The Role of Zinc in Leishmaniasis and Tuberculosis

Abstract: Popular Abstract in English Bolivia, as with other Latin American countries, is considered to be in an epidemiological transition due to the continued persistence of infectious diseases, and nutritional deficiencies related to poverty and food insecurity, together with an increase in chronic non-communicable diseases mainly related to lifestyle factors. The work presented in this thesis was focused on finding strategies that can help reduce the impact of cutaneous leishmaniasis and pulmonary tuberculosis in Bolivia, which are hampering its social and economic development. The effect of supplementing conventional drug therapies with zinc on the clinical course of these diseases and on the modulation of the immune response was studied. The local injection of antimony directly into the border of the ulcer in cutaneous leishmaniasis was also investigated. The results showed that zinc supplementation provided no additional benefits regarding clinical recovery or biomarkers in cutaneous leishmaniasis or pulmonary tuberculosis. The time-dependent changes in the immune function observed in patients with these diseases were not attributable to zinc supplementation. The use of intralesional injections of antimony in cutaneous leishmaniasis showed a clinical cure rate of 70%, which can be compared with 17% using the placebo. Injecting small amounts of antimony directly into the border of the ulcer could provide an economic alternative for the treatment of cutaneous leishmaniasis. The results of the present work indicate that further research on other micronutrients as low-cost alternative co-adjuvants in the treatment of these infections is necessary.