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Torchelsen FKVDS, Mazzeti AL, Mosqueira VCF. Drugs in preclinical and early clinical development for the treatment of Chagas´s disease: the current status. Expert Opin Investig Drugs 2024; 33:575-590. [PMID: 38686546 DOI: 10.1080/13543784.2024.2349289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/25/2024] [Indexed: 05/02/2024]
Abstract
INTRODUCTION Chagas disease is spreading faster than expected in different countries, and little progress has been reported in the discovery of new drugs to combat Trypanosoma cruzi infection in humans. Recent clinical trials have ended with small hope. The pathophysiology of this neglected disease and the genetic diversity of parasites are exceptionally complex. The only two drugs available to treat patients are far from being safe, and their efficacy in the chronic phase is still unsatisfactory. AREAS COVERED This review offers a comprehensive examination and critical review of data reported in the last 10 years, and it is focused on findings of clinical trials and data acquired in vivo in preclinical studies. EXPERT OPINION The in vivo investigations classically in mice and dog models are also challenging and time-consuming to attest cure for infection. Poorly standardized protocols, availability of diagnosis methods and disease progression markers, the use of different T. cruzi strains with variable benznidazole sensitivities, and animals in different acute and chronic phases of infection contribute to it. More synchronized efforts between research groups in this field are required to put in evidence new promising substances, drug combinations, repurposing strategies, and new pharmaceutical formulations to impact the therapy.
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Affiliation(s)
- Fernanda Karoline Vieira da Silva Torchelsen
- School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Brazil
- Post-Graduation Program in Pharmaceutical Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ana Lia Mazzeti
- Department of Biomedical Sciences and Health, Academic Unit of Passos, University of Minas Gerais State, Passos, Brazil
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Chandler DJ, Bonifaz A, van de Sande WWJ. An update on the development of novel antifungal agents for eumycetoma. Front Pharmacol 2023; 14:1165273. [PMID: 37274106 PMCID: PMC10232793 DOI: 10.3389/fphar.2023.1165273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/09/2023] [Indexed: 06/06/2023] Open
Abstract
Eumycetoma, a chronic subcutaneous mycosis, responds poorly to the available antifungal treatments and patients often require extensive surgical resection or amputation of the affected limb. More effective treatments are needed for eumycetoma. This article will describe some of the approaches being used to develop and evaluate new treatments for eumycetoma, summarise the latest developments and discuss the challenges that lie ahead.
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Affiliation(s)
- David J. Chandler
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, United Kingdom
- Dermatology Department, Brighton General Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom
| | - Alexandro Bonifaz
- Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico
| | - Wendy W. J. van de Sande
- Erasmus MC, University Medical Center Rotterdam, Department of Medical Microbiology and Infectious Diseases, Rotterdam, Netherlands
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de Souza RL, Mengarda AC, Roquini DB, Melo CO, de Morais MC, C Espírito-Santo MC, de Sousa DP, Moraes JD, Oliveira EE. Enhancing the antischistosomal activity of carvacryl acetate using nanoemulsion. Nanomedicine (Lond) 2023; 18:331-342. [PMID: 37140262 DOI: 10.2217/nnm-2022-0228] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Aim: To formulate a carvacryl acetate nanoemulsion (CANE) and test its antischistosomal activity. Materials & methods: CANE was prepared and tested in vitro on Schistosoma mansoni adult worms and both human and animal cell lines. Next, CANE was administered orally to mice infected with either a prepatent infection or a patent infection of S. mansoni. Results: CANE was stable during 90 days of analysis. CANE showed in vitro anthelmintic activity, and no cytotoxic effects were observed. In vivo, CANE was more effective than the free compounds in reducing worm burden and egg production. Treatment with CANE was more effective for prepatent infections than praziquantel. Conclusion: CANE improves antiparasitic properties and may be a promising delivery system for schistosomiasis treatment.
