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Rezende Ribeiro N, Magno Oliveira Santos L, Silva Costa S, Kei Myasaki C, Pagliara Lage D, Tamietti Martins V, Cristiane Fortes De Brito R, Chaves Freire L, Maria Ravena Severino Carvalho A, Victor Serafim Brigido B, José Alves R, Antonio Ferraz Coelho E, Mendes Roatt B, Menezes-Souza D, Costa Duarte M. Development of a topical treatment for tegumentary leishmaniasis using 8-hydroxyquinoline. Eur J Pharm Biopharm 2024; 199:114306. [PMID: 38679213 DOI: 10.1016/j.ejpb.2024.114306] [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: 03/06/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/01/2024]
Abstract
In the context of neglected diseases, tegumentary leishmaniasis (TL) presents an emerging and re-emerging character in the national territory and in the world. The treatment of TL has limitations, such as intravenous administration route, high toxicity, and high treatment costs. Thus, several researchers work on new therapeutic strategies to improve the effectiveness of the treatment of leishmaniasis. In this light, the present study used a topical formulation, containing 8-hydroquinoline (8-HQN), for the treatment of Balb/c mice infected with L. amazonensis. After the treatment, the mean diameter of the lesion was measured, as well as the parasite load in organs and immunological parameters associated with the treatment. The results showed that the animals treated with 8-HQN 5%, when compared to controls, showed a reduction in the mean diameter of the lesion and in the parasite load. The animals treated with the ointment showed a type 1 cellular immune response profile associated with the production of cytokines such as INF-γ and TNF-α. In addition, the treatment did not demonstrate toxicity to mice. Therefore, the topical formulation containing 8-HQN 5% is a promising candidate in the topical treatment and could be considered, in the future, as an alternative for the treatment of TL.
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Affiliation(s)
- Naianda Rezende Ribeiro
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Magno Oliveira Santos
- Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Scarleth Silva Costa
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carolina Kei Myasaki
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Daniela Pagliara Lage
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vivian Tamietti Martins
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rory Cristiane Fortes De Brito
- Laboratório de Morfopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Larissa Chaves Freire
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Maria Ravena Severino Carvalho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bryan Victor Serafim Brigido
- Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo José Alves
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil
| | - Eduardo Antonio Ferraz Coelho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruno Mendes Roatt
- Laboratório de Morfopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Laboratório de Pesquisas Clínicas, Programa de Pós-graduação em Ciências Farmacêuticas/CiPharma, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Daniel Menezes-Souza
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Programa de Pós-graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana Costa Duarte
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Berhe H, Kumar Cinthakunta Sridhar M, Zerihun M, Qvit N. The Potential Use of Peptides in the Fight against Chagas Disease and Leishmaniasis. Pharmaceutics 2024; 16:227. [PMID: 38399281 PMCID: PMC10892537 DOI: 10.3390/pharmaceutics16020227] [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: 11/12/2023] [Revised: 12/28/2023] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
Chagas disease and leishmaniasis are both neglected tropical diseases that affect millions of people around the world. Leishmaniasis is currently the second most widespread vector-borne parasitic disease after malaria. The World Health Organization records approximately 0.7-1 million newly diagnosed leishmaniasis cases each year, resulting in approximately 20,000-30,000 deaths. Also, 25 million people worldwide are at risk of Chagas disease and an estimated 6 million people are infected with Trypanosoma cruzi. Pentavalent antimonials, amphotericin B, miltefosine, paromomycin, and pentamidine are currently used to treat leishmaniasis. Also, nifurtimox and benznidazole are two drugs currently used to treat Chagas disease. These drugs are associated with toxicity problems such as nephrotoxicity and cardiotoxicity, in addition to resistance problems. As a result, the discovery of novel therapeutic agents has emerged as a top priority and a promising alternative. Overall, there is a need for new and effective treatments for Chagas disease and leishmaniasis, as the current drugs have significant limitations. Peptide-based drugs are attractive due to their high selectiveness, effectiveness, low toxicity, and ease of production. This paper reviews the potential use of peptides in the treatment of Chagas disease and leishmaniasis. Several studies have demonstrated that peptides are effective against Chagas disease and leishmaniasis, suggesting their use in drug therapy for these diseases. Overall, peptides have the potential to be effective therapeutic agents against Chagas disease and leishmaniasis, but more research is needed to fully investigate their potential.
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Affiliation(s)
| | | | | | - Nir Qvit
- The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel; (H.B.); (M.K.C.S.); (M.Z.)
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Manful EE, Dofuor AK, Gwira TM. The role of tryptophan derivatives as anti-kinetoplastid agents. Heliyon 2024; 10:e23895. [PMID: 38187297 PMCID: PMC10770616 DOI: 10.1016/j.heliyon.2023.e23895] [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: 08/12/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 01/09/2024] Open
Abstract
Kinetoplastids are the causative agents for a spectrum of vector-borne diseases including Leishmaniasis, Chagas disease and Trypanosomiasis that affect millions of people worldwide. In the absence of safe and effective vaccines, chemotherapy, in conjunction with vector control, remain the most significant control approach for kinetoplastid diseases. However, commercially available treatment for these neglected tropical diseases frequently ends up with toxic side effects and increasing resistance. To meet the rising need for innovative medications, alternative chemotherapeutic agents are required. Moreover, insights into target-based mode of action of chemotherapeutic agents are required if novel drugs that may outwit resistance to commercially available drugs are to be developed. Tryptophan has been implicated in a variety of diseases and disorders due to its fundamental role as a precursor to several bioactive metabolites, as well as its importance in the improvement of health and nutrition, diagnostics, and therapeutics. The regulation of tryptophan metabolism plays a fundamental role in the growth of kinetoplastids. Moreover, the levels of tryptophan may serve as a biomarker to distinguish between the stages of kinetoplastids making it an important amino acid to explore for drug targets. The main aim of this review is thus to provide a comprehensive literature synthesis of tryptophan derivatives to explore as potential anti-kinetoplastids. Here we highlight the role of tryptophan derivatives as chemotherapeutic agents against kinetoplastids. The reviewed compounds provide insights into potential new drug interventions that may combat the increasing problem of anti-kinetoplastid resistance.
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Affiliation(s)
- Ewura-Esi Manful
- Division of Molecular Biology and Human Genetics, Stellenbosch University, South Africa
| | - Aboagye Kwarteng Dofuor
- Department of Biological Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Theresa Manful Gwira
- West African Center for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Ghana
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Ahmed G, Jamal F, Tiwari RK, Singh V, Rai SN, Chaturvedi SK, Pandey K, Singh SK, Kumar A, Narayan S, Vamanu E. Arsenic exposure to mouse visceral leishmaniasis model through their drinking water linked to the disease exacerbation via modulation in host protective immunity: a preclinical study. Sci Rep 2023; 13:21461. [PMID: 38052913 PMCID: PMC10698031 DOI: 10.1038/s41598-023-48642-z] [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: 04/19/2023] [Accepted: 11/28/2023] [Indexed: 12/07/2023] Open
Abstract
A large body of evidence has shown a direct link between arsenic exposure and drug resistance to Leishmania parasites against antimonial preparations in visceral leishmaniasis (VL) hyper-endemic regions, especially in India and its sub-continent. However, the implicated roles of arsenic on the VL host, pathophysiological changes, and immune function have not yet been clarified, particularly at the reported concentration of arsenic in the VL hyper-endemic area of Bihar, India. Herein, we exposed the mouse VL model to arsenic (0.5 mg/L to 2 mg/L) through their drinking water and analyzed its effect on T cells proliferation, Th1/Th2-mediators, MAPK signaling cascade, and parasite load in preclinical models. Coherently, the parasite count in Giemsa stained spleen imprint has been investigated and found significant positive associations with levels of arsenic exposure. The liver and kidney function tests (AST, ALT, ALP, BUN, Creatinine, Urea, etc.) are apparent to hepatonephric toxicity in arsenic exposed VL mice compared to unexposed. This observation appears to be consistent with the up-regulated expression of immune regulatory Th2 mediators (IL-4, IL-10, TGF-β) and down-regulated expression of Th1 mediators (IL-12, IFN-γ, TNF-α) with a suppressed leishmanicidal function of macrophage (ROS, NO, iNOS). We also established that arsenic exposure modulated the host ERK-1/2 and p38 MAPK signaling cascade, limited T lymphocyte proliferation, and a lower IgG2a/IgG1 ratio to favor the Leishmania parasite survival inside the host. This study suggests that the contorted Th1-subtype and exacerbated Th2-subtype immune responses are involved in the increased susceptibility and pathogenesis of Leishmania parasite among subjects/individuals regularly exposed to arsenic.
