{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T14:14:25Z","timestamp":1789913665706,"version":"4.0.1"},"reference-count":19,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,7,1]]},"abstract":"<jats:p>Cutaneous leishmaniasis (CL) is a worldwide disease endemic in several regions of the globe. The hallmark of CL is skin ulcers likely driven by efforts of the immune system to control <jats:italic>Leishmania<\/jats:italic> growth. Cytokines, such as tumor necrosis factor (TNF) and interferon-gamma can control disease progression in animal models. Nevertheless, the impact of these cytokines in CL ulcer outcome is not well established in humans. In this study, 96 CL patients from an endemic area of <jats:italic>Leishmania braziliensis<\/jats:italic> were enrolled for a follow-up study that consisted of clinical and immunological evaluations in a 2-year period. Statistical analysis revealed that healing time (<jats:italic>P<\/jats:italic> = 0.029), age (<jats:italic>P<\/jats:italic> = 0.002), and TNF levels (<jats:italic>P<\/jats:italic> = 0.0002) positively correlate with ulcer size at the time of the first clinical evaluation. Our findings suggest that ulcer size correlates with healing time and TNF levels support the use of TNF inhibitors combined with standard therapy to improve healing in CL patients with severe lesions.<\/jats:p>","DOI":"10.4269\/ajtmh.2011.10-0680","type":"journal-article","created":{"date-parts":[[2011,7,6]],"date-time":"2011-07-06T18:34:20Z","timestamp":1309977260000},"page":"70-73","source":"Crossref","is-referenced-by-count":71,"title":["Lesion Size Correlates with Leishmania Antigen-Stimulated TNF-Levels in Human Cutaneous Leishmaniasis"],"prefix":"10.4269","volume":"85","author":[{"given":"Fabiano","family":"Oliveira","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Bafica","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea B.","family":"Rosato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia B. F.","family":"Favali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson M.","family":"Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Cafe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoel","family":"Barral-Netto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldina","family":"Barral","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Acta Trop","first-page":"55","article-title":"Polymerase chain reaction (PCR) is highly sensitive for diagnosis of mucosal leishmaniasis","volume":"94","author":"Oliveira","year":"2005"},{"key":"R2","series-title":"Trans R Soc Trop Med Hyg","first-page":"409","article-title":"Predominance of Leishmania braziliensis braziliensis in the regions of Tres Bracos and Corte de Pedra, Bahia, Brazil","volume":"82","author":"Rosa","year":"1988"},{"key":"R3","series-title":"Am J Trop Med Hyg","first-page":"256","article-title":"Lymphadenopathy as the first sign of human cutaneous infection by Leishmania braziliensis","volume":"53","author":"Barral","year":"1995"},{"key":"R4","series-title":"Clin Immunol","first-page":"314","article-title":"Characterization of the local and systemic immune responses in patients with cutaneous leishmaniasis due to Leishmania major","volume":"91","author":"Gaafar","year":"1999"},{"key":"R5","series-title":"Infect Immun","first-page":"7453","article-title":"Differences in gamma interferon production in vitro predict the pace of the in vivo response to Leishmania amazonensis in healthy volunteers","volume":"69","author":"Pompeu","year":"2001"},{"key":"R6","series-title":"Clin Exp Immunol","first-page":"341","article-title":"Antigen specific correlations of cellular immune responses in human leishmaniasis suggests mechanisms for immunoregulation","volume":"136","author":"Antonelli","year":"2004"},{"key":"R7","series-title":"Rev Soc Bras Med Trop","first-page":"7","article-title":"Evaluation of IFN-gamma and TNF-alpha as immunological markers of clinical outcome in cutaneous leishmaniasis","volume":"35","author":"D'Oliveira","year":"2002"},{"key":"R8","series-title":"Infect Immun","first-page":"6734","article-title":"Up-regulation of Th1-type responses in mucosal leishmaniasis patients","volume":"70","author":"Bacellar","year":"2002"},{"key":"R9","series-title":"Int J Dermatol","first-page":"203","article-title":"American cutaneous leishmaniasis unresponsive to antimonial drugs: successful treatment using combination of N-methilglucamine antimoniate plus pentoxifylline","volume":"42","author":"Bafica","year":"2003"},{"key":"R10","series-title":"Immunol Lett","first-page":"226","article-title":"Activated inflammatory T cells correlate with lesion size in human cutaneous leishmaniasis","volume":"101","author":"Antonelli","year":"2005"},{"key":"R11","series-title":"Am J Trop Med Hyg","first-page":"79","article-title":"Selection of a skin test antigen for American visceral leishmaniasis","volume":"35","author":"Reed","year":"1986"},{"key":"R12","series-title":"Clin Infect Dis","first-page":"E69","article-title":"Failure of early treatment of cutaneous leishmaniasis in preventing the development of an ulcer","volume":"34","author":"Machado","year":"2002"},{"key":"R13","series-title":"Rev Soc Bras Med Trop","first-page":"169","article-title":"Human cutaneous leishmaniasis in Tr\u00eas Bra\u00e7os, Bahia-Brazil. An area of Leishmania braziliensis transmission. II. Cutaneous disease presentation and evolution","volume":"17","author":"Llanos-Cuentas","year":"1984"},{"key":"R14","series-title":"Clin Exp Dermatol","first-page":"369","article-title":"Age-related changes in wound healing","volume":"19","author":"Van de Kerkhof","year":"1994"},{"key":"R15","series-title":"Biol Res","first-page":"233","article-title":"Serum levels of tumor necrosis factor in patients with American cutaneous leishmaniasis","volume":"26","author":"Castes","year":"1993"},{"key":"R16","series-title":"Mem Inst Oswaldo Cruz","first-page":"225","article-title":"Tumor necrosis factor-alpha in human american tegumentary leishmaniasis","volume":"91","author":"Da-Cruz","year":"1996"},{"key":"R17","series-title":"J Infect Dis","first-page":"853","article-title":"Tumor necrosis factor (cachectin) in human visceral leishmaniasis","volume":"163","author":"Barral-Netto","year":"1991"},{"key":"R18","series-title":"Wound Repair Regen","first-page":"13","article-title":"Mitogenic activity and cytokine levels in non-healing and healing chronic leg ulcers","volume":"8","author":"Trengove","year":"2000"},{"key":"R19","series-title":"Am J Trop Med Hyg","first-page":"87","article-title":"Successful treatment of refractory mucosal leishmaniasis with pentoxifylline plus antimony","volume":"65","author":"Lessa","year":"2001"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/85\/1\/article-p70.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/85\/1\/article-p70.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/85\/1\/article-p70.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T19:43:53Z","timestamp":1723059833000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/85\/1\/article-p70.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,7,1]]},"references-count":19,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.2011.10-0680","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,7,1]]}}}