Newton001 Leishmaniasis in the Brazilian Amazon: the role of accessory microbiota in disease progression, pathobiology and immunity.

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Leishmania spp. infection represents a serious public health burden in Brazil, with 35,000 suspected cases annually. Disfiguring and occasionally fatal cutaneous and muco-cutaneous forms of Leishmaniasis are most common in the Amazon region of Brazil. Differential clinical severity and drug-resistance profiles are widely reported between patients. There is thus an urgent need to identify what factors might be responsible for different patient outcomes. Leishmania species and genotype have a role in defining disease severity, as does the host immune response. Less commonly considered is the role that secondary bacterial infections and commensal skin microbiota have in modulating pathology and immunity. In this multidisciplinary project we propose to use state-of-the-art techniques to monitor Leishmania lesion-associated microbial diversity and host immune response to reveal the factors that underlie cutaneous Leishmaniasis severity and progression in Amazonian Brazil.