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Latifi A. Reviewing the Effects of Miltefosine and Suggesting It for the Treatment of Coronavirus Disease (COVID-19). Infect Dis (Lond) 2020; 13:1178633720977488. [PMID: 33311985 PMCID: PMC7716057 DOI: 10.1177/1178633720977488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 11/03/2020] [Indexed: 11/16/2022] Open
Abstract
Objective: Miltefosine is an anti-cancer drug used to treat leishmaniasis and deadly opportunistic free-living amoeba and other deadly pathogenic microorganisms. Several studies have demonstrated its antiviral effect. In this study, we discuss the effectiveness of this drug on pathogenic microorganisms, and according to the functional system of the medicine, we present this drug as a therapeutic proposal to treat Coronavirus disease (COVID-19) Methods: A literature search was conducted in electronic databases, including Pubmed, Science Direct, Elsevier, and Google Scholar, and articles published from 2006 to 2020 (the last decade) were selected. The search keywords included Miltefosine, microorganism, pathogen, and treatment. Results: The studies indicated that Miltefosine had therapeutic effects on leishmaniasis and deadly opportunistic free-living amoeba and other deadly pathogenic microorganisms. Several studies have proven its antiviral effect. Conclusion: Owing to the beneficial effects of this drug on pathogenic and deadly microorganisms and antiviral effects, and due to the epidemic of Coronavirus and the lack of effective treatment and vaccine, this drug is recommended as one of the treatment options for this disease.
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Affiliation(s)
- Alireza Latifi
- School of Public Health, Department of Medical Parasitology and Mycology, Tehran University of Medical Sciences, Tehran, Iran
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Valenzuela-Oses JK, García MC, Feitosa VA, Pachioni-Vasconcelos JA, Gomes-Filho SM, Lourenço FR, Cerize NN, Bassères DS, Rangel-Yagui CO. Development and characterization of miltefosine-loaded polymeric micelles for cancer treatment. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 81:327-333. [DOI: 10.1016/j.msec.2017.07.040] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/13/2017] [Accepted: 07/27/2017] [Indexed: 02/06/2023]
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Scariot DB, Britta EA, Moreira AL, Falzirolli H, Silva CC, Ueda-Nakamura T, Dias-Filho BP, Nakamura CV. Induction of Early Autophagic Process on Leishmania amazonensis by Synergistic Effect of Miltefosine and Innovative Semi-synthetic Thiosemicarbazone. Front Microbiol 2017; 8:255. [PMID: 28270805 PMCID: PMC5318461 DOI: 10.3389/fmicb.2017.00255] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 02/07/2017] [Indexed: 12/24/2022] Open
Abstract
Drug combination therapy is a current trend to treat complex diseases. Many benefits are expected from this strategy, such as cytotoxicity decrease, retardation of resistant strains development, and activity increment. This study evaluated in vitro combination between an innovative thiosemicarbazone molecule – BZTS with miltefosine, a drug already consolidated in the leishmaniasis treatment, against Leishmania amazonensis. Cytotoxicity effects were also evaluated on macrophages and erythrocytes. Synergistic antileishmania effect and antagonist cytotoxicity were revealed from this combination therapy. Mechanisms of action assays were performed in order to investigate the main cell pathways induced by this treatment. Mitochondrial dysfunction generated a significant increase of reactive oxygen and nitrogen species production, causing severe cell injuries and promoting intense autophagy process and consequent apoptosis cell death. However, this phenomenon was not strong enough to promote dead in mammalian cell, providing the potential selective effect of the tested combination for the protozoa. Thus, the results confirmed that drugs involved in distinct metabolic routes are promising agents for drug combination therapy, promoting a synergistic effect.
