Isometamidium-dextran complex: toxicity and activity against Trypanosoma vivax and Trypanosoma congolense in rats and mice

Development of cationic Isometamidium chloride loaded long-acting lipid nanoformulation: optimization, cellular uptake, pharmacokinetics, biodistribution, and immunohistochemical evaluation

The aim of the present work involved the development and evaluation of long-acting Isometamidium chloride (ISMM)-Docusate sodium (DS) complex loaded lipid nanoparticles (LA ISMM-DS LNP). The development involved screening various anionic complexing agents, including DS, dextran sulphate, and sodium alginate. Anionic DS was selected to synthesize hydrophobic ionic complex (ISMM-DS HIC), which was loaded into lipid nanoparticles (LA ISMM-DS LNP) by in situ complexation followed by the solvent evaporation method. 35-5-folds increase in the drug loading of hydrophilic cationic ISMM within nanoparticles was observed due to ISMM-DS HIC. The LA ISMM-DS LNP were non-hemolytic (0-2.52%), cytocompatible (80.6-47.5% cell viability), and enhanced THP-1 cellular uptake (2.3-folds higher) compared with free ISMM. The LA ISMM-DS LNP engender protracted in vivo plasma drug concentration for seven days with enhanced AUC_0-ꝏ, MRT_0-ꝏ, and t_1/2, along with reduced Cl compared with free ISMM. Interestingly, the amount of ISMM was 2.9-, 4.2- and 2.0-folds higher in target reticuloendothelial (RES) organs like liver (Kupffer cells), spleen (spleenotropic macrophages and 15% T-lymphocytes), and lymph nodes (75% T-lymphocytes), respectively in LA ISMM-DS LNP group compared with free ISMM. Furthermore, LA ISMM-DS LNP caused higher peripheral blood mononuclear cells (PBMC) infiltration with diminished toxicity and inflammation. Therefore, the in vitro and in vivo studies predicted enhanced safety and efficacy of LA ISMM-DS LNP compared with free ISMM. To conclude, successfully developed LA ISMM-DS LNP would elicit a tremendous clinical potential for treatment and prevention against trypanosomiasis.

Chemotherapy and delivery systems: haemoparasites

Chemotherapy of haemoparasitic diseases in domestic animals is dependent on a limited number of compounds, many of which are chemically closely related. In this review, a summary is given of each of the drugs currently available for treatment and prophylaxis of trypanosomosis and the tick-borne diseases theileriosis, babesiosis, anaplasmosis and cowdriosis. In contrast to the situation with the drugs used for tick-borne diseases, drug resistance appears to be becoming an increasing problem associated with the compounds used for trypanosomosis. The literature that has been reviewed, therefore, is that which relates to the methods used to identify and quantify drug resistance in trypanosome populations, reports of resistance to trypanocides, and cross-resistance between trypanosome populations, reports of resistance to trypanocides, and cross-resistance between trypanocides. The possible reason(s) for the apparent lack of development of resistance to the compounds used for treatment of tick-borne diseases is also discussed. Local toxicity at the site of injection is a problem that is particularly associated with many of the trypanocides when used on a long-term basis in individual animals. Various alternative preparations of the currently used trypanocides therefore have been evaluated in an attempt to reduce this toxicity, and are summarised. Finally, future developments in haemoparasitic chemotherapy are considered and, for trypanosomosis, highlight the importance of integrating chemotherapeutic and chemoprophylactic programmes with control of the vector when drug resistance becomes a significant constraint.

Notes on the routine intravenous use of isometamidium in the control of bovine trypanosomiasis on the Kenya coast

Various chemotherapeutic regimes were used to control trypanosomiasis in 3,000 Boran cattle on an estate on the Kenya coast. Recently the therapeutic use of isometamidium by the intravenous route was adopted to treat individual trypanosome-infected cattle. This was in order to overcome tissue reactions encountered after intramuscular injection and also to control a "thin cow" syndrome attributed to chronic trypanosomiasis. Toxic side effects were eliminated by careful attention to the intravenous technique which was safely used in calves, pregnant cattle and bulls. Weekly blood sampling and treatments of infected individuals resulted in a reduction of cases from 2,187 to 208 out of 46,495 and 46,329 samples examined in 1985 and 1986 respectively. The standard of management was very high and although this routine successfully controlled bovine trypanosomiasis on this estate its application elsewhere is likely to be limited.