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The Role of Zinc in Leishmaniasis and Tuberculosis

Guzman, Miguel LU (2014)
Abstract (Swedish)
Popular Abstract in English

Bolivia, as with other Latin American countries, is considered to be in an epidemiological transition due to the continued persistence of infectious diseases, and nutritional deficiencies related to poverty and food insecurity, together with an increase in chronic non-communicable diseases mainly related to lifestyle factors. The work presented in this thesis was focused on finding strategies that can help reduce the impact of cutaneous leishmaniasis and pulmonary tuberculosis in Bolivia, which are hampering its social and economic development.

The effect of supplementing conventional drug therapies with zinc on the clinical course of these diseases and on the modulation of the immune... (More)
Popular Abstract in English

Bolivia, as with other Latin American countries, is considered to be in an epidemiological transition due to the continued persistence of infectious diseases, and nutritional deficiencies related to poverty and food insecurity, together with an increase in chronic non-communicable diseases mainly related to lifestyle factors. The work presented in this thesis was focused on finding strategies that can help reduce the impact of cutaneous leishmaniasis and pulmonary tuberculosis in Bolivia, which are hampering its social and economic development.

The effect of supplementing conventional drug therapies with zinc on the clinical course of these diseases and on the modulation of the immune response was studied. The local injection of antimony directly into the border of the ulcer in cutaneous leishmaniasis was also investigated.

The results showed that zinc supplementation provided no additional benefits regarding clinical recovery or biomarkers in cutaneous leishmaniasis or pulmonary tuberculosis. The time-dependent changes in the immune function observed in patients with these diseases were not attributable to zinc supplementation.

The use of intralesional injections of antimony in cutaneous leishmaniasis showed a clinical cure rate of 70%, which can be compared with 17% using the placebo. Injecting small amounts of antimony directly into the border of the ulcer could provide an economic alternative for the treatment of cutaneous leishmaniasis. The results of the present work indicate that further research on other micronutrients as low-cost alternative co-adjuvants in the treatment of these infections is necessary. (Less)
Abstract
The synergistic relation between nutritional deficiency and infection may have negative effects on the immune system, making individuals more vulnerable to infection. Zinc can affect the resistance to infections by modulating cytokine release, and by acting as a cofactor of thymulin, which induces the differentiation of immature T lymphocytes. To investigate the modulation of the immune response by zinc during infections, placebo-controlled intervention studies were conducted on individuals with leishmaniasis and tuberculosis through the oral administration of 45 mg zinc per day together with pharmacological therapy. The changes in biochemical markers in plasma were evaluated, and the immune response was assessed in plasma and blood... (More)
The synergistic relation between nutritional deficiency and infection may have negative effects on the immune system, making individuals more vulnerable to infection. Zinc can affect the resistance to infections by modulating cytokine release, and by acting as a cofactor of thymulin, which induces the differentiation of immature T lymphocytes. To investigate the modulation of the immune response by zinc during infections, placebo-controlled intervention studies were conducted on individuals with leishmaniasis and tuberculosis through the oral administration of 45 mg zinc per day together with pharmacological therapy. The changes in biochemical markers in plasma were evaluated, and the immune response was assessed in plasma and blood lymphocytes. Changes in most of the biochemical and inflam¬matory markers were observed with time, independently of zinc supplementation. In tuberculosis, an increase of 22% was observed in the zinc plasma concentration in the zinc-supplemented group versus 6% in the placebo group. No differences were observed in the clinical signs in leishmaniasis at the time of healing. The function of the immune system did not appear to be affected by zinc supplementation in either of the diseases. Supplementation with 45 mg zinc during treatment for these two diseases failed to have additional effects on the clinical recovery or the immune response. The intralesional injection of antimony in leishmaniasis was also investigated in a separated study. This resulted in healing of lesions with a cure rate of 70%, indicating that this strategy could be useful. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Professor Kurtzhals, Jørgen, University of Copenhagen, Copenhagen, Denmark
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Cutaneous leishmaniasis, tuberculosis, zinc supplementation, lymphocytes, cell proliferation, INF-γ, CD4+/CD8+ ratio
pages
158 pages
publisher
Lund University
defense location
The Centre for Chemistry and Chemical Engineering, Getingevägen 60, Lund University Faculty of Engineering
defense date
2014-05-19 10:00
ISBN
978-91-7473-653-3
language
English
LU publication?
yes
id
4fd94722-a106-4e09-9a16-75f0f3f4b86a (old id 4394054)
date added to LUP
2014-04-23 13:00:25
date last changed
2016-09-19 08:45:04
@phdthesis{4fd94722-a106-4e09-9a16-75f0f3f4b86a,
  abstract     = {The synergistic relation between nutritional deficiency and infection may have negative effects on the immune system, making individuals more vulnerable to infection. Zinc can affect the resistance to infections by modulating cytokine release, and by acting as a cofactor of thymulin, which induces the differentiation of immature T lymphocytes. To investigate the modulation of the immune response by zinc during infections, placebo-controlled intervention studies were conducted on individuals with leishmaniasis and tuberculosis through the oral administration of 45 mg zinc per day together with pharmacological therapy. The changes in biochemical markers in plasma were evaluated, and the immune response was assessed in plasma and blood lymphocytes. Changes in most of the biochemical and inflam¬matory markers were observed with time, independently of zinc supplementation. In tuberculosis, an increase of 22% was observed in the zinc plasma concentration in the zinc-supplemented group versus 6% in the placebo group. No differences were observed in the clinical signs in leishmaniasis at the time of healing. The function of the immune system did not appear to be affected by zinc supplementation in either of the diseases. Supplementation with 45 mg zinc during treatment for these two diseases failed to have additional effects on the clinical recovery or the immune response. The intralesional injection of antimony in leishmaniasis was also investigated in a separated study. This resulted in healing of lesions with a cure rate of 70%, indicating that this strategy could be useful.},
  author       = {Guzman, Miguel},
  isbn         = {978-91-7473-653-3},
  keyword      = {Cutaneous leishmaniasis,tuberculosis,zinc supplementation,lymphocytes,cell proliferation,INF-γ,CD4+/CD8+ ratio},
  language     = {eng},
  pages        = {158},
  publisher    = {Lund University},
  school       = {Lund University},
  title        = {The Role of Zinc in Leishmaniasis and Tuberculosis},
  year         = {2014},
}