Abstract
Prediction parameters of possible outcomes of canine leishmaniasis (CanL) therapy might help with therapeutic decisions and animal health care. Here, we aimed to develop a diagnostic method with predictive value by analyzing two groups of dogs with CanL, those that exhibited a decrease in parasite load upon antiparasitic treatment (group: responders) and those that maintained high parasite load despite the treatment (group: non-responders). The parameters analyzed were parasitic load determined by q-PCR, hemogram, serum biochemistry and immune system-related gene expression signature. A mathematical model was applied to the analysis of these parameters to predict how efficient their response to therapy would be. Responder dogs restored hematological and biochemical parameters to the reference values and exhibited a Th1 cell activation profile with a linear tendency to reach mild clinical alteration stages. Differently, non-responders developed a mixed Th1/Th2 response and exhibited markers of liver and kidney injury. Erythrocyte counts and serum phosphorus were identified as predictive markers of therapeutic response at an early period of assessment of CanL. The results presented in this study are highly encouraging and may represent a new paradigm for future assistance to clinicians to interfere precociously in the therapeutic approach, with a more precise definition in the patient’s prognosis.
Highlights
Canine leishmaniasis (CanL) is a severe disease caused by the protozoa Leishmania infantum [1,2,3]
Leishmania infantum absolute parasite load evolution in spleen and bone marrow of a cohort of dogs under leishmanicidal treatment for 12 months were distinct between two groups
Most studies of prognostic factors for treatment success or failure in leishmaniasis were restricted to humans [33,34,35,36,37], and the infected dog has been seen only as a protozoan reservoir
Summary
Canine leishmaniasis (CanL) is a severe disease caused by the protozoa Leishmania infantum [1,2,3]. As full-blown disease is associated with active infection [8], efficacy of CanL treatment should be primarily centered in its capability of reducing L. infantum load. Treatment of CanL is a challenge for veterinary practitioners regarding anti-parasitical efficacy, adverse effects and cost. Current leishmanicidal drugs, such as antimonials, miltefosine and allopurinol, can clinically cure dogs or temporarily improve clinical signs, but no evidence of efficacy in terms of a parasitological cure exists for any of them [8,9]. In Brazil, where most of the South American cases of L. infantum infection occur, the use of antimonials for canine treatment is prohibited [11]
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