Visceral Leishmaniasis Collin Price Spring 2011

Visceral Leishmaniasis – also known as Kala Azar – is a systemic disease that primarily affects the liver, spleen, and bone marrow

Symptoms of VL include hepatosplenomegaly, high fever, anemia, and weight loss

Like every disease we have studied, visceral Leishmaniasis is a disease of the poor 

VL is endemic in 88 countries, with 90% of cases occurring in Brazil, Bangladesh, India, Nepal and Sudan.

The causal agent is a protozoan of genus Leishmania - related to organisms causing Sleeping Sickness, Chagas, and Malaria

Leishmaniasis is transmitted via a blood sucking sand fly of the species Phlebotominae

Look familiar?

Proteins on the surface of the promastigote allow the organism to escape lysis by the complement system

Once inside the macrophage, the protozoan relies on a trans-membrane pump to acquire iron for metabolism

The best way to diagnose infection with Leishmaniasis is visualization of the amastigotes in blood or aspirates from infected tissue

Classically, therapy has involved treatment with antimonial compounds

Miltefosine might be the answer, with a 95% cure rate!

35 Countries around the world have reported cases of VL/HIV co-infection oinfection/en/leishmaniasis_hiv_countries.gif

Rescue in Sudan “Where else in the world could 50% of the population die without anyone knowing?” -Dr. Jill Seaman

REFERENCES  Pictures  (SEM)        of%20Drugs%20for%20the%20Treatment%20of%20Visceral%20Leishmaniasis.html of%20Drugs%20for%20the%20Treatment%20of%20Visceral%20Leishmaniasis.html  0/Leishmania_tropica_7.jpg 0/Leishmania_tropica_7.jpg  leishmania/images/cutaneous-leishmaniasis-leishmania.jpg

REFERENCES  Information   Amanda C Stanley1 and Christian R Engwerda1. Balancing immunity and pathology in visceral leishmaniasis. Immunology and Cell Biology (2007) 85, 138–147. doi: /sj.icb ; published online 5 December 2006   Alison M. Shakarian, Glen C. McGugan, Manju B. Joshi, Mary Stromberg, Lauren Bowers, Christine Ganim, Jessica Barowski and Dennis M. Dwyer. Identification, characterization, and expression of a unique secretory lipase from the human pathogen Leishmania donovani. Molecular and Cellular Biochemistry. Volume 341, Numbers 1-2,  Emanuela Handman. Leishmaniasis: Current Status of Vaccine Development. Clin. Microbiol. Rev. April :  Christian R Engwerda, Paul M Kaye, Organ-specific immune responses associated with infectious disease, Immunology Today, Volume 21, Issue 2, 1 February 2000, Pages  J Román Luque-Ortega, José M Saugar, Cristina Chiva, David Andreu, Luis Rivas. Identification of new leishmanicidal peptide lead structures by automated real-time monitoring of changes in intracellular ATP. Biochem. J. (2003) 375 (221-30)