Abstract
Cutaneous or tegumentary leishmaniasis is a neglected tropical disease caused by parasite protozoa belong to two subgenera (Leishmania and Viannia). Cutaneous leishmaniasis normally produces ulcers in different parts of the body such as face, legs and arms. Normally the ulcers are in large numbers and they cause serious psychological and social problems in affected populations. Leishmania (V.) braziliensis presents considerable clinical importance, since is considered the main species that causes American cutaneous leishmaniasis (ACL) in Brazil. In São Paulo State, ACL is a re-emerging disease causing cutaneous lesions that has been associated with mucosal metastasis. This review discussed the complex interaction between the diversity of Leishmania species, vectors, wild and domestic reservoirs in different geographical environments. All these factors combined to the different host response originated the different clinical forms. Other important cited topics were the complexity of elements involving ACL transmission; the different clinical forms of the disease, as well as the difficulties in to establish the accurate diagnosis. Also, the article discussed the epidemiological diversity with the vector distribution, the ecopidemiological data of the disease, and the mechanisms L. (V.) braziliensis adaptation Different studies involving molecular epidemiology contributed for the knowledge of the constant parasite adaptation in different hosts. This review was based on scientific articles, books, and electronic portals. These data point a wide distribution associated with heterogeneous types of transmission. Different studies justify the genetic variability exhibited by L. (V.) braziliensis as phenomenon for
References
World Health Organization. Leishmaniasis. [acesso em Abril de 2015]. Disponível em: http://www.who.int/leishmaniasis/en/
Lainson R, Shaw JJ. Evolution, classification and geographical distribution. In: Peters, Killick-Dendrick. The leishmaniasis in biology and medicine. London: Academic Press, 1987, p. 1-20.
Ashford RW, Desjejum P, Deraadt P. Estimation of population at risk of infection and number of cases of leishmaniasis. Parasitol Today. 1992; 8: 104-5.
Grimaldi GJ, Tesh RB. Leishmaniasis of the New World: current concepts and implications for the future research. Clin Microbiol Rev. 1993; 6: 230-50.
Rey L. O complexo “Leishmania braziliensis” e as Leishmaniases tegumentares americanas. In: Rey L. Rey: Parasitologia. Rio de Janeiro: Guanabara Koogan 3. edição, 2001, p. 227-39.
Coura JR. Leishmaniose tegumentar americana. In Coura JR. Dinâmica das doenças infecciosas e parasitárias. Guanabara Koogan. Rio de Janeiro, 2005, p. 697-712.
Goto H, Lindoso JA. Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis. Expert Rev Anti Infect Ther. 2010; 8:419-33.
Murray HW, Berman JD, Davies CR, Saravia NG. Advances in leishmaniasis. Lancet. 2005; 4:1561-77.
Marzochi MCA, Schubach AO, Marzochi KBF. Leishmaniose tegumentar americana. In Cimerman B, Cimerman S. Parasitologia humana e seus fundamentos gerais. São Paulo, Atheneu. 1999, 39-64.
Pirmez C1, da Silva Trajano V, Paes-Oliveira Neto M, da-Cruz AM, Gonçalves-da-Costa SC, Catanho M, Degrave W, Fernandes O. Use of PCR in diagnosis of human american tegumentary leishmaniasis in Rio de Janeiro, Brazil. J Clin Microbiol. 1999: 37: 1819-23.
Ramos-E-Silva M, De Moura Castro Jacques C. Leishmaniasis and other dermatozoonoses in Brazil. Clin Dermatol 2002; 20: 122-34.
Gontijo B, Carvalho MLR. Leishmaniose tegumentar americana. Rev Soc Bras Med Trop. 2003; 36: 71-80.
Costa JML, Saldanha ACR, Nascimento D, Sampaio G, Carneiro F, Lisboa E, Barral A. Modalidades clínicas, diagnóstico e abordagem terapêutica da leishmaniose tegumentar Costa JML, Saldanha ACR, Nascimento D Sampaio G, Carneiro F, Lisboa E, Barral A. Modalidades clínicas, diagnóstico e abordagem terapêutica da leishmaniose tegumentar no Brasil. Gaz Med Bahia. 2009; 79.
Goto H, Lauletta Lindoso JA. Cutaneous and mucocutaneous leishmaniasis. Infect Dis Clin North Am. 2012; 26: 293-307.
Guimarães LH, Machado PRL, Lessa HA, Lessa M, Oliveira AD, Carvalho EM. Aspectos clínicos da leishmaniose tegumentar. Gaz Med Bahia. 2008; 74.
