Trial reportPLoS medicine2006
Unresponsiveness to Glucantime treatment in Iranian cutaneous leishmaniasis due to drug-resistant Leishmania tropica parasites.
Trial report in PLoS medicine, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 131 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
131 citing papers in PubMed, 3 syntheses or guidelines pooled it, 298 citations in OpenAlex.
- The Geographical Distribution of Human Cutaneous and VisceralFrontiers in public health · 2021Pooled it
- Efficacy of miltefosine compared with glucantime for the treatment of cutaneous leishmaniasis: a systematic review and meta-analysis.Epidemiology and health · 2019Pooled it
- Efficacy of thermotherapy to treat cutaneous leishmaniasis: a meta-analysis of controlled clinical trials.PloS one · 2015Pooled it
- Efficacy of intra-lesional injections of meglumine antimoniate once a week vs. twice a week in the treatment of cutaneous leishmaniasis caused by L. tropica in Iran: A randomized controlled clinical trial.PLoS neglected tropical diseases · 2022Trial
- Rapid healing of cutaneous leishmaniasis by high-frequency electrocauterization and hydrogel wound care with or without DAC N-055: a randomized controlled phase IIa trial in Kabul.PLoS neglected tropical diseases · 2014Trial
- Trial
- Systemic meglumine antimoniate in acute cutaneous leishmaniasis: children versus adults.The American journal of tropical medicine and hygiene · 2011Trial
- First-line therapy for human cutaneous leishmaniasis in Peru using the TLR7 agonist imiquimod in combination with pentavalent antimony.PLoS neglected tropical diseases · 2009Trial
- A pilot study evaluating the tolerability and effectiveness of miltefosine and sodium stibogluconate for the treatment of cutaneous leishmaniasis in Kandahar, Afghanistan.Tropical medicine and health · 2026Article
- Cutaneous leishmaniasis in Afghanistan.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2025Review
- Upregulation of antioxidant genes in antimony-resistant Leishmania tropica clinical isolates.Molecular biology reports · 2025Article
- Genomic characterization of Leishmania (V.) braziliensis associated with antimony therapeutic failure and variable in vitro tolerance to amphotericin B.Scientific reports · 2025Article
- Identification of CβS and ODC antimony resistance markers in anthroponotic cutaneous leishmaniasis field isolates by gene expression profiling.Parasite epidemiology and control · 2025Article
- Investigating the Effect of Satureja khuzestanica Essential oil on MDR1 Gene Expression in Leishmania major.Acta parasitologica · 2024Article
- Article
- Article
- Systematic Review of Treatment Failure and Clinical Relapses in Leishmaniasis from a Multifactorial Perspective: Clinical Aspects, Factors Associated with the Parasite and Host.Tropical medicine and infectious disease · 2023Review
- Genetic disruption of nucleoside transporter 4 reveals its critical roles in malaria parasite sporozoite functions.Pathogens and global health · 2023Article
- Laboratory diagnostics for human Leishmania infections: a polymerase chain reaction-focussed review of detection and identification methods.Parasites & vectors · 2022Review
- The role of ATP-binding cassette transporter genes expression in treatment failure cutaneous leishmaniasis.AMB Express · 2022Article
71 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent circumstantial evidence suggests that an increasing number of Iranian patients with cutaneous leishmaniasis are unresponsive to meglumine antimoniate (Glucantime), the first line of treatment in Iran. This study was designed to determine whether the clinical responses (healing, or non-healing) were correlated with the susceptibility of Leishmania parasites to Glucantime. METHODS AND
findingsIn vitro susceptibility testing was first performed on 185 isolated parasites in the intracellular mouse peritoneal macrophage model. A strong correlation between the clinical outcome and the in vitro effective concentration 50% (EC50) values was observed. Parasites derived from patients with non-healing lesions had EC50 values at least 4-fold higher than parasites derived from lesions of healing patients. A selection of these strains was typed at the molecular level by pulsed-field gels and by sequencing the pteridine reductase 1 (PTR1) gene. These techniques indicated that 28 out of 31 selected strains were Leishmania tropica and that three were Leishmania major. The L. major isolates were part of a distinct pulsed-field group, and the L. tropica isolates could be classified in three related additional pulsed-field groups. For each pulsed-field karyotype, we selected sensitive and resistant parasites in which we transfected the firefly luciferase marker to assess further the in vitro susceptibility of field isolates in the monocyte cell line THP1. These determinations confirmed unequivocally that patients with non-healing lesions were infected with L. tropica parasites resistant to Glucantime. Additional characterization of the resistant isolates showed that resistance is stable and can be reversed by buthionine sulfoximine, an inhibitor of glutathione biosynthesis.
conclusionsTo the authors' knowledge, this is the first report of proven resistant parasites contributing to treatment failure for cutaneous leishmaniasis and shows that primary Glucantime-resistant L. tropica field isolates are now frequent in Iran.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.