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Intakhan N, Saeung A, Rodrigues Oliveira SM, Pereira MDL, Chanmol W. Synergistic Effects of Artesunate in Combination with Amphotericin B and Miltefosine against Leishmania infantum: Potential for Dose Reduction and Enhanced Therapeutic Strategies. Antibiotics (Basel) 2024; 13:806. [PMID: 39334981 PMCID: PMC11428804 DOI: 10.3390/antibiotics13090806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 08/17/2024] [Accepted: 08/20/2024] [Indexed: 09/30/2024] Open
Abstract
Leishmaniasis is a tropical infectious disease caused by Leishmania parasites. The disease can be spread by the bite of an infected sand fly. Currently, five chemotherapeutic drugs are available in leishmaniasis treatment. However, these drugs exhibit toxicity and serious adverse effects on infected individuals, necessitating alternative treatment strategies. One such strategy involves using combinations of existing antileishmanial drugs. In this study, we evaluated the interaction between artesunate (AS) and three antileishmanial drugs-amphotericin B (AmB), miltefosine (MF), and paromomycin (PM) against Leishmania infantum. This evaluation marks the first time such an assessment has been conducted. The Chou-Talalay combination index method was employed to analyze the drug interaction. The findings revealed that the interaction between AS and AmB ranged from antagonistic to synergistic, while the interaction between AS and MF showed moderate to strong synergism. In contrast, the interaction between AS and PM resulted in an antagonistic interaction, which differs from the combinations with AmB or MF. This study provides valuable insights for developing novel drug regimens for leishmaniasis treatment, emphasizing the potential of AS and its combination with existing antileishmanial drugs. Further research is necessary to optimize drug combinations and minimize adverse effects, leading to more effective therapeutic outcomes.
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Affiliation(s)
- Nuchpicha Intakhan
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand;
- Center of Excellence Research for Melioidosis and Microorganisms, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Atiporn Saeung
- Department of Parasitology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Sonia M. Rodrigues Oliveira
- CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal; (S.M.R.O.); (M.d.L.P.)
- HMRI—Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Maria de Lourdes Pereira
- CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal; (S.M.R.O.); (M.d.L.P.)
- Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Wetpisit Chanmol
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand;
- Center of Excellence Research for Melioidosis and Microorganisms, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand
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Rodrigues ACJ, Carloto ACM, Gonçalves MD, Concato VM, Detoni MB, dos Santos YM, Cruz EMS, Madureira MB, Nunes AP, Pires MFMK, Santos NC, Marques REDS, Bidoia DL, Borges Figueiredo F, Pavanelli WR. Exploring the leishmanicidal potential of terpenoids: a comprehensive review on mechanisms of cell death. Front Cell Infect Microbiol 2023; 13:1260448. [PMID: 37799331 PMCID: PMC10550302 DOI: 10.3389/fcimb.2023.1260448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/24/2023] [Indexed: 10/07/2023] Open
Abstract
Leishmaniasis is a neglected tropical disease with a wide spectrum of clinical manifestations, ranging from visceral to cutaneous, with millions of new cases and thousands of deaths reported each year. The species of Leishmania and the immune response of the host determine the severity of the disease. Leishmaniasis remains challenging to diagnose and treat, and there is no vaccine available. Several studies have been conducted on the use of herbal medicines for the treatment of leishmaniasis. Natural products can provide an inexhaustible source of chemical diversity with therapeutic potential. Terpenes are a class of natural products derived from a single isoprene unit, a five-carbon compound that forms the basic structure of isoprenoids. This review focuses on the most important and recent advances in the treatment of parasites of the genus Leishmania with different subclasses of terpenes. Several mechanisms have been proposed in the literature, including increased oxidative stress, immunomodulatory role, and induction of different types of parasite cell death. However, this information needs to be brought together to provide an overview of how these compounds can be used as therapeutic tools for drug development and as a successful adjuvant strategy against Leishmania sp.