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Affiliation(s)
- Débora B Scariot
- Laboratório de Inovação Tecnológica no Desenvolvimento de Fármacos e Cosméticos, Departamento de Farmácia, Universidade Estadual de Maringá Maringá, Brazil
| | - Elizandra A Britta
- Laboratório de Inovação Tecnológica no Desenvolvimento de Fármacos e Cosméticos, Departamento de Farmácia, Universidade Estadual de Maringá Maringá, Brazil
| | - Amanda L Moreira
- Laboratório de Inovação Tecnológica no Desenvolvimento de Fármacos e Cosméticos, Departamento de Farmácia, Universidade Estadual de Maringá Maringá, Brazil
| | - Hugo Falzirolli
- Departamento de Química, Universidade Estadual de Maringá Maringá, Brazil
| | - Cleuza C Silva
- Departamento de Química, Universidade Estadual de Maringá Maringá, Brazil
| | - Tânia Ueda-Nakamura
- Laboratório de Inovação Tecnológica no Desenvolvimento de Fármacos e Cosméticos, Departamento de Farmácia, Universidade Estadual de Maringá Maringá, Brazil
| | - Benedito P Dias-Filho
- Laboratório de Inovação Tecnológica no Desenvolvimento de Fármacos e Cosméticos, Departamento de Farmácia, Universidade Estadual de Maringá Maringá, Brazil
| | - Celso V Nakamura
- Laboratório de Inovação Tecnológica no Desenvolvimento de Fármacos e Cosméticos, Departamento de Farmácia, Universidade Estadual de Maringá Maringá, Brazil
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da Gama Bitencourt JJ, Pazin WM, Ito AS, Barioni MB, de Paula Pinto C, Santos MAD, Guimarães THS, Santos MRMD, Valduga CJ. Miltefosine-loaded lipid nanoparticles: Improving miltefosine stability and reducing its hemolytic potential toward erythtocytes and its cytotoxic effect on macrophages. Biophys Chem 2016; 217:20-31. [PMID: 27497059 DOI: 10.1016/j.bpc.2016.07.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 07/19/2016] [Accepted: 07/24/2016] [Indexed: 01/30/2023]
Abstract
The toxic effects of miltefosine on the epithelial cells of the gastrointestinal tract and its hemolytic action on erythrocytes have limited its use as an antileishmanial agent. As part of our search for new strategies to overcome the side effects of miltefosine during the treatment of leishmaniasis, we have developed stable miltefosine-loaded lipid nanoparticles in an attempt to reduce the toxic effects of the drug. We have evaluated lipid nanoparticles containing varying amounts of miltefosine and cholesterol, prepared by sonication, in terms of their physicochemical properties, preliminary stability, hemolytic potential toward erythrocytes, and cytotoxicity to macrophages and to promastigote and amastigote forms of Leishmania (L.) chagasi. Miltefosine loading into lipid nanoparticles was 100% for low drug concentrations (7.0 to 20.0mg/mL). Particle size decreased from 143nm (control) to between 43 and 69nm. From fluorescence studies, it was observed that the presence of miltefosine and cholesterol (below 103μM) promoted ordering effects in the phospholipid region of the nanoparticles. The formulation containing 15mg/mL miltefosine was stable for at least six months at 4°C and in simulated gastrointestinal fluids, and did not promote epithelial gastrointestinal irritability in Balb/C mice. When loaded into lipid nanoparticles, the hemolytic potential of miltefosine and its cytotoxicity to macrophages diminished, while its antiparasitic activity remained unaltered. The results suggested that miltefosine-loaded lipid nanoparticles may be promising for the treatment of leishmaniasis and might be suitable for oral and parenteral use.
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Affiliation(s)
| | - Wallance Moreira Pazin
- Department of Physics, Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo
| | - Amando Siuiti Ito
- Department of Physics, Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo.
| | - Marina Berardi Barioni
- Department of Physics, Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo
| | - Carolline de Paula Pinto
- Department of Pharmacy and Biotechnology, Anhanguera, University of São Paulo (UNIAN-SP), Brazil
| | | | | | | | - Claudete Justina Valduga
- Department of Pharmacy and Biotechnology, Anhanguera, University of São Paulo (UNIAN-SP), Brazil.
