TÜRKİYE’DE KRONİK KUTANÖZ LEİSHMANİASİS’DE İN VİTRO VE İN VİVO MODELDE MİLTEFOSİN ETKİNLİĞİNİN DEĞERLENDİRİLMESİ
Project no. 86 · Status: Kapanmış · 2017
Summary
The most common form of leishmaniasis that cause infection in millions of people around the world is cutaneous leishmaniasis (CL). CL, usually with one or more long-standing cutaneous lesions, can be divided into two major groups; acute CL (ACL) and chronic CL (CCL). In this study, it was aimed to compare in vitro and in vivo treatment efficacy of miltefosin, an orally used alkylphospholipid analogue, with the pentavalent antimonial compounds used in standard therapy. Leishmania promastigotes produced in enriched medium from clinical materials taken from the lesions of five CCL patients from Turkey were subjected to in vitro resistance tests using two separate methods (hemasitometer slip and XTT test) in order to detect the activities of meglumine antimoniate (MA) and miltefosine. In order to maintain an in vivo model, three groups were formed, each consisting of 5 male Mus musculus (Balb / C mice) of the same weight and age. In this model, cryopreserved promastigotes from a CCL patient were used. The infected mice were sacrificed at 24th week. Microscopy, culture and molecular methods were applied to the swabs and tissue suspensions obtained from the foot pads of the sacrificed mice. In microscopy, one of the miltefosine group was positive, four were positive in the MA group and all were positive in the control group. By culture and molecular methods, a sample was positive in the miltefosine group, four were positive in the MA group and all samples were positive in the control group. This study have provided valuable data regarding the possible presence of MA resistance in CCL infections that are difficult to treat and the possible benefits of miltefosine as a treatment alternative for patients with this clinical presentation. It is also predicted that oral treatment with miltefosine will increase the patient compliance and lead to positive outcomes in long-term treatments of these cases, rather than invasive MA therapy which is applied intra-lesionary or parenterally.