Evaluation of oxidative stress and some hormonal and immunological parameters of Cutaneous Leishmaniasis patients in AL-Anbar Governorate

Abstract

Leishmaniasis is a series of diseases caused by parasites of the genus Leishmania, which are intracellular haemoflagellate protozoan parasites, Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis, with a wide range of clinical manifestations. Cutaneous leishmaniasis is an endemic in Iraq including Al-Anbar governorate. There are two forms of CL, zoonotic (ZCL) and anthroponotic (ACL) which are caused by two species of Leishmania protozoa (L.major and L.tropica)that are transmitted by a bite of the infected female sandflies (Phlebotomus), as biological vectors to humans. The aim of the study is to evaluate the effect of this disease on some biochemical parameters and oxidative stress biomarker levels in serum of patients in Al-Anbar governorate. This includes sex hormones (progesterone, estrogen and testosterone), interleukin )IL-6, IL-10), Malondialdehyde (MDA) and Total Antioxidant Capacity (T-AOC). The study included 80 blood samples of CL patients (45 males 56% and 35 females 44%) and 60 blood samples from healthy individuals (32 males 53% and 28 females 47%) as control group. The sampling period started from the beginning of January 2021 until the end of March 2021. Specimen of patients and healthy individuals were divided according to gender and distributed according to their ages to 7 groups. The study showed that the CL is more frequently reported in men than women, also distribution percentage of ulcers in the body of patient were on the face(17%), upper extremities (47%), lower extremities(30%), trunk (6%). The disease was more prevalent in patients living in rural areas (63%) than in urban areas (37%), and the cases of diseases affecting younger age groups mostly of both sexes than the other age groups, living in urban or rural areas. This study showed that the number of dry Lesions was more than wet lesion 58 (72%), 22 (28%) respectively. The numbers II of Lesions in the body are ranged between 1 to 5 ulcers, the cases infection with one ulcer (single lesions) were seen in the majority of patients for both sexes in rural and urban areas. The detection of sex hormones showed there was association between CL disease and the levels of estradiol and testosterone in CL females patients, compared with the control group (P ≤ 0.05). While, there was no significant differences in progesterone levels in CL patients, compared to healthy individuals. The results showed that there was a significant increase in the MDA level in CL patients, comparing to the control group, (P< 0.0001), the results also showed that there was a significant increase in the T-AOC serum levels of CL patient group as compared with the healthy subjects (P ≤ 0.0001). The immunological study for patients serums of CL has showed an increase in the level of IL-6 in the serum of patients during infection compared with the control group (P≤ 0.0001). On the other hand, the levels of IL-10 were significantly lower in patients than in the control group (P ≤ 0.05). Statistical analysis of data was accomplished by using logistic regression. After statistical analysis processes. It was found that there was two prediction equations of the disease which can conclude if individuals infected or uninfected and to know the type of lesions wet there it was or dry. The role of Malondialdehyde MDA as an early biochemical marker of peroxidation damage during CL is clearly demonstrated in this study by an increase in its levels.