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Clinical and Immunological Outcome in Cutaneous Leishmaniasis Patients Treated with Pentoxifylline

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  • Serviço de Imunologia, Complexo Hospitalar Universitário Professor Edgard Santos, Salvador, Bahia, Brazil; National Institute of Science and Technology–Tropical Disease, Salvador, Bahia, Brasil; Instituto de Ciências da Saúde da Universidade Federal da Bahia, Salvador, Bahia, Brasil

Pentoxifylline is a tumor necrosis factor-α (TNF-α) inhibitor that also attenuates the immune response and decreases tissue inflammation. The association of pentoxifylline with antimony improves the cure rate of mucosal and cutaneous leishmaniasis. In this randomized and double blind pilot trial, cure rate was higher, although not significant, in patients who received antimony plus pentoxifylline than in those patients receiving antimony plus placebo. A significant decrease in TNF-α and interferon-γ (IFN-γ) levels during therapy was more pronounced in the antimony plus pentoxifylline group, whereas CCL-3 (Chemokine [C-C motif] ligand 3) decreased similarly in both groups. The increased levels of CXCL-9 (Chemokine [C-X-C motif] ligand 9) during therapy were lower in the antimony plus pentoxifylline group. Therapy with pentoxifylline modifies cytokines and chemokines production, which may be associated with therapeutic outcome.

Author Notes

* Address correspondence to Sara Passos, HUPES, R. Joao das Botas s/n Canela, Salvador 401101-60, Bahia, Brazil. E-mail: saratpassos@hotmail.com

Financial support: INCT-DT 573839/2008-5 and ICIDR grant AI088650.

Authors' addresses: Graça Brito, Mayra Dourado, Ludmila Polari, Daniela Celestino, Lucas P. Carvalho, Adriano Queiroz, Paulo R. L. Machado, and Sara Passos, Serviço de Imunologia, Complexo Hospitalar Universitário Professor Edgard Santos, Salvador, Bahia, Brazil, E-mails: gracaobrito@yahoo.com.br, mayradourado@hotmail.com, mila_farmacia@hotmail.com, dany_celestino@hotmail.com, carvalholp@ig.com.br, adrianoqs@gmail.com, prlmachado@uol.com.br, and saratpassos@hotmail.com. Edgar M. Carvalho, HUPES, R. Joao das Botas s/n Canela, Salvador, Bahia, Brazil, E-mail: imuno@ufba.br.

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