide has significant anti-leishmanial activities on amastigotes. Our results demonstrated that CM11 antimicrobial peptide may provide an alternative therapeutic approach for L. major treatment.
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http://dx.doi.org/10.1016/j.exppara.2018.11.006DOI Listing
January 2019

Potent antileishmanial activity of chitosan against Iranian strain of (MRHO/IR/75/ER): and assay.

J Vector Borne Dis 2018 Apr-Jun;55(2):111-115

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background & Objectives: Leishmaniasis is one of the major neglected zoonotic parasitic diseases whose treatment and control is very complex. Pentavalent antimonials remain the primary drugs against different forms of leishmaniasis, however, resistance to antimony and its toxic effects has necessitated the development of alternative medications such as use of medicinal plants and natural compounds. The aim of the current study was to assess the in vitro and in vivo activities of chitosan as a natural resource against Leishmania major.

Methods: Low molecular weight chitosan, with 95% degree of deacetylation was melted in normal saline to a final concentration of 50, 100, 200 and 400 μg/ml. Then, the promastigotes of L. major (Iranian strain) were added to the wells of 96-well plate and 20 μl of each concentration was added to the RPMI 1640 medium. Live and dead promastigotes were counted after adding 0.1% eosin stain. The efficacy of the chitosan was also examined in BALB/c mice infected with Iranian strain of L. major. All in vitro experiments were performed in triplicate and the results of in vitro and in vivo tests were compared to the acetic acid and NaOH as negative control and glucantime as positive control.

Results: The low molecular weight chitosan was completely effective at concentrations of 100, 200 and 400 μg/ml on promastigotes of L. major after 180 min of application. Moreover, in the in vivo study, the mean size of dermal lesions significantly decreased in the groups treated with the chitosan compared to the control group.

Interpretation & Conclusion: According to the results of the study, it can be concluded that chitosan is a potent active compound against L. major and could be evaluated as a new antileishmanial drug in the future.
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http://dx.doi.org/10.4103/0972-9062.242557DOI Listing
December 2018

Molecular-Based Detection of in Human Blood Samples in a New Focus of Visceral Leishmaniasis in Lorestan Province, Iran.

J Arthropod Borne Dis 2018 Mar 18;12(1):67-75. Epub 2018 Mar 18.

Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: The fatal form of leishmaniasis is visceral form (VL), found in some of the countries in the world. Visceral leishmaniasis has been reported sporadically from all provinces in Iran, including Lorestan. This study aimed to characterize parasite species in DAT positive and some of the DAT negative human blood samples of Delfan district, Lorestan Province, central Iran.

Methods: Blood amples were collected from different geographical areas of Delfan. Serum was used for DAT test and remained part of molecular study. DNA was extracted by using DNG-plus extracted kit (Cinagen, Iran). Polymerase chain reaction amplification of kDNA and PCR-RFLP of ITS1 was done to identify species. Some amplicons were sequenced, submitted to GenBank and analyzed by BLASTn.

Results: Expected band of kDNA for (720bp) was amplified in 16 out of 186 (8.6%) samples which showed previously anti- antibody at different titers or were negative serologically. Using BLASTn, 93% similarity with has been shown. The rDNA-ITS1 was amplified only in 9 samples (4.7%). RFLP pattern was similar to what expected for .

Conclusion: A new emerging hypo-endemic focus, caused by , is going to be established in Delphan District, Lorestan Province. Further studies on vector and reservoirs are necessary for the region and other parts of Lorestan Province.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046108PMC
March 2018

Transmission of by (Acari: Ixodidae) in Dogs.

Iran J Parasitol 2017 Oct-Dec;12(4):482-489

Dept. of Medical Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Background: is the most widely distributed tick in the world, which is partly due to its biological flexibility and the global distribution of its major host, the domestic dog. In Mediterranean region it could be principal reservoir host for usually transmitted by the phlebotomine sand flies. In this study, we evaluated the vector potential of in transmitting to uninfected dogs.

