Study of miltefosine susceptibility in isolates of Leishmania (Viannia) braziliensis

Abstract

Leishmaniasis is a disease caused by protozoan parasites of the genus Leishmania. In Brazil, Leishmania braziliensis is mainly responsible for causing cutaneous leishmaniasis, which is characterized by the appearance of ulcerative lesions in the skin and that can develop into the mucocutaneous form of the disease or disseminated, both very severe. The treatment of the disease in Brazil is still mainly based on the use of meglumine antimoniate, wich is a high cost and toxic drug, requires parenteral application and demonstrated cure rates decreasing in recent years. Miltefosine (hexadecylphosphocholine) is a drug first developed as antineoplastic, which showed activity against leishamanias. It is the only drug used for the oral treatment of leishmaniasis not requiring hospitalization. The drug is already used in Asia, Europe. In India, where it is widely used in the treatment of visceral leishmaniasis showed high cure rates, but studies show that parasite's susceptibility to the drug varies among different species and strains. The objective is to evaluate the susceptibility of Leishmania braziliensis isolates from different regions of Brazil to miltefosine, in order to contribute to the evaluation of the potential of miltefosine as a drug to treat leishmaniasis in Brazil and to understand the mechanisms of action and resistance for the drug. (AU)