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Briones Nieva CA, Cid AG, Romero AI, García-Bustos MF, Villegas M, Bermúdez JM. An appraisal of the scientific current situation and new perspectives in the treatment of cutaneous leishmaniasis. Acta Trop 2021; 221:105988. [PMID: 34058160 DOI: 10.1016/j.actatropica.2021.105988] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 12/18/2022]
Abstract
Leishmaniasis is a Neglected Tropical Diseases caused by protozoan parasites of the genus Leishmania. It is a major health problem in many tropical and subtropical regions of the world and can produce three different clinical manifestations, among which cutaneous leishmaniasis has a higher incidence in the world than the other clinical forms. There are no recognized and reliable means of chemoprophylaxis or vaccination against infections with different forms of leishmaniasis. In addition, chemotherapy, unfortunately, remains, in many respects, unsatisfactory. Therefore, there is a continuing and urgent need for new therapies against leishmaniasis that are safe and effective in inducing a long-term cure. This review summarizes the latest advances in currently available treatments and improvements in the development of drug administration. In addition, an analysis of the in vivo assays was performed and the challenges facing promising strategies to treat CL are discussed. The treatment of leishmaniasis will most likely evolve into an approach that uses multiple therapies simultaneously to reduce the possibility of developing drug resistance. There is a continuous effort to discover new drugs to improve the treatment of leishmaniasis, but this is mainly at the level of individual researchers. Undoubtedly, more funding is needed in this area, as well as greater participation of the pharmaceutical industry to focus efforts on the development of chemotherapeutic agents and vaccines for this and other neglected tropical diseases.
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Affiliation(s)
- C A Briones Nieva
- Instituto de Investigaciones para la Industria Química, Universidad Nacional de Salta - Consejo Nacional de Investigaciones Científicas y Técnicas, Av. Bolivia 5150, (4400) Salta, Argentina
| | - Alicia Graciela Cid
- Instituto de Investigaciones para la Industria Química, Universidad Nacional de Salta - Consejo Nacional de Investigaciones Científicas y Técnicas, Av. Bolivia 5150, (4400) Salta, Argentina
| | - Analía Irma Romero
- Instituto de Investigaciones para la Industria Química, Universidad Nacional de Salta - Consejo Nacional de Investigaciones Científicas y Técnicas, Av. Bolivia 5150, (4400) Salta, Argentina
| | - María Fernanda García-Bustos
- Instituto de Patología Experimental, Universidad Nacional de Salta - Consejo Nacional de Investigaciones Científicas y Técnicas, Salta, Argentina
| | - Mercedes Villegas
- Instituto de Investigaciones para la Industria Química, Universidad Nacional de Salta - Consejo Nacional de Investigaciones Científicas y Técnicas, Av. Bolivia 5150, (4400) Salta, Argentina
| | - José María Bermúdez
- Instituto de Investigaciones para la Industria Química, Universidad Nacional de Salta - Consejo Nacional de Investigaciones Científicas y Técnicas, Av. Bolivia 5150, (4400) Salta, Argentina.
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Núñez MJ, Martínez ML, López-Arencibia A, Bethencourt-Estrella CJ, San Nicolás-Hernández D, Jiménez IA, Lorenzo-Morales J, Piñero JE, Bazzocchi IL. In Vitro Susceptibility of Kinetoplastids to Celastroloids from Maytenus chiapensis. Antimicrob Agents Chemother 2021; 65:e02236-20. [PMID: 33753334 PMCID: PMC8316137 DOI: 10.1128/aac.02236-20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 03/08/2021] [Indexed: 01/06/2023] Open
Abstract
Leishmaniasis and Chagas are among the most significant neglected tropical diseases. Due to several drawbacks with the current chemotherapy, developing new antikinetoplastid drugs has become an urgent issue. In the present work, a bioassay-guided investigation of the root bark of Maytenus chiapensis on Leishmania amazonensis and Trypanosoma cruzi led to the identification of two D:A-friedo-nor-oleanane triterpenoids (celastroloids), 20β-hydroxy-tingenone (celastroloid 5) and 3-O-methyl-6-oxo-tingenol (celastroloid 8), as promising antikinetoplastid leads. They displayed higher potency on L. amazonensis promastigotes (50% inhibitory concentrations [IC50s], 0.44 and 1.12 μM, respectively), intracellular amastigotes (IC50s, 0.83 and 1.91 μM, respectively), and T. cruzi epimastigote stage (IC50s, 2.61 and 3.41 μM, respectively) than reference drugs miltefosine and benznidazole. This potency was coupled with an excellent selectivity index on murine macrophages. Mechanism of action studies, including mitochondrial membrane potential (Δψm) and ATP-level analysis, revealed that celastroloids could induce apoptotic cell death in L. amazonensis triggered by the mitochondria. In addition, the structure-activity relationship is discussed. These findings strongly underline the potential of celastroloids as lead compounds to develop novel antikinetoplastid drugs.
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Affiliation(s)
- Marvin J Núñez
- Laboratorio de Investigación en Productos Naturales, Facultad de Química y Farmacia, Universidad de El Salvador, San Salvador, El Salvador
| | - Morena L Martínez
- Laboratorio de Investigación en Productos Naturales, Facultad de Química y Farmacia, Universidad de El Salvador, San Salvador, El Salvador
| | - Atteneri López-Arencibia
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, La Laguna, Tenerife, Canary Islands, Spain
| | - Carlos J Bethencourt-Estrella
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, La Laguna, Tenerife, Canary Islands, Spain
| | - Desirée San Nicolás-Hernández
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, La Laguna, Tenerife, Canary Islands, Spain
| | - Ignacio A Jiménez
- Instituto Universitario de Bio-Orgánica Antonio González, Departamento de Química Orgánica, Universidad de La Laguna, La Laguna, Tenerife, Canary Islands, Spain
| | - Jacob Lorenzo-Morales
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, La Laguna, Tenerife, Canary Islands, Spain
| | - José E Piñero
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, La Laguna, Tenerife, Canary Islands, Spain
| | - Isabel L Bazzocchi
- Instituto Universitario de Bio-Orgánica Antonio González, Departamento de Química Orgánica, Universidad de La Laguna, La Laguna, Tenerife, Canary Islands, Spain
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