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Affiliation(s)
- Rafael L de Souza
- Laboratory of Synthesis & Drug Delivery, State University of Paraíba, João Pessoa, 58071-160, Brazil
| | - Ana C Mengarda
- Research Center for Neglected Diseases, Guarulhos University, Guarulhos, 07023-070, Brazil
| | - Daniel B Roquini
- Research Center for Neglected Diseases, Guarulhos University, Guarulhos, 07023-070, Brazil
| | - Camila O Melo
- Laboratory of Synthesis & Drug Delivery, State University of Paraíba, João Pessoa, 58071-160, Brazil
| | - Mayara C de Morais
- Department of Pharmaceutical Sciences, Federal University of Paraíba, João Pessoa, 58051-900, Brazil
| | - Maria Cristina C Espírito-Santo
- Laboratory of Immunopathology of Schistosomiasis (LIM-06), Department of Infectious & Parasitic Diseases, Faculty of Medicine, University of São Paulo, São Paulo, 01246903, Brazil
- Laboratory of Helminthology, Institute of Tropical Medicine, University of São Paulo, São Paulo, 05403-000, Brazil
| | - Damião P de Sousa
- Department of Pharmaceutical Sciences, Federal University of Paraíba, João Pessoa, 58051-900, Brazil
| | - Josué de Moraes
- Research Center for Neglected Diseases, Guarulhos University, Guarulhos, 07023-070, Brazil
| | - Elquio E Oliveira
- Laboratory of Synthesis & Drug Delivery, State University of Paraíba, João Pessoa, 58071-160, Brazil
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Mazzeti AL, Gonçalves KR, Boasquívis PF, Barbosa J, Pereira BG, Soeiro MDNC, Mosqueira VCF, Bahia MT. Poly-ε-Caprolactone Implants for Benznidazole Prolonged Release: An Alternative to Chagas Disease Oral Treatment. Pharmaceutics 2023; 15:pharmaceutics15041126. [PMID: 37111612 PMCID: PMC10147077 DOI: 10.3390/pharmaceutics15041126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/20/2023] [Accepted: 03/24/2023] [Indexed: 04/05/2023] Open
Abstract
Benznidazole (BZ) tablets are the currently prescribed treatment for Chagas disease. However, BZ presents limited efficacy and a prolonged treatment regimen with dose-dependent side effects. The design and development of new BZ subcutaneous (SC) implants based on the biodegradable poly-ɛ-caprolactone (PCL) is proposed in this study for a controlled release of BZ and to improve patient compliance. The BZ–PCL implants were characterized by X-ray diffraction, differential scanning calorimetry, and scanning electron microscopy, which indicated that BZ remains in its crystalline state dispersed in the polymer matrix with no polymorphic transitions. BZ–PCL implants, even at the highest doses, induce no alteration of the levels of hepatic enzymes in treated animals. BZ release from implants to blood was monitored in plasma during and after treatment in healthy and infected animals. Implants at equivalent oral doses increase the body’s exposure to BZ in the first days compared with oral therapy, exhibiting a safe profile and allowing sustained BZ concentrations in plasma to induce a cure of all mice in the experimental model of acute infection by the Y strain of T. cruzi. BZ–PCL implants have the same efficacy as 40 daily oral doses of BZ. Biodegradable BZ implants are a promising option to reduce failures related to poor adherence to treatment, with more comfort for patients, and with sustained BZ plasma concentration in the blood. These results are relevant for optimizing human Chagas disease treatment regimens.
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Affiliation(s)
- Ana Lia Mazzeti
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, RJ, Brazil
- Laboratório de Parasitologia Básica e Aplicada, Universidade do Estado de Minas Gerais, Unidade Acadêmica de Passos, Passos 37900-106, MG, Brazil
- Laboratório de Doenças Parasitárias, Escola de Medicina & Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto 35400-000, MG, Brazil
| | - Karolina R. Gonçalves
- Laboratório de Doenças Parasitárias, Escola de Medicina & Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto 35400-000, MG, Brazil
| | | | - Jamile Barbosa
- Diretoria Industrial, Fundação Ezequiel Dias, Belo Horizonte 30510-010, MG, Brazil
| | - Bruno G. Pereira
- Diretoria Industrial, Fundação Ezequiel Dias, Belo Horizonte 30510-010, MG, Brazil
| | | | - Vanessa Carla Furtado Mosqueira
- Laboratory of Pharmaceutics and Nanotechnology (LDGNano), School of Pharmacy, Federal University of Ouro Preto, Ouro Preto 35400-000, MG, Brazil
| | - Maria Terezinha Bahia
- Laboratório de Doenças Parasitárias, Escola de Medicina & Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto 35400-000, MG, Brazil
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Mengarda AC, Iles B, Longo JPF, de Moraes J. Recent approaches in nanocarrier-based therapies for neglected tropical diseases. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2023; 15:e1852. [PMID: 36161523 DOI: 10.1002/wnan.1852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/09/2022] [Accepted: 08/30/2022] [Indexed: 11/07/2022]
Abstract
Neglected tropical diseases (NTDs) remain major public health problems in developing countries. Reducing the burden of NTDs requires sustained collaborative drug discovery efforts to achieve the goals of the new NTDs roadmap launched by the World Health Organization. Oral drugs are the most convenient choice and usually the safest and least expensive. However, the oral use of some drugs for NTDs treatment has many drawbacks, including toxicity, adverse reactions, drug resistance, drug low solubility, and bioavailability. Since there is an imperative need for novel and more effective drugs to treat the various NTDs, in recent years, several compound-loaded nanoparticles have been prepared with the objective of evaluating their application as an oral drug delivery system for the treatment of NTDs. This review focuses on the various types of nanoparticle drug delivery systems that have been recently used against the major NTDs caused by parasites such as leishmaniasis, Chagas disease, and schistosomiasis. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Infectious Disease.
