Vaccination and the Immunological Control of Leishmaniasis
Vaccination against cutaneous leishmaniasis has long been practiced. Accounts in the literature suggest that from as early as the 19th Century children in Baghdad had been vaccinated against “Oriental Sore”, by inoculating material from active human lesions into the skin of the arm or thigh (Wenyon, 1911). In this way long-lasting immunity could be induced and the likelihood of developing disfiguring facial scars avoided. To my knowledge there has been only one vaccination study on human visceral leishmaniasis caused by L. donovani. Manson-Bahr (1961) reported that inoculation with a non-visceralising ground squirrel strain of L. donovani protected against challenge with the human parasite. The ground squirrel parasite has, in fact, been identified as L. major using biochemical and serological methods (Chance et al., 1978). However, the use of live material is subject to obvious drawbacks, scarring is inevitable at the site of inoculation and there is always the possibility of a particularly susceptible recipient developing a chronic or severe infection. The problems inherent in the use of virulent vaccines have stimulated trials using attenuated parasites or parasite fractions. Although these have proved disappointing with regard to Old World cutaneous leishmaniasis, recent field trials in South America have produced encouraging results. Using a vaccine consisting of equal parts heat-killed and sonicated promastigotes from five different parasite isolates, Mayrink et al (1985) successfully and significantly protected from infection 70% of the participants that became skin-test positive following vaccination.
KeywordsVisceral Leishmaniasis Ground Squirrel Cutaneous Leishmaniasis Leishmania Species Immunological Control
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