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Affiliation(s)
- Ghufran Ahmed
- Department of Microbiology, Rajendra Memorial Research Institute of Medical Sciences, Patna, 800007, India
| | - Fauzia Jamal
- Department of Microbiology, Rajendra Memorial Research Institute of Medical Sciences, Patna, 800007, India
| | - Ritesh K Tiwari
- Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Patna, 800007, India
| | - Veer Singh
- Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Patna, 800007, India
| | - Sachchida Nand Rai
- Centre of Experimental Medicine and Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Sanjay K Chaturvedi
- Department of Microbiology, Rajendra Memorial Research Institute of Medical Sciences, Patna, 800007, India
| | - Krishna Pandey
- Department of Clinical Medicine, Rajendra Memorial Research Institute of Medical Sciences, Patna, 800007, India
| | - Santosh K Singh
- Centre of Experimental Medicine and Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Ashish Kumar
- Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Patna, 800007, India
| | - Shyam Narayan
- Department of Microbiology, Rajendra Memorial Research Institute of Medical Sciences, Patna, 800007, India.
| | - Emanuel Vamanu
- Faculty of Biotechnology, University of Agricultural Sciences and Veterinary Medicine of Bucharest, 011464, Bucharest, Romania.
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Meira C, Silva J, Quadros H, Silva L, Barreto B, Rocha V, Bomfim L, Santos E, Soares M. Galectins in Protozoan Parasitic Diseases: Potential Applications in Diagnostics and Therapeutics. Cells 2023; 12:2671. [PMID: 38067100 PMCID: PMC10705098 DOI: 10.3390/cells12232671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/04/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
Neglected tropical diseases (NTDs) constitute a group of diseases that generally develop in tropical or subtropical climatic conditions and are related to poverty. Within the spectrum of NTDs, diseases caused by protozoa such as malaria, Chagas disease, and leishmaniasis exhibit elevated mortality rates, thereby constituting a substantial public health concern. Beyond their protozoan etiology, these NTDs share other similarities, such as the challenge of control and the lack of affordable, safe, and effective drugs. In view of the above, the need to explore novel diagnostic predictors and therapeutic targets for the treatment of these parasitic diseases is evident. In this context, galectins are attractive because they are a set of lectins bound to β-galactosides that play key roles in a variety of cellular processes, including host-parasite interaction such as adhesion and entry of parasites into the host cells, and participate in antiparasitic immunity in either a stimulatory or inhibitory manner, especially the galectins-1, -2, -3, and -9. These functions bestow upon galectins significant therapeutic prospects in the context of managing and diagnosing NTDs. Thus, the present review aims to elucidate the potential role of galectins in the diagnosis and treatment of malaria, leishmaniasis, and Chagas disease.
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Affiliation(s)
- Cássio Meira
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador 21040-900, Bahia, Brazil; (J.S.); (H.Q.); (L.S.); (B.B.); (V.R.); (L.B.)
- SENAI Institute of Innovation in Health Advanced Systems (ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Bahia, Brazil;
| | - Jaqueline Silva
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador 21040-900, Bahia, Brazil; (J.S.); (H.Q.); (L.S.); (B.B.); (V.R.); (L.B.)
| | - Helenita Quadros
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador 21040-900, Bahia, Brazil; (J.S.); (H.Q.); (L.S.); (B.B.); (V.R.); (L.B.)
| | - Laís Silva
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador 21040-900, Bahia, Brazil; (J.S.); (H.Q.); (L.S.); (B.B.); (V.R.); (L.B.)
| | - Breno Barreto
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador 21040-900, Bahia, Brazil; (J.S.); (H.Q.); (L.S.); (B.B.); (V.R.); (L.B.)
- SENAI Institute of Innovation in Health Advanced Systems (ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Bahia, Brazil;
- Institute of Health Sciences, Federal University of Bahia (UFBA), Salvador 40170-110, Bahia, Brazil
| | - Vinícius Rocha
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador 21040-900, Bahia, Brazil; (J.S.); (H.Q.); (L.S.); (B.B.); (V.R.); (L.B.)
- SENAI Institute of Innovation in Health Advanced Systems (ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Bahia, Brazil;
| | - Larissa Bomfim
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador 21040-900, Bahia, Brazil; (J.S.); (H.Q.); (L.S.); (B.B.); (V.R.); (L.B.)
| | - Emanuelle Santos
- SENAI Institute of Innovation in Health Advanced Systems (ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Bahia, Brazil;
| | - Milena Soares
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador 21040-900, Bahia, Brazil; (J.S.); (H.Q.); (L.S.); (B.B.); (V.R.); (L.B.)
- SENAI Institute of Innovation in Health Advanced Systems (ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Bahia, Brazil;
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Sherafati J, Dayer MS, Ghaffarifar F, Akbarzadeh K, Pirestani M. Evaluating leishmanicidal effects of Lucilia sericata products in combination with Apis mellifera honey using an in vitro model. PLoS One 2023; 18:e0283355. [PMID: 37535629 PMCID: PMC10399734 DOI: 10.1371/journal.pone.0283355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 03/07/2023] [Indexed: 08/05/2023] Open
Abstract
Leishmaniasis is a zoonotic disease caused by an intracellular parasite from the genus Leishmania. Lack of safe and effective drugs has increasingly promoted researches into new drugs of natural origin to cure the disease. The study, therefore, aimed to investigate the anti-leishmanial effects of Lucilia sericata larval excretion/secretion (ES) in combination with Apis mellifera honey as a synergist on Leishmania major using an in vitro model. Various concentrations of honey and larval ES fractions were tested against promastigotes and intracellular amastigotes of L. major using macrophage J774A.1 cell line. The inhibitory effects and cytotoxicity of ES plus honey were evaluated using direct counting method and MTT assay. To assess the effects of larval ES plus honey on the amastigote form, the rate of macrophage infection and the number of amastigotes per infected macrophage cell were estimated. The 50% inhibitory concentration (IC50) values were 21.66 μg/ml, 43.25 60 μg/ml, 52.58 μg/ml, and 70.38 μg/ml for crude ES plus honey, ES >10 kDa plus honey, ES <10 kDa plus honey, and honey alone, respectively. The IC50 for positive control (glucantime) was 27.03 μg/ml. There was a significant difference between viability percentages of promastigotes exposed to different doses of applied treatments compared to the negative control (p≤ 0.0001). Microscopic examination of amastigote forms revealed that dosages applied at 150 to 300 μg/ml significantly reduced the rate of macrophage infection and the number of amastigotes per infected macrophage cell. Different doses of larval products plus honey did not show a significant toxic effect agaist macrophage J774 cells. The larval ES fractions of L. sericata in combination with A. mellifera honey acted synergistically against L. major.
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Affiliation(s)
- Jila Sherafati
- Faculty of Medical Sciences, Department of Parasitology and Medical Entomology, Tarbiat Modares University, Tehran, Iran
- Faculty of Medical Sciences, Student Research Committee, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Saaid Dayer
- Faculty of Medical Sciences, Department of Parasitology and Medical Entomology, Tarbiat Modares University, Tehran, Iran
| | - Fatemeh Ghaffarifar
- Faculty of Medical Sciences, Department of Parasitology and Medical Entomology, Tarbiat Modares University, Tehran, Iran
| | - Kamran Akbarzadeh
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Pirestani
- Faculty of Medical Sciences, Department of Parasitology and Medical Entomology, Tarbiat Modares University, Tehran, Iran
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Mas A, Hurtado-Morillas C, Martínez-Rodrigo A, Orden JA, de la Fuente R, Domínguez-Bernal G, Carrión J. A Tailored Approach to Leishmaniases Vaccination: Comparative Evaluation of the Efficacy and Cross-Protection Capacity of DNA vs. Peptide-Based Vaccines in a Murine Model. Int J Mol Sci 2023; 24:12334. [PMID: 37569710 PMCID: PMC10418836 DOI: 10.3390/ijms241512334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Zoonotic leishmaniases are a worldwide public health problem for which the development of effective vaccines remains a challenge. A vaccine against leishmaniases must be safe and affordable and should induce cross-protection against the different disease-causing species. In this context, the DNA vaccine pHisAK70 has been demonstrated to induce, in a murine model, a resistant phenotype against L. major, L. infantum, and L. amazonensis. Moreover, a chimeric multiepitope peptide, HisDTC, has been obtained by in silico analysis from the histone proteins encoded in the DNA vaccine and has showed its ability to activate a potent CD4+ and CD8+ T-cell protective immune response in mice against L. infantum infection. In the present study, we evaluated the plasmid DNA vaccine pHisAK70 in comparison with the peptide HisDTC (with and without saponin) against L. major and L. infantum infection. Our preliminary results showed that both formulations were able to induce a potent cellular response leading to a decrease in parasite load against L. infantum. In addition, the DNA candidate was able to induce better lesion control in mice against L. major. These preliminary results indicate that both strategies are potentially effective candidates for leishmaniases control. Furthermore, it is important to carry out such comparative studies to elucidate which vaccine candidates are the most appropriate for further development.