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Eissa MM, El-Moslemany RM, Ramadan AA, Amer EI, El-Azzouni MZ, El-Khordagui LK. Miltefosine Lipid Nanocapsules for Single Dose Oral Treatment of Schistosomiasis Mansoni: A Preclinical Study. PLoS One 2015; 10:e0141788. [PMID: 26574746 PMCID: PMC4648507 DOI: 10.1371/journal.pone.0141788] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 10/13/2015] [Indexed: 01/09/2023] Open
Abstract
Miltefosine (MFS) is an alkylphosphocholine used for the local treatment of cutaneous metastases of breast cancer and oral therapy of visceral leishmaniasis. Recently, the drug was reported in in vitro and preclinical studies to exert significant activity against different developmental stages of schistosomiasis mansoni, a widespread chronic neglected tropical disease (NTD). This justified MFS repurposing as a potential antischistosomal drug. However, five consecutive daily 20 mg/kg doses were needed for the treatment of schistosomiasis mansoni in mice. The present study aims at enhancing MFS efficacy to allow for a single 20mg/kg oral dose therapy using a nanotechnological approach based on lipid nanocapsules (LNCs) as oral nanovectors. MFS was incorporated in LNCs both as membrane-active structural alkylphospholipid component and active antischistosomal agent. MFS-LNC formulations showed high entrapment efficiency (EE%), good colloidal properties, sustained release pattern and physical stability. Further, LNCs generally decreased MFS-induced erythrocyte hemolytic activity used as surrogate indicator of membrane activity. While MFS-free LNCs exerted no antischistosomal effect, statistically significant enhancement was observed with all MFS-LNC formulations. A maximum effect was achieved with MFS-LNCs incorporating CTAB as positive charge imparting agent or oleic acid as membrane permeabilizer. Reduction of worm load, ameliorated liver pathology and extensive damage of the worm tegument provided evidence for formulation-related efficacy enhancement. Non-compartmental analysis of pharmacokinetic data obtained in rats indicated independence of antischistosomal activity on systemic drug exposure, suggesting possible gut uptake of the stable LNCs and targeting of the fluke tegument which was verified by SEM. The study findings put forward MFS-LNCs as unique oral nanovectors combining the bioactivity of MFS and biopharmaceutical advantages of LNCs, allowing targeting via the oral route. From a clinical point of view, data suggest MFS-LNCs as a potential single dose oral nanomedicine for enhanced therapy of schistosomiasis mansoni and possibly other diseases.
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Affiliation(s)
- Maha M. Eissa
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Riham M. El-Moslemany
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
| | - Alyaa A. Ramadan
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
| | - Eglal I. Amer
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mervat Z. El-Azzouni
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Labiba K. El-Khordagui
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
- * E-mail:
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Tan KB, Ling LU, Bunte RM, Chng WJ, Chiu GNC. Liposomal codelivery of a synergistic combination of bioactive lipids in the treatment of acute myeloid leukemia. Nanomedicine (Lond) 2014; 9:1665-79. [DOI: 10.2217/nnm.13.123] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The aim of this work was to develop a liposomal formulation to facilitate delivery of a synergistic safingol/C2-ceramide combination in the treatment of acute myeloid leukemia (AML). Materials & methods: Liposomes were prepared using the extrusion method and the bioactive lipids were encapsulated passively. Drug concentrations were determined by liquid chromatography tandem mass spectrometry. Antileukemic activity was evaluated using human leukemic cell lines, patient samples and U937 leukemic xenograft models. Results: A stable liposome formulation was developed to coencapsulate safingol and C2-ceramide at 1:1 molar ratio with >90% encapsulation efficiency. The liposomal safingol/C2-ceramide was effective in AML cell lines, patient samples and murine xenograft models of AML, compared with liposomal safingol or liposomal C2-ceramide alone despite a dose reduction of 33%. Conclusion: Our study provided proof-of-concept evidence to deliver synergistic combination of bioactive lipid to achieve complete remission in AML. Original submitted: 27 February 2013; Revised submitted: 25 June 2013
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Affiliation(s)
- Kuan-Boone Tan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 02–09, 18 Science Drive 4, Singapore 117543, Singapore
| | - Leong-Uung Ling
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 02–09, 18 Science Drive 4, Singapore 117543, Singapore
| | - Ralph M Bunte
- Office of Research, Duke-National University of Singapore Graduate Medical School, Singapore
| | - Wee-Joo Chng
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
- Department of Haematology-Oncology, National University Cancer Institute of Singapore, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gigi NC Chiu
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 02–09, 18 Science Drive 4, Singapore 117543, Singapore
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Lopes RM, Corvo ML, Eleutério CV, Carvalheiro MC, Scoulica E, Cruz MEM. Formulation of oryzalin (ORZ) liposomes: In vitro studies and in vivo fate. Eur J Pharm Biopharm 2012; 82:281-90. [PMID: 22771930 DOI: 10.1016/j.ejpb.2012.06.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 06/25/2012] [Accepted: 06/26/2012] [Indexed: 01/08/2023]
Affiliation(s)
- Rui M Lopes
- iMed.UL - Research Institute for Medicines and Pharmaceutical Sciences, Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
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