Visceral Leishmanasis in Bihar State, Indian

利什曼病的分布和发病率最近有所扩大。内脏利什曼病是特别麻烦，因为它导致大多数死亡。印度、尼泊尔、孟加拉国、苏丹和巴西的VL病例占全球报告病例的90%。在印度数百万处于危险之中的人中，比哈尔邦占近90%的病例，其次是西孟加拉、贾坎德和东部北方邦。这个拟议的热带医学研究中心分为3个项目，将解决影响内脏利什曼病在印度比哈尔邦的个人和社区的流行病学，临床，免疫学和遗传因素。构成该TMRC的各个项目还旨在提供新的数据，这些数据将更广泛地适用于全球其他主要疾病疫源地控制计划的持续发展，包括开发新型疫苗和诊断辅助工具。三个主要项目的主题分别为： 项目一：印度比哈尔邦内脏利什曼病的临床和流行病学研究：本项目的目标是提供流行病学和临床证据，指导在印度比哈尔邦消灭或控制内脏利什曼病的工作，并提供流行病学数据，为未来的控制计划提供更广泛的信息，包括开发新疫苗和诊断辅助工具。 项目2：调节性T细胞亚群和细胞因子在印度比哈尔邦人VL发病机制中的作用。该项目是一项重点研究，将调查调节性T细胞和抑制性细胞因子在人类内脏利什曼病发病机制中的作用，以期开发基于免疫的疗法，逆转与活动性疾病相关的免疫抑制。 项目3：印度比哈尔邦内脏利什曼病的遗传危险因素。本项目将探讨内脏利什曼病遗传易感性的遗传因素，目的是确定有助于疾病发病机制的基因/机制/途径。 TMRC将汇集流行病学家，临床医生，免疫学家和分子遗传学家的独特组合，以解决内脏利什曼病这一致命疾病的全球主要焦点之一的问题。

There has been a recent expansion in the distribution and the incidence of leishmaniasis. Visceral leishmaniasis is particularly troublesome as it causes most fatalities. India, Nepal, Bangladesh, Sudan and Brazil harbor 90% of the worldwide reported VL cases. Amongst the millions at risk in India, the state of Bihar accounts for nearly 90% of cases, followed by the states of West Bengal, Jharkhand and Eastern Uttar Pradesh. This proposed Tropical Medicine Research Center is divided into 3 projects that will address epidemiological, clinical, immunological and genetic factors that influence the prevalence, distribution and pathogenesis of visceral leishmaniasis in individuals and communities in Bihar State in India. The individual projects that make up this TMRC are also designed to provide new data that will be more broadly applicable to the continuing development of control programs in the other major global foci of disease, including development of novel vaccines and diagnostic aids. Themes of the three major projects are: Project 1: Clinical and epidemiological studies of Visceral Leishmaniasis in Bihar, India: Goals of this project are to provide the epidemiological and clinical evidence that is required to guide efforts to eliminate or control visceral leishmaniasis in the state of Bihar, India, and to provide epidemiological data that will more broadly inform future control programs including development of novel vaccines and diagnostic aids. Project 2: The role of regulatory T cell subsets and cytokines in the pathogenesis of human VL in Bihar, India. This project is a focused study that will investigate the role of regulatory T cells and suppressive cytokines in the pathogenesis of human visceral leishmaniasis, with a view toward the development of immune-based therapies that will reverse the immunosuppression associated with active disease. Project 3: Genetic risk factors for Visceral Leishmaniasis in Bihar, India. This project will address genetic factors that underly genetic susceptibility to visceral leishmaniasis, with the purpose of identifying genes/ mechanisms/ pathways that contribute to the pathogenesis of disease. The TMRC will bring together a unique combination of epidemiologists, clinicians, immunologists and molecular geneticists to tackle the problem of visceral leishmaniasis in one of the major global foci of this fatal disease.