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Affiliation(s)
- Alicia Mas
- INMIVET Group, Animal Health Department, Veterinary School, Universidad Complutense Madrid, 28040 Madrid, Spain
| | - Clara Hurtado-Morillas
- INMIVET Group, Animal Health Department, Veterinary School, Universidad Complutense Madrid, 28040 Madrid, Spain
| | - Abel Martínez-Rodrigo
- INMIVET Group, Animal Science Department, Veterinary School, Universidad Complutense Madrid, 28040 Madrid, Spain
| | - José A. Orden
- INMIVET Group, Animal Health Department, Veterinary School, Universidad Complutense Madrid, 28040 Madrid, Spain
| | - Ricardo de la Fuente
- INMIVET Group, Animal Health Department, Veterinary School, Universidad Complutense Madrid, 28040 Madrid, Spain
| | - Gustavo Domínguez-Bernal
- INMIVET Group, Animal Health Department, Veterinary School, Universidad Complutense Madrid, 28040 Madrid, Spain
| | - Javier Carrión
- INMIVET Group, Animal Health Department, Veterinary School, Universidad Complutense Madrid, 28040 Madrid, Spain
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Pacheco-Fernandez T, Markle H, Verma C, Huston R, Gannavaram S, Nakhasi HL, Satoskar AR. Field-Deployable Treatments For Leishmaniasis: Intrinsic Challenges, Recent Developments and Next Steps. Res Rep Trop Med 2023; 14:61-85. [PMID: 37492219 PMCID: PMC10364832 DOI: 10.2147/rrtm.s392606] [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: 03/01/2023] [Accepted: 06/08/2023] [Indexed: 07/27/2023] Open
Abstract
Leishmaniasis is a neglected tropical disease endemic primarily to low- and middle-income countries, for which there has been inadequate development of affordable, safe, and efficacious therapies. Clinical manifestations of leishmaniasis range from self-healing skin lesions to lethal visceral infection with chances of relapse. Although treatments are available, secondary effects limit their use outside the clinic and negatively impact the quality of life of patients in endemic areas. Other non-medicinal treatments, such as thermotherapies, are limited to use in patients with cutaneous leishmaniasis but not with visceral infection. Recent studies shed light to mechanisms through which Leishmania can persist by hiding in cellular safe havens, even after chemotherapies. This review focuses on exploring the cellular niches that Leishmania parasites may be leveraging to persist within the host. Also, the cellular, metabolic, and molecular implications of Leishmania infection and how those could be targeted for therapeutic purposes are discussed. Other therapies, such as those developed against cancer or for manipulation of the ferroptosis pathway, are proposed as possible treatments against leishmaniasis due to their mechanisms of action. In particular, treatments that target hematopoietic stem cells and monocytes, which have recently been found to be necessary components to sustain the infection and provide a safe niche for the parasites are discussed in this review as potential field-deployable treatments against leishmaniasis.
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Affiliation(s)
- Thalia Pacheco-Fernandez
- Division of Emerging and Transfusion Transmitted Disease, Center for Biologics Evaluation and Research Food and Drug Administration, Silver Spring, MD, 20993, USA
| | - Hannah Markle
- Division of Emerging and Transfusion Transmitted Disease, Center for Biologics Evaluation and Research Food and Drug Administration, Silver Spring, MD, 20993, USA
| | - Chaitenya Verma
- Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, 43201, USA
| | - Ryan Huston
- Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, 43201, USA
- Department of Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, 43201, USA
| | - Sreenivas Gannavaram
- Division of Emerging and Transfusion Transmitted Disease, Center for Biologics Evaluation and Research Food and Drug Administration, Silver Spring, MD, 20993, USA
| | - Hira L Nakhasi
- Division of Emerging and Transfusion Transmitted Disease, Center for Biologics Evaluation and Research Food and Drug Administration, Silver Spring, MD, 20993, USA
| | - Abhay R Satoskar
- Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, 43201, USA
- Department of Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, 43201, USA
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Lima SKSD, Jesus JA, Raminelli C, Laurenti MD, Passero LFD. High Selectivity of 8-Hydroxyquinoline on Leishmania (Leishmania) and Leishmania (Viannia) Species Correlates with a Potent Therapeutic Activity In Vivo. Pharmaceuticals (Basel) 2023; 16:ph16050707. [PMID: 37242490 DOI: 10.3390/ph16050707] [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: 04/12/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
Leishmaniasis is a neglected disease caused by protozoa of the genus Leishmania, which causes different clinical manifestations. Drugs currently used in the treatment such as pentavalent antimonial and amphotericin B cause severe side effects in patients, and parasite resistance has been reported. Thus, it is necessary and urgent to characterize new and effective alternative drugs to replace the current chemotherapy of leishmaniasis. In this regard, it has been experimentally demonstrated that quinoline derivatives present significative pharmacological and parasitic properties. Thus, the aim of this work was to demonstrate the leishmanicidal activity of 8-hydroxyquinoline (8-HQ) in vitro and in vivo. The leishmanicidal activity (in vitro) of 8-HQ was assayed on promastigote and intracellular amastigote forms of L. (L.) amazonensis, L. (L.) infantum chagasi, L. (V.) guyanensis L. (V.) naiffi, L. (V.) lainsoni, and L. (V.) shawi. Additionally, the levels of nitric oxide and hydrogen peroxide were analyzed. The therapeutic potential of 8-HQ was analyzed in BALB/c mice infected with a strain of L. (L.) amazonensis that causes anergic cutaneous diffuse leishmaniasis. In vitro data showed that at 24 and 72 h, 8-HQ eliminated promastigote and intracellular amastigote forms of all studied species and this effect may be potentialized by nitric oxide. Furthermore, 8-HQ was more selective than miltefosine. Infected animals treated with 8-HQ by the intralesional route dramatically reduced the number of tissue parasites in the skin, and it was associated with an increase in IFN-γ and decrease in IL-4, which correlated with a reduction in inflammatory reaction in the skin. These results strongly support the idea that 8-HQ is an alternative molecule that can be employed in the treatment of leishmaniasis, given its selectivity and multispectral action in parasites from the Leishmania genus.
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Affiliation(s)
- Sarah Kymberly Santos de Lima
- Institute of Biosciences, São Paulo State University (UNESP), Praça Infante Dom Henrique, s/n, São Vicente 11330-900, Brazil
- Laboratory of Pathology of Infectious Diseases (LIM50), Department of Pathology, Medical School of São Paulo University, São Paulo 01246-903, Brazil
| | - Jéssica Adriana Jesus
- Institute of Biosciences, São Paulo State University (UNESP), Praça Infante Dom Henrique, s/n, São Vicente 11330-900, Brazil
| | - Cristiano Raminelli
- Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Diadema 09920-000, Brazil
| | - Márcia Dalastra Laurenti
- Laboratory of Pathology of Infectious Diseases (LIM50), Department of Pathology, Medical School of São Paulo University, São Paulo 01246-903, Brazil
| | - Luiz Felipe Domingues Passero
- Institute of Biosciences, São Paulo State University (UNESP), Praça Infante Dom Henrique, s/n, São Vicente 11330-900, Brazil
- Institute for Advanced Studies of Ocean, São Paulo State University (UNESP), Rua João Francisco Bensdorp, 1178, São Vicente 11350-011, Brazil
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10
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Synthetic hydrazones: In silico studies and in vitro evaluation of the antileishmania potential. Toxicol In Vitro 2023; 88:105560. [PMID: 36681287 DOI: 10.1016/j.tiv.2023.105560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/05/2022] [Accepted: 01/15/2023] [Indexed: 01/20/2023]
Abstract
Bioprospecting and synthesis of strategically designed molecules have been used in the search for drugs that can be in leishmaniasis. Hydrazones (HDZ) are promising compounds with extensive biological activities. The objective of this work was to perform in silico studies of hydrazones 1-5 and to evaluate their antileishmanial, cytotoxic and macrophage immunomodulatory potential in vitro. Hydrazones were subjected to prediction and molecular docking studies. Antileishmanial protocols on promastigotes and amastigotes of Leishmania amazonensis, cytotoxicity and macrophage immunomodulatory activity were performed. Hydrazones showed a good pharmacokinetic profile and hydrazone 3 and hydrazone 5 were classified as non-carcinogenic. Hydrazone 5 obtained the best conformation with trypanothione reductase. Hydrazone 1 and hydrazone 3 obtained the best mean inhibitory concentration (IC50) values for promastigotes, 4.4-61.96 μM and 8.0-58.75 μM, respectively. It also showed good activity on intramacrophagic amastigotes, with hydrazone 1 being the most active (IC50 = 6.79 μM) with selectivity index of 56. In cytotoxicity to macrophages hydrazone 3 was the most cytotoxic (CC50 = 256.3 ± 0,04 μM), while hydrazone 4 the least (CC50 = 1055.9 ± 0.03 μM). It can be concluded that the hydrazones revealed important pharmacokinetic and toxicological properties, in addition to antileishmania potential in reducing infection and infectivity in parasitized macrophages.
