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ТHE ROLE OF IMMUNITY IN THE DEVELOPMENT OF
CLINICAL VARIETIES OF CUTANEOUS LEISHMANIASIS
Makhmudov Farkhod Akhmedovich
Bukhara State Medical Institute named after Abu Ali ibn Sina,
Uzbekistan, Bukhara, st. Gijduvanskaya 23. Tel: +998 (65) 223-00-50
e-mail: maxmudov.farxad@bsmi.uz
https://doi.org/10.5281/zenodo.15478246
ARTICLE INFO
ABSTRACT
Qabul qilindi: 10-May 2025 yil
Ma’qullandi: 15- May 2025 yil
Nashr qilindi: 21-May 2025 yil
The study examined the efficacy of aloe extract in the
topical application of zoonotic leishmaniasis. To date,
specific drug prevention of leishmaniasis has not been
developed. One of the important problems in
dermatology is the search for effective, low-toxic agents
and methods of therapy for cutaneous leishmaniasis,
since the drugs used have cardio-, hepato-, and
nephrotoxicity.
KEYWORDS
aloe
extract,
apoptosis,
promastigotes, in vitro, in vivo,
Leishmania major..
Relevance.
The prevalence of leishmaniasis is one of the highest among diseases of parasitic
etiology. Up to 1 million people are affected worldwide every year(1).
The causative agent of cutaneous leishmaniasis was first identified in 1898 in Tashkent
by P.F. Barovsky (2). In 1898, P. F. Borovsky accurately determined the systematic position of
Leishmania, classifying it as a protozoan. Many articles describe, which carefully describes the
pathogen, which the authors refer to protozoa, close to trypanosomes (3).
By the beginning of the 20th century, the use of various cauterizing and astringent
agents became a common method of treatment: red-hot iron and caustic potash
(Heidenreich), chromium (Cherepnin), lapis (Rapchevsky), lactic acid (Manotskov, Shulgin),
zinc chloride (Mish-kin, Satinsky ) (Dobrotvorskaya N.V. 1940). E. I. Martsinovsky also used a
surgical method of treatment, removed “under cocaine, ulcers and acne in four patients, and
after a few days complete healing occurred. There were no relapses." (four). Professor VL
Yakimov wrote in 1913 that there is no specific treatment for cutaneous leishmaniasis (5).
In world healthcare practice, according to WHO recommendations from 2010, pentavalent
antimony drugs are used for the specific treatment of cutaneous leishmaniasis (6), an
antitumor agent for local use: Miltefosine (Impavido, Paladin - Canada), antibacterial drugs:
Amphotericin B, AmBisom ; Paromomycin (India), Monomycin (Uzbekistan), drugs of non-
specific, auxiliary action: antiseptics, the action of which is aimed at combating secondary
infection that has joined (7) In this regard, the publications of authors who empirically
treated patients with antibiotics of various pharmacological groups are valuable. These are
doxycycline (8) and cefotaxime (Claforan - 3rd generation cephalosporin) (9). At the same
time, there are no data on preclinical studies of these drugs in the literature. Considering that
cefotaxime (claforan) is an imported drug (France), it is relevant for research with the aim of
import substitution to study in vitro and in vivo a domestic antibiotic from the same group -
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ceftriaxone. A universal drug for the treatment of leishmaniasis are preparations of 5-valent
antimony. Therefore, meglumine antimonate (glucantim) can be used as a control when
evaluating the effectiveness of other drugs.
Studies by foreign experts indicate that the etiological factor of the disease may not be
the leishmania itself, but the virus in them (LRV - leishmanial RNA virus), found in 1988 in a
patient infected with L. Guyanensis (10). It was later found in L. braziliensis and was
associated with a more severe course of CL, up to the development of mucocutaneous
leishmaniasis (11). When hamsters are infected with Leishmania containing LRV, a strong
inflammatory response is noted due to an increase in the level of IFN-β, as well as an
extension of the survival of parasites with the virus (12).
In 1928, the treatment of patients with cutaneous leishmaniasis with autohemotherapy
without effect was reported (2).
Aloe is known as a medicinal plant. The enhanced antimicrobial properties of aloe vera
are attributed to aloe-emodin, present in aloe latex, in the exudate of the aloe plant, which has
antibacterial, antifungal, and antitumor effects (13).
Aloe has been used for traditional medicinal purposes in several cultures. Extracts of A.
vera in vitro stimulate the proliferation of several cell types. Many studies have shown that
treatment with A.vera gel extracts leads to faster wound healing, can have a direct effect on
the wound healing process in general, which is manifested in an increase in the rate of wound
contraction and increased collagen synthesis. (14).