Methods: During 2014, five dogs with clinical manifestations of canine visceral leishmaniasis (CVL), high anti- antibody titers and tick infestation, were selected from CVL endemic areas (Tehran and Alborz provinces). At least, twenty live ticks were removed from each infected dog. After morphological identification, the ticks were divided into two groups; ticks belonging to the first group were dissected for parasitological examinations and semi-nested PCR assay, and those of the second group were selected for the transmission of CVL caused by to uninfected dogs. Following tick infestation, all uninfected dogs were kept for 9 months and examined monthly for clinical and serological tests.

Results: Nearly, 67% of ticks were infected by using the semi-nested PCR. All other parasitological tests of ticks were negative. Clinical examinations and serological tests of the investigated dogs revealed negative results. Nested-PCR test results performed on splenic biopsy samples of dogs were also negative.

Conclusion: -positive ticks were unable to transfer from infected dogs to healthy ones. The detection of DNA in ticks collected from naturally infected dogs by semi-nested PCR does not prove their vectorial competence.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756297PMC
January 2018

Cloning of K26 Hydrophilic Antigen from Iranian Strain of .

Iran J Public Health 2017 Oct;46(10):1359-1365

Zoonosis Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Visceral leishmaniasis (VL) caused by is the most severe form of leishmaniasis in Iran, which causes a high mortality rate in the case of inaccurate diagnosis and treatment. This study aimed to clone of K26 gene from Iranian strain of and register the sequencing results in Genbank to facilitate the preparation a new K26 antigen for the detection of infection.

Methods: was obtained from an infected domestic dog in Meshkin-Shahr area from northwestern Iran in 2015. Canine visceral leishmaniasis was confirmed by direct agglutination test (DAT), rK39 dipstick and parasitological methods. was confirmed by N-acetyl glucosamine -1-phosphate transferase (nagt)-PCR and its sequencing. The band of interest for k26 form Iranian strain of was purified by gel extraction kit after PCR amplification and then ligated into pBluescript II SK (+) and pET-32a (+), respectively. The sequences of recombinant plasmids were analyzed and submitted to Genbank.

Results: The submission of rk26 nucleotide sequence was performed to the GeneBank/NCBI Data Base under accession number KY212883. The related gene was showed a homology about 99% to and k26 gene, while the level of homology in comparison with different strains of ranged from 84-94%.

Conclusion: The successful rk26 cloning into an expression vector performed in this study could help to produce a new recombinant antigen for serodiagnosis of VL especially in areas where is the main causative agent.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750347PMC
October 2017

Seroprevalence of Visceral Leishmaniasis in Children up to 12 Years old Among Nomadic Tribes from Rural Areas of Pars Abad, Northwestern Iran: an Observational Study in 2015.

J Arthropod Borne Dis 2017 Jun 27;11(2):331-337. Epub 2017 May 27.

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Since Pars Abad district had been known as a focus of visceral leishmaniasis (VL) in Ardabil Province but the prevalence of the disease in nomadic tribes has not been determined, thus, this study was conducted.

Methods: This descriptive cross-sectional study was conducted on children up to 12yr old of nomadic tribes from Pars Abad County, Ardabil Province, Iran in 2015. For each individual, a questionnaire including age, sex, clinical manifestations, history of disease, and contact with reservoir hosts of VL were completed, separately. To determine VL seroprevalence, blood samples were collected from the children and after centrifugation, the plasma samples were tested using Direct Agglutination Test (DAT) for detection of anti- antibodies. Statistical analyses were performed using SPSS16.

Results: From 776 children up to 12yr old, 2 (0.25%) showed anti- antibodies at titers 1:1600 and only one case (0.13%) showed anti- antibodies at titers 1:3200. The child with anti- antibodies titers of 1:3200 showed mild fever for more than 2 months period, paleness, weakness and mild splenomegaly. After physical examination and confirmation of VL (kala-azar), the patient was treated with antileishmanial drugs.

Conclusion: The findings indicated that infection is being circulated with low prevalence in nomadic tribes of Pars Abad but it is necessary that the surveillance system is regularly monitored among physicians and public health managers in the studied areas.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641621PMC
June 2017

Feline leishmaniosis due to Leishmania infantum in Northwest Iran: The role of cats in endemic areas of visceral leishmaniosis.

