{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T08:03:35Z","timestamp":1793174615681,"version":"4.5.0"},"reference-count":41,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,9]]},"abstract":"<jats:p>There is evidence that elderly patients with cutaneous leishmaniasis (CL) have more mucosal and disseminated diseases than young patients and their cells produce less antigen-induced interferon (IFN)-\u03b3. Herein, we compared the roles of interleukin (IL)-10 and IL-15 as modulators of antigen-induced immune responses and the incidence of adverse reaction and response to therapy in young versus elderly patients with CL. Study participants included 35 senior (60\u201385 years) and 35 young (18\u201340 years) patients who had a diagnosis of CL documented by typical cutaneous lesions containing <jats:italic>Leishmania braziliensis<\/jats:italic> DNA. Elderly patients had less lymph node enlargement. Antigen-induced blood cell cytokine responses were studied in the absence or presence of IL-10 antibody or exogenously added recombinant IL-15. The ratio of IFN-\u03b3\/IL-10 was lower in elderly patients, and IFN-\u03b3 production was enhanced by either neutralization of IL-10 or exogenous recombinant IL-15 in blood cells from elderly but not young patients. Patients were treated three times weekly with antimony at 20 mg\/kg\/day for 20 doses. Although there was no difference in response to therapy between the two groups, two young patients needed rescue therapy with amphotericin B. Ventricular arrhythmias and ventricular overload were more frequent in elderly patients. We conclude that elderly patients have alterations in the immune response that may influence clinical manifestations, but we did not find that they had a higher failure rate than young subjects to antimony therapy. However, because of the high rate of electrocardiographic abnormalities during therapy, antimony should not be used in elderly patients with CL.<\/jats:p>","DOI":"10.4269\/ajtmh.17-0736","type":"journal-article","created":{"date-parts":[[2018,3,27]],"date-time":"2018-03-27T07:00:39Z","timestamp":1522134039000},"page":"1317-1324","source":"Crossref","is-referenced-by-count":25,"title":["The Elderly Respond to Antimony Therapy for Cutaneous Leishmaniasis Similarly to Young Patients but Have Severe Adverse Reactions"],"prefix":"10.4269","volume":"98","author":[{"given":"Alexsandro Souza do","family":"Lago","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Imunologia, Hospital Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maur\u00edcio","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunologia, Hospital Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto M.","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunologia, Hospital Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neuza","family":"Lago","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunologia, Hospital Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Silva","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunologia, Hospital Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Roberto","family":"Queiroz","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunologia, Hospital Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas P.","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunologia, Hospital Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil;"},{"name":"CNPq\/MCT, Instituto Nacional de Ci\u00eancia e Tecnologia em Doen\u00e7as Tropicais (INCT-DT), Salvador, Brazil;"},{"name":"Laborat\u00f3rio de Pesquisas Cl\u00ednicas do Instituto Gon\u00e7alo Moniz (IGM), Fiocruz, Salvador, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Schriefer","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunologia, Hospital Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil;"},{"name":"CNPq\/MCT, Instituto Nacional de Ci\u00eancia e Tecnologia em Doen\u00e7as Tropicais (INCT-DT), Salvador, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo","family":"Machado","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunologia, Hospital Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil;"},{"name":"CNPq\/MCT, Instituto Nacional de Ci\u00eancia e Tecnologia em Doen\u00e7as Tropicais (INCT-DT), Salvador, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar M.","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunologia, Hospital Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil;"},{"name":"CNPq\/MCT, Instituto Nacional de Ci\u00eancia e Tecnologia em Doen\u00e7as Tropicais (INCT-DT), Salvador, Brazil;"},{"name":"Laborat\u00f3rio de Pesquisas Cl\u00ednicas do Instituto Gon\u00e7alo Moniz (IGM), Fiocruz, Salvador, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"PLoS One","first-page":"35671","article-title":"Leishmaniasis worldwide and global estimates of its incidence","volume":"7","author":"Alvar","year":"2012"},{"key":"b2","series-title":"Clin Microbiol Rev","first-page":"230","article-title":"Leishmaniasis of the New World: current concepts and implications for future research","volume":"6","author":"Grimaldi","year":"1993"},{"key":"b3","series-title":"Mem Inst Oswaldo Cruz","first-page":"239","article-title":"Clinical and immunopathological spectrum of American cutaneous leishmaniasis with special reference to the disease in Amazonian Brazil: a 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