title: Treatment Outcome of the Drug-resistant Zoonotic Cutaneous Leishmaniasis by Glucantime.
abstract: BACKGROUND
  Resistance ofLeishmaniaspecies to antimonial drugs has increased. Hence, in the present studyLeishmania majorisolates were collected from patients with resistance phenotype and the presence/absence of resistance to Glucantime was investigated.
  
  
  METHODS
  Samples were taken from 10 cutaneous leishmaniasis (CL) patients who had not responded to chemotherapy with Glucantime. Nested polymerase chain reaction (PCR) was performed to identify the isolated species. Stationary phase promastigotes were added to the grown, adhesive J774 macrophages. Values obtained from standard strain were compared with the test cultures after exposure to the medicine.In vivo, the effects of Glucantime were assessed by comparing the sizes and the parasite burden of the lesions on mouse model.
  
  
  RESULTS
  The results of amplified band on agarose gel demonstrated all samples wereL. major. After exposure to medicine, a reduction of intracellular amastigotes to half was detected.In vivo, the parasite was eliminated in 90% of mice with lesions caused by both isolates of patients and standardL. major, and their lesions became smaller significantly.
  
  
  CONCLUSIONS
  Pentavalent antimonial (SbV) salts are the main component of chemotherapy against leishmaniasis. However, the medicine has been found ineffective. In the present study, isolates from patients with no response to treatment had no significant difference from the standardL. majorstrain (as the sensitive strain). Therefore, in patients with resistance phenotype to Glucantime, the parasites did not actually have intrinsic resistance, i.e., environmental and host factors prevented the successful treatment of the disease.
authors.affiliation: Department of Parasitology, School of Medicine, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran.
authors.forename: Simindokht
authors.initials: S
authors.lastname: Soleimanifard
authors.affiliation: Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Arjmand
authors.affiliation: Department of Parasitology, School of Medicine, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran.
authors.forename: Sedighe
authors.initials: S
authors.lastname: Saberi
authors.affiliation: Department of Anatomical Sciences and Molecular Biology, Medical School, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran.
authors.forename: Mansoor
authors.initials: M
authors.lastname: Salehi
authors.affiliation: Department of Parasitology, School of Medicine, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran; Department of Parasitology, Skin Disease and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran.
authors.forename: Seyed Hossain
authors.initials: SH
authors.lastname: Hejazi
keywords: Glucantime; Leishmania; Leishmania major; resistance; treatment