Canine leishmaniosis and peripheral neuropathy: a lesson from the neurologist

Abstract Background Canine leishmaniosis (CanL), a sand fly-borne zoonotic disease caused by Leishmania infantum, is potentially lethal in dogs. A similar or slightly higher quantity of antigens over antibodies promotes the formation of soluble circulating immune complexes (sCIC), which are deposite...

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Main Authors: Floriana Gernone, Domenico Otranto, Jairo Alfonso Mendoza-Roldan, Annamaria Uva, Kaspar Matiasek, Andrea Zatelli
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Parasites & Vectors
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Online Access:https://doi.org/10.1186/s13071-025-06773-4
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author Floriana Gernone
Domenico Otranto
Jairo Alfonso Mendoza-Roldan
Annamaria Uva
Kaspar Matiasek
Andrea Zatelli
author_facet Floriana Gernone
Domenico Otranto
Jairo Alfonso Mendoza-Roldan
Annamaria Uva
Kaspar Matiasek
Andrea Zatelli
author_sort Floriana Gernone
collection DOAJ
description Abstract Background Canine leishmaniosis (CanL), a sand fly-borne zoonotic disease caused by Leishmania infantum, is potentially lethal in dogs. A similar or slightly higher quantity of antigens over antibodies promotes the formation of soluble circulating immune complexes (sCIC), which are deposited in the capillary wall, causing the inflammatory cascade responsible for clinical manifestations. Nervous system involvement during CanL is rarely reported in both humans and dogs, and the exact underlying process involving the peripheral nervous system (PNS) is still debated in both species. Methods Two male mixed-breed dogs were presented for exercise intolerance, non-ambulatory flaccid tetraparesis and decreased/absent flexor reflexes in all four limbs. Both dogs were seropositive for L. infantum and presented clinicopathological abnormalities suggestive of active CanL. One dog had received N-methyl-glucamine antimoniate two months before presentation without neurological improvement. Results Generalized PNS involvement was confirmed in both dogs. Biopsies of muscle and nerve tissues showed mononuclear cell inflammatory infiltration, and quantitative real-time polymerase chain reaction (PCR) was positive for Leishmania spp. In addition, Leishmania spp. antigen was detected in the nerve from one dog by immunohistochemistry. Both dogs were started on N-methyl-glucamine antimoniate and allopurinol in association with immunosuppressive corticosteroid therapy, recovering in few weeks. Conclusions Peripheral neuropathies during active CanL can be a consequence of sCIC deposition on endoneurial vascular endothelium comprising the blood–nerve barrier and its consequent breakdown. However, an abnormal host immune response triggered by L. infantum causing demyelination and/or axonal disruption is also possible. The positive response to the immunosuppressive therapy further supports an immune-mediated origin of the PNS condition. Therefore, CanL should be included in the differential diagnosis of PNS disease in dogs, especially in areas endemic for L. infantum. Graphical Abstract
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spelling doaj-art-a2d254a1600a43f99dfd78737d1b02692025-08-20T03:21:01ZengBMCParasites & Vectors1756-33052025-06-011811810.1186/s13071-025-06773-4Canine leishmaniosis and peripheral neuropathy: a lesson from the neurologistFloriana Gernone0Domenico Otranto1Jairo Alfonso Mendoza-Roldan2Annamaria Uva3Kaspar Matiasek4Andrea Zatelli5Department of Veterinary Medicine, University of Bari Aldo MoroDepartment of Veterinary Medicine, University of Bari Aldo MoroDepartment of Veterinary Medicine, University of Bari Aldo MoroDepartment of Veterinary Medicine, University of Bari Aldo MoroSection of Clinical and Comparative Neuropathology, Ludwig-Maximilians-UniversitätDepartment of Veterinary Medicine, University of Bari Aldo MoroAbstract Background Canine leishmaniosis (CanL), a sand fly-borne zoonotic disease caused by Leishmania infantum, is potentially lethal in dogs. A similar or slightly higher quantity of antigens over antibodies promotes the formation of soluble circulating immune complexes (sCIC), which are deposited in the capillary wall, causing the inflammatory cascade responsible for clinical manifestations. Nervous system involvement during CanL is rarely reported in both humans and dogs, and the exact underlying process involving the peripheral nervous system (PNS) is still debated in both species. Methods Two male mixed-breed dogs were presented for exercise intolerance, non-ambulatory flaccid tetraparesis and decreased/absent flexor reflexes in all four limbs. Both dogs were seropositive for L. infantum and presented clinicopathological abnormalities suggestive of active CanL. One dog had received N-methyl-glucamine antimoniate two months before presentation without neurological improvement. Results Generalized PNS involvement was confirmed in both dogs. Biopsies of muscle and nerve tissues showed mononuclear cell inflammatory infiltration, and quantitative real-time polymerase chain reaction (PCR) was positive for Leishmania spp. In addition, Leishmania spp. antigen was detected in the nerve from one dog by immunohistochemistry. Both dogs were started on N-methyl-glucamine antimoniate and allopurinol in association with immunosuppressive corticosteroid therapy, recovering in few weeks. Conclusions Peripheral neuropathies during active CanL can be a consequence of sCIC deposition on endoneurial vascular endothelium comprising the blood–nerve barrier and its consequent breakdown. However, an abnormal host immune response triggered by L. infantum causing demyelination and/or axonal disruption is also possible. The positive response to the immunosuppressive therapy further supports an immune-mediated origin of the PNS condition. Therefore, CanL should be included in the differential diagnosis of PNS disease in dogs, especially in areas endemic for L. infantum. Graphical Abstracthttps://doi.org/10.1186/s13071-025-06773-4Leishmania infantumNeurological signsPeripheral nervous systemBlood–nerve barrierPathogenesisDogs
spellingShingle Floriana Gernone
Domenico Otranto
Jairo Alfonso Mendoza-Roldan
Annamaria Uva
Kaspar Matiasek
Andrea Zatelli
Canine leishmaniosis and peripheral neuropathy: a lesson from the neurologist
Parasites & Vectors
Leishmania infantum
Neurological signs
Peripheral nervous system
Blood–nerve barrier
Pathogenesis
Dogs
title Canine leishmaniosis and peripheral neuropathy: a lesson from the neurologist
title_full Canine leishmaniosis and peripheral neuropathy: a lesson from the neurologist
title_fullStr Canine leishmaniosis and peripheral neuropathy: a lesson from the neurologist
title_full_unstemmed Canine leishmaniosis and peripheral neuropathy: a lesson from the neurologist
title_short Canine leishmaniosis and peripheral neuropathy: a lesson from the neurologist
title_sort canine leishmaniosis and peripheral neuropathy a lesson from the neurologist
topic Leishmania infantum
Neurological signs
Peripheral nervous system
Blood–nerve barrier
Pathogenesis
Dogs
url https://doi.org/10.1186/s13071-025-06773-4
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