R. Dietze; R.C. Araújo; M.L.R. Lima; J.A. Vexenat; P.D. Marsden; A.C. Barreto
RESUMO
Os autores relatam o resultado de um ensaio terapêutico em sagüis com uma cepa de Leishmania donovani isolada de um caso humano fatal de calazar, clinicamente resistente aos antimoniais (Glucantime e Pentostam), Anfotericina B ePentamidina. Os testes cutâneos realizados no paciente para avaliação da imunidade celular foram negativos à exceção do DNCB a 2%. Quatro sangüis adultos (Callithrix jacchus) foram inoculados por via intraperitoneal com uma suspensão deformas amastigotas de L. donovani. Duzentos e dez dias após, todos os animais mostravam formas amastigotas do protozoário, evidenciadas através de punção hepática por aspiração. Iniciou-se então um esquema terapêutico com glucantime (28 mgSbv/kg/dia) em três séries de 10 dias com cinco dias de intervalo entre elas em três dosprimatas,ficando o quarto animal como controle. Nos três animais tratados houve curaparasitológica da doença, o mesmo não ocorrehdo com o controle. O fato de a amostra de L. donovani ter sido, no paciente, resistente aos vários tratamentos e ter sido sensível em modelo experimental à terapêutica com glucantime, sugere a possibilidade de que fatores imunológicos do paciente possam ter contribuído para a evolução fatal da doença.
Palavras-chave: Calazar. Resistência ao tratamento. Infecção experimental em sagüis.
ABSTRACT
The authors describe a therapeutic study in marmosets (Callithrix jacchus) of a strain of Leishmania donovaniisolated from a fatal human case of Kala-azar. The patient failed to respond to antimoniais (Glucantime and Pentostam), Amphotericin B and pentamidine therapy. Skin tests for the evaluation of cellular immunity were negative with the exception of 2% dinitrochlobenzene. Four adult marmosets were inoculated intraperitoneally with a suspension of amastigotes of L. donovani isolated from the hamster liver and spleen. Two hundred and ten days later all the animals had amastigotes in aspirates obtained by liver puncture. Glucantime treatment 28 mg/kilogram body weightper day for 3 series of 10 days was begun in three animals while the fourth was kept as a control. The three treated animals became parasite free in contrast to the control marmoset. The fact that this strain of L. donovani was unresponsive in the patient, inspite of various attempts at treatment, and yet responded to antimoniais in marmosets suggest that the patients immune response was defective leading to a fatal outcome.
Keywords: Kala-azar. Resistence to treatment. Experimental infection in marmosets.
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Recebido para publicação em 17/8/1984.
Faculdade de Ciências da Saúde – Núcleo de Medicina Tropical e Nutrição, Universidade de Brasília, Brasília, DF – 70.910 – Brasil.
Este trabalho recebeu suporte financeiro do UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases Projeto N.° 790356.