Vet Parasitol Reg Stud Reports 2017 Aug 28;9:13-16. Epub 2017 Mar 28.

Meshkin-Shahr Station, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Visceral leishmaniosis caused by Leishmania infantum (L. infantum) is an important zoonotic disease endemic in the Mediterranean region. Domestic dogs and other wild canines are the main reservoir hosts for the parasite, while domestic cats (Felis catus) may be carriers of L. infantum, and play a role as secondary reservoirs for the parasite. In the present study, serological (DAT), parasitological (microscopic smears and culture) and molecular methods (nested PCR) were used to evaluate infection with L. infantum in 103 stray cats collected from villages of Meshkin Shahr district, located in Ardabil province which is a well-known endemic region of human and canine visceral leishmaniosis in Iran. Overall, 25 out of 103 cats (24.27%) displayed anti-Leishmania antibodies with different titers. Amastigote forms of the parasite were detected in microscopic smears of the spleen of a cat with high anti-Leishmania antibodies using DAT. L. infantum was identified on microscopic slides by nested PCR, and the results were confirmed by sequence analysis. Based on the high rate of seropositive cats in this study, we conclude that cats may have an important role in the maintenance of L. infantum in the endemic areas of zoonotic visceral leishmaniosis in Iran.
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http://dx.doi.org/10.1016/j.vprsr.2017.03.010DOI Listing
August 2017

Alteration of Direct Agglutination Test (DAT) results in Iranian Kala-Azar patients: a case series.

J Parasit Dis 2017 Jun 31;41(2):446-449. Epub 2016 Aug 31.

Health Care Center of Meshkinshahr, Ardabil University of Medical Sciences, Meshkin-shahr, Iran.

The early diagnosis of visceral leishmaniasis (VL) using Direct Agglutination Tests (DAT) and its treatment and control are essential actions taken in rural health centers in endemic foci of the infection based on the national protocols set by the Iranian Ministry of Health and Medical Education. Eleven clinically confirmed VL patients with typical VL symptoms and negative results of DAT, admitted to the pediatrics department of Valiasr Hospital in Meshkinshahr underwent parasitological tests. 7 of the total of 11 patients had positive result of bone marrow puncture smears and all of them had negative results of DAT. Thus factors that had led to false negative DAT results were examined. The patients' blood samples were collected in microhematocrit tubes using the finger prick technique, centrifuged and their plasma then separated. The complete medical history of the patients was taken using a questionnaire. The laboratory staff therefore checked the quality of anti-leishmania antigen, materials and equipment used. The patients' medical history showed that they had all been administered corticosteroid medications such as dexamethasone or hydrocortisone prior to visiting the laboratory. The DAT was repeated in these patients 2-3 weeks after their last administration of corticosteroids. The antibody titers were positive this time. A total of 3 of the collected specimens (27.3 %) showed a titer of 1.3200, 5 (46 %) showed a titer of 1.1600 and 3 (27.3 %) a titer of 1.800. Due to the effects of some medications, particularly corticosteroids, on serological tests, the patients' full medical history should be taken prior to performing this test and physicians working at endemic regions of this infection should be notified about these drug interactions.
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http://dx.doi.org/10.1007/s12639-016-0825-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447602PMC
June 2017

Canine Visceral Leishmaniasis in Wild Canines (Fox, Jackal, and Wolf) in Northeastern Iran Using Parasitological, Serological, and Molecular Methods.

J Arthropod Borne Dis 2016 Dec 4;10(4):538-545. Epub 2016 Oct 4.

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Although many studies had been conducted on various aspects of canine visceral leishmaniasis (CVL) in domestic dogs in the endemic areas of Iran, investigations on CVL in wild canines are rare.

Methods: This is a cross-sectional study was conducted from December 2012 to 2013 in northeast of Iran where human VL is endemic. Wild canines were trapped around the areas where human VL cases had been previously identified. Wild canines were collected and examined both clinically and serologically using direct agglutination test (DAT). Microscopically examinations were performed in all the seropositive wild canines for the presence of the amastigote form of spp. Some sp. which had been isolated from the spleens of wild canines, were examined analyzed by conventional PCR and sequencing techniques using α-tubulin and GAPDH genes.

