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Stepwise addition of protamine sulphate and<jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>in a layer\u2010by\u2010layer manner was used to form<jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">NCs<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DOX<\/jats:styled-content>.<jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">NCs<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DOX<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\">NE\u2010DOX<\/jats:styled-content>and<jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>ree<jats:styled-content style=\"fixed-case\">DOX<\/jats:styled-content>were compared for their cytotoxicity against<jats:italic>Leishmania donovani<\/jats:italic>\u2010infected macrophages<jats:italic>in vitro<\/jats:italic>and generation of<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>\u2010cell responses in infected hamsters<jats:italic>in vivo<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Size and \u03b6 potential of the<jats:styled-content style=\"fixed-case\">NE\u2010DOX<\/jats:styled-content>and<jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">NCs<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DOX<\/jats:styled-content>formulations were 310 \u00b1 2.1\u2009nm and (\u2212)32.6 \u00b1 2.1\u2009mV, 342 \u00b1 4.1\u2009nm and (\u2212)29.3 \u00b1 1.2\u2009mV respectively.<jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">NCs<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DOX<\/jats:styled-content>was better (1.5 times) taken up by<jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>774<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>.1 macrophages compared with<jats:styled-content style=\"fixed-case\">NE\u2010DOX<\/jats:styled-content>.<jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">NCs<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DOX<\/jats:styled-content>showed greater efficacy than<jats:styled-content style=\"fixed-case\">NE\u2010DOX<\/jats:styled-content>against intramacrophagic amastigotes. SA\u2010NCs\u2010DOX treatment exhibited enhanced apoptotic efficiency than NE\u2010DOX and free DOX as evident by cell cycle analysis, decrease in mitochondrial membrane potential, ROS and NO production. T\u2010cell responses, when assessed through lymphoproliferative responses,<jats:styled-content style=\"fixed-case\">NO<\/jats:styled-content>production along with enhanced levels of<jats:styled-content style=\"fixed-case\">iNOS<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1,<jats:styled-content style=\"fixed-case\">IFN<\/jats:styled-content>\u2010\u03b3 and<jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>\u201012 were found to be up\u2010regulated after<jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">NCs<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DOX,<\/jats:styled-content>compared with responses to<jats:styled-content style=\"fixed-case\">NE\u2010DOX<\/jats:styled-content>\u2005<jats:italic>in vivo<\/jats:italic>. Parasitic burden was decreased in<jats:italic>Leishmania<\/jats:italic>\u2010infected hamsters treated with<jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">NCs<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DOX<\/jats:styled-content>, compared with<jats:styled-content style=\"fixed-case\">NE\u2010DOX<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Implications<\/jats:title><jats:p>Our results provide insights into the development of an alternative approach to improved management of leishmaniasis through a combination of chemotherapy with stimulation of the innate immune 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