title: Interactions between immunity and chemotherapy in the treatment of the trypanosomiases and leishmaniases.
abstract: The immune status of a host infected with Trypanosoma spp. or Leishmania spp. can play an important role in successful chemotherapy. In animal models, treatment of African trypanosomiasis with difluoromethylornithine or melarsoprol requires an appropriate antibody-mediated immune response. An intact immune system is also necessary for rapid clearance of trypanosomes from the bloodstream following treatment with suramin or quinapyramine. Similarly, an efficient cell-mediated immune responses is required for maximal efficacy of pentavalent antimonials in the treatment of leishmaniasis. However, the potential relationship between parasite-induced or acquired immunosuppression and effective chemotherapy has been poorly studied. Macrophages which have been activated by bacterial cell wall components or gamma-interferon are known to display increased activity against Leishmania donovani or Trypanosoma cruzi. In experimental and clinical visceral leishmaniasis, use of macrophage activators together with pentavalent antimonials has lowered the dose of antimony required to cure the infection.
authors.affiliation: Department of Medical Parasitology, London School of Hygiene and Tropical Medicine, U.K.
authors.forename: B J
authors.initials: BJ
authors.lastname: Berger
authors.forename: A H
authors.initials: AH
authors.lastname: Fairlamb
mesh_terms: D000818:Animals; D000917:Antibody Formation / Q000187:drug effects; D000981:Antiprotozoal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000518:Eflornithine / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D016867:Immunocompromised Host; D007896:Leishmaniasis / Q000188:drug therapy* / Q000276:immunology; D051379:Mice; D051381:Rats; D014344:Trypanocidal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D014353:Trypanosomiasis, African / Q000188:drug therapy* / Q000276:immunology
chemical_list: D000981:Antiprotozoal Agents; D014344:Trypanocidal Agents; D000518:Eflornithine