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Towards effective cutaneous leishmaniasis treatment with light-based technologies. A systematic review and
Fernanda Viana Cabral1, Tiago Henrique Dos Santos Souza2, Fábio Parra Sellera3
1Center for Lasers and Applications, Energy and Nuclear Research Institute (IPEN/CNEN), São Paulo, SP, Brazil.
Abstract:
Cutaneous leishmaniasis (CL) is a neglected disease that represents a serious global public health concern. We performed a systematic review with meta-analysis targeting the use of light-based therapies on CL in preclinical studies since they are essential to identify the benefits, challenges, and limitations of proposing new technologies to fight CL. We searched Pubmed and Web of Science to include original preclinical researches in English that used light-based technologies to fight CL. Inclusion criteria encompassed any animal model for CL induction, an untreated infected group as the comparator, reliable and consistent methodology to develop and treat CL, focus on an antimicrobial therapeutic approach, and data for lesion size and/or parasite load in the infection site. We identified eight eligible articles, and all of them used photodynamic therapy (PDT). For the meta-analysis, three studies were included regarding the parasite load in the infection site and four comprised the lesion size. No overall statistically significant differences were observed between untreated control and PDT groups for parasite load. Differently, PDT significantly reduced the lesion size regardless of the protocol used to treat CL (in mm, SMD: -1.90; 95% CI: -3.74 to -0.07, p = 0.04). This finding is particularly encouraging since CL promotes disfiguring lesions that profoundly affect the quality of life of patients. We conclude that PDT is a new promising technology able to be topically used against CL if applied in more than one session, making it a promising ally for the management of CL.
Insights
Photodynamic therapy (PDT) shows promise for treating cutaneous leishmaniasis (CL), a neglected disease. While PDT did not significantly reduce parasite load in preclinical studies, it effectively reduced lesion size, improving patient quality of life.
Area of Science:
- Medical research
- Parasitology
- Dermatology
Background:
- Cutaneous leishmaniasis (CL) is a neglected tropical disease with significant public health implications.
- Disfiguring skin lesions in CL profoundly impact patient quality of life.
Purpose of the Study:
- To systematically review and meta-analyze preclinical studies on light-based therapies for CL.
- To assess the efficacy of photodynamic therapy (PDT) in managing CL lesions and parasite load.
Main Methods:
- Systematic review and meta-analysis of preclinical studies on light-based therapies for CL.
- Searched PubMed and Web of Science for relevant research using animal models.
- Included studies with untreated controls, focusing on lesion size and parasite load.
Main Results:
- Eight eligible articles were identified, all utilizing photodynamic therapy (PDT).
- Meta-analysis showed no significant difference in parasite load reduction between PDT and control groups.
- PDT significantly reduced lesion size in CL models (SMD: -1.90; p=0.04).
Conclusions:
- Photodynamic therapy (PDT) is a promising topical treatment for cutaneous leishmaniasis (CL).
- Multiple PDT sessions may be necessary for effective CL management.
- PDT offers a potential new therapeutic strategy for CL, improving patient outcomes.
