Visceral Leishmaniasis (Kala Azar)

A chronic disease caused by LEISHMANIA DONOVANI and transmitted by the bite of several sandflies of the genera Phlebotomus and Lutzomyia. It is commonly characterized by fever, chills, vomiting, anemia, hepatosplenomegaly, leukopenia, hypergammaglobulinemia, emaciation, and an earth-gray color of the skin. The disease is classified into three main types according to geographic distribution: Indian, Mediterranean (or infantile), and African.

Also Known As:

Networked: 2641 relevant articles (286 outcomes, 332 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Infection
2.	Visceral Leishmaniasis (Kala Azar)
3.	Leishmaniasis
4.	Cutaneous Leishmaniasis
5.	Acquired Immunodeficiency Syndrome (AIDS)

Experts

1.	Sundar, Shyam: 111 articles (08/2015 - 09/2002)
2.	Dube, Anuradha: 37 articles (08/2015 - 11/2004)
3.	Boelaert, Marleen: 34 articles (10/2015 - 01/2004)
4.	Sundar, S: 31 articles (07/2015 - 03/2000)
5.	Das, Pradeep: 30 articles (02/2016 - 01/2008)
6.	Pandey, Krishna: 24 articles (02/2016 - 01/2005)
7.	Salotra, Poonam: 24 articles (10/2015 - 04/2004)
8.	Reis, Alexandre Barbosa: 24 articles (07/2015 - 06/2004)
9.	Ali, Nahid: 24 articles (01/2015 - 12/2002)
10.	Roy, Syamal: 23 articles (03/2015 - 06/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Visceral Leishmaniasis:

