{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T19:57:35Z","timestamp":1792267055136,"version":"4.4.0"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T00:00:00Z","timestamp":1603065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NIH AI136032"],"award-info":[{"award-number":["NIH AI136032"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013101","name":"National Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013101","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Brazilian Ministry of Science, Technology and Innovation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cutaneous leishmaniasis (CL) caused by L. braziliensis is characterized by 1 or multiple well-limited ulcerated lesions. Diabetes mellitus (DM) impairs neutrophil and monocyte function, and there is a report of vegetative lesions in a patient with both diseases in Morocco. Here we evaluate the influence of DM on clinical manifestations, immune response, and in the treatment of CL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The participants were 36 DM patients with CL and 36 patients with CL without DM, matched by age and gender. The diagnosis of CL was performed by documentation of DNA of L. braziliensis by polymerase chain reaction in the lesion biopsy and histopathologic findings. All patients were treated with Glucantime (Sanofi-Aventis) 20 mg\/kg of weight per day for 20 days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no difference in the majority of the clinical variables between the groups, and the cure rate in patients with CL and DM (67%) was similar to that observed in CL patients (56%; P \u02c3 .05). The most important finding was the documentation that 36% of the patients with DM and CL had atypical cutaneous lesions characterized by large superficial ulcers without defined borders. High levels of interferon-\u03b3, tumor necrosis facor, and interleukin-1\u03b2 were detected in the supernatants of mononuclear cells stimulated with Leishmania antigen in patients with DM and atypical CL. Moreover, while cure was observed in only 33% of the patients with DM and atypical CL lesions, it was observed in 85% of patients with typical lesions (P\u2005&amp;lt;\u2005.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>DM modifies the clinical presentation of CL, enhances pro-inflammatory cytokine production, and impairs response to antimony therapy.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ofid\/ofaa491","type":"journal-article","created":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T16:10:04Z","timestamp":1603123804000},"source":"Crossref","is-referenced-by-count":11,"title":["Diabetes Modifies the Clinic Presentation of Cutaneous Leishmaniasis"],"prefix":"10.1093","volume":"7","author":[{"given":"Alexsandro S","family":"Lago","sequence":"first","affiliation":[{"name":"Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador, Bahia, Brazil"},{"name":"Post-Graduate Course in Health Sciences, Federal University of Bahia Medical School, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filipe R","family":"Lima","sequence":"additional","affiliation":[{"name":"Gon\u00e7alo Moniz Institute (IGM), Fiocruz, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto M","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Gon\u00e7alo Moniz Institute (IGM), Fiocruz, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Sampaio","sequence":"additional","affiliation":[{"name":"Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador, Bahia, Brazil"},{"name":"Post-Graduate Course in Health Sciences, Federal University of Bahia Medical School, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neuza","family":"Lago","sequence":"additional","affiliation":[{"name":"Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz H","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Federal University of Southern Bahia, Teixeira de Freitas, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamile","family":"Lago","sequence":"additional","affiliation":[{"name":"Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador, Bahia, Brazil"},{"name":"Post-Graduate Course in Health Sciences, Federal University of Bahia Medical School, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo R L","family":"Machado","sequence":"additional","affiliation":[{"name":"Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador, Bahia, Brazil"},{"name":"Post-Graduate Course in Health Sciences, Federal University of Bahia Medical School, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas P","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador, Bahia, Brazil"},{"name":"Post-Graduate Course in Health Sciences, Federal University of Bahia Medical School, Salvador, Bahia, Brazil"},{"name":"Gon\u00e7alo Moniz Institute (IGM), Fiocruz, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9rgio","family":"Arruda","sequence":"additional","affiliation":[{"name":"Gon\u00e7alo Moniz Institute (IGM), Fiocruz, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar M","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Immunology Service, Professor Edgard Santos University Hospital Complex, Federal University of Bahia, Salvador, Bahia, Brazil"},{"name":"Post-Graduate Course in Health Sciences, Federal University of Bahia Medical School, Salvador, Bahia, Brazil"},{"name":"Gon\u00e7alo Moniz Institute (IGM), Fiocruz, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,10,19]]},"reference":[{"key":"2020122901395193400_CIT0001","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1093\/infdis\/156.1.73","article-title":"Epidemiology of American cutaneous leishmaniasis due to Leishmania braziliensis braziliensis","volume":"156","author":"Jones","year":"1987","journal-title":"J Infect 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