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11
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Amini SM, Hadighi R, Najm M, Alipour M, Hasanpour H, Vosoogh M, Vosough A, Hajizadeh M, Badirzadeh A. The Therapeutic Effects of Curcumin-coated Gold Nanoparticle Against Leishmania Major Causative Agent of Zoonotic Cutaneous Leishmaniasis (ZCL): An In Vitro and In Vivo Study. Curr Microbiol 2023; 80:104. [PMID: 36781499 DOI: 10.1007/s00284-022-03172-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 12/15/2022] [Indexed: 02/15/2023]
Abstract
We synthesized and characterized curcumin-coated gold nanoparticles (Cur@AuNPs) and investigated their stability, cytotoxicity, leishmanicidal activity in in vitro and in in vivo experiments. Cur@AuNPs synthesized through a simple one-pot green chemistry technique. The in vitro leishmanicidal activity of curcumin-coated gold nanoparticles against extracellular promastigotes and intracellular amastigotes of protozoan parasite Leishmania major (L. major) was determined by applying the tetrazolium reduction colorimetric quantitative MTT technique. For in vivo assessment, the footpad lesion size and parasite burden in two infection site organs including lymph nodes and footpads of susceptible BALB/c mice infected with L. major were measured. Mice immune responses in all study groups were quantified by measuring the levels of gamma interferon (IFN-γ) and interleukin-4 (IL-4). Viability of Leishmania promastigotes significantly diminished with the inhibition in promastigotes growth (IC50) of 64.79 μg/mL and 29.89 μg/mL for 24 h and 48 h, respectively. In vitro nanoparticles treatment efficiently cleared the L. major amastigotes explanted in macrophages but had no harmful toxicity on the mice cells. In the in vivo condition, in the treated infected BALB/c mice the CL lesion size, Leishmania parasite burden, and IL-4 were decreased, while IFN-γ was significantly increased. The results suggest that Cur@AuNP was an effective compound against Leishmania parasite in vitro and in vivo, efficiently induced T-helper 1 (Th1) responses and augmented host cellular immune responses, and ending in a reduced Leishmania parasite burden. Therefore, it may be identified as a novel potential therapeutic approach for the local therapy of zoonotic CL treatment with high cure rates.
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Affiliation(s)
- Seyed Mohammad Amini
- Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ramtin Hadighi
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Najm
- Department of Medical Laboratory Sciences, Faculty of Paramedical Sciences, Lahijan Branch Islamic Azad University, Lahijan, Iran
| | - Maryam Alipour
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Hasanpour
- Department of Parasitology and Mycology, School of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran
| | - Mehran Vosoogh
- Center of Experimental and Comparative Studies, Iran University of Medical Sciences, Tehran, Iran
| | - Araz Vosough
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Garmsar Branch, Islamic Azad University, Garmsar, Iran
| | - Maryam Hajizadeh
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Badirzadeh
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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12
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Sreedharan V, Rao KB. Protease inhibitors as a potential agent against visceral Leishmaniasis: A review to inspire future study. Braz J Infect Dis 2023; 27:102739. [PMID: 36603827 PMCID: PMC9871078 DOI: 10.1016/j.bjid.2022.102739] [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: 09/03/2022] [Revised: 11/21/2022] [Accepted: 12/16/2022] [Indexed: 01/04/2023] Open
Abstract
Leishmaniasis is transmitted by sandfly which carries the intracellular protozoa in their midgut. Among visceral, cutaneous and mucocutaneous leishmaniasis, visceral type that is caused by Leishmania donovani is the most lethal one. Findings of leishmanial structure and species took place in 19th century and was initiated by Donovan. Leishmaniasis is still a major concern of health issues in many endemic countries in Asia, Africa, the Americas, and the Mediterranean region. Worldwide1.5-2 million new cases of cutaneous leishmaniasis and 500,000 cases of visceral leishmaniasis are reported each year. Leishmaniasis is endemic in nearly 90 countries worldwide and close to 12 million new cases of leishmaniasis are reported worldwide annually. Studies on antileishmanial drug development is of major concern as leishmaniasis are the second largest parasitic killer in the world and the available drugs are either toxic or costly. The major surface GP63 protease, also known as Zinc- metalloproteases present on the surface of leishmanial promastigotes, can be targeted for drug development. Protease inhibitors targeting such surface proteases show promising results. Different protease inhibitors have been isolated from marine actinobacteria against many infectious diseases. Metabolites produced by these actinobacteria may have greater importance for the discovery and development of new antileishmanial drugs. Hence, this review discusses the background, current situation, treatment, and protease inhibitors from marine actinobacteria for drug development against GP63 molecules.
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Affiliation(s)
| | - K.V. Bhaskara Rao
- Corresponding author at: Department of Biomedical Sciences, School of BioSciences and Technology, VIT University, Vellore, Tamil Nadu, 632 014, India.
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Centrin-deficient Leishmania mexicana confers protection against Old World visceral leishmaniasis. NPJ Vaccines 2022; 7:157. [DOI: 10.1038/s41541-022-00574-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/07/2022] [Indexed: 12/04/2022] Open
Abstract
AbstractLeishmaniasis is one of the top neglected tropical diseases with significant morbidity and mortality in low and middle-income countries (LMIC). However, this disease is also spreading in the developed world. Currently, there is a lack of effective strategies to control this disease. Vaccination can be an effective measure to control leishmaniasis and has the potential to achieve disease elimination. Recently, we have generated centrin gene-deleted new world L. mexicana (LmexCen−/−) parasites using CRISPR/Cas9 and showed that they protect mice against a homologous L. mexicana infection that causes cutaneous disease. In this study, we tested whether LmexCen−/− parasites can also protect against visceral leishmaniasis caused by L. donovani in a hamster model. We showed that immunization with LmexCen−/− parasites is safe and does not cause lesions. Furthermore, such immunization conferred protection against visceral leishmaniasis caused by a needle-initiated L. donovani challenge, as indicated by a significant reduction in the parasite burdens in the spleen and liver as well as reduced mortality. Similar control of parasite burden was also observed against a sand fly mediated L. donovani challenge. Importantly, immunization with LmexCen−/− down-regulated the disease promoting cytokines IL-10 and IL-4 and increased pro-inflammatory cytokine IFN-γ resulting in higher IFN-γ/IL-10 and IFN-γ/IL4 ratios compared to non-immunized animals. LmexCen−/− immunization also resulted in long-lasting protection against L. donovani infection. Taken together, our study demonstrates that immunization with LmexCen−/− parasites is safe and efficacious against the Old World visceral leishmaniasis.
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Mounia A, Mohamed E, Mohamed H, Samia B. A Community Based Survey of Knowledge, Attitudes, and Practices Concerning Leishmaniasis in Central Morocco. J Community Health 2022; 47:932-942. [PMID: 35921052 DOI: 10.1007/s10900-022-01126-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 12/26/2022]
Abstract
Leishmaniasis is a major health problem caused by a protozoan of the genus Leishmania, most commonly transmitted by infected female sand flies. Intersectoral collaboration is essential for the implementation of integrated vector management control with community participation. The present study aims to evaluate the knowledge, attitude and practices of the population toward leishmaniasis in central Morocco. A quantitative cross-sectional study was conducted using an administered questionnaire assisted by health professionals, on 750 people in the Marrakech Safi, endemic region of cutaneous leishmaniasis (CL). Of those, 702 agreed to be recruited for our study, of which 63,5% were women, 48,1% were aged between 18 and 40 years, and more than half of the participants (60%) were from rural areas. Overall, the knowledge, attitude and practices (KAPs) for leishmaniasis are too poor for more than 85% of the population in the study area. Basic knowledge and perceptions of leishmaniasis were good for 14,6% of respondents. While, 4,5% of the members had good knowledge of CL, only 0,7% had good level of knowledge about vesciral leishmaniasis (VL). Furthermore 3,7% of those polled have favorable attitudes and preventive practices. No association was found between knowledge and age, province or occupation. However, rural residents were four times more likely than urbain residents to have good basic knowledge (ORA = 4,74; CI95%: 1,04 -22,05). In addition, the female gender also has the chance to possess good basic knowledge and perceptions 3 times more than the men (ORA = 3,18; CI95%: 1,16 -8,69). The low level of KAPs regarding leishmaniasis proves the lack of community participation in the fight against leishmaniasis in central Morocco.
