{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T11:26:31Z","timestamp":1769945191633,"version":"3.49.0"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p><jats:italic>Leishmania braziliensis<\/jats:italic> is the most important cause of cutaneous leishmaniasis (CL) in the Americas. A Th1-type immune response is required to control <jats:italic>Leishmania<\/jats:italic> infection, but an exaggerated inflammatory response leads to the development of ulcers seen in CL. Infection with intestinal helminths has the potential to inhibit the Th1 response in a manner that depends both on the species of helminth present as well as the burden of helminthiasis. We conducted a prospective cohort study of CL patients from an endemic area between January and December 2017 with either negative or high intestinal helminth burden to characterize relationships between helminth burden, <jats:italic>L<\/jats:italic>. <jats:italic>braziliensis<\/jats:italic> quantification within CL lesions, clinical aspects of CL, and therapeutic response. Of 234 participants with leishmaniasis who underwent stool examination at the time of diagnosis, 45% had detectable helminth infection. The overall cure rate after 90 days was 66%, with a median time to resolution of disease of 40 days (interquartile range: 30\u201365 days). There was no significant association between the type of helminth infection or the magnitude of intestinal helminth burden at the time of diagnosis and <jats:italic>L<\/jats:italic>. <jats:italic>braziliensis<\/jats:italic> genomic DNA (gDNA) detected in biopsies from CL lesions. Likewise, there was no association between helminth burden and response to treatment after 90 days. Considering quantification of parasite DNA in CL lesions, participants who were cured at 90 days had a median of 0.017 ng\/mg gDNA, and participants who failed therapy had a median of 0.091 ng\/mg gDNA (<jats:italic>P<\/jats:italic> = 0.03). The results indicate that cutaneous <jats:italic>Leishmania<\/jats:italic> load may influence therapeutic response in CL.<\/jats:p>","DOI":"10.4269\/ajtmh.20-1664","type":"journal-article","created":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T13:35:23Z","timestamp":1629120923000},"page":"1060-1066","source":"Crossref","is-referenced-by-count":3,"title":["Influence of Intestinal Helminth Burden on Clinical Manifestations, Therapeutic Response, and Leishmania braziliensis Load in Patients with New World Cutaneous Leishmaniasis"],"prefix":"10.4269","volume":"105","author":[{"given":"Brady","family":"Page","sequence":"first","affiliation":[{"name":"1Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusettes;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Lago","sequence":"additional","affiliation":[{"name":"2Servi\u00e7o de Imunologia, Complexo Hospitalar Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliana Almeida","family":"Silva","sequence":"additional","affiliation":[{"name":"2Servi\u00e7o de Imunologia, Complexo Hospitalar Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Schriefer","sequence":"additional","affiliation":[{"name":"2Servi\u00e7o de Imunologia, Complexo Hospitalar Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brazil;"},{"name":"3Instituto Nacional de Ci\u00eancia e Tecnologia em Doen\u00e7as Tropicais, CNPq, Minist\u00e9rio de Ci\u00eancia, Tecnologia e Inova\u00e7\u00e3o, Bahia, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamile","family":"Lago","sequence":"additional","affiliation":[{"name":"2Servi\u00e7o de Imunologia, Complexo Hospitalar Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00edvia","family":"Oliveira","sequence":"additional","affiliation":[{"name":"2Servi\u00e7o de Imunologia, Complexo Hospitalar Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz Henrique","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"4Universidade Federal do Sul da Bahia, Ilh\u00e9us, Brazil;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marshall","family":"Glesby","sequence":"additional","affiliation":[{"name":"5Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgar M.","family":"Carvalho","sequence":"additional","affiliation":[{"name":"2Servi\u00e7o de Imunologia, Complexo Hospitalar Universit\u00e1rio Prof. Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brazil;"},{"name":"3Instituto Nacional de Ci\u00eancia e Tecnologia em Doen\u00e7as Tropicais, CNPq, Minist\u00e9rio de Ci\u00eancia, Tecnologia e Inova\u00e7\u00e3o, Bahia, Brazil;"},{"name":"6Instituto Gon\u00e7alo Moniz, Fuda\u00e7\u00e3o Oswaldo Crux (Fiocruz), Salvador, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/105\/4\/article-p1060.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/105\/4\/article-p1060.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T19:12:57Z","timestamp":1633547577000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/105\/4\/article-p1060.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,6]]},"references-count":0,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.20-1664","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,6]]}}}