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Guest Article

New approaches for vaccines against a neglected disease – leishmaniasis

Dr. David Kitz Krämer

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In contrast to cancer, cardiovascular disease and diabetes, which are on a daily focus in public news and research there are still many lethal diseases today that affect millions of people but are mostly neglected. One of these often poverty-related diseases is leishmaniasis. Leishmaniasis is caused by protozoan parasites (Leishmania), which are transmitted by the bite of sandflies that act as an insect vector. The disease occurs in countries such as Afghanistan, Bangladesh, Bolivia, Brazil, India, Iran, Syria and different parts of North and Central Africa. Infection may occur as a relatively mild cutaneous form with skin ulcers that usually heal within a few months, leaving scarred skin, but also as a mucocutaneous form, in which ulcers destroy the mucosa of the nose, mouth, throat and related cavities partially or completely, leaving the patients often disfigured for life and susceptible to secondary bacterial infections. The most harmful form, caused by Leishmania donovani, is visceral leishmaniasis (also named kala azar, which is Hindi for black fever) that causes high fever, weight loss, enlargement of the liver and spleen and has a mortality rate of nearly 100 percent if it is not properly treated. Treatment itself has severe side effects and is often not possible in the endemic areas.

Prevention is better than cure, as the saying goes, but the elaborate life cycle of leishmania and its habit to use cells from the immune system as a hideout makes it particularly difficult to develop an appropriate vaccine.

But in 2012 the nonprofit Infectious Disease Research Institute (IDRI) based at Seattle started a first trial with volunteers in order to test the very first vaccine against visceral leishmaniasis for humans. Research will proceed with Phase I trials in India – a country where visceral leishmaniasis is endemic. The vaccine contains two fused recombinant proteins from Leishmania (see also) and an adjuvant that increases the immune response. A vaccine against leishmaniasis in dogs (the most important reservoir host for the parasite) was developed successfully. In contrast to the human version, this vaccine contains secreted proteins from Leishmania infantum and an adjuvant that enhances the immune response. Hopefully many roads lead to Rome.


Dr. David Kitz Krämer


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