Results: Altogether, 84 wild canines including foxes (, n=21), Jackals (, n=60) and wolves (, n=3) were collected. Four foxes and seven jackals showed anti- antibodies with titers of 1:320-1:20480 in DAT. Furthermore, one fox and one jackal were parasitologically (microscopy and culture) positive and was confirmed by sequence analysis.

Conclusion: The present study showed that sylvatic cycle of had been established in the studied endemic areas of VL in northeastern Iran.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5186744PMC
December 2016

Modification on Direct Agglutination Antigen Preparation for Simplified Sero-Diagnosis of Human and Canine Visceral Leishmaniasis.

Iran J Parasitol 2015 Jul-Sep;10(3):360-5

Meshkin Shahr Health Centre, Ardabil University of Medical Sciences, Meshkin Shahr, Iran.

Background: Visceral leishmaniasis is systematic serous parasitic disease with public health importance. Zoonotic form of visceral leishmaniasis is wide spread in Mediterranean basin and South America regions. Direct agglutination test (DAT) is an accurate, reliable and non-expensive serological test for the diagnosis of visceral leishmaniasis in human and canines but the antigen preparation involves some limitations. This study aimed to compare the conventional production of DAT antigen with our modified DAT antigen and then assessed on human and dog pooled sera.

Methods: Conventional DAT antigen has been prepared at the School of Public Health, Tehran University of Medical Sciences and some modifications were carried out on it, which named as modified DAT antigen. Three positive and one negative human and dog pooled serum were separately used for the comparison of modified DAT with conventional DAT antigen batches with one-month interval for a period of 9 months.

Results: A good concordance was observed between modified DAT compared to conventional DAT antigens for the detection of visceral leishmaniasis on human (100%) and dog (94.4%) pooled sera, respectively.

Conclusion: Since the modified DAT antigen could be reduced the preparation time from 3 days to several hours and a good degree of agreement was found between modified DAT and convention DAT antigen batches, it can be used as a simple and easy tool for screening and serodiagnosis of human and canine L. infantum infection.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4662736PMC
December 2015

Double-Blind Randomized Efficacy Field Trial of Alum Precipitated Autoclaved Leishmania major (Alum-ALM) Vaccine Mixed With BCG Plus Imiquimod Vs. Placebo Control Group.

Iran J Parasitol 2015 Jul-Sep;10(3):351-9

Meshkin-Shahr Research station, School of Public Health, Tehran University of Medical Sciences, Iran.

Background: Canine visceral leishmaniasis (CVL) is not only an emerging veterinary concern but also a public health threat in endemic areas. The aim of this study was to assess the efficacy, immunogenicity and safety of two doses of aluminum hydroxide (alum) precipitated Leishmania major (Alum-ALM) mixed with BCG plus imiquimod against CVL.

Methods: A total of 560 ownership dogs were serologically tested and 234 healthy dogs with no clinical signs of CVL, no anti-Leishmania antibodies and negative leishmanin skin test were selected and double-blind randomly injected intradermally either with 0.1 ml Alum-ALM (200µg protein) mixed with BCG (2 × 10(6) CFUs) plus imiquimod (121 dogs) or with 0.1 ml of normal saline (113 dogs).

Results: The follow-up examinations showed that there was no side effect associated with the vaccination except one case. Strong skin test conversion were seen in vaccinated group (30.3%) compared to the control group (6.6%) at 22-24 weeks after the booster injection (p<0.001). The seroconversion was 16.3% (18/110) in vaccinated group and 26.4% (28/106) in control group after two transmission cycles but the difference was not significant (P=0.095). The efficacy rate based on seroconversion was 40.4 %.

Conclusion: Two injections of Alum-ALM mixed with BCG and imiquimod is safe, although decreases the seroconversion rate of CVL, but the overall efficacy was low.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4662735PMC
December 2015

Visceral Leishmaniasis in Rural Areas of Alborz Province of Iran and Implication to Health Policy.

Korean J Parasitol 2015 Aug 25;53(4):379-83. Epub 2015 Aug 25.

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Iran.