Ministério da Saúde do Brasil. Secretaria de Vigilância em Saúde. Manual de Vigilância da Leishmaniose Tegumentar Americana. 2.ed. atual. Brasília. Editora do Ministério da Saúde, 2010. [acesso em Abril de 2015] Disponível em: http://bvsms.saude.gov. br/bvs/publicacoes/manual_vigilancia_ leishmaniose_tegumentar_americana.pdf
Lessa MM, Lessa H A, Castro T WN, Oliveira A, Scherifer A, Machado P, et al. Leishmaniose mucosa: aspectos clínicos e epidemiológicos. Rev Bras Otorrinolaringolo. 2007; 73: 843-7.
Elmahallawy EK, Sampedro Martinez A, Rodriguez-Granger J, Hoyos-Mallecot Y Agil A et al. Diagnosis of leishmaniasis. J Infect Dev Ctries. 2014; 13: 961-72.
Gomes CM, de Paula NA, Morais OO, Soares KA, Roselino AM, Sampaio RN. Complementary exams in the diagnosis of american tegumentary leishmaniasis. An Bras Dermatol. 2014; 5: 701-9.
Gomes AH, Armelin IM, Menon SZ, Pereira-Chioccola VL. Leishmania (V.) braziliensis: detection by PCR in biopsies from patients with cutaneous leishmaniasis. Exp Parasitol. 2008; 119: 319-24.
Martins AL, Barreto JA, Lauris JR, Martins AC. American tegumentary leishmaniasis: correlations among immunological, histopathological and clinical parameters. An Bras Dermatol. 2014; 1: 52-8.
de Vries HJ, Reedijk SH, Schallig HD. Cutaneous leishmaniasis: recent developments in diagnosis and management. Am J Clin Dermatol. 2015:16:99-109.
Gomes AH, Ferreira IM, Lima ML, Cunha EA, Garcia AS, Araujo MF et al. PCR identification of Leishmania in diagnosis and control of canine leishmaniasis. Vet Parasitol. 2007; 144: 234-41.
Pereira-Chioccola VL. Molecular diagnosis of leishmaniasis: contribution to the American visceral leishmaniasis surveillance program in Sao Paulo state. BEPA. 2009; 68: 4-13.
Degrave W, Fernandes O, Campebell D, Bozza M, Lopes U. Use of molecular probes and PCR for detection and typing of Leishmania - a mini review. Mem Inst Oswaldo Cruz. 1994; 89: 463-9.
Costa JML, Saldanha ACR, Nascimento D, Sampaio G, Carneiro F, Lisboa E, Barral A. Modalidades clínicas, diagnóstico e abordagem terapêutica da leishmaniose tegumentar no Brasil. Gaz Med Bahia. 2009; 79 (3): 70-83
Colombo FA, Odorizzi RM, Laurenti MD, Galati EA, Canavez F, Pereira-Chioccola VL Detection of Leishmania (Leishmania) infantum RNA in fleas and ticks collected from naturally infected dogs. Parasitol Res. 2011; 109: 267-74.
Gomes AH, Martines RB, Kanamura CT, Gava R, Barbo MLP, Iglezias S D’A et al, In situ immune response in human American cutaneous leishmaniasis – a possible role for IL-10, IL-17 and NK cells. Plos one.2015: in press.
Marzochi MCA, Marzochi KBF. Tegumentary and visceral leishmaniasis in Brazil-emerging anthropozoonosis and possibilities for their control. Cad Saúde Pub.1994; 10: 359-75.
Basano AS, Camargo LMA. American cutaneous leishmaniasis: history, epidemiology and prospects for control. Rev Bras Epidemiol. 2004; 7: 328-37.
Altamirano-Enciso AJ, Marzochi MC, Moreira JS, Schubach AO, Marzochi KB. On the origin and spread of cutaneous and mucosal leishmaniasis, based on pre and post Colombian historical source. Hist Cienc Saude Manguinhos. 2003; 10: 852-82.
Costa JML. Epidemiologia das leishmanioses no Brasil. Gaz Med Bahia 2005; 75: 3-17.
Ministério da Saúde. Portal Saúde. [acesso em Abril de 2015]. Disponível em: http://portalsaude.saude.gov.br/index php/o-ministerio/principal/secretarias/svs/ leishmaniose-tegumentar-americana-lta
Gomes AC. Sandfly vectorial ecology in the State of São Paulo. Mem Inst Oswaldo Cruz. 1994; 89: 457-60.