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Affiliation(s)
- Ana Carolina Jacob Rodrigues
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer, Department of Pathological Sciences, State University of Londrina, Londrina, Brazil
- Cell Biology Laboratory, Carlos Chagas Institute- Fiocruz, Curitiba, Brazil
| | - Amanda Cristina Machado Carloto
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer, Department of Pathological Sciences, State University of Londrina, Londrina, Brazil
| | | | - Virgínia Márcia Concato
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer, Department of Pathological Sciences, State University of Londrina, Londrina, Brazil
| | - Mariana Barbosa Detoni
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer, Department of Pathological Sciences, State University of Londrina, Londrina, Brazil
| | - Yasmin Munhoz dos Santos
- Laboratory of Experimental Immunoparasitology, Department of Pathological Sciences, State University of Londrina, Londrina, Brazil
| | - Ellen Mayara Souza Cruz
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer, Department of Pathological Sciences, State University of Londrina, Londrina, Brazil
| | - Maria Beatriz Madureira
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer, Department of Pathological Sciences, State University of Londrina, Londrina, Brazil
| | - Angélica Paulina Nunes
- Laboratory for Metabolic Disorders of Reproduction, Department of Pathological Sciences, State University of Londrina, Londrina, Brazil
| | - Maria Fernanda Maya Kuriki Pires
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer, Department of Pathological Sciences, State University of Londrina, Londrina, Brazil
| | - Natália Concimo Santos
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer, Department of Pathological Sciences, State University of Londrina, Londrina, Brazil
| | | | - Danielle Lazarin Bidoia
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer, Department of Pathological Sciences, State University of Londrina, Londrina, Brazil
| | | | - Wander Rogério Pavanelli
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer, Department of Pathological Sciences, State University of Londrina, Londrina, Brazil
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Gashe F, Wynendaele E, De Spiegeleer B, Suleman S. Degradation kinetics of artesunate for the development of an ex-tempore intravenous injection. Malar J 2022; 21:256. [PMID: 36068561 PMCID: PMC9450271 DOI: 10.1186/s12936-022-04278-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Artesunate is recommended by the World Health Organization (WHO) for parenteral treatment of severe Plasmodium falciparum malaria. However, artesunate is inherently unstable in an aqueous solution and hydrolyses rapidly after its preparation for injection. Therefore, the aim of the study was to evaluate the stabilizing effects of phosphate buffer and mannitol against short-term (ex-tempore) artesunate hydrolysis. Methods A HPLC–UV isocratic method was developed using a reversed-phase fused core column (HALO RP-C18) and a mobile phase consisting of a mixture of 45% ammonium formate 10 mM in water (pH 4.5) and 55% methanol. Artesunate was formulated as aqueous solutions using a design of experiment (DOE) to investigate the artesunate stabilizing effects of pH (8–10), phosphate buffer strength (0.3–0.5 M), and mannitol (0–0.22 mmol/mL). The solutions were incubated at predefined temperatures (5, 25, and 40 °C) with subsequent analysis. Arrhenius equation was applied to model and evaluate the stability results. Results The developed HPLC-based method using fused-core stationary phase allowed to selectively quantify artesunate in the presence of its main hydrolysis degradants; namely β-dihydroartemisinin (β-DHA) and α-dihydroartemisinin (α-DHA) within 10 min. By applying the Arrhenius equation, the rate of hydrolysis of the drug increased approximately by 3.4 as the temperature raised by 10 °C. Buffer strength was found to be the main factor affecting the hydrolysis rate constants at 5 and 25 °C (p < 0.05), the activation energy (p = 0.009), and the frequency factor (p = 0.045). However, the effect of the buffer was predominant on the activation energy and hydrolysis rate constants, revealing its stabilizing effect on the drug at lower buffer strength (0.3 M). Within the investigated range (pH = 8–10), pH was found to influence the activation energy, with a positive stabilizing effect in the pH range of 8–9. The addition of mannitol as stabilizing agent into artesunate aqueous formulation did not show an improved response. Conclusion Phosphate buffer was the main stability determining factor of artesunate in the aqueous intravenous (i.v.) formulation and was found to be more effective in stabilizing artesunate at a buffer strength of 0.3 M in pH 8–9, while mannitol lacked stabilizing effect. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04278-4.
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Affiliation(s)
- Fanta Gashe
- Jimma University Laboratory of Drug Quality (JuLaDQ) and School of Pharmacy, Jimma University, PO Box 378, Jimma, Ethiopia.,Drug Quality and Registration (DruQuaR) Group, Faculty of Pharmaceutical Sciences, Ghent University, Harelbekestraat 72, 9000, Ghent, Belgium
| | - Evelien Wynendaele
- Drug Quality and Registration (DruQuaR) Group, Faculty of Pharmaceutical Sciences, Ghent University, Harelbekestraat 72, 9000, Ghent, Belgium
| | - Bart De Spiegeleer
- Drug Quality and Registration (DruQuaR) Group, Faculty of Pharmaceutical Sciences, Ghent University, Harelbekestraat 72, 9000, Ghent, Belgium
| | - Sultan Suleman
- Jimma University Laboratory of Drug Quality (JuLaDQ) and School of Pharmacy, Jimma University, PO Box 378, Jimma, Ethiopia.
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