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Biomedical subjects

L Gradoni

Publications and source records attributed to L Gradoni.

120 records · Page 7Linked to original sources

HIV-Leishmania co-infections in Italy. Isoenzyme characterization of Leishmania causing visceral leishmaniasis in HIV patients.

Visceral leishmaniasis (VL) infections in patients with human immunodeficiency virus (HIV) infection are dramatically increasing in Mediterranean countries such as Spain, France and Italy. A study has been carried out to characterize biochemically the agents of typical or unusual VL in subjects with HIV infection and to compare results with those obtained so far from VL and cutaneous leishmaniasis (CL) infections in HIV negative subjects. Twelve Leishmania stocks were isolated from 8 HIV patients and typed through the electrophoretic analysis of 14 isoenzymes. All the stocks were identified as L. infantum s.l. According to zymodeme classification, the results can be summarized as follows: (i) only half of the subjects were infected with the expected commonest viscerotropic zymodeme in the Mediterranean area, MON 1; (ii) 2 patients were infected with the most widespread agent of CL in Italy, L. infantum MON 24; (iii) one subject was found infected with a zymodeme (MON 78) which, so far, has been found only in Malta as an agent of CL; (iv) one subject was infected with a new zymodeme, MON 136, which shares biochemical characteristics with 2 dermotropic L. infantum zymodemes, MON 78 and MON 111. Thus, half of the HIV patients surveyed displayed severe visceralization of parasites usually showing low virulence in HIV negative subjects.

Animals↗

HIV-Leishmania co-infections in Italy: serological data as an indication of the sequence of acquisition of the two infections.

Twenty-two sera from visceral leishmaniasis (VL) patients with human immunodeficiency virus (HIV) infection (50% with the acquired immune deficiency syndrome) were examined for anti-Leishmania immunoglobulin G (IgG) antibodies and compared with 35 sera from VL patients without HIV (controls). Significant titres of specific IgG were found in 81.8% of co-infections. However, while control sera showed a restricted range of anti-Leishmania IgG titres, sera from co-infection cases displayed a considerable degree of variability, both quantitative and qualitative. They were clearly divided into 2 groups: one (18 sera) showing a continuous grading from nil to mid-concentrations of specific antibodies, the other (3 sera) showing titres 30-fold higher than this range. Taking into account the major immunological abnormalities involving humoral response described in HIV patient, the 2 groups may reflect a different sequence of acquisition of the 2 infective agents; the former representing VL acquired after HIV infection, and the latter representing the contrary situation.

AIDS-Related Opportunistic Infections↗

Recrudescence of visceral leishmaniasis in Albania: retrospective analysis of cases during 1997 to 2001 and results of an entomological survey carried out during 2001 in some districts.

The epidemiological status of zoonotic visceral leishmaniasis (VL) in Albania is almost unknown to international health organizations and to the scientific community. Results from a retrospective analysis of recent VL cases, and from an entomological survey carried out in summer 2001 are reported here. From January 1997 to December 2001, 867 parasitologically confirmed VL cases were recorded in 35 of 36 Albanian districts with an average of 173 cases/year and a cumulative morbidity of 2.8/10000 population. The temporal distribution of cases showed an increasing trend (from 144 to 209), indicating that cases have almost doubled during the past 10 years. A high proportion of the patients (67.6%) was children aged < 5 years. The entomological survey confirmed Phlebotomus neglectus as the probable vector, being the most abundant and widespread species. The increase in VL morbidity, 20-40-fold higher than in other southern European countries, could be attributed to increased susceptibility of infants to clinical disease or to variations in Leishmania infection associated with changes in canine reservoir and/or vector populations.

Adolescent↗

Early efficacy of liposomal amphotericin B in the treatment of visceral leishmaniasis.

The rapidity and efficacy of a short course of liposomal amphotericin B was evaluated in 29 children affected by visceral leishmaniasis (Leishmania infantum). Their overall health status was assessed using the prognostic inflammatory and nutritional index (PINI), and their haematological status by the reticulocyte count and haemoglobin blood levels. All these quantities were measured on day 0, and 3 and 10 d after starting therapy. A significant decrease of inflammatory signs, associated with an improved reticulocyte count, was recorded after 3 d of therapy. A significant increase of haemoglobin levels was also observed 10 d after the start of treatment. The early reduction of inflammatory signs and the improvement of bone marrow function in most patients confirmed the validity of amphotericin B therapy. The PINI score is helpful in assessing the severity of visceral leishmaniasis and the follow-up of its treatment.

Adolescent↗

Decreased lipid fluidity of the erythrocyte membrane in dogs with leishmaniasis-associated anaemia.

In both man and the dog, anaemia resulting from natural leishmaniasis is often severe and mainly associated with a shortened life span of erythrocytes. Lipid fluidity of erythrocyte membranes from 17 dogs with anaemia caused by visceral leishmaniasis was investigated by means of fluorescence polarization. Results were compared with those from three groups of control animals (10 healthy dogs, seven dogs with visceral leishmaniasis but no anaemia, and 10 dogs with anaemia unrelated to leishmaniasis). Fluorescence polarization values recorded for animals with leishmaniasis-associated anaemia were elevated-indicating reduced erythrocyte membrane fluidity-and significantly higher than in the control groups. Mechanical sequestration by the spleen due to increased cell rigidity, or alterations in receptor/ligand erythrocyte cytoadherence mechanisms, or both, may result from decreased membrane fluidity and hence contribute to the anaemia of Leishmania -infected dogs.

Anemia↗