Camargo-Neves VLF, Gomes AC, Antunes JLF. Correlação da presença de espécies de flebotomíneos (Diptera: Psychodidae) com registros de casos da leishmaniose tegumentar americana no Estado de São Paulo, Brasil. Rev Soc Bras Med Trop. 2002; 35: 299-306.
Silva LMR, Cunha PR. A urbanização da leishmaniose tegumentar americana no Município de Campinas-São Paulo (SP) e região: magnitude do problema e desafios. An Brasil Dermatol. 2007; 82: 515-9.
Shimabukuro PH, da Silva TR, Ribeiro FO, Baton LA, Galati EA. Geographical distribution of American cutaneous leishmaniasis and its phlebotomine vectors (Diptera: Psychodidae) in the state of São Paulo, Brazil. Parasit Vectors. 2010; 3: 121.
Tolezano JE. Ecoepidemiological aspects of American cutaneous leishmaniasis in the state of São Paulo, Brazil. Mem Inst Oswaldo Cruz. 1994; 89: 427-34.
Silva RA, Mercado VTC, Henriques LF, Ciaravolo RMC, Wanderley DMV. Magnitude e tendência da leishmaniose tegumentar Americana no Estado de São Paulo, Brasil, 1975 a 2008. Rev Bras Epidemiol. 2012; 15: 617-26.
Reinaldo VB, Buzzar MR. A situação epidemiológica da leishmaniose tegumentar Americana no Estado de São Paulo no período de 2007 a 2014. BE CVE. 2016; 6 (01). (no prelo).
Secundino NFC, Freitas VC, Pimenta PFP. A biologia da interação dos flebotomíneos com a Leishmania. In: Barral A, Costa J. Leishmanias e a Leishmaniose Tegumentar nas Américas. 2011. p. 90-101.
Cupolillo E, Brahim LR, Toaldo CB, de Oliveira-Neto MP, de Brito ME, Falqueto A, et al. Genetic polymorphism and molecular epidemiology of Leishmania (Viannia) braziliensis from different hosts and geographic areas in Brazil J Clin Microbiol. 2003; 41: 3126-32.
Salomón OD, Quintana MG, Mastrángelo AV. Leishmaniasis tegumentária americana salud pública y conservación de la biodiversidad. In: Barral A, Costa J. Leishmanias e a Leishmaniose Tegumentar nas Américas. 2011. p. 39-54.
PAHO. Leishmaniases: Epidemiological Report of the Americas. 2013. n.1. [acesso em Abril de 2015]. Disponível em: http:// www.paho.org/hq/index.php?option=com docman&task=doc_view&gid=21608&Itemid
Condino ML, Azevedo CC. Aspectos epidemiológicos da leishmaniose tegumentar Americana no município de Ubatuba, litoral norte - Estado de São Paulo - 1993-2003 Boletim Epidemiológico Paulista. 2004 Ano1. Disponível em: http://www.cve. saude.sp.gov.br/agencia/bepa1_lta.htm
Condino MLF, Sampaio SMP, Henriques LF, Galati EAB, Wanderley DMV, Corrêa FMA. Leishmaniose tegumentar americana: flebotomíneos de área de transmissão no município de Teodoro Sampaio, região sudoeste do Estado de São Paulo, Brasil. Rev Soc Bras Med Trop. 1998; 31: 355-60.
Kazemi B. Genomic organization of Leishmania species. Iran J Parasitol. 2011; 6: 1-18.
Smith DF, Peacock CS, Cruz AK. Comparative genomics: from genotype to disease phenotype in the leishmaniases. Int J Parasitol. 2007; 37: 1173-86.
Dujardin JC. Structure, dynamics and function of Leishmania genome: resolving the puzzle of infection, genetics and evolution? Infect Genet Evol. 2009; 9: 290-7.
Winter LMF, Cruz AK. Biologia molecular da Leishmania: Genoma da Leishmania. In: Barral A, Costa J Leishmanias e a leishmaniose tegumentar nas américas. 2011. p. 24-38.
Kramer S. Developmental regulation of gene expression in the absence of transcriptional control: the case of kinetoplastids. Mol Biochem Parasitol. 2012; 181: 61-72.
Schönian G, Kuhls K, Mauricio IL. Molecular approaches for a better understanding of the epidemiology and population genetics of Leishmania. Parasitology. 2011; 138: 405-25.
Schönian G, Mauricio I, Gramiccia M, añavate C, Boelaert M, Dujardin JC. Leishmaniasis in the Mediterranean in the era of molecular epidemiology. Trends Parasitol. 2008; 24:135-42.
