<div dir="ltr"><div class="gmail_default" style="font-size:small;font-family:verdana,sans-serif">Indeed, treatment is required for patients with resistant kala-azar undergoing splenectomy. Recently, we had an adult patient submitted to several treatments with glucantime, liposomal amphotericin B and pentamidin.<br>
<br>After splenectomy, he received seven doses of amph B and is cured now, after one year, with negative BM.<br><br></div><div class="gmail_default" style="font-size:small;font-family:verdana,sans-serif">There are quite a few reports of success, but there is a report of a asplenic patient with kala-azar (I have not read it yet, Dorcas just told me: (Bada JL, Arderiu A, Gimenez J, Gumez-Acha JA. Kala-azar of longstanding
evolution in an asplenic patient. Trans R Soc Trop Med Hyg. 1979;73(3):347-8.
PubMed PMID: 473333 in PubMed).</div><div class="gmail_default" style="font-size:small;font-family:verdana,sans-serif">
<br></div><div class="gmail_default" style="font-size:small;font-family:verdana,sans-serif">
The group from D. Sacks has shown interesting findings on CD4 T-cells secreting IL-10. We wonder if the spleen is the main source of this cytokine, since bone marrow and liver are also heavily parasitized, but are cleared after splenectomy.<br>
<br></div><div class="gmail_default" style="font-size:small;font-family:verdana,sans-serif">I've read a few papers on the subject (see attached) but we still need this clue to design better treatments and vaccines. <br>
<br></div><div class="gmail_default" style="font-size:small;font-family:verdana,sans-serif">David, Susanne, Shalini, Perikala, any hint?<br><br></div></div><div class="gmail_extra"><br><br><div class="gmail_quote">2013/8/27 Dr Omar Hamarsheh <span dir="ltr"><<a href="mailto:ohamarsheh@gmail.com" target="_blank">ohamarsheh@gmail.com</a>></span><br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div link="blue" vlink="purple" lang="EN-US"><div><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Dear All,<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">I am not an immunologist but I have an opinion that I would like to share; splenectomy cures patients with Visceral Leishmaniasis. <u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">large masses of Leishmania in case of visceral Leishmaniasis is existed in reticuloendothelial system including spleen. Removal of spleen will remove huge masses of the parasite infected cells. In cases of serious splenomegaly and cytopenia, spelenectomy become a good option.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">All the best,<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">omar<u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p>
<p class="MsoNormal"><b><span style>-------------------------------------<u></u><u></u></span></b></p><p class="MsoNormal"><b><span style>Omar Hamarsheh, MSc., PhD<u></u><u></u></span></b></p><p class="MsoNormal"><b><span style>Al-Quds University<u></u><u></u></span></b></p>
<p class="MsoNormal"><b><span style>Department of Biological Sciences<u></u><u></u></span></b></p><p class="MsoNormal"><b><span style>P.O.Box 51000<u></u><u></u></span></b></p><p class="MsoNormal"><b><span style>Jerusalem<u></u><u></u></span></b></p>
<p class="MsoNormal"><b><span style>PALESTINE<u></u><u></u></span></b></p><p class="MsoNormal"><b><span style> <u></u><u></u></span></b></p><p class="MsoNormal"><b><span style>Tel: 00970-599197097<u></u><u></u></span></b></p>
<p class="MsoNormal"><b><span style>Fax: 00970-22796960<u></u><u></u></span></b></p><p class="MsoNormal"><b><span style> <u></u><u></u></span></b></p><p class="MsoNormal"><b><span style>Email: <a href="mailto:ohamarsheh@gmail.com" target="_blank"><span style="color:blue">ohamarsheh@gmail.com</span></a><u></u><u></u></span></b></p>
<p class="MsoNormal"><b><span style> <a href="http://mail.alquds.edu/~f3706/" target="_blank"><span style="color:blue">mail.alquds.edu/~f3706/</span></a><u></u><u></u></span></b></p><div class="im"><p class="MsoNormal">
<span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p><div style="border:none;border-top:solid #b5c4df 1.0pt;padding:3.0pt 0in 0in 0in"><p class="MsoNormal">
<b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> <a href="mailto:leish-l-bounces@lineu.icb.usp.br" target="_blank">leish-l-bounces@lineu.icb.usp.br</a> [mailto:<a href="mailto:leish-l-bounces@lineu.icb.usp.br" target="_blank">leish-l-bounces@lineu.icb.usp.br</a>] <b>On Behalf Of </b>Carlos Costa<br>
<b>Sent:</b> Wednesday, August 21, 2013 3:53 PM<br><b>To:</b> Leish-L<br><b>Subject:</b> [Leish-l] spleen<u></u><u></u></span></p></div><p class="MsoNormal"><u></u> <u></u></p></div><div><div><p class="MsoNormal"><span style="font-family:"Verdana","sans-serif"">Dear leishimmunologists,<u></u><u></u></span></p>
</div><div><div class="h5"><div><p class="MsoNormal"><span style="font-family:"Verdana","sans-serif""><u></u> <u></u></span></p></div><div><p class="MsoNormal"><span style="font-family:"Verdana","sans-serif"">Do you have any guess on why splenectomy cures kala-azar? Would it be the absence of spleen-derived IL-10?<u></u><u></u></span></p>