1.	liposomal amphotericin BFDA Link 10/01/2002 - "Liposomal amphotericin B is a new drug which is highly efficacious in the treatment of visceral leishmaniasis and produces minimal toxicity. " 05/01/1996 - "Liposomal amphotericin B is a promising new drug which is highly efficacious in the treatment of Indian kala-azar and produces minimal toxicity." 01/01/2009 - "Treatment with liposomal amphotericin B proved to be very effective in this severe case of visceral leishmaniasis." 01/01/1995 - "Recently complete remission of polyresistant visceral leishmaniasis was obtained by injection of liposomal amphotericin B. " 11/01/2012 - "Visceral leishmaniasis was diagnosed, and she was treated successfully with parenteral liposomal Amphotericin-B (Ambisome(®)). "
2.	Amphotericin B (Amphotericin)FDA LinkGeneric 01/15/2012 - "Amphotericin B (AmB), is a highly effective antileishmanial agent used as first-line treatment in different formulations in visceral leishmaniasis endemic areas of Bihar, India. " 11/01/1999 - "This patient never received highly active antiretroviral treatment and the visceral leishmaniasis could not be cured even with liposomal amphotericin. " 09/01/1992 - "Because lipid particles are phagocytized by the reticuloendothelial system, lipid-associated amphotericin B should be concentrated in infected macrophages and be very effective against visceral leishmaniasis. " 08/01/2009 - "This formulation has overcome amphotericin B's significant physicochemical barriers to absorption and holds promise for the development of a self-administered oral therapy for the treatment of visceral leishmaniasis." 05/01/2009 - "Safety and efficacy of high-dose infusions of a preformed amphotericin B fat emulsion for treatment of Indian visceral leishmaniasis."
3.	miltefosineIBA 05/01/2007 - "Oral miltefosine, which is very effective in visceral leishmaniasis caused by L. " 12/01/2006 - "Miltefosine, an alkyl phospholipid has been found effective against visceral leishmaniasis (VL) in adults in various studies. " 01/01/2015 - "Miltefosine has been found to be effective in the treatment of Visceral Leishmaniasis (VL). " 07/01/2012 - "Enhancement in therapeutic efficacy of miltefosine in combination with synthetic bacterial lipopeptide, Pam3Cys against experimental Visceral Leishmaniasis." 10/01/2011 - "Effect of Pam3Cys induced protection on the therapeutic efficacy of miltefosine against experimental visceral leishmaniasis."
4.	AntigensIBA 01/25/2010 - "In this study we compared the vaccine potentiality of three cationic formulations with Leishmania donovani promastigote membrane antigens (LAg) and the best vesicle was evaluated for long-term protection against experimental visceral leishmaniasis. " 01/01/2012 - "Despite negative results of rk-39 test and bone marrow biopsy, a very high suspicion for visceral leishmaniasis (VL) led us to go for direct agglutination test (DAT) and polymerase chain reaction (PCR) for leishmanial antigen that revealed positive results. " 04/30/2001 - "GP36 induced significant protection against murine visceral leishmaniasis at concentrations commonly used for vaccination with recombinant antigens." 08/01/2015 - "Evaluation of the immunogenicity and protective efficacy of killed Leishmania donovani antigen along with different adjuvants against experimental visceral leishmaniasis." 10/23/2008 - "Our earlier studies identified a fraction (F2) of Leishmania donovani soluble promastigote antigen belonging to 97.4-68 kDa for its ability to stimulate Th1-type cellular responses in cured visceral leishmaniasis (VL) patients as well as in cured hamsters. "
5.	AntimonyIBA 12/01/2005 - "In conclusion, the present study showed that multiple dose treatment with LMA was effective in improving antimony levels in the bone marrow of dogs with visceral leishmaniasis and in reducing the number of positive animals, even though it was not sufficient to achieve complete elimination of parasites." 01/01/2008 - "Based on the results of this pilot study, a further evaluation of the efficacy of HPE therapy, which may offer a cost-effective way of improving the treatment of antimony-resistant cases of visceral leishmaniasis, is being undertaken." 01/01/2008 - "An aqueous extract of human placenta (HPE) was found to offer protection against established experimental visceral leishmaniasis in BALB/c mice and hamsters, whether the Leishmania donovani strain involved was one that was sensitive or resistant to pentavalent antimony. " 04/08/2013 - "The efficacy of this vaccination regimen in a murine and hamster model of visceral leishmaniasis caused by both antimony resistant (Sb-R) and sensitive (Sb-S) Leishmania (L.) donovani is examined. " 10/15/2008 - "In Bihar, India, home to nearly one-half of the world's burden of visceral leishmaniasis, drug resistance has ended the usefulness of pentavalent antimony, which is the traditional first-line treatment. "