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Affiliation(s)
- Amane Mounia
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco.
| | - Echchakery Mohamed
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco.,Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Hafidi Mohamed
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco
| | - Boussaa Samia
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco.,Ministry of Health and Social Protection, ISPITS-Higher Institute of Nursing and Technical Health Occupations, Rabat, Morocco
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15
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Pinheiro AC, de Souza MVN. Current leishmaniasis drug discovery. RSC Med Chem 2022; 13:1029-1043. [PMID: 36324493 PMCID: PMC9491386 DOI: 10.1039/d1md00362c] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 08/12/2022] [Indexed: 01/09/2023] Open
Abstract
Leishmaniasis is a complex protozoan infectious disease and, associated with malnutrition, poor health services and unavailability of prophylactic control measures, neglected populations are particularly affected. Current drug regimens are outdated and associated with some drawbacks, such as cytotoxicity and resistance, and the development of novel, efficacious and less toxic drug regimens is urgently required. In addition, leishmanial pathogenesis is not well established or understood, and a prophylactic vaccine is an unfulfilled goal. Human kinetoplastid protozoan infections, including leishmaniasis, have been neglected for many years, and in an attempt to overcome this situation, some new drug targets were recently identified, enabling the development of new drugs and vaccines. Compounds from new drug classes have also shown excellent antileishmanial activities, some of the most promising ones included in clinical trials, and could be a hope to control the disease burden of this endemic disease in the near future. In this review, we discuss the limitations of current control methods, explore the wide range of compounds that are being screened and identified as antileishmanial drug prototypes, summarize the advances in identifying new drug targets aiming at innovative treatments and explore the state-of-art vaccine development field, including immunomodulation strategies.
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16
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Wang X, Chen J, Zheng J. The state of the art of extracellular vesicle research in protozoan infection. Front Genet 2022; 13:941561. [PMID: 36035188 PMCID: PMC9417467 DOI: 10.3389/fgene.2022.941561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/25/2022] [Indexed: 11/25/2022] Open
Abstract
Protozoan diseases seriously affect the health of human beings, livestock and poultry and lead to high economic and medical costs. Extracellular vesicles (EVs) are membranous structures formed through biological processes that play important roles in immune regulation. Studies have shown that parasites transmit information to hosts through EVs to modulate host immune responses. The major roles played by EVs released from parasites involve facilitating parasitization of the host. In this review, we discuss relevant recently obtained data on EVs secreted by different kinds of protozoa, including their molecular mechanisms, and discuss the roles played by EVs in the occurrence and development of parasitic diseases.
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Affiliation(s)
- Xinlei Wang
- Department of Clinical Laboratory, The Second Hospital of Jilin University, Jilin University, Changchun, China
| | - Jie Chen
- Institute of Theoretical Chemistry, Jilin University, Changchun, China
| | - Jingtong Zheng
- Department of Pathogenobiology, College of Basic Medical Sciences, Jilin University, Changchun, China
- *Correspondence: Jingtong Zheng,
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Guedes DL, da Silva ED, Castro MCAB, Júnior WLB, Ibarra-Meneses AV, Tsoumanis A, Adriaensen W, van Griensven J, Pereira VRA, de Medeiros ZM. Comparison of serum cytokine levels in symptomatic and asymptomatic HIV-Leishmania coinfected individuals from a Brazilian visceral leishmaniasis endemic area. PLoS Negl Trop Dis 2022; 16:e0010542. [PMID: 35714136 PMCID: PMC9246190 DOI: 10.1371/journal.pntd.0010542] [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: 12/18/2021] [Revised: 06/30/2022] [Accepted: 05/27/2022] [Indexed: 12/03/2022] Open
Abstract
Background Visceral leishmaniasis (VL) remains an important infectious disease worldwide. VL-HIV coinfected individuals can present with atypical clinical forms of VL and have a high risk of VL relapse. Some cytokines have been described as potential markers to diagnose active VL and to predict the severity of the cases. However, few studies have included VL-HIV coinfected patients. We aimed to characterize the levels of several cytokines among VL-HIV coinfected individuals living in a VL-endemic area in Northeast Brazil. Methods This was a retrospective, cross-sectional study, aiming to estimate the levels of various cytokines in symptomatic and asymptomatic VL-HIV coinfected individuals. There were 134 study participants (35 symptomatic VL-HIV, 75 asymptomatic VL-HIV, and 24 healthy controls), all ≥ 18 years-old. Serum cytokine levels (interferon-γ, tumor necrosis factor, and interleukins 2, 4, 6, 10, and 17A) were quantified using the Becton Dickinson-BD’s Cytometric Bead Array (CBA) system. Results The population mainly consisted of men (64.9%), with a median age of 35 (27–41) years. Asymptomatic individuals were younger (p = 0.013), with more years of education (p < 0.001), and were more often on antiretroviral therapy (p < 0.001) than those in the symptomatic group. Hemoglobin levels (p < 0.001), lymphocytes (p < 0.001) and CD4 count (p < 0.001) were lower in symptomatic individuals, while HIV viral loads were higher (p < 0.001). In the symptomatic VL-HIV coinfected group, we observed increased serum levels of IL-17A, IL-6, and IL-10 compared to asymptomatic patients and the healthy controls. There were no differences in the levels of all cytokines between asymptomatic VL-HIV coinfected individuals and the healthy controls. Conclusions Higher serum levels of IL-17A, IL-6, and IL-10 cytokines were observed in symptomatic coinfected individuals but not in asymptomatically infected individuals. More studies among HIV-positive persons are needed to better understand the role of serum cytokines for prognosis, to define cure and predict VL relapses in VL-HIV coinfected individuals. Visceral leishmaniasis (VL) is a parasitic disease, classified as a neglected disease by the World Health Organization. It is present in more than 60 countries in four continents, with most tropical and subtropical countries affected. Without treatment, the disease is fatal. HIV-positive persons are especially affected by VL, with a worst prognosis. One of the main complications is the frequent reactivation of the disease even after successful treatment (VL relapse). Up to now, it is not clear why and when these reactivations occur, and many researches are trying to find some biological markers to answer this. Cytokines are one of these markers that may explain the progression of the disease. In this study, we compared the level of several key cytokines in symptomatic VL-HIV coinfected patients, asymptomatic VL-HIV coinfected individuals, and healthy controls living in a VL-endemic region in Northeastern Brazil. The serum cytokine levels were higher in symptomatic patients when compared with asymptomatic and healthy controls. More studies following VL-HIV patients are necessary to understand how these cytokines and the other biomarkers vary over time and whether they can predict VL relapse, and also the progression and the prognosis of the disease.
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Affiliation(s)
- Diego Lins Guedes
- Department of Parasitology, Aggeu Magalhães Institute–Oswaldo Cruz Foundation (Fiocruz), Recife, Pernambuco, Brazil
- Curso de medicina, Núcleo de Ciências da Vida, Centro Acadêmico do Agreste, Universidade Federal de Pernambuco, Caruaru, Pernambuco, Brazil
- * E-mail:
| | - Elis Dionísio da Silva
- Department of Immunology, Aggeu Magalhães Institute–Oswaldo Cruz Foundation (Fiocruz), Recife, Pernambuco, Brazil
| | - Maria Carolina Accioly Brelaz Castro
- Department of Immunology, Aggeu Magalhães Institute–Oswaldo Cruz Foundation (Fiocruz), Recife, Pernambuco, Brazil
- Parasitology Laboratory, Federal University of Pernambuco, Vitoria de Santo Antão, Pernambuco, Brazil
| | - Walter Lins Barbosa Júnior
- Department of Parasitology, Aggeu Magalhães Institute–Oswaldo Cruz Foundation (Fiocruz), Recife, Pernambuco, Brazil
| | - Ana Victoria Ibarra-Meneses
- Département de pathologie et microbiologie. Faculté de médecine vétérinaire. Université de Montréal, Saint-Hyacinthe, QC, Canada
- The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Montreal, Canada
| | - Achilleas Tsoumanis
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Wim Adriaensen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Johan van Griensven
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Valéria Rêgo Alves Pereira
- Department of Immunology, Aggeu Magalhães Institute–Oswaldo Cruz Foundation (Fiocruz), Recife, Pernambuco, Brazil
| | - Zulma Maria de Medeiros
- Department of Parasitology, Aggeu Magalhães Institute–Oswaldo Cruz Foundation (Fiocruz), Recife, Pernambuco, Brazil
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18
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Lage DP, Machado AS, Vale DL, Freitas CS, Linhares FP, Cardoso JMO, Pereira IAG, Ramos FF, Tavares GSV, Ludolf F, Oliveira-da-Silva JA, Bandeira RS, Silva AM, Simões LC, Reis TAR, Oliveira JS, Christodoulides M, Chávez-Fumagalli MA, Roatt BM, Martins VT, Coelho EAF. Recombinant guanosine-5'-triphosphate (GTP)-binding protein associated with Poloxamer 407-based polymeric micelles protects against Leishmania infantum infection. Cytokine 2022; 153:155865. [PMID: 35339043 DOI: 10.1016/j.cyto.2022.155865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/12/2022] [Accepted: 03/09/2022] [Indexed: 11/03/2022]
Abstract
Leishmania virulence proteins should be considered as vaccine candidates against disease, since they are involved in developing infection in mammalian hosts. In a previous study, a Leishmania guanosine-5'-triphosphate (GTP)-binding protein was identified as a potential parasite virulence factor. In the present work, the gene encoding GTP was cloned and the recombinant protein (rGTP) was evaluated as a vaccine candidate against Leishmania infantum infection. The protein was associated with saponin (rGTP/Sap) or Poloxamer 407-based micelles (rGTP/Mic) as adjuvants, and protective efficacy was investigated in BALB/c mice after parasite challenge. Both rGTP/Sap and rGTP/Mic compositions induced a Th1-type immune response in vaccinated animals, with significantly higher levels of IFN-γ, IL-12, IL-2, TNF-α, GM-CSF, nitrite, specific IgG2a isotype antibody and positive lymphoproliferation, when compared to the control groups. This response was accompanied by significantly lower parasite load in the spleens, livers, bone marrows and draining lymph nodes of the animals. Immunological and parasitological evaluations indicated that rGTP/Mic induced a more polarized Th1-type response and higher reduction in the organ parasitism, and with lower hepatotoxicity, when compared to the use of rGTP/Sap. In conclusion, our preliminary data suggest that rGTP could be considered for further development as a vaccine candidate to protect against VL.
