A global pathology network supporting research on leishmaniasis.
LeishPathNet lays the foundation for change in how research and training in pathology is applied to neglected diseases, adding considerable value to the clinical samples that are generously donated by patients for research.
By introducing a digital pathology network to facilitate the sharing of clinical data across countries, this project sets out to understand the basis for variability of treatment response in cutaneous leishmaniasis across different countries.
By understanding why some patients respond to treatment and others do not, better use can be made of the drugs that are available and potentially reduce costs and suffering associated with treatment failures.
The leishmaniasis are parasitic diseases caused by one of several species of single cell parasites (Leishmania) that are transmitted to humans by the bite of infected phlebotamine sand flies.
These diseases affect over 150 million people across 98 countries worldwide, including many low and middle income countries (LMICs). Some forms of leishmaniasis are fatal, whereas other are very stigmatising and affect quality of life, particularly in children and women.
Few drugs are available for patients with leishmaniasis and no vaccines are currently registered for use in preventing or treating these diseases. Importantly, the drugs that we do have are not universally effective and often have significant side effects.
Sometimes patients even in the same geographical area will respond quite differently to therapy, and for some drugs effectiveness may vary widely between different countries. In order to make the best use of current and future drugs for the leishmaniasis, we need to understand more about why this is the case, and use that information to select appropriate drugs or drug combination for use in different settings.
Using the appropriate treatment would save costs in healthcare, minimise the patient suffering that results from administering ineffective treatments, and reduce the economic burden of disease on patients, their families and communities.
With initial funding for two years, this project is seeking new pathways to managing patients with leishmaniasis and conducting research into these diseases. We will use new molecular approaches to extract as much information as possible from small tissue samples that are collected from patients to diagnose their leishmaniasis, and use this information to start to develop new tests that can help clinicians decide on the best course of treatment.
A global pathology network will ensure that the information obtained from these tissue samples is used most effectively for research, clinical decision making and for education and training.
We will analyse the added value of these changes in approach, in order to provide a case for their adoption by health systems in LMICs and by the funders of research.
Ultimately, by adopting these practices we will seek to deliver improvements in health and economic prosperity in LMICs.
The project consolidates and expands partnerships established over the last five years between a leading UK centre and three endemic country centres that are well known for their research on leishmaniasis.
- York Biomedical Research Institute, which has incorporated the former Centre for Immunology and Infection, has 13 Primary Investigators (eight working on leishmaniasis). We have access to containment facilities, MHRA and HTA-approved laboratories and bioinformatics support.
- The Biosciences Technology Facility provides core imaging and cytometry facilities. The facility acts as a Zeiss beta test centre and provider of training courses for the Royal Society of Microscopy.
- The Centre for Health Economics is a leading international centre of excellence in health economics. The centre is home to 50 economists and regularly provides advice and analysis for organisations such as NICE, the Bill and Melinda Gates Foundation, and the WHO.
- Instituto de Medicina Tropical of University of Sao Paulo (IMTSP) has inter-institutional postgraduate pathology programmes across Brazil, and close interactions with the Faculdade de Medicina, USP.
- IPGME&R is the nodal diagnostic centre for the task force on kala-azar elimination (in West Bengal) and has close interactions with the Calcutta School of Tropical Medicine.
- University of Sri Jayewardenepura (USJ) is one of two leishmaniasis referral centres identified by the Ministry of Heath Sri Lanka. It also conducts diagnostics related to other parasitic diseases.