Control of Visceral Leishmaniasis by Immunotherapeutic and Prophylactic Strategies

Visceral leishmaniasis (VL) or kala-azar is the most dreadful of all forms of leishmaniasis caused by Leishmania donovani in Old World and Leishmania chagasi and/or Leishmania infantum in New World affecting millions of people worldwide. In active VL, macrophages host the replicating amastigotes in...

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Main Authors: Alexandre Barbosa Reis, Hira L Nakhasi, Jesus G Valenzuela, Nahid Ali
Format: Online
Language:English
Published: Frontiers Media SA 2021
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Online Access:18161
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author Alexandre Barbosa Reis
Hira L Nakhasi
Jesus G Valenzuela
Nahid Ali
author_browse Alexandre Barbosa Reis
Hira L Nakhasi
Jesus G Valenzuela
Nahid Ali
author_facet Alexandre Barbosa Reis
Hira L Nakhasi
Jesus G Valenzuela
Nahid Ali
author_sort Alexandre Barbosa Reis
collection Directory of Open Access Books
description Visceral leishmaniasis (VL) or kala-azar is the most dreadful of all forms of leishmaniasis caused by Leishmania donovani in Old World and Leishmania chagasi and/or Leishmania infantum in New World affecting millions of people worldwide. In active VL, macrophages host the replicating amastigotes in phagolysosomal compartments leading to splenomegaly, hepatomegaly, hyperglobulinemia, anemia, weight-loss, incessant fever and ultimately death if not treated. Treatments available against the disease are limited by increased incidence of resistance, serious side-effects, high cost and long course of treatment. Immuno-chemotherapy is an alternative to overcome the limitations of the drugs against VL. Combination of one or more of immunotherapeutic agents like BCG, Alum, IFN-?, antigen-pulsed dendritic cells (DC), etc. with chemotherapeutic drugs have been tested raising hopes for a suitable immuno-chemotherapy against VL and Post Kala-azar Dermal Leishmaniasis (PKDL). Antagonists of IL-10, TGF-ß, IL-13 have been effectively used with pentavalent antimonials in treatment of experimental VL. Some parasitic antigens and liposomal formulations have also been shown to impart superior therapeutic effectiveness to antileishmanial drugs. For socio-economic reasons prophylaxis is always more desirable than therapy. Although no vaccine against any form of leishmaniasis in humans is available, patients successfully treated show considerable protection from reinfection highlighting the possibility of developing prophylactic measures against the disease. Subsequently a lot of interest has been focused recently towards developing vaccines against VL and many potential vaccine candidates like whole cell (attenuated or heat killed), crude fractions, purified subunits, DNAs, recombinant proteins, fusion proteins, and genetically modified live attenuated parasites etc. have been reported. These vaccine candidates are either activators of CD4+Th1 cells and/or CD8+ T cells or neutralizers of immuno-suppression. Cationic liposomal formulations, nanoparticle and virosome delivery systems, etc. have been used to increase potency and durability of various vaccine candidates. Immuno-modulators like TLR agonists have been shown to be promising adjuvants in enhancing efficacy and overcoming the challenge of human administrable vaccine formulations. Recently role of sand fly salivary gland proteins as immune-modulators also has been explored. Various strategies such as heterologous prime boosting, targeted antigen delivery, adjuvant mediated protection, have been undertaken. Likewise, precise role of regulatory T cells (Tregs) in VL disease progression needs to be investigated and exploited to develop both immuno-therapeutic and prophylactic methods. A breakthrough in immunotherapy and prophylactic strategy would help in eradication of the parasites from the pool of natural reservoirs namely VL and PKDL patients, asymptomatic carrier individuals and infected dogs ensuring success of global VL control programs.