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Affiliation(s)
- Daniela P Lage
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Amanda S Machado
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Danniele L Vale
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Camila S Freitas
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Flávia P Linhares
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Jamille M O Cardoso
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Departamento de Ciências Biológicas, Insituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Isabela A G Pereira
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda F Ramos
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Grasiele S V Tavares
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda Ludolf
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - João A Oliveira-da-Silva
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Raquel S Bandeira
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Alessandra M Silva
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Luciana C Simões
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Thiago A R Reis
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Jamil S Oliveira
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901 Minas Gerais, Brazil
| | - Myron Christodoulides
- Neisseria Research Group, Molecular Microbiology, School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton SO16 6YD, England
| | | | - Bruno M Roatt
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Departamento de Ciências Biológicas, Insituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Vívian T Martins
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Eduardo A F Coelho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil; Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901 Belo Horizonte, Minas Gerais, Brazil.
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19
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Shedding Lights on Crude Venom from Solitary Foraging Predatory Ant Ectatomma opaciventre: Initial Toxinological Investigation. Toxins (Basel) 2022; 14:toxins14010037. [PMID: 35051015 PMCID: PMC8781531 DOI: 10.3390/toxins14010037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/22/2021] [Accepted: 12/24/2021] [Indexed: 01/17/2023] Open
Abstract
Some species of primitive predatory ants, despite living in a colony, exercise their hunting collection strategy individually; their venom is painful, paralyzing, digestive, and lethal for their prey, yet the toxins responsible for these effects are poorly known. Ectatomma opaciventre is a previously unrecorded solitary hunting ant from the Brazilian Cerrado. To overcome this hindrance, the present study performed the in vitro enzymatic, biochemical, and biological activities of E. opaciventre to better understand the properties of this venom. Its venom showed several proteins with masses ranging from 1-116 kDa, highlighting the complexity of this venom. Compounds with high enzymatic activity were described, elucidating different enzyme classes present in the venom, with the presence of the first L-amino acid oxidase in Hymenoptera venoms being reported. Its crude venom contributes to a state of blood incoagulability, acting on primary hemostasis, inhibiting collagen-induced platelet aggregation, and operating on the fibrinolysis of loose red clots. Furthermore, the E. opaciventre venom preferentially induced cytotoxic effects on lung cancer cell lines and three different species of Leishmania. These data shed a comprehensive portrait of enzymatic components, biochemical and biological effects in vitro, opening perspectives for bio-pharmacological application of E. opaciventre venom molecules.
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20
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Häfner S. Polymeric Promotion. Microbes Infect 2021; 24:104910. [PMID: 34838737 DOI: 10.1016/j.micinf.2021.104910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/07/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Sophia Häfner
- University of Copenhagen, BRIC Biotech Research & Innovation Centre, Lund Group, 2200 Copenhagen, Denmark.
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21
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Ren D, Cao W, Liu X, Han Q, Fan W, Li G, Xia H, Zhang X. Case Report: Use of Liposomal Amphotericin B in Low Doses in Patients With Visceral Leishmaniasis. Front Med (Lausanne) 2021; 8:766400. [PMID: 34869476 PMCID: PMC8635719 DOI: 10.3389/fmed.2021.766400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 10/26/2021] [Indexed: 11/28/2022] Open
Abstract
Background: No consensus has been reached regarding the optimal therapy for visceral leishmaniasis (VL), which affects ~12 million people worldwide. Case Presentation: This report described four cases of VL encountered in the First Affiliated Hospital of Xi'an Jiaotong University between October 2019 and December 2020. Of the four patients, one patient experienced relapse after antimonial treatment, and the remaining patients had primary VL (including one patient with impaired kidney function and one patient with hemophagocytic syndrome). All patients received a novel treatment protocol, namely the low-dose L-AmB therapy, which was characterized by a low initial dose, cautious dose escalation, and low-dose therapy as maintenance. All patients were cured without severe complications, and there was no further recurrence during follow-up. Conclusions: This case series demonstrated the safety and efficacy of the low-dose L-AmB therapy for VL patients, providing novel treatment protocol for the VL.
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Affiliation(s)
- Danfeng Ren
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wenya Cao
- Dialysis Department of Nephrology Hospital, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaojing Liu
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qunying Han
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wanhu Fan
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Guoliang Li
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Han Xia
- Hugobiotech Co., Ltd., Beijing, China
| | - Xi Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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22
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Kumari D, Perveen S, Sharma R, Singh K. Advancement in leishmaniasis diagnosis and therapeutics: An update. Eur J Pharmacol 2021; 910:174436. [PMID: 34428435 DOI: 10.1016/j.ejphar.2021.174436] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/10/2021] [Accepted: 08/16/2021] [Indexed: 12/11/2022]
Abstract
Leishmaniasis is regarded as a neglected tropical disease by World Health Organization (WHO) and is ranked next to malaria as the deadliest protozoan disease. The primary causative agents of the disease comprise of diverse leishmanial species sharing clinical features ranging from skin abrasions to lethal infection in the visceral organs. As several Leishmania species are involved in infection, the role of accurate diagnosis becomes pivotal in adding new dimensions to anti-leishmanial therapy. Diagnostic methods must be fast, reliable, easy to perform, highly sensitive, and specific to differentiate among similar parasitic diseases. Herein, we present the conventional and recent approaches impended for the disease diagnosis and their sensitivity, specificity, and clinical application in parasite detection. Furthermore, we have also elaborated various new methods to cure leishmaniasis, which include host-directed therapies, drug repurposing, nanotechnology, and combinational therapy. This review addresses novel techniques and innovations in leishmaniasis, which can aid in unraveling new strategies to fight against the deadly infection.
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Affiliation(s)
- Diksha Kumari
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Summaya Perveen
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Rashmi Sharma
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Kuljit Singh
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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23
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Longoni SS, Tiberti N, Bisoffi Z, Piubelli C. Monoclonal Antibodies for Protozoan Infections: A Future Reality or a Utopic Idea? Front Med (Lausanne) 2021; 8:745665. [PMID: 34712683 PMCID: PMC8545981 DOI: 10.3389/fmed.2021.745665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/17/2021] [Indexed: 12/15/2022] Open
Abstract
Following the SARS-CoV-2 pandemic, several clinical trials have been approved for the investigation of the possible use of mAbs, supporting the potential of this technology as a therapeutic approach for infectious diseases. The first monoclonal antibody (mAb), Muromonab CD3, was introduced for the prevention of kidney transplant rejection more than 30 years ago; since then more than 100 mAbs have been approved for therapeutic purposes. Nonetheless, only four mAbs are currently employed for infectious diseases: Palivizumab, for the prevention of respiratory syncytial virus (RSV) infections, Raxibacumab and Obiltoxaximab, for the prophylaxis and treatment against anthrax toxin and Bezlotoxumab, for the prevention of Clostridium difficile recurrence. Protozoan infections are often neglected diseases for which effective and safe chemotherapies are generally missing. In this context, drug resistance and drug toxicity are two crucial problems. The recent advances in bioinformatics, parasite genomics, and biochemistry methodologies are contributing to better understand parasite biology, which is essential to guide the development of new therapies. In this review, we present the efforts that are being made in the evaluation of mAbs for the prevention or treatment of leishmaniasis, Chagas disease, malaria, and toxoplasmosis. Particular emphasis will be placed on the potential strengths and weaknesses of biological treatments in the control of these protozoan diseases that are still affecting hundreds of thousands of people worldwide.