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Affiliation(s)
- Ana C Mengarda
- Research Center for Neglected Diseases, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Bruno Iles
- Department of Genetics and Morphology, Institute of Biological Sciences, University of Brasília, Brasília, Distrito Federal, Brazil
| | - João Paulo F Longo
- Department of Genetics and Morphology, Institute of Biological Sciences, University of Brasília, Brasília, Distrito Federal, Brazil
| | - Josué de Moraes
- Research Center for Neglected Diseases, Guarulhos University, Guarulhos, São Paulo, Brazil
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Scariot DB, Staneviciute A, Zhu J, Li X, Scott EA, Engman DM. Leishmaniasis and Chagas disease: Is there hope in nanotechnology to fight neglected tropical diseases? Front Cell Infect Microbiol 2022; 12:1000972. [PMID: 36189341 PMCID: PMC9523166 DOI: 10.3389/fcimb.2022.1000972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/30/2022] [Indexed: 11/22/2022] Open
Abstract
Nanotechnology is revolutionizing many sectors of science, from food preservation to healthcare to energy applications. Since 1995, when the first nanomedicines started being commercialized, drug developers have relied on nanotechnology to improve the pharmacokinetic properties of bioactive molecules. The development of advanced nanomaterials has greatly enhanced drug discovery through improved pharmacotherapeutic effects and reduction of toxicity and side effects. Therefore, highly toxic treatments such as cancer chemotherapy, have benefited from nanotechnology. Considering the toxicity of the few therapeutic options to treat neglected tropical diseases, such as leishmaniasis and Chagas disease, nanotechnology has also been explored as a potential innovation to treat these diseases. However, despite the significant research progress over the years, the benefits of nanotechnology for both diseases are still limited to preliminary animal studies, raising the question about the clinical utility of nanomedicines in this field. From this perspective, this review aims to discuss recent nanotechnological developments, the advantages of nanoformulations over current leishmanicidal and trypanocidal drugs, limitations of nano-based drugs, and research gaps that still must be filled to make these novel drug delivery systems a reality for leishmaniasis and Chagas disease treatment.
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Affiliation(s)
- Debora B. Scariot
- Department of Biomedical Engineering, Chemistry of Life Processes Institute, and Simpson Querrey Institute, Northwestern University, Evanston and Chicago, IL, United States
- *Correspondence: Debora B. Scariot,
| | - Austeja Staneviciute
- Department of Biomedical Engineering, Chemistry of Life Processes Institute, and Simpson Querrey Institute, Northwestern University, Evanston and Chicago, IL, United States
| | - Jennifer Zhu
- Department of Biomedical Engineering, Chemistry of Life Processes Institute, and Simpson Querrey Institute, Northwestern University, Evanston and Chicago, IL, United States
| | - Xiaomo Li
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Pathology, Northwestern University, Chicago, IL, United States
| | - Evan A. Scott
- Department of Biomedical Engineering, Chemistry of Life Processes Institute, and Simpson Querrey Institute, Northwestern University, Evanston and Chicago, IL, United States
| | - David M. Engman
- Department of Pathology, Northwestern University, Chicago, IL, United States
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