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    Cytokine profiles, blood parasite load and clinical features of visceral leishmaniasis in West Pokot County, Kenya

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    Publication Date
    2024-06-15
    Authors
    van Dijk, Norbert
    Carter, Jane
    Kiptanui, David
    Pinelli, Elena
    Schallig, Henk
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    (5 total)
    Type
    Article, Journal
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    Citation

    van Dijk N, Carter J, Kiptanui D, Pinelli E, Schallig H. Cytokine profiles, blood parasite load and clinical features of visceral leishmaniasis in West Pokot County, Kenya. Parasitology. 2024 Jun;151(7):753-761. doi: 10.1017/S0031182024000751. Epub 2024 Sep 23. PMID: 39311405; PMCID: PMC11474019.

    Abstract/Overview

    Visceral leishmaniasis (VL) is a severe infectious disease caused by protozoan parasites of the Leishmania donovani complex. Blood cytokine concentrations in VL patients can inform us about underlying immunopathogenesis and may serve as a biomarker for treatment effectiveness. However, cytokine levels have not yet been studied in VL patients from Kenya, where case load is high. This study measured the serum cytokine profile, blood parasite load and clinical and haematological features of VL patients from West Pokot County, Kenya, over the course of treatment with sodium stibogluconate and paromomycin (SSG-PM). VL patients recruited at the hospital presented with splenomegaly and weight loss, and frequently had pancytopenia and anaemia. Median Leishmania parasite load in blood, determined with real-time polymerase chain reaction, was 2.6 × 104 parasite equivalents mL−1. Compared to endemic healthy controls, serum interferon gamma (IFN-γ), interleukin 5 (IL-5), IL-6, IL-10, IL-12p70, IL-17A and IL-27 were significantly elevated in untreated VL patients. Severe VL was associated with higher IL-10 and lower IFN-γ levels. After 17 daily injections with SSG-PM, disease symptoms disappeared, leukocyte and thrombocyte counts significantly increased, and blood parasite load decreased to undetectable levels in all VL patients. There was a significant decrease in IL-10 and IL-6, whereas IL-17A levels increased; the remaining cytokines showed no significant concentration change during treatment. In conclusion, the results suggest that SSG-PM treatment of VL patients from West Pokot was effective. Moreover, both inflammatory and regulatory immune responses appeared to decrease during treatment, although the increase in IL-17A could reflect a partial continuation of immune activation.

    Subject/Keywords
    Kenya; cytokines; haematology; parasite load; visceral leishmaniasis.
    Further Details

    DOI: 10.1017/S0031182024000751

    Publisher
    Parasitology
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    https://repository.amref.ac.ke/handle/20.500.14173/988
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    • Peer-Reviewed Articles [29]

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