6.	Antimony Sodium Gluconate (Sodium, Stibogluconate)IBA 04/01/2007 - "In most of the Indian subcontinent, the first line treatment for visceral leishmaniasis (VL) is sodium stibogluconate (SSG), an antimonial drug, but the efficacy of the drug varies according to region. " 06/01/1996 - "The implementation of action plan not only established declining trends in morbidity and mortality due to Visceral Leishmaniasis in the district but also successfully contained the cases unresponsive to first line treatment with Sodium Stibogluconate by reducing the prevalence of such cases from 12.42% in 1992 to 8.59% in 1994. " 03/01/1998 - "Results of the study show that treatment of cases of Kala-azar with sodium stibogluconate in a dosage of 20 mg/kg/day for a longer period of 30 days is effective with a higher cure rate and minimum side effects, for treatment of cases of Kala-azar in this eastern part of Nepal, endemic for the disease." 01/01/1977 - "At low concentrations, sodium stibogluconate, the drug of choice for kala azar treatment in Iraq proved to be poorly effective in the prevention of promastigotes growth in vitro. " 06/01/2001 - "The aim of this study was to evaluate the efficacy of a 20 days regimen of sodium stibogluconate and to ascertain the epidemiological, clinical and laboratory features of visceral leishmaniasis in children. "
7.	Liposomes (Liposome)IBA 04/01/2005 - "In this study, we evaluate the effect of phospholipid on the adjuvanicity and protective efficacy of liposome vaccine carriers against visceral leishmaniasis (VL) in a hamster model. " 10/01/2014 - "Mixed formulation of conventional and pegylated liposomes as a novel drug delivery strategy for improved treatment of visceral leishmaniasis." 01/01/2012 - "Subcutaneous immunization of BALB/c mice with SLA entrapped in liposomes or with MPL-TDM elicited partial protection against experimental visceral leishmaniasis. " 09/01/2001 - "The efficacy of 20(S)-camptothecin (CPT), free and incorporated into sterically stabilized liposomes, has been investigated in vitro against Leishmania donovani promastigotes and in vivo in a murine model of visceral leishmaniasis. " 03/01/2012 - "These results show the potential of PS-liposome formulations for the successful targeted delivery of BPQ in visceral leishmaniasis."
8.	Fluorometholone (FML)FDA Link 01/01/2015 - "FML-loaded DCs are one of the promising tools for protection against murine visceral leishmaniasis." 12/08/2000 - "A phase III trial of efficacy of the FML-vaccine against canine kala-azar in an endemic area of Brazil (São Gonçalo do Amaranto, RN)." 01/01/2015 - "To investigate the efficacy of FML loaded dendritic cells (DCs) in protection against visceral leishmaniasis. " 09/10/2002 - "This means that 95% protection against kala-azar was achieved in vaccinees, after FML-QuilA vaccination (80% of vaccine efficacy (VE)). " 02/01/1994 - "A detailed study of the molecular events related to vaccination against murine visceral leishmaniasis with total and fractionated FML is currently underway."
9.	Paromomycin (Paromomycin Sulfate)FDA LinkGeneric 01/01/2015 - "Though the impact of these findings should be further explored, the study results suggest that the epidemiological implications of acquired paromomycin-resistance may remain minimal other than the loss of one of the last remaining drugs effective against visceral leishmaniasis. " 12/01/1998 - "Comparison of the efficacy of free and non-ionic-surfactant vesicular formulations of paromomycin in a murine model of visceral leishmaniasis." 04/18/1998 - "A 21 day course of aminosidine 16 or 20 mg/kg/day should be considered as first line treatment for visceral leishmaniasis in Bihar." 10/01/2015 - "Effectiveness Study of Paromomycin IM Injection (PMIM) for the Treatment of Visceral Leishmaniasis (VL) in Bangladesh." 01/01/2011 - "Phase 4 pharmacovigilance trial of paromomycin injection for the treatment of visceral leishmaniasis in India."
10.	SaponinsIBA 01/08/2010 - "Leishmune, the first licensed vaccine for prophylaxis against canine visceral leishmaniasis (CVL) and is also immunotherapeutic when used with double saponin adjuvant concentration. " 01/30/2008 - "A vaccine against canine visceral leishmaniasis (CVL), comprising Leishmania braziliensis promastigote protein, sand fly gland extract (SGE) and saponin adjuvant, was evaluated in dog model, in order to analyse the immunogenicity of the candidate vaccine. " 11/01/2007 - "Cellular and humoral immune responses of dogs to a candidate vaccine, composed of Leishmania braziliensis promastigote protein plus saponin as adjuvant, have been investigated as a pre-requisite to understanding the mechanisms of immunogenicity against canine visceral leishmaniasis (CVL). " 08/14/2007 - "In order to assess the immunotherapeutic potential on canine visceral leishmaniasis of the Leishmune vaccine, formulated with an increased adjuvant concentration (1mg of saponin rather than 0.5mg), 24 mongrel dogs were infected with Leishmania (L.) chagasi. " 01/08/2007 - "Assessment of the monoterpene, glycidic and triterpene-moieties' contributions to the adjuvant function of the CP05 saponin of Calliandra pulcherrima Benth during vaccination against experimental visceral leishmaniasis."

