Correlation between clinical responses with the drugsusceptibility of parasites in Iranian cutaneous leishmaniasis caused by Leishmania major.

Reviews have shown increasing number of Iranian patients with cutaneous leishmaniasis (CL) who are unresponsive to pentavalent antimonial compounds such as meglumine antimoniate (Glucantime, MA). The present investigation aims to determine the correlation between clinical responses (healing, or non-healing) with susceptibility of Leishmania parasites to glucantime. Initially, in vitro susceptibility of Leishmania parasites was carried out on 93 isolates using macrophage models. Identification of these species was also performed by molecular methods including Nested-PCR and PCR-RFLP. The f indicated that total isolated were L. major. A significant association between the clinical outcome and the in vitro effective concentration 50% (EC50) values was observed. Leishmania derived from patients with non-healing lesions had EC50 values at least 3-fold higher than parasites isolated from lesions of healing patients. By molecular methods, patterns for both sensitive and resistant samples demonstrated restriction band which is related to L. major. The obtained findings in the present study demonstrated that MA-resistant L. major field isolates are now frequent in Iran. Such studies help to find strategies for rapidly diagnosing resistance in order to improve the clinical management of CL.