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spelling doab-20.500.12854ir-440312024-03-31T13:10:20Z Control of Visceral Leishmaniasis by Immunotherapeutic and Prophylactic Strategies Alexandre Barbosa Reis Hira L Nakhasi Jesus G Valenzuela Nahid Ali R5-920 RA1-1270 RC581-607 Immuno modulator Th1 response Visceral leishmaniasis Immunotherapy Vaccine thema EDItEUR::M Medicine and Nursing Visceral leishmaniasis (VL) or kala-azar is the most dreadful of all forms of leishmaniasis caused by Leishmania donovani in Old World and Leishmania chagasi and/or Leishmania infantum in New World affecting millions of people worldwide. In active VL, macrophages host the replicating amastigotes in phagolysosomal compartments leading to splenomegaly, hepatomegaly, hyperglobulinemia, anemia, weight-loss, incessant fever and ultimately death if not treated. Treatments available against the disease are limited by increased incidence of resistance, serious side-effects, high cost and long course of treatment. Immuno-chemotherapy is an alternative to overcome the limitations of the drugs against VL. Combination of one or more of immunotherapeutic agents like BCG, Alum, IFN-?, antigen-pulsed dendritic cells (DC), etc. with chemotherapeutic drugs have been tested raising hopes for a suitable immuno-chemotherapy against VL and Post Kala-azar Dermal Leishmaniasis (PKDL). Antagonists of IL-10, TGF-ß, IL-13 have been effectively used with pentavalent antimonials in treatment of experimental VL. Some parasitic antigens and liposomal formulations have also been shown to impart superior therapeutic effectiveness to antileishmanial drugs. For socio-economic reasons prophylaxis is always more desirable than therapy. Although no vaccine against any form of leishmaniasis in humans is available, patients successfully treated show considerable protection from reinfection highlighting the possibility of developing prophylactic measures against the disease. Subsequently a lot of interest has been focused recently towards developing vaccines against VL and many potential vaccine candidates like whole cell (attenuated or heat killed), crude fractions, purified subunits, DNAs, recombinant proteins, fusion proteins, and genetically modified live attenuated parasites etc. have been reported. These vaccine candidates are either activators of CD4+Th1 cells and/or CD8+ T cells or neutralizers of immuno-suppression. Cationic liposomal formulations, nanoparticle and virosome delivery systems, etc. have been used to increase potency and durability of various vaccine candidates. Immuno-modulators like TLR agonists have been shown to be promising adjuvants in enhancing efficacy and overcoming the challenge of human administrable vaccine formulations. Recently role of sand fly salivary gland proteins as immune-modulators also has been explored. Various strategies such as heterologous prime boosting, targeted antigen delivery, adjuvant mediated protection, have been undertaken. Likewise, precise role of regulatory T cells (Tregs) in VL disease progression needs to be investigated and exploited to develop both immuno-therapeutic and prophylactic methods. A breakthrough in immunotherapy and prophylactic strategy would help in eradication of the parasites from the pool of natural reservoirs namely VL and PKDL patients, asymptomatic carrier individuals and infected dogs ensuring success of global VL control programs. 2021-02-11T10:34:45Z 2021-02-11T10:34:45Z 2016-01-19 14:05:46 2015 book 18161 16648714 9782889195527 https://directory.doabooks.org/handle/20.500.12854/44031 eng Frontiers Research Topics image/jpeg Attribution 4.0 International http://www.frontiersin.org/books/Control_of_Visceral_Leishmaniasis_by_Immunotherapeutic_and_Prophylactic_Strategies/554 http://journal.frontiersin.org/researchtopic/1970/control-of-visceral-leishmaniasis-by-immunotherapeutic-and-prophylactic-strategies Frontiers Media SA 10.3389/978-2-88919-552-7 10.3389/978-2-88919-552-7 bf5ce210-e72e-4860-ba9b-c305640ff3ae 9782889195527 144 open access
spellingShingle R5-920
RA1-1270
RC581-607
Immuno modulator
Th1 response
Visceral leishmaniasis
Immunotherapy
Vaccine
thema EDItEUR::M Medicine and Nursing
Alexandre Barbosa Reis
Hira L Nakhasi
Jesus G Valenzuela
Nahid Ali
Control of Visceral Leishmaniasis by Immunotherapeutic and Prophylactic Strategies
title Control of Visceral Leishmaniasis by Immunotherapeutic and Prophylactic Strategies
title_full Control of Visceral Leishmaniasis by Immunotherapeutic and Prophylactic Strategies
title_fullStr Control of Visceral Leishmaniasis by Immunotherapeutic and Prophylactic Strategies
title_full_unstemmed Control of Visceral Leishmaniasis by Immunotherapeutic and Prophylactic Strategies
title_short Control of Visceral Leishmaniasis by Immunotherapeutic and Prophylactic Strategies
title_sort control of visceral leishmaniasis by immunotherapeutic and prophylactic strategies
topic R5-920
RA1-1270
RC581-607
Immuno modulator
Th1 response
Visceral leishmaniasis
Immunotherapy
Vaccine
thema EDItEUR::M Medicine and Nursing
topic_facet R5-920
RA1-1270
RC581-607
Immuno modulator
Th1 response
Visceral leishmaniasis
Immunotherapy
Vaccine
thema EDItEUR::M Medicine and Nursing
url 18161
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