Visceral leishmaniasis (VL) or kala-azar mainly affects children in endemic areas. This study was conducted to determine the seroprevalence of VL using direct agglutination test (DAT) in children living in rural districts of Alborz Province located 30 km from Tehran capital city of Iran. Multi-stage cluster random sampling was applied. Blood samples were randomly collected from 1,007 children under 10 years of age in the clusters. A total of 37 (3.7%) of the studied population showed anti-Leishmania infantum antibodies with titers of ≥1:800. There was a significant association between positive sera and various parts of the rural areas of Alborz Province (P<0.002). Two children with anti-Leishmania infantum antibodies titers of ≥1:3,200 indicated kala-azar clinical features and treated with anti-leishmaniasis drugs in pediatric hospital. The findings of this study indicated that Leishmania infection is prevalent in rural areas of Alborz Province. Therefore, it is necessary to increase the awareness and alertness among physicians and public health managers, particularly in high-risk rural areas of the province in Iran.
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http://dx.doi.org/10.3347/kjp.2015.53.4.379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566508PMC
August 2015

Seroepidemiologic Survey of Canine Visceral Leishmaniasis in Tehran and Alborz Provinces of Iran.

J Arthropod Borne Dis 2014 Dec 9;8(2):132-8. Epub 2014 Apr 9.

Department of Clinical Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran.

Background: A two year seroepidemiological study was designed to find out the seroprevalence and risk factors of canine visceral leishmaniasis (CVL) among stray and owned dogs in Tehran and Alborz Provinces of Iran.

Methods: Blood samples of 602 dogs living in 11 counties of Tehran and Alborz Provinces were taken by venipuncture in 2008-2010. After separation of blood sera, anti-leishmanial antibodies were detected by direct agglutination test (DAT).

Results: Overall, of the 408 and 194 serum samples collected randomly from dogs in 11 localities in Tehran and Alborz Provinces, 18/408 (4.41%) and 12/194 (6.18%) respectively were found positive. Among the localities, Shemiran in Tehran Province and Karaj In Alborz Province had the highest prevalence rates. No statistically significant differences were found between sex and living place but there was significant difference between living status (owned or stray) and CVL infection of dogs in Alborz Province (P= 0.018). The highest seroprevalence (7.5%) was found in dogs aged 3 to 5 years old. Only 20% of the seropositive dogs were symptomatic.

Conclusion: Concerning possible human infections in Tehran and Alborz Provinces, both symptomatic and asymptomatic seropositive dogs should be considered as a risk.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478424PMC
December 2014

Canine visceral leishmaniasis: seroprevalence survey of asymptomatic dogs in an endemic area of northwestern Iran.

J Parasit Dis 2015 Jun 20;39(2):221-4. Epub 2013 Jun 20.

Meshkin-Shahr Research Station, National Institute of Health Research, Tehran, Iran.

Canine visceral leishmaniasis is a major public health problem that is endemic in tropical and sub tropical countries and is fatal in humans and dogs. In addition to symptomatic dogs, asymptomatic ones seem as source of Leishmania infantum infection. Thus surveillance and control programs of reservoir hosts are essential. This study aimed to evaluate the sero-prevalence of visceral leishmaniasis in asymptomatic domestic dogs from in an endemic area of north west, Iran. A cross sectional study was carried out in Meshkin-Shahr district during 2011-2012. Blood samples collected from 508 asymptomatic domestic dogs were tested by direct agglutination test. In this study 508 dogs (397 males and 111 females, mean age, 3.24 years) from western and eastern parts of the Meshkin-Shahr were examined. A total of 508 dogs examined 119 dogs (23.4 %) had antibodies (titers of ≥1:320) against L. infantum. Statistically significance was occurred between male (25.4 %) and female (16.2) sero-prevalence (P = 0.042). No statistically significance was observed between age groups (P = 0.22). Compared with previous studies it seems to increase sero-prevalence of visceral leishmaniasis in dogs in the studied areas caused by ecological changes. High proportion of asymptomatic but seropositive dogs emphasizes the importance of dogs without clinical signs in the epidemiology of zoonotic leishmaniasis. Thus, the necessity of using serological tests in asymptomatic dogs is recommended for disease control strategy.
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http://dx.doi.org/10.1007/s12639-013-0325-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4456513PMC
June 2015

Stability of Freeze-Dried Sera Stored at Different Temperatures for the Detection of Anti-Leishmania infantum Antibodies Using Direct Agglutination Test.

