The intracellular protozoan parasites of the genus Leishmania are the causative agents of leishmaniasis, a vector-borne disease of major public health concern, estimated to affect 12 million people worldwide. The clinical manifestations of leishmaniasis are highly variable and can range from self-healing localized cutaneous lesions to life-threatening disseminated visceral disease. Once introduced into the skin by infected sandflies, Leishmania parasites interact with a variety of immune cells, such as neutrophils, monocytes, dendritic cells (DCs), and macrophages. The resolution of infection requires a finely tuned interplay between innate and adaptive immune cells, culminating with the activation of microbicidal functions and parasite clearance within host cells. However, several factors derived from the host, insect vector, and Leishmania spp., including the presence of a double-stranded RNA virus (LRV), can modulate the host immunity and influence the disease outcome. In this review, we discuss the immune mechanisms underlying the main forms of leishmaniasis, some of the factors involved with the establishment of infection and disease severity, and potential approaches for vaccine and drug development focused on host immunity.

Toxicity and poor adherence to treatment that favors the generation of resistance in the Leishmania parasites highlight the need to develop better alternatives. Here, we evaluated the in vitro effectiveness of hydrazone derived from chromanes 2-(2,3-dihydro-4H-1-benzothiopyran-4-ylidene) hydrazide (TC1) and 2-(2,3-dihydro-4H-1-benzopyran-4-ylidene) hydrazide (TC2) and the mixture of triterpene saponin hederagenin-3-O-(3,4-O-diacetyl-ß-D-xylopyranosyl-(1à3)-a-L- rhamnopyranosyl-(1à2)-a-L-arabinofuranoside, hederagenin-3-O-(3,4-O-diacetyl-a-L- arabinopyranosyl-(1à3)-a-L-rhamnopyranosyl-(1à2)-a-L-arabinofuranoside and, hederagenin-3-O-(4-O-acetyl-ß-D-xylopyranosyl-(1à3)-a-L-rhamnopyranosyl-(1à2)-a-L-arabinofuranoside from Sapindus saponaria (SS) on L. braziliensis and L. pifanoi. Mixtures of TC1 or TC2 with saponin were formulated for topical application and the therapeutic effectiveness was evaluated in the model for cutaneous leishmaniasis (CL) in golden hamster. The mode of action of these compounds was tested on various parasite processes and ultrastructural parasite modifications. TC1, TC2 and SS showed moderate cytotoxicity when tested independently but toxicity was improved when tested in combination. The compounds were more active against intracellular Leishmania amastigotes. In vivo studies showed that combinations of TC1 or TC2 with SS in 1:1 ratio (w/w) cured 100% of hamsters with no signs associated with toxicity. The compounds did cause changes in the mitochondrial activity of the parasite with a decrease in ATP levels and depolarization of membrane potential and overproduction of reactive oxygen species; nevertheless, these effects were not related to alterations in membrane permeability. The phagolysosome ultrastructure was also affected impacting the survival of Leishmania but the function of the lysosome nor the pH inside the phagolysosome did not change. Lastly, there was a protease inhibition which was directly related to the decrease in the ability of Leishmania to infect and multiply inside the macrophage. The results suggest that the combination of TC1 and TC2 with SS in a 1:1 ratio is capable of curing CL in hamsters. This effect may be due to the ability of these compounds to affect parasite survival and the ability to infect new cells.

Internal Transcribed Spacer ITS-2 rRNA nemabiome metabarcoding is increasingly used to characterize gastrointestinal nematode (GIN) communities. While powerful, current approaches have some limitations in their flexibility and applicability to smaller-scale studies and diagnostic use. The short read lengths provided by the Illumina platform may lack discriminatory power for some closely related species and also pose a challenge for new marker selection and primer design. To address these challenges, we have developed ITS-1/5.8S/ITS-2 rRNA Oxford Nanopore Technologies (ONT) long-read metabarcoding for ovine gastrointestinal nematodes. Samples from two previous field studies, from UK and western Canadian sheep farms were used. ITS-1/5.8S/ITS-2 long-read metabarcoding showed strong concordance with prior ITS-2 data for the major GIN species in both datasets, with minor discrepancies for some low abundance taxa mainly due to differences in reference sequence database representation. We also used the PrimerTC tool to design a new primer pair, EC1 and EC2, to minimize the amplification of off-target fungal sequences derived from fecal DNA and maximize the nematode sequence read depth when ONT ITS-1/5.8S/ITS-2 metabarcoding was applied directly to ovine fecal stool DNA. In summary, ITS-1/5.8S/ITS-2 ONT long-read nemabiome metabarcoding showed good agreement with ITS-2 metabarcoding and the use of primer pair EC1/EC2 should make the approach more tolerant of fecal contamination of parasite material, with the potential for direct application to ovine fecal DNA. Overall, these new developments should make nemabiome metabarcoding more accessible, discriminating, and flexible for both research and diagnostic applications.