Nirmala N Rege
Visceral Leishmaniasis : Can We Dream Its Eradication?
Japi, Vol.49, June 2001, p.605
There are 20 different species of Leishmania and 3 clinical forms; visceral (Kala-azar), mucocutaneous (American Leishmaniasis) or cutaneous (Aleppo boil). Visceral Leishmaniasis i.e. Kala-azar can be fatal. The usual drugs are pentavalent antimonials to which a very large number are now resistant (25-40% in Bihar). Pentamidine and Amphotericin-B are not very effective and are toxic. Aminosidine (paramomycin) is also not very effective and is highly toxic. Allopurinol is very weakly effective. Roxithromycin at a dose of 300mg twice daily for 21 days produced 80% cure.
The most promising drug is Miltefosine. Oral Miltefosine concentrates in the liver and spleen. Clinical trials show that symptomatic recovery takes place in 3 days and complete cure in 10-14 days. The dose is approximately 100mg a day for 4-6 weeks. Side-effects are almost non-existent. The drug should be available in 2-3 years times in the Indian market
R Alan, B Ezekowitz
Commentary: Mannose-binding lectin in prediction of susceptibility to infection
The Lancet, Vol.358, August 25, 2001, pg. 598-599.
O Neth, I Hann, et al
Deficiency of mannose-binding lectin and burden of infection in children with malignancy: a prospective study.
The Lancet, vol.358, August 25, 2001, pg.614.
Mannose-binding lectin (also known as mannan-binding lectin and mannose-binding protein) as a potential modifier of susceptibility to infection in patients who have chemotherapy-induced febrile neutropenia. It is postulated that MBL is an ante-antibody. It is a circulating serum protein that recognizes microorganisms.
It is thought of as an ante-antibody because it seems to act in the first minutes and hours of an infection. It acts as an opsonin and activates complement.