</div><div><p class="MsoNormal"><span style="font-family:"Verdana","sans-serif""><u></u> <u></u></span></p></div><div><p class="MsoNormal"><span style="font-family:"Verdana","sans-serif"">All my best,<u></u><u></u></span></p>
</div><div><p class="MsoNormal"><span style="font-family:"Verdana","sans-serif""><u></u> <u></u></span></p></div><div><p class="MsoNormal"><span style="font-family:"Verdana","sans-serif"">Carlos.<u></u><u></u></span></p>
</div><div><p class="MsoNormal"><u></u> <u></u></p></div><p class="MsoNormal">-- <u></u><u></u></p><div><p class="MsoNormal"><span style="font-family:"Verdana","sans-serif"">Carlos H. N. Costa, MD, DSc.</span><u></u><u></u></p>
<p class="MsoNormal"><span style="font-family:"Verdana","sans-serif"">Coordenador</span><u></u><u></u></p><p class="MsoNormal"><span style="font-family:"Verdana","sans-serif"">Laboratório de Leishmanioses - LabLeish</span><u></u><u></u></p>
<p class="MsoNormal"><span style="font-family:"Verdana","sans-serif"">Universidade Federal do Piauí</span><u></u><u></u></p><div><p class="MsoNormal"><span style="font-family:"Verdana","sans-serif"">Instituto de Doenças Tropicais Natan Portella</span><u></u><u></u></p>
<p class="MsoNormal"><span style="font-family:"Verdana","sans-serif"">Rua Artur de Vasconcelos 151-Sul</span><u></u><u></u></p><div><p class="MsoNormal"><span style="font-family:"Verdana","sans-serif"">64001-450 Teresina-PI</span><u></u><u></u></p>
<p class="MsoNormal"><span style="font-family:"Verdana","sans-serif"">Brazil<u></u><u></u></span></p><p class="MsoNormal"><span style="font-family:"Verdana","sans-serif"">Telephones: <a href="tel:%2B55%2086%203222-4377" value="+558632224377" target="_blank">+55 86 3222-4377</a> (W), <u></u><u></u></span></p>
<p class="MsoNormal" style="text-align:center" align="center"><span style="font-family:"Verdana","sans-serif""><a href="tel:%2B55%2086%203221-3062" value="+558632213062" target="_blank">+55 86 3221-3062</a> (W), <u></u><u></u></span></p>
<p class="MsoNormal" style="text-align:center" align="center"><span style="font-family:"Verdana","sans-serif""><a href="tel:%2B55%2086%203237-1075" value="+558632371075" target="_blank">+55 86 3237-1075</a> (R). <u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-family:"Verdana","sans-serif""><u></u> <u></u></span></p><p class="MsoNormal"><span style="font-family:"Verdana","sans-serif""><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Verdana","sans-serif"">Aviso: As informações contidas nesta mensagem são CONFIDENCIAIS, protegidas pelo sigilo legal, por direitos autorais e destinadas exclusivamente à pessoa ou organização para a qual a mensagem foi destinada.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Verdana","sans-serif"">Warning: This message is meant only for the intended recipient of the transmission. It is forbidden any unauthorized use, alteration, reproduction and distribution. If you are not the correct recipient, please notify us immediately by return e-mail and delete this message from your system.<u></u><u></u></span></p>
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<br>-- <br><div dir="ltr"><div style="text-align:left"><span style="font-family:verdana,sans-serif">Carlos H. N. Costa, MD, DSc.</span></div><div style="text-align:left"><span style="font-family:verdana,sans-serif">Coordenador</span></div>
<div style="text-align:left"><span style="font-family:verdana,sans-serif">Laboratório de Leishmanioses - LabLeish</span></div><div style="text-align:left"><span style="font-family:verdana,sans-serif">Universidade Federal do Piauí</span><br>
</div><div><div style="text-align:left"><span style="font-family:verdana,sans-serif">Instituto de Doenças Tropicais Natan Portella</span></div><div style="text-align:left"><font face="verdana, sans-serif">Rua Artur de Vasconcelos 151-Sul</font></div>
<div><div style="text-align:left"><span style="font-family:verdana,sans-serif">64001-450 Teresina-PI</span></div><font face="verdana, sans-serif"><div style="text-align:left">Brazil</div><div style="text-align:left">Telephones: +55 86 3222-4377 (W), <div style="text-align:center;display:inline!important">
<div style="text-align:center;display:inline!important">+55 86 3221-3062 (W), </div></div><div style="text-align:center;display:inline!important">+55 86 3237-1075 (R). </div></div><div style="text-align:left"><br></div><div style="text-align:left">
<br></div><span style="font-size:x-small"><div style="text-align:left">Aviso: As informações contidas nesta mensagem são CONFIDENCIAIS, protegidas pelo sigilo legal, por direitos autorais e destinadas exclusivamente à pessoa ou organização para a qual a mensagem foi destinada.</div>
<div style="text-align:left">Warning: This message is meant only for the intended recipient of the transmission. It is forbidden any unauthorized use, alteration, reproduction and distribution. If you are not the correct recipient, please notify us immediately by return e-mail and delete this message from your system.</div>
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