Short Communication

Nutritional Intake and Chronicity Associated with the Old World Cutaneous Leishmaniasis: Role of Vitamin A


Background: Old world cutaneous leishmaniasis (CL) is known as a self-healing cutaneous parasitic infection. Host immunity has a fundamental role in the course of this infection. This study was designed to investigate the relationship between nutritional status and vitamin A intake with the clinical course of CL.

Methods: Overall, 250 patients with CL attending a dermatology clinic in Imam Reza Hospital Mashhad, Iran, were enrolled from Apr 2011 to Aug 2012. For data gathering, a semi-quantitative 302-item food frequency questionnaire was utilized. They received routine treatment protocols for leishmaniasis and 1 year of follow-up

Results: As for the 149 patients who completed the study, a deficiency of macro and micronutrients, particularly vitamin A, was significantly related to a chronic clinical disease course.

Conclusion: Imbalanced or insufficient nutritional intake including vitamin A deficiency, may influence the clinical course of CL.

1. Postigo JAR (2010). Leishmaniasis in the world health organization eastern Medi-terranean region. Int J Antimicrob Agents, 36 Suppl 1:S62-5.
2. Tashakori M, Ajdary S, Kariminia A et al (2003). Characterization of Leishmania species and L. major strains in different endemic areas of cutaneous leishmaniasis in Iran. Iran Biomed J,7(2):43-50.
3. Burnett MW (2015). Cutaneous leishmania-sis. J Spec Oper Med,15(1):128-9.
4. McGwire BS, Satoskar AR (2014). Leish-maniasis: clinical syndromes and treat-ment. QJM,107(1):7-14.
5. Pazoki H, Fakhar M, Rasooli A et al (2016). Lupoid leishmaniasis among the known cases of cutaneous leishmaniasis in Herat Province, western Afghanistan. J Infect Public Health, 9(5):557-563.
6. Murray HW, Berman JD, Davies CR, Saravia NG (2005). Advances in leishmaniasis. Lancet,366(9496):1561-77.
7. Louzir H, Melby PC, Salah AB et al (1998). Immunologic determinants of disease evolution in localized cutaneous leish-maniasis due to Leishmania major. J Infect Dis,177(6):1687-95.
8. Reithinger R, Dujardin J-C, Louzir H et al (2007). Cutaneous leishmaniasis. Lancet Infect Dis,7(9):581-96.
9. Revillard J, Cozon G (1990). Experimental models and mechanisms of immune de-ficiencies of nutritional origin. Food Addit Contam, 7 Suppl 1:S82-6.
10. Sacks DL, Melby PC (2015). Animal models for the analysis of immune responses to leishmaniasis. Curr Protoc Immunol, 108:19.2.1-19.2.24.
11. Anstead GM, Chandrasekar B, Zhao W et al (2001). Malnutrition alters the innate im-mune response and increases early vis-ceralization following Leishmania donovani infection. Infect Immun,69(8):4709-18.
12. Carrillo E, Jimenez MA, Sanchez C et al (2014). Protein malnutrition impairs the immune response and influences the se-verity of infection in a hamster model of chronic visceral leishmaniasis. PLoS One,9(2):e89412.
13. Mashayekhi Goyonlo V, Elnour H, Nord-lind K (2014). Interleukin-2 expression in lupoid and usual types of old world cuta-neous leishmaniasis. Iran Red Crescent Med J, 16(11):e5410.
14. Mashayekhi-Ghoyonlo V, Kiafar B, Rohani M et al (2015). Correlation between Soci-oeconomic Status and Clinical Course in Patients with Cutaneous Leishmaniasis. J Cutan Med Surg,19(1):40-4.
15. Mirmiran P, Hosseini Esfahani F, Mehrabi Y et al (2010). Reliability and relative valid-ity of an FFQ for nutrients in the Tehran Lipid and Glucose Study. Public Health Nutr,13(5):654-62.
16. Ghazizadeh S, Noori M, Norouzy A et al (2014). Scientific: validity and reproduci-bility of Iranian food frequency question-naire. Nutrition and Food Sciences Research, 1(Supple 1):16.
17. Malekshah A, Kimiagar M, Saadatian-Elahi M et al (2006). Validity and reliability of a new food frequency questionnaire com-pared to 24 h recalls and biochemical measurements: pilot phase of Golestan cohort study of esophageal cancer. Eur J Clin Nutr,60(8):971-7.
18. França T, Ishikawa L, Zorzella-Pezavento S et al (2009). Impact of malnutrition on immunity and infection. J Venom Anim Toxins Incl Trop Dis,15(3):374-90.
19. Schaible UE, Kaufmann SH (2007). Malnu-trition and infection: complex mecha-nisms and global impacts. PLoS Med,4(5):e115.
20. Dayakar A, Chandrasekaran S, Veronica J, Maurya R (2011). Role of leptin in human visceral leishmaniasis? Med Hypotheses, 77(3):416-8.
21. Malafaia G, Serafim TD, Silva ME et al (2009). Protein-energy malnutrition de-creases immune response to Leishmania chagasi vaccine in BALB/c mice. Parasite Immunol, 31(1):41-9.
22. Corware K, Yardley V, Mack C et al (2014). Protein energy malnutrition increases ar-ginase activity in monocytes and macro-phages. Nutr Metab (Lond), 11(1):51.
23. Maciel BLL, Lacerda HG, Queiroz JW et al (2008). Association of nutritional status with the response to infection with Leishmania chagasi. Am J Trop Med Hyg, 79(4):591-8.
24. Pourfallah F, Javadian S, Zamani Z et al (2009). Evaluation of serum levels of zinc, copper, iron, and zinc/copper ratio in cu-taneous leishmaniasis. Iran J Arthropod Borne Dis, 3(2):7-11.
25. Guzman-Rivero M, Rojas E, Verduguez-Orellana A et al (2014). Nutritional status in patients with cutaneous leishmaniasis and a study of the effects of zinc sup-plementation together with antimony treatment. Food Nutr Res,58:23353.
26. Oliveira A, Brito P, Schubach Aet al (2013). Influence of the nutritional status in the clinical and therapeutical evolution in adults and elderly with American Tegu-mentary Leishmaniasis. Acta Trop,128(1):36-40.
27. Stephensen CB, Jiang X, Freytag T (2004). Vitamin A Deficiency Increases the In Vivo Development of IL-10–Positive Th2 Cells and Decreases Development of Th1 Cells in Mice. J Nutr, 134(10):2660-6.
28. Anstead G, Zhang Q, Melby P (2009). Mal-nutrition promotes prostaglandin over leukotriene production and dysregulates eicosanoid-cytokine crosstalk in activated resident macrophages. Prostaglandins Leu-kot Essent Fatty Acids, 81(1):41-51
29. Wintergerst ES, Maggini S, Hornig DH (2007). Contribution of selected vitamins and trace elements to immune function. Ann Nutr Metab,51(4):301-23.
30. Hughes DA, Darlington LG, Bendich A (2003). Diet and human immune func-tion: Springer Science & Business Media.
IssueVol 49 No 1 (2020) QRcode
SectionShort Communication(s)
Cutaneous leishmaniasis Nutrition Vitamin A

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
MASHAYEKHI GOYONLO V, NOROUZY A, NEMATI M, LAYEGH P, AKHLAGHI S, TAHERI AR, KIAFAR B. Nutritional Intake and Chronicity Associated with the Old World Cutaneous Leishmaniasis: Role of Vitamin A. Iran J Public Health. 2020;49(1):167-172.