Iran J Public Health 2014 Nov;43(11):1557-62

3. Dept. of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran.

Background: This study aimed to evaluate freeze-dried sera as an alternative to non-freeze dried for detection of anti-Leishmania infantum antibodies over the course of 11 months using the direct agglutination test (DAT).

Methods: Altogether, 60 serum samples (30 from humans and 30 from dogs) were collected from various geographical locations in Iran. All the collected sera were pooled and each pooled serum sample contained 10 different sera. In the beginning, the human and dog pooled sera were categorized as positive (weak and strong) and negative based on anti-L. infantum antibodies using the DAT. All the freeze-dried and non-freeze-dried sera were stored at -70°C, -20°C, 4°C, 22-28°C and 56°C for 11 months. The positive and negative human and dog pooled sera were separately tested using the DAT each month and the results were compared to non-freeze-dried sera kept under the same conditions.

Results: We found strong agreement (100%) between the results obtained from freeze-dried human and dog in strong DAT positive sera kept at -70°C, -20°C, 4°C and 22-28°C during this study. The human and dog pooled sera stored at 56°C were corrupted after 2 weeks. The DAT results were highly reproducible using freeze-dried human pooled sera in the beginning and month 11 of this study (CV = 0.036).

Conclusion: Freeze-dried human and dog strong DAT positive sera are highly stable under different temperature conditions, are easy to transport and are safe for use as positive and negative serum controls in laboratories.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449506PMC
November 2014

Seroepidemiological survey of human visceral leishmaniasis in ilam province, west of iran in 2013.

Iran J Parasitol 2015 Jan-Mar;10(1):56-61

Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Visceral leishmaniasis (VL) as one of the most important human parasitic disease is endemic in some parts of Iran. Several cases of VL have been reported recently in the Ilam Province. The current study aimed to assess the present status of human VL in the region.

Methods: A random cluster sampling method was used to collect 456 serums samples from the children up to 12 years of age and 10% of adults living in urban and rural areas of the province. All the collected serum samples were tested by direct agglutination test (DAT) to detect anti- Leishmania infantum antibodies.

Results: Of the examined 456 serum samples with direct agglutination test (DAT), only 21 (0.43%) sera showed anti- Leishmania antibodies at titers 1:400 and higher. Distribution of anti- Leishmania antibodies titers were: 1:400(n=4), 1:800(n=11), 1:1600(n=3), 1:3200(n=1), and 1:6400(n=1). Individuals with titers ≥1:3200 showed clinical signs and symptoms such as fever and splenomegaly. The highest and lowest seropositivity were observed in the age groups of 5-9 and >15 years old, respectively. There were no significant difference between the rate of seropositivity in males and females.

Conclusion: VL with a low prevalence circulates in some parts of Ilam province, particularly in the southern parts. Complementary studies should be needed to find animal reservoir hosts and vectors. Furthermore, health systems and physicians should pay particular attention to the disease.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4403540PMC
April 2015

Assessment of the Effects of a Novel Herbal Immunomodulator Drug (IMOD) on Cytokine Profiles in Experimental Canine Visceral Leishmaniasis: a Preliminary Survey.

Iran J Parasitol 2014 Sep;9(3):292-301

Department of Epidemiology, Pasteur institute of Iran, Tehran, Iran.

Background: Cytokines play a fundamental role in the regulation of immune responses in remission and/or relapsing of leishmaniasis. Therefore, immunotherapy for the treatment of canine visceral leishmaniasis (CVL) has represented a principle approach in control of the infection. The present research aimed to evaluating the immunotherapeutic potential of a novel herbal immunomodulator drug (IMOD) on CVL.

Methods: Twelve mongrel dogs were intravenously infected with Iranian strain of L. infantum and randomly divided into three groups; 1: negative control (non-infected), 2: immunotherapy with IMOD and 3: positive control (non-treated). Cell proliferation and Th1-/Th2-type cytokines were measured in peripheral blood mononuclear cell (PBMC) by cell proliferation kit I (MTT) and enzyme-linked immunospot (ELISpot) assays, respectively.

