Efficacy of photodynamic therapy in the treatment of cutaneous leishmaniasis (original) (raw)
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Effective treatment with photodynamic therapy of cutaneous leishmaniasis: A case report
Dermatologic Therapy, 2019
Leishmaniasis is a vector borne disease transmitted by phlebotomine sandflies. Cutaneous leishmaniasis (CL) predominantly causes skin ulcers but may disseminate. CL may present a therapeutic challenge. The present study reports the case of a 15-year old boy with CL consisting of a single, ulcer on the leg, resistant to pentavalent antimony, oral fluconazole and topical ketoconazole therapy. Repeated photodynamic therapy (PDT) using ALA resulted in complete healing of the ulcer, suggesting utility of this approach in resistant cases of CL.
Journal of lasers in medical sciences, 2015
Introduction American cutaneous leishmaniasis (ACL) occurs in the Americas from southern United States to northern Argentina. ACL has clinical importance due to the high incidence and severe clinical manifestations. 1 ACL can have 2 forms, the skin (the most frequent form of the disease with skin lesion) and mucocutaneous (partial or total destruction of mucous membranes surrounding the nasopharynx region). 1-3 There may also be disseminated disease with various skin ulcers, and the diffuse disease characterized by nodular lesions without the presence of ulceration. 2 ACL has been treated with pentavalent antimonials (N-methylglucamine), as the preferential drug, and polienics antibiotics (amphotericin B), aminoglicosideos (paromomycin) and antiprotozoal agent (pentamidine isothionate), 4 but they can lead to serious side effects and discontinuation of treatment by the patients. In recent years, alternative treatments have been used for ACL and among them, photodynamic therapy (PDT) has shown promising results. 4,5 PDT builds on the application of a photosensitizer compound into the target tissue that is illuminated with light
Experimental Parasitology, 2011
The aim of this study was to investigate the effectiveness of Photodynamic Therapy (PDT) using Methylene Blue (MB) as the photosensitizing compound and a Light-Emitting Diode (LED) in American cutaneous leishmaniasis (ACL). Hamsters were experimentally infected with Leishmania (Leishmania) amazonensis. After the development of the lesions in the footpad, the animals were treated with MB three times a week for 3 months. Ten minutes after each application of MB, the lesions were irradiated with LED for 1 h. The lesions were evaluated weekly by the measurement of the hamster footpad thickness. At the end of the treatment the parasitic load was quantified in the regional lymph node of the hamsters. The treatment promoted a decrease in the thickness of infected footpad (P = 0.0001) and reduction in the parasitic load in the regional lymph node (P = 0.0007) of the animals from group treated with MB + LED. PDT using MB + LED in ACL caused by L. amazonensis shows a strong photodynamic effect. This therapy is very promising, once it is an inexpensive system and the own patient can apply it in their wound and in their house without the need of technical assistance.
Antimicrobial Agents and Chemotherapy, 2015
An evaluation of the leishmanicidal activityin vitroandin vivoof hypericin, an expanded-spectrum photosensitizer found inHypericum perforatum, is presented. Hypericin was evaluated against intracellular amastigotesin vitroofLeishmania(Viannia)panamensis. A topical formulation containing 0.5% hypericin was developed and assayedin vivoin a hamster model of cutaneous leishmaniasis. Results demonstrate that hypericin induces a significant antiamastigote effectin vitroagainstL. panamensisby decreasing the number of parasites inside infected cells. The topical formulation of 0.5% hypericin allows healing ofL. panamensis-induced lesions upon a topical application of 40 mg/day plus visible-light irradiation (5 J/cm2, 15 min), twice a week for 3 weeks.
Journal of Lasers in Medical Sciences
Introduction: American tegumentary leishmaniasis (ATL) is a zoonotic disease caused by protozoan parasites of the genus Leishmania that affects the skin and mucous membrane. Currently, the available drugs for the treatment are injectable, with side effects, long-term treatment regimen and there is the possibility of drug resistance. Thus, alternative therapies have been tested, including photodynamic therapy (PDT). We evaluated the efficacy of PDT on its own and associated with the prescribed ATL treatment. Methods: BALB/c mice were infected with Leishmania (Leishmania) amazonensis and divided into 6 groups: Gluc+PDT, treated with Glucantime® and photodynamic therapy (PDT) with methylene blue (MB)/red LED (light-emitting diode); Gluc, treated with Glucantime®; PDT, treated with PDT with MB/red LED; Ampho+PDT, treated with amphotericin and PDT with MB/red LED; Ampho, treated with amphotericin; and control, which were infected but not treated. Two treatment cycles were performed. Afte...
Photodynamic Therapy Using Methylene Blue to Treat Cutaneous Leishmaniasis
Photomedicine and Laser Surgery, 2011
Objective: The purpose of this study was to show the efficiency and underlying mechanism of action of photodynamic therapy (PDT) using methylene blue (MB) and non-coherent light sources to treat cutaneous leishmaniasis (CL). Background data: Systemic treatment can cause severe side effects, and PDT using porphyrin precursors as sensitizers has been used as an alternative to treat CL. MB has been used under illumination or in the dark to treat a wide range of medical conditions, and it exhibits antimicrobial activity against protozoa and viruses. Methods: In in vitro tests, the cell viability (via a MTT colorimetric assay) of Leishmania amazonensis parasites was evaluated as a function of MB concentration. In in vivo experiments, we analyzed the treatment of two lesions from a patient with leishmaniasis. The patient received a low dose of pentavalent antimony (SbV), and one lesion was treated with PDT. Results: We observed IC 50 decreases from 100 to 20 lM in response to PDT when MB was used in different concentrations in in vitro tests. Use of SbV in combination with the PDT protocol produced faster wound recovery when compared with the use of SbV alone. Conclusions: The in vitro experiments and the results from the clinical case suggest that the inexpensive PDT protocol that is based on MB and RL50Ò may be used to treat CL caused by L. amazonensis.