دورية أكاديمية
Monitoring the Long-Term Effectiveness of Miltefosine in Indian Post-Kala-Azar Dermal Leishmaniasis.
| العنوان: | Monitoring the Long-Term Effectiveness of Miltefosine in Indian Post-Kala-Azar Dermal Leishmaniasis. |
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| المؤلفون: | Roy S; Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, India., Moulik S; Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, India., Roy M; Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, India., Ghosh MK; Department of Tropical Medicine, School of Tropical Medicine, Kolkata, India., Chaudhuri SJ; Department of Microbiology, Sarat Chandra Chattopadhyay Government Medical College and Hospital, Howrah, India., Pandey DK; Kala-Azar Elimination Programme, World Health Organization Country Office, New Delhi, India., Jain S; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland., Dagne DA; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland., Chatterjee M; Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, India. |
| المصدر: | The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2024 Mar 05; Vol. 110 (4), pp. 656-662. Date of Electronic Publication: 2024 Mar 05 (Print Publication: 2024). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Society of Tropical Medicine and Hygiene Country of Publication: United States NLM ID: 0370507 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1476-1645 (Electronic) Linking ISSN: 00029637 NLM ISO Abbreviation: Am J Trop Med Hyg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Northbrook, IL : American Society of Tropical Medicine and Hygiene Original Publication: Baltimore. |
| مواضيع طبية MeSH: | Leishmaniasis, Visceral*/parasitology , Leishmaniasis, Cutaneous*/parasitology , Leishmania* , Leishmania donovani*, Phosphorylcholine/*analogs & derivatives, Humans ; DNA |
| مستخلص: | Post-kala-azar dermal leishmaniasis (PKDL), the dermal sequel to visceral leishmaniasis (VL), is characterized by hypopigmented macules (macular) and/or papules and nodules (polymorphic). Post-kala-azar dermal leishmaniasis plays a significant role in disease transmission, emphasizing the need for monitoring chemotherapeutic effectiveness. Accordingly, this study aimed to quantify the parasite burden in PKDL patients after treatment with miltefosine by a quantitative polymerase chain reaction (qPCR). A Leishmania kinetoplastid gene-targeted qPCR was undertaken using DNA from skin biopsy specimens of patients with PKDL at three time points, i.e., at disease presentation (week 0, n = 157, group 1), upon completion of treatment (week 12, n = 39, group 2), and at any time point 6 months after completion of treatment (week ≥36, n = 54, group 3). A cycle threshold (Ct) <30 was considered the cutoff for positivity, and load was quantified as the number of parasites/µg genomic DNA (gDNA); cure was considered when samples had a Ct >30. The parasite load at disease presentation (group 1) was 10,769 (1,339-80,441)/µg gDNA (median [interquartile range]). In groups 2 and 3, qPCR results were negative in 35/39 cases (89.7%) and 48/54 cases (88.8%), respectively. In the 10/93 (10.8%) qPCR-positive cases, the parasite burdens in groups 2 and 3 were 2,420 (1,205-5,661)/µg gDNA and 22,195 (5,524-100,106)/µg gDNA, respectively. Serial monitoring was undertaken in 45 randomly selected cases that had completed treatment; all cases in groups 2 or 3 had a Ct >30, indicating cure. Overall, qPCR confirmed an 89.2% cure (as 83/93 cases showed parasite clearance), and the persistent qPCR positivity was attributed to nonadherence to treatment or unresponsiveness to miltefosine and remains to be investigated. |
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| معلومات مُعتمدة: | 001 International WHO_ World Health Organization |
| المشرفين على المادة: | 53EY29W7EC (miltefosine) 9007-49-2 (DNA) 107-73-3 (Phosphorylcholine) |
| تواريخ الأحداث: | Date Created: 20240305 Date Completed: 20240405 Latest Revision: 20240420 |
| رمز التحديث: | 20240420 |
| مُعرف محوري في PubMed: | PMC10993836 |
| DOI: | 10.4269/ajtmh.23-0197 |
| PMID: | 38442428 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1476-1645 |
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| DOI: | 10.4269/ajtmh.23-0197 |