Endocrine Abstracts

Objective: Visceral Leishmaniasis is a macrophage associated disorder for the treatment of which antimony based drug like Sodium Antimony Gluconate has been the first choice in the recent past. About 5 percent of the patients may develop insulin dependent diabetes mellitus. It appears to have a direct action on pancreatic beta cells, resulting in initial insulin release followed by impaired insulin secretion. Within this context we looked into alternate therapies of treatment along with SAG on triggering the CD2 epitope.

Methods: We have evaluated the effect of combining CD2 with conventional antimonial (sb) therapy in protection in BALB/c mice infected with either drug sensitive or resistant strain of Leishmania donovani with 3 million parasites via-intra-cardiac route. Mice were treated with anti CD2 adjunct SAG sub-cutaneously twice a week for 4 weeks. Assessment for measurement of weight, spleen size, anti-Leishmania antibody titer, T cell and anti-leishmanial macrophage function was carried out day 0, 10, 22 and 34 post treatments. Insulin levels were also determined on the same intervals.

Results: The combination therapy was shown boosting significant proportion of T cells to express CD25 compared to SAG monotherapy. Although, the level of IFN-γ was not statistically different between combination vs monotherapy (P = 0.298) but CD2 treatment even alone significantly influenced IFN- γ production than either SAG treatment (P = 0.045) or with CD2 adjunct SAG treatment (P = 0.005) in Ld-S strain as well as in Ld-R strain. The influence of CD2 adjunct treatment was also documented in anti-leishmanial functions in macrophages. Interestingly insulin levels were observed to be optimal on supplementing SAG along with CD2.

Conclusion: SAG along with CD2 could be used as a potential therapy to overcome incidences of Diabetes mellitus during Visceral Leishmaniasis.