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Recurrent cutaneous leishmaniasis: A role for persistent parasites?

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Abstract

Leishmaniosis is, with increasing frequency, reported as an opportunistic infection of immunosuppressed individuals. Re-activation of persistent parasites may be responsible for the disease in a number of these patients. Here, Toni Aebischer reviews some of the evidence for the implication of persistent Leishmania infections in recurrent disease with the emphasis on cutaneous leishmoniasis in humans and in the mouse model. The data suggest that parasite persistence is a common feature in Leishmania infections. The availability of on excellent laboratory model provides on opportunity to study this phenomenon in detail. The findings of these analyses are likely to be important for the identification of people at risk of developing recurrent disease and for the assessment of new therapies for relapsing leishmaniasis and might also have implications for the design of a future anti-Leishmania vaccine.

References (29)

  • L. Gradoni et al.

    Trans. R. Soc. Trop. Med. Hyg.

    (1993)
  • A.M. Da-Cruz

    Trans. R. Soc. Trop. Med. Hyg.

    (1992)
  • J. Alexander et al.

    Adv. Parasitol.

    (1992)
  • N.G. Saravia

    Lancet

    (1990)
  • T.W. Spithill et al.

    Mol. Biol. Parasitol.

    (1984)
  • M. Scaglia

    Trans. R. Soc. Trop. Med. Hyg.

    (1989)
  • M. Gramiccia et al.

    Trans. R. Soc. Trop. Med. Hyg.

    (1992)
  • C. Leclerc

    Trans. R. Soc. Trop. Med. Hyg.

    (1981)
  • S.H. Giannini

    Mol. Biochem. Parositol.

    (1990)
  • B.S. Peters

    Q. J. Med.

    (1980)
  • P.D. Marsden et al.
  • F. Modabber

    Parasitology

    (1989)
  • J.G. Howard
  • H. Moll et al.

    Immunol. Cell Biol.

    (1988)
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