Rougeron V, De Meeûs T, Kako Ouraga S, Hide M, Bañuls AL. “Everything you always wanted to know about sex (but were afraid to ask)” in Leishmania after two decades of laboratory and field analyses. PLOS Pathog. 2010; 6: e1001004.
Akopyants NS, Kimblin N, Secundino N, Patrick R, Peters N, Lawyer P, Dobson DE, Beverley SM, Sacks DL. Demonstration of genetic exchange during cyclical development of Leishmania in the sand fly vector. Science. 2009; 324: 265-8.
Miles MA, Yeo M, Mauricio IL. Genetics. Leishmania exploit sex. Science. 2009; 324: 187-9.
Marlow MA. Epidemiologia molecular da leishmaniose tegumentar americana no Estado de Santa Catarina, Brasil. [Tese de doutorado da Universidade Federal de Santa Catarina]. Florianópolis, SC., 2013.
Cupolillo E, Momen H, Grimaldi G Jr. Genetic diversity in natural populations of New World Leishmania. Mem Inst Oswaldo Cruz. 1998; 93: 663-8.
Schriefer A, Schriefer AL, Góes-Neto A, Guimarães LH, Carvalho LP, Almeida RP, et al .Multiclonal Leishmania braziliensis population structure and its clinical implication in a region of endemicity for American tegumentary leishmaniasis. Infect Immun. 2004; 72: 508-14
Ferreira LT, Gomes, AHS, Pereira-Chioccola VL. Genotype characterization of Leishmania (Viannia) braziliensis isolated from human and canine biopsies with American cutaneous leishmaniasis. Rev Inst Med Trop S Paulo. 2015. In press
Oliveira FS, Valete-Rosalino CM, Schubach AO, Pacheco RS. kDNA minicircle signatures of Leishmania (Viannia) braziliensis in oral and nasal mucosa from mucosal leishmaniasis patients. Diagn Microbiol Infect Dis. 2010. 66: 361-5.
Silva LA, de Sousa CS, Graça GC, Porrozzi R, Cupolillo E. Sequence analysis and PCR-RFLP profiling of the hsp70 gene as a valuable tool for identifying Leishmania species associated with human leishmaniasis in Brazil. Infect Genet Evol. 2010; 10: 77-83.
Buitrago R, Cupolillo E, Bastrenta B, Le Pont F, Martinez E, Barnabé C, Brenière SF. PCR-RFLP of ribosomal internal transcribed spacers highlights inter and intra-species variation among Leishmania strains native to La Paz, Bolivia. Infect Genet Evol. 2011; 11: 557-63.
Baptista C, Schubach AO, Madeira MF, de Freitas CML, Guimarães SPA, Helena SBJ, et al. Evaluation of genetic polymorphism of Leishmania (V.) braziliensis isolates obtained from the same patient before and after therapeutic failure or reactivation of cutaneous lesions. J Trop Med. 2012; 2012:808132.
Baptista C, Schubach AO, Madeira MF, Leal CA, Pires MQ, Oliveira FS, et al. Leishmania (Viannia) braziliensis genotypes identified in lesions of patients with atypical or typical manifestations of tegumentary leishmaniasis: evaluation by two molecular markers. Exp Parasitol. 2009; 121: 317-22.
De Oliveira GM, Madeira MF, Oliveira FS, Pires MQ, Pacheco RS. Canine cutaneous leishmaniasis: Dissemination and tissue tropism of genetically distinct Leishmania Viannia) braziliensis populations. Vet Med Int. 2013; 2013:982183.
Schriefer ALF, Souza RS, Guimarães LH, Góes-Neto A, Schriefer A. Papel do parasita e do hospedeiro na expressão clínica das Leishmanioses. Gaz Med Bahia. 2008; 74
Queiroz A, Sousa R, Heine C, Cardoso M, Guimarães LH, Machado PR, Carvalho EM, Riley LW, Wilson ME, Schriefer A. Association between an emerging disseminated form of leishmaniasis and Leishmania (Viannia) braziliensis strain polymorphisms. J Clin Microbiol. 2012; 12: 4028-34.
Gomes AC, Camargo-Neves VL. The strategy and prospects for the control of cutaneous leishmaniasis in the state of São Paulo. Rev Soc Bras Med Trop. 1998. 31: 549-52.
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2016 Lasaro Teixeira Ferreira, Vera Lucia Pereira-Chioccola