Aloe vera is well known for its antioxidant, anti-inflammatory, anti-diabetic, pain-
relieving, immune, anti-aging, and anti-cancer properties (15).
Various parts of the plant contain about 75 nutrients as well as 200 active compounds,
including amino acids, sugars, enzymes, vitamins, minerals, saponins, anthraquinones, lignin,
and salicylic acid (16). Volatile components and ascorbic acid are present in the flowers, while
polysaccharides, lignin, pectin, hemicellulose and cellulose are present in the peel. Similarly,
the leaves are a source of various organic acids, enzymes, phenolic compounds, minerals, and
vitamins (17).
Aloe vera as an ingredient is defined as a preparation that maximizes the desired
components while maintaining them in an active and unchanged form, minimizes the amount
of ingredients that have a negative effect, retains the benefits, and is present in the final
product in quantities sufficient to obtain the desired results. (18.21)
A number of antioxidants such as alpha-tocopherol, carotenoids, ascorbic acid,
flavonoids, tannins, vitamin C and E are present in aloe vera (19,20). Many authors report on
the antioxidant potential of aloe vera extracts (leaves and flowers). (21,22,23).
Because of its unique composition,, various industrial applications of Aloe Vera have
begun to be applied. This article summarizes the therapeutic use of aloe vera as well as its use
in the topical treatment of cutaneous leishmaniasis.
Purpose of the study.
The aim of this study was to evaluate the effect of aloe vera leaf
exudate on Leishmania major in lesions. To assess clinical and laboratory change in topical
treatment of zoonotic leishmaniasis with aloe extract
.
Material and research methods.
A study was made of 50 stationary cards of sick
children, men and women with zoonotic leishmaniasis for 2 months, average age from 3 to 56
years. Patients complained of necrotic foci, leishmaniomas accompanied by an increase in
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regional lymph nodes and lymphangitis (usually painless) and wounds with complications of
purulent infection with the development of phlegmon, erysipelas. A microscopic examination
of the material from the wound was made in order to diagnose the Borovski's div. All
patients had positive parasitological parameters.
To evaluate the geometric model, patients with zoonotic leishmaniasis (Karakulsky
district) were divided into 2 groups according to the course of the disease and according to
the method of application of the aloe extract. Patients of group 1 (main group) To study the
effect of aloe extract with 4 times local application for 20 days in patients with wound size
from 0.5 to 2 cm or more, and with complications in regional lymph nodes.
Patients of the 2nd group (patients of the control group) received conventional therapy.
Results and discussions:
In the 1st group (32 people) with a wound size of 0.5 to 2 cm
or more, and with complications in the regional lymph nodes.
The remaining patients of the 2nd group, regardless of the size of the wound, received
traditional therapy. Normal epitilization of wounds with almost perfect smooth scars in the
1st group occurred in (2 people), in the 2nd group in (1 person).
The following results were obtained after 20 days of application of aloe extract. Changes
in the geometry of wounds among patients with leishmaniasis disease (patients of the 1st
group) were detected in the largest number of patients with the formation of mild atrophic
scars in 21.9% of cases (7 people). A scar with keloid-like growths was identified in an equal
number of patients - 31.3% (10 people). In 47% (10 people) of patients who have scars with
screenings: an irregularly shaped scar is located in the center, surrounded on the periphery
by small scars caused by seeding tubercles, and with scars-keloid-like growths, they were
identified in 28% (3 people). Patients of the 2nd group (patients of the control group)
received traditional therapy in 22.22% (4 people) with mild atrophic scars, with keloid-like
growths were detected in 26.66% (3 people), the rest of the patients who had not yet begun
epithilization during the study 55.5%(10 people).
The following results were obtained that the timing of cleansing and healing of
leishmania wounds depend on the clinical form of the disease.
Comparative results of topical application of aloe extract in patients with CL. Patients of
the 1st group, who used aloe extract, the scarring process began on the 16-20th day, patients
of the 2nd group, the scarring process began after 2 months of applying the traditional
medical procedure.
Cutaneous leishmaniasis is a significant, potentially modifiable risk factor for enlarging
the geometric boundaries of wounds, which in turn increases scar area. Thus, the increase in
the size of the scar is a more significant factor in the formation of the social complex. Topical
application of aloe extract has shown that the use of this compound in the initial stages of CL
wound formation reduces the size of the lesion
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