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Interactions between immunity and chemotherapy in the treatment of the trypanosomiases and leishmaniases

Published online by Cambridge University Press:  06 April 2009

B. J. Berger  and
A. H. Fairlamb
B. J. Berger
Affiliation:
Department of Medical Parasitology, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
A. H. Fairlamb*
Affiliation:
Department of Medical Parasitology, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
*
*Correspondence author.
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Summary

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 response 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.

Keywords

trypanosomiasisleishmaniasischemotherapyimmunosuppressionimmunochemotherapy
Type
Research Article
Information
Parasitology , Volume 105 , Issue S1: Chemotherapy and the immune system , January 1992 , pp. S71 - S78
Copyright
Copyright © Cambridge University Press 1992

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