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Affiliation(s)
- Silvia Stefania Longoni
- Department of Infectious-Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Natalia Tiberti
- Department of Infectious-Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Zeno Bisoffi
- Department of Infectious-Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Sacro Cuore Don Calabria Hospital, Verona, Italy.,Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Chiara Piubelli
- Department of Infectious-Tropical Diseases and Microbiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Sacro Cuore Don Calabria Hospital, Verona, Italy
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24
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Fernandes VDS, da Rosa R, Zimmermann LA, Rogério KR, Kümmerle AE, Bernardes LSC, Graebin CS. Antiprotozoal agents: How have they changed over a decade? Arch Pharm (Weinheim) 2021; 355:e2100338. [PMID: 34661935 DOI: 10.1002/ardp.202100338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 12/21/2022]
Abstract
Neglected tropical diseases are a diverse group of communicable diseases that are endemic in low- or low-to-middle-income countries located in tropical and subtropical zones. The number and availability of drugs for treating these diseases are low, the administration route is inconvenient in some cases, and most of them have safety, efficacy, or adverse/toxic reaction issues. The need for developing new drugs to deal with these issues is clear, but one of the most drastic consequences of this negligence is the lack of interest in the research and development of new therapeutic options among major pharmaceutical companies. Positive changes have been achieved over the last few years, although the overall situation remains alarming. After more than one decade since the original work reviewing antiprotozoal agents came to light, now it is time to question ourselves: How has the scenario for the treatment of protozoal diseases such as malaria, leishmaniasis, human African trypanosomiasis, and American trypanosomiasis changed? This review covers the last decade in terms of the drugs currently available for the treatment of these diseases as well as the clinical candidates being currently investigated.
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Affiliation(s)
- Vitória de Souza Fernandes
- Department of Pharmaceutical Sciences, Pharmaceutical and Medicinal Chemistry Laboratory, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Rafael da Rosa
- Department of Organic Chemistry, Medicinal Chemistry and Molecular Diversity Laboratory, Federal Rural University of Rio de Janeiro, Seropédica, Rio de Janeiro, Brazil
| | - Lara A Zimmermann
- Department of Organic Chemistry, Medicinal Chemistry and Molecular Diversity Laboratory, Federal Rural University of Rio de Janeiro, Seropédica, Rio de Janeiro, Brazil
| | - Kamilla R Rogério
- Department of Pharmaceutical Sciences, Pharmaceutical and Medicinal Chemistry Laboratory, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Arthur E Kümmerle
- Department of Pharmaceutical Sciences, Pharmaceutical and Medicinal Chemistry Laboratory, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Lilian S C Bernardes
- Department of Organic Chemistry, Medicinal Chemistry and Molecular Diversity Laboratory, Federal Rural University of Rio de Janeiro, Seropédica, Rio de Janeiro, Brazil
| | - Cedric S Graebin
- Department of Pharmaceutical Sciences, Pharmaceutical and Medicinal Chemistry Laboratory, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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25
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Zhang W, Li Z, Yang H, Wang G, Liu G, Wang Y, Bello BK, Zhao P, Liang W, Dong J. Aeromonas sobria Induces Proinflammatory Cytokines Production in Mouse Macrophages via Activating NLRP3 Inflammasome Signaling Pathways. Front Cell Infect Microbiol 2021; 11:691445. [PMID: 34513725 PMCID: PMC8428973 DOI: 10.3389/fcimb.2021.691445] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/03/2021] [Indexed: 12/25/2022] Open
Abstract
Aeromonas sobria, a common conditional pathogenic bacteria, is widely distributed in the environment and causes gastroenteritis in humans or septicemia in fish. Of all Aeromonas species, A. sobria is the most frequently isolated from human infections especially in immunocompromised subjects. Innate immunity is the first protection system of organism to resist non-specific pathogens invasion; however, the immune response process of hosts against A. sobria infection re\mains unexplored. The present study established an A. sobria infection model using primary mouse peritoneal macrophages (PMφs). The adherence and cytotoxicity of A. sobria on PMφs were determined by May-Grünwald Giemsa staining and LDH release measurement. Pro-inflammatory cytokine expression levels were measured using qPCR, western blotting, and ELISA methods. We also investigated the levels of ASC oligomerization and determined the roles of active caspase-1 in IL-1β secretion through inhibition assays and explored the activated pattern recognition receptors through immunofluorescence. We further elucidated the roles of activated inflammasome in regulating the host's inflammatory response through inhibition combined with ELISA assays. Our results showed that A. sobria induced lytic cell death and LDH release, whereas it had no adhesive properties on PMφs. A. sobria triggered various proinflammatory cytokine transcription level upregulation, and IL-1β occupied the highest levels. The pro-IL-1β protein expression levels increased in a dose-dependent manner with MOI ranging from 1 to 100. This process was regulated by ASC-dependent inflammasome, which cleavage pro-IL-1β into active IL-1β p17 with activated caspase-1 p20. Meanwhile, the expression levels of NLRP3 receptor significantly increased, location analysis revealed puncta-like surrounding nuclear, and inhibition of NLRP3 inflammasome downregulated caspase-1 activation and IL-1β secretion. Blocking of NLRP3 inflammasome activation through K+ efflux and cathepsin B or caspase approaches downregulated A. sobria-induced proinflammatory cytokine production. Overall, these data indicated that A. sobria induced proinflammatory cytokine production in PMφs through activating NLRP3 inflammasome signaling pathways.
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Affiliation(s)
- Wei Zhang
- Key Jiangsu Institute of Marine Resources Development, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, Jiangsu Ocean University, Lianyungang, China
| | - Zhixing Li
- Key Jiangsu Institute of Marine Resources Development, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, Jiangsu Ocean University, Lianyungang, China
| | - Haitao Yang
- Key Jiangsu Institute of Marine Resources Development, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, Jiangsu Ocean University, Lianyungang, China
| | - Guanglu Wang
- Key Jiangsu Institute of Marine Resources Development, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, Jiangsu Ocean University, Lianyungang, China
| | - Gang Liu
- Key Jiangsu Institute of Marine Resources Development, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, Jiangsu Ocean University, Lianyungang, China
| | - Yu Wang
- Key Jiangsu Institute of Marine Resources Development, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, Jiangsu Ocean University, Lianyungang, China
| | - Babatunde Kazeem Bello
- State key laboratory of Rice Biology, Lianyungang Academy of Agricultural Sciences, Lianyungang, China
| | - Panpan Zhao
- Key Jiangsu Institute of Marine Resources Development, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, Jiangsu Ocean University, Lianyungang, China
| | - Wei Liang
- Laboratory Department of Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, China
| | - Jingquan Dong
- Key Jiangsu Institute of Marine Resources Development, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, Jiangsu Ocean University, Lianyungang, China
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26
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de L Paula LA, Cândido ACBB, Santos MFC, Caffrey CR, Bastos JK, Ambrósio SR, Magalhães LG. Antiparasitic Properties of Propolis Extracts and Their Compounds. Chem Biodivers 2021; 18:e2100310. [PMID: 34231306 DOI: 10.1002/cbdv.202100310] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/06/2021] [Indexed: 11/09/2022]
Abstract
Propolis is a bee product that has been used in medicine since ancient times. Although its anti-inflammatory, antioxidant, antimicrobial, antitumor, and immunomodulatory activities have been investigated, its anti-parasitic properties remain poorly explored, especially regarding helminths. This review surveys the results obtained with propolis around the world against human parasites. Regarding protozoa, studies carried out with the protozoa Trypanosoma spp. and Leishmania spp. have demonstrated promising results in vitro and in vivo. However, there are fewer studies for Plasmodium spp., the etiological agent of malaria and less so for helminths, particularly for Fasciola spp. and Schistosoma spp. Despite the favorable in vitro results with propolis, helminth assays need to be further investigated. However, propolis has shown itself to be an excellent natural product for parasitology, thus opening new paths and approaches in its activity against protozoa and helminths.
