Immunotherapy with the saponin enriched-Leishmune® vaccine versus immunochemotherapy in dogs with natural canine visceral leishmaniasis

• Published in: Vaccine Vol. 28; no. 3; pp. 597 - 603
• Main Authors: Borja-Cabrera, G.P, Santos, F.N, Santos, F.B, Trivellato, Fernando Antonio de A, Kawasaki, Jarbas Kiyoshi A, Costa, Andreia Cerqueira, Castro, Tatiana, Nogueira, F.S, Moreira, M.A.B, Luvizotto, M.C.R, Palatnik, M, Palatnik-de-Sousa, C.B
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 08.01.2010; Elsevier
• Subjects: Adjuvants, Immunologic - therapeutic use; Allergy and Immunology; Allopurinol; Allopurinol - therapeutic use; Amphotericin B; Amphotericin B - therapeutic use; Animals; Antiprotozoal Agents; Applied microbiology; Biological and medical sciences; Canine visceral leishmaniasis; Dog Diseases - pathology; Dog Diseases - therapy; Dogs; Drug Therapy - methods; Drug Therapy, Combination; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Human protozoal diseases; Immunochemotherapy; Immunotherapy; Immunotherapy - methods; Infectious diseases; Kala-azar; Leishmania; Leishmania chagasi; Leishmaniasis, Visceral - pathology; Leishmaniasis, Visceral - therapy; Leishmaniasis, Visceral - veterinary; Leishmune; Leshmaniasis; Lymph Nodes - parasitology; Medical sciences; Microbiology; Parasitic diseases; Protozoal diseases; Protozoan Vaccines - therapeutic use; Saponin; Saponins - therapeutic use; Survival Analysis; Treatment Outcome; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects); Kala-azar; Leishmania chagasi; Immunochemotherapy; Leishmune; Amphotericin B; Immunotherapy; Allopurinol; Canine visceral leishmaniasis; Saponin; Protozoal disease; Kala azar; Antiprotozoal agent; Pyrazolopyrimidine derivatives; Antifungal agent; Dog; Kinetoplastida; Fissipedia; Protozoa; Carnivora; Hypouricemic agent; Enzyme; Enzyme inhibitor; Vaccine; Leishmaniasis; Parasitosis; Infection; Vertebrata; Antibiotic; Mammalia; Polyenic compound; Xanthine oxidase; Parasiticide; Oxidoreductases; Veterinary
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2009.09.071

Abstract Leishmune® , the first licensed vaccine for prophylaxis against canine visceral leishmaniasis (CVL) and is also immunotherapeutic when used with double saponin adjuvant concentration. The Leishmune® therapeutic vaccine was assessed for immunotherapy (IT) in 31 infected dogs and for immunochemotherapy (ICT) in combination with allopurinol or amphotericinB/allopurinol, in 35 dogs. Compared to infected untreated control dogs, at month 3, both treatments increased the proportion of dogs showing intradermal response to Leishmania antigen to a similar extent (from 8 to 67%, in the IT and to 76%, in the ICT groups), and conversely reduced from 100 to 38% (IT) and to 18% (ICT) the proportion of symptomatic cases, from 54 to 12% (IT) and to 15% (ICT) the proportion of parasite evidence in lymph nodes and from 48 to 19% (IT) and 12% (ICT) the proportion of deaths, indicating that the immunotherapy with enriched-Leishmune® vaccine promotes the control of the clinical and parasitological signs of CVL rendering most dogs asymptomatic although PCR positive. By month 8, negative lymph node PCR results were obtained in 80% of the ICT-treated dogs, but only in 33% of the IT group ( p = 0.0253), suggesting that the combination of additional chemotherapy with Leishmune® -enriched saponin vaccination abolished, not only the symptoms but also the latent infection condition, curing the dogs. The animals were followed up until 4.5 years after the beginning of the experiment and, compared to the untreated control group at month 3 (12/25 dogs; 48%), a decrease in the rate of CVL deaths was only seen after ICT treatment (7/35 dogs; 20%; 0.0273) but not after IT treatment (10/31 dogs; 32%; p = 0.278), pointing out an additional advantage of the ICT treatment with the enriched-Leishmune® in the control and cure of CVL.