Therapies and Procedures

1.	Drug Therapy (Chemotherapy) 03/01/1983 - "Efficacy of combined immunostimulation and chemotherapy in experimental visceral Leishmaniasis." 01/01/2012 - "We believe these findings support further study of the potential of RF07 as a possible alternative for the chemotherapy of visceral leishmaniasis." 02/01/1987 - "These studies on patients with visceral leishmaniasis in Bihar, north India, support previous observations regarding T cell unresponsiveness in patients with active disease: it is profound, it is specific, and it is reversible after successful chemotherapy. " 01/01/1983 - "Liposomal chemotherapy in visceral leishmaniasis: an ultrastructural study of an intracellular pathway." 08/01/2015 - "The chemotherapy of visceral leishmaniasis (VL) has several limitations including resistance and toxicity of the existing drugs. "
2.	Aftercare (After-Treatment) 02/25/2000 - "The results of the present study indicate that kala-azar patients, who have a high risk of developing PKDL after treatment can be identified by measuring plasma CRP." 01/01/2014 - "We also assessed efficacy in all patients who completed treatment and 6 month follow-up after treatment with or without visceral leishmaniasis relapse (per protocol analysis). " 11/01/2013 - "Biochemical and nutritional evaluation of patients with visceral leishmaniasis before and after treatment with leishmanicidal drugs." 05/01/2011 - "KAtex was performed using freshly voided urine samples obtained from 36 parasitologically confirmed cases of VL before and after treatment as well as from 40 healthy controls (20 each from kala-azar-endemic and non-endemic zones). " 07/01/2010 - "We report the case of a human immunodeficiency virus-1-infected patient who had several relapses of visceral leishmaniasis after treatment with standard therapies and responded to a combined therapy."
3.	Immunotherapy 03/01/2014 - "These findings encouraged us to use rLdccys1 in the immunotherapy of naturally infected dogs from Teresina, Piauí, a region of high incidence of visceral leishmaniasis in Brazil. " 01/01/2014 - "Immunotherapy and targeted therapies in treatment of visceral leishmaniasis: current status and future prospects." 01/01/2014 - "This review gives an overview of visceral leishmaniasis, with particular emphasis on the innate and adaptive immune responses, vaccine and vaccination strategies and their potentials for immunotherapy against the disease. " 01/01/2014 - "Immunity to visceral leishmaniasis: implications for immunotherapy." 01/01/2012 - "TLR4 and NKT cell synergy in immunotherapy against visceral leishmaniasis."
4.	Injections 06/01/1991 - "Treatment consisted of multiple i.v. injections beginning 4 and 2 days before infection (prophylactic), either simultaneously with the infection or at various times of the exacerbation and remission phases of visceral leishmaniasis. " 10/01/2006 - "We present a rare neglected case of fungal pulmonary valve endocarditis which presented with typical extra cardiac manifestations after repeated injections for treatment of visceral leishmaniasis. " 04/01/1991 - "Two hundred and forty patients of kala-azar unresponsive to antimonial were treated with pentamidines in a dose of 4 mg/kg body weight on alternate days for 20 injections. " 01/01/2000 - "Hepatitis B and C viral infections in Indian kala-azar patients receiving injectable anti-leishmanial drugs: a community-based study." 06/21/2007 - "Injectable paromomycin for Visceral leishmaniasis in India."
5.	Oral Administration 11/01/2004 - "Clinical efficacy was demonstrated for the treatment of visceral leishmaniasis with the advantage of oral administration over the currently recommended antileishmanial drugs that require parenteral administration. " 12/01/2006 - "Although miltefosine is not the most active compound of its class against Leishmania parasites in vitro, the early demonstration of activity after oral administration in experimental models of visceral leishmaniasis helped to bring this compound to the attention of WHO TDR for further development in a unique collaboration model with the pharmaceutical industry (Zentaris GmbH). " 04/01/2011 - "donovani amastigote cannot access host polyamines in sufficient amounts for survival and growth; (4) and validate ODC as a drug target, although oral administration of DFMO is an unlikely therapeutic paradigm for visceral leishmaniasis." 10/01/2008 - "Miltefosine has been established as the first oral administration drug against cutaneous and visceral leishmaniasis. " 08/01/2009 - "Our reformulation of amphotericin B for oral administration has resulted in a highly efficacious antileishmanial treatment that significantly reduces or eradicates liver parasitemia in a murine model of visceral leishmaniasis. "