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Affiliation(s)
- Lucas A de L Paula
- Research Group on Natural Products, Center for Research in Sciences and Technology, University of Franca, Avenida Dr. Armando Salles of Oliveira 201, CEP 14404-600, Franca, SP, Brazil
| | - Ana C B B Cândido
- Research Group on Natural Products, Center for Research in Sciences and Technology, University of Franca, Avenida Dr. Armando Salles of Oliveira 201, CEP 14404-600, Franca, SP, Brazil
| | - Mario F C Santos
- Research Group on Natural Products, Center for Research in Sciences and Technology, University of Franca, Avenida Dr. Armando Salles of Oliveira 201, CEP 14404-600, Franca, SP, Brazil
| | - Conor R Caffrey
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Jairo K Bastos
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, CEP 14.040-903, Ribeirão Preto, SP, Brazil
| | - Sérgio R Ambrósio
- Research Group on Natural Products, Center for Research in Sciences and Technology, University of Franca, Avenida Dr. Armando Salles of Oliveira 201, CEP 14404-600, Franca, SP, Brazil
| | - Lizandra G Magalhães
- Research Group on Natural Products, Center for Research in Sciences and Technology, University of Franca, Avenida Dr. Armando Salles of Oliveira 201, CEP 14404-600, Franca, SP, Brazil.,Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
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27
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Cavalcante GM, Camara CA, Silva EMSD, Santos MS, Leite AB, Queiroz AC, Evelyn Da Silva A, Araújo MV, Alexandre-Moreira MS, Silva TMS. Leismanicidal Activity of Propolis Collected in the Semiarid Region of Brazil. Front Pharmacol 2021; 12:702032. [PMID: 34276385 PMCID: PMC8281046 DOI: 10.3389/fphar.2021.702032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/16/2021] [Indexed: 12/20/2022] Open
Abstract
Objective: The aim of the current study is to investigate the chemical composition, cytotoxic effect, and leishmanicidal activity of propolis collected in the semi-arid region of Bahia, Brazil. Methods: EtOH extract, hexane, EtOAc and MeOH fractions from propolis were analyzed by ultra-performance liquid chromatography coupled with diode array detector and quadrupole time-of-flight mass spectrometry. The identification was based on the exact mass, general fragmentation behaviors and UV absorption of the flavonoids. The in vitro cytotoxic effect and leishmanicidal activity of ethanolic extract, hexane, ethyl acetate, and methanolic fractions of propolis were evaluated. Results: Five triterpenes and twenty-four flavonoids were identified. The propolis did not present toxicity to the host cell up to the maximum concentration tested. In addition, all tested samples showed statistically significant activity against promastigotes of Leishmania chagasi and Leishmania amazonensis. Regarding the activity against amastigote forms of L. amazonensis, the hexane fraction, presented statistically significant activity with IC50 of 1.3 ± 0.1 μg/ml. Conclusion: The results support the idea that propolis can be used for future antileishmania studies.
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Affiliation(s)
- Giani Maria Cavalcante
- Phytochemical Bioprospecting Laboratory, Chemistry Department, Rural Federal University of Pernambuco, Pernambuco, Brazil
| | - Celso Amorim Camara
- Phytochemical Bioprospecting Laboratory, Chemistry Department, Rural Federal University of Pernambuco, Pernambuco, Brazil
| | | | - Mariana Silva Santos
- Pharmacology and Immunity Laboratory, Institute of Biological and Health Sciences, Federal University of Alagoas, Alagoas, Brazil
| | - Anderson Brandão Leite
- Pharmacology and Immunity Laboratory, Institute of Biological and Health Sciences, Federal University of Alagoas, Alagoas, Brazil
| | - Aline Cavalcanti Queiroz
- Pharmacology and Immunity Laboratory, Institute of Biological and Health Sciences, Federal University of Alagoas, Alagoas, Brazil.,Microbiology, Immunology and Parasitology Laboratory, Campus Arapiraca, Federal University of Alagoas, Alagoas, Brazil
| | - Amanda Evelyn Da Silva
- Pharmacology and Immunity Laboratory, Institute of Biological and Health Sciences, Federal University of Alagoas, Alagoas, Brazil
| | - Morgana Vital Araújo
- Pharmacology and Immunity Laboratory, Institute of Biological and Health Sciences, Federal University of Alagoas, Alagoas, Brazil
| | - Magna Suzana Alexandre-Moreira
- Pharmacology and Immunity Laboratory, Institute of Biological and Health Sciences, Federal University of Alagoas, Alagoas, Brazil
| | - Tania Maria Sarmento Silva
- Phytochemical Bioprospecting Laboratory, Chemistry Department, Rural Federal University of Pernambuco, Pernambuco, Brazil
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28
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Rodrigues G, Raj P, Monappa V, Gowda C, Carnelio S. Primary cervical lymph nodal leishmaniasis. Trop Doct 2021; 51:613-614. [PMID: 34080445 DOI: 10.1177/00494755211022502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Leishmaniasis, an endemic disease in several parts of India, is a parasitic disease caused by protozoa and transmitted by the sandfly. Although cutaneous and visceral varieties are common, isolated lymph nodal involvement is extremely rare, and the diagnosis is often delayed owing to its uncommon presentation and lack of awareness of this possibility. We present a 72-year-old woman with asymptomatic right facial lymphadenopathy which on biopsy revealed leishmaniasis and responded well to drug therapy.
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Affiliation(s)
- Gabriel Rodrigues
- Professor, Department of General Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Pulak Raj
- Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Vidya Monappa
- Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Chiranth Gowda
- Department of General Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Sunitha Carnelio
- Department of Oral and Maxillofacial Pathology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
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29
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Immunotherapy in treatment of leishmaniasis. Immunol Lett 2021; 233:80-86. [PMID: 33771555 DOI: 10.1016/j.imlet.2021.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/12/2021] [Accepted: 03/19/2021] [Indexed: 11/21/2022]
Abstract
Leishmaniasis caused by various species of protozoan transmitted by sand fly vectors occurs as a spectrum of clinical features including cutaneous, mucocutaneous and visceral forms. It is a geographically distributed parasitic disease and a major public health problem in the world. The clinical syndromes are highly variable depending on the parasite species, host genetics, vectors and environment. To date, there is no effective vaccine and traditional treatments are toxic, expensive with long administration duration and many adverse side effects and/or drug resistance. Instead of treatments based on chemotherapy, certain strategies aim to recover leishmaniasis and reduce the parasitic burden. Immunotherapy has focused on the induction of effective immune response to rapidly control the disease. Recent studies have indicated that a single dose of a suitable therapeutic vaccine induces a quick and lasting recovery in patients. Immunotherapy reduces the toxicity of drug and the emergence of resistance dramatically. It could be an effective addition to chemotherapy with a safe and potent drug compared with monotherapy, resulting in a prophylactic and therapeutic cure of leishmaniasis. This review has focused on treatment of leishmaniasis with particular emphasis on immunotherapy as an alternative to conventional drug treatment.
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Boniface PK, Sano CM, Elizabeth FI. Unveiling the Targets Involved in the Quest of Antileishmanial Leads Using In silico Methods. Curr Drug Targets 2021; 21:681-712. [PMID: 32003668 DOI: 10.2174/1389450121666200128112948] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Leishmaniasis is a neglected tropical disease associated with several clinical manifestations, including cutaneous, mucocutaneous, and visceral forms. As currently available drugs have some limitations (toxicity, resistance, among others), the target-based identification has been an important approach to develop new leads against leishmaniasis. The present study aims to identify targets involved in the pharmacological action of potent antileishmanial compounds. METHODS The literature information regarding molecular interactions of antileishmanial compounds studied over the past half-decade is discussed. The information was obtained from databases such as Wiley, SciFinder, Science Direct, National Library of Medicine, American Chemical Society, Scientific Electronic Library Online, Scopus, Springer, Google Scholar, Web of Science, etc. Results: Numerous in vitro antileishmanial compounds showed affinity and selective interactions with enzymes such as arginase, pteridine reductase 1, trypanothione reductase, pyruvate kinase, among others, which are crucial for the survival and virulence of the Leishmania parasite. CONCLUSION The in-silico activity of small molecules (enzymes, proteins, among others) might be used as pharmacological tools to develop candidate compounds for the treatment of leishmaniasis. As some pharmacologically active compounds may act on more than one target, additional studies of the mechanism (s) of action of potent antileishmanial compounds might help to better understand their pharmacological action. Also, the optimization of promising antileishmanial compounds might improve their biological activity.
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Affiliation(s)
- Pone K Boniface
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Cinthya M Sano
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Ferreira I Elizabeth
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
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Abstract
Leishmaniasis is one of the chronic debilitating vector-borne diseases caused by obligate intracellular protozoa. The global burden of disease although not increasing but potential risk of spread is there. At least 20 species of Leishmania are pathogenic to human beings. The transmission is from female sandfly through a blood meal. The disease pathogenesis is dependent on parasite and host mechanism-primarily cell-mediated immunity. The three common forms are visceral, cutaneous, and mucocutaneous. The diagnostic tests are mainly based on aspiration from the spleen or bone marrow. The use of K39 antibodies is the best serodiagnostic test. Antimonial, amphotericin B, miltefosine, and paromomycin are the drugs used to treat leishmaniasis. Amphotericin therapy shows the response within 7 to 10 days in most subjects, and 2 weeks of therapy is sufficient. However, those going into relapse need new treatment regimes. There is a definite benefit of combination therapy. However, there is still no breakthrough on a vaccine for prophylaxis. How to cite this article: Daga MK, Rohatgi I, Mishra R. Leishmaniasis. Indian J Crit Care Med 2021;25(Suppl 2):S166-S170.
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Affiliation(s)
- Mradul K Daga
- Department of Medicine, Maulana Azad Medical College, New Delhi, India
| | - Ishan Rohatgi
- Department of Medicine, Maulana Azad Medical College, New Delhi, India
| | - Rashmi Mishra
- Department of Medicine, Maulana Azad Medical College, New