Results: At the 60 days follow-up assessment, no adverse effects were observed in treated interventional group. Cellular proliferation assay indicated that PBMCs of IMOD group had higher stimulation index (SI) than positive control group (p < 0.05). Enhancement of CD4+T cells such as IL-2, IL-4 & IL-10 were detected in negative control group due to in vitro IMOD stimulation 30 days post-treatment. In accordance to decreasing trends of Th1 & Th2 cytokines in positive control group, the mean number of IFN-γ IL-2, IL-4 and IL-10 spot forming cells (SFCs) down regulated for IMOD group during the study.

Conclusion: These data indicate that IMOD had immunomodulatory potential but is not sufficient for total parasitic cure due to balance of Th1/Th2 cytokines. This is a preliminary study and we propose to undertake a series of experiments to evaluate the CVL due to in vitro modulatory effects of IMOD.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316559PMC
September 2014

Evaluation of a Novel Herbal Immunomodulator Drug (IMOD) in Treatment of Experimental Canine Visceral leishmaniasis.

Iran J Pharm Res 2014 ;13(4):1357-67

Department of Biochemistry, Faculty of Basic Siences, University of Gilan, Rasht, Iran.

Toxicity and drug resistance against pentavalent antimonials, medications of choice in treatment of leishmaniasis for more than 5 decades, have become important subjects globally. This study was a randomized, open labeled trial that was designed to determine efficacy and safety of IMOD as a novel herbal immunomodulator drug for treatment of canine visceral leishmaniasis (CVL). Twenty healthy mongrel dogs were infected with Iranian strain of L. Infantum amastigotes and randomly divided to 5 groups with four animals for each included on: I: negative control (non-infected) II: Glucantime® III: Glucantime® plus IMOD (immune-chemotherapy) IV: IMOD and V: positive control (non-treated). Physical examination, hematological, biochemical, serological, parasitological, pathological and imaging evaluations were performed pre-/post- interventions every month for 3 months. Comparing with control groups (I&V), immune-chemotherapy group (Glucantime® plus IMOD) showed significantly higher efficacy in resolving the clinical signs and hematobiochemistry factors. Based on our results, using IMOD in combination with meglumine antimoniate (Glucantime®) has significantly improved CVL than the latter drug alone. So, it seems this new herbal medicine is useful as adjuvant therapy for canine visceral leishmaniasis.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232802PMC
January 2015

Emergence of co-infection of visceral leishmaniasis in HIV-positive patients in northeast Iran: a preliminary study.

Travel Med Infect Dis 2014 Mar-Apr;12(2):173-8. Epub 2013 Sep 26.

Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Visceral leishmaniasis (VL) serosurvey was carried out on 49 HIV/AIDS patients among 500 asymptomatic HIV/infected patients who registered in the Khorasan Razavi Province during the last 14 years. HIV infections were detected by ELISA and confirmed using western blot assay at the AIDS centre of the Khorasan Razavi Province. All collected sera were screened using the direct agglutination test (DAT). The sera with anti-Leishmania infantum antibodies at a titre of 1:100 were considered positive for VL infection and serum titration was performed from 1:100 to 1:102,400. Nine (18.4%) patients were sero-positive according to DAT. The distribution of sera titrations were as follows: 1:100 (n = 6) 1:1600 (n = 1); 1:25,600 (n = 1) and 1:102,400 (n = 1). All sero-positive cases showed clinical signs and symptoms. The most predominant signs and symptoms of co-infection of visceral leishmaniasis in HIV-positive patients were pneumonia (n = 2), hepatosplenomegaly (n = 2), lymphadenopathy (n = 2), anaemia (n = 1), prolonged fever (n = 1) and cachexia (n = 1). Our finding shows that VL (or kala-azar) is an opportunistic disease in HIV-positive patients that may be occurred in VL endemic areas of Iran.
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http://dx.doi.org/10.1016/j.tmaid.2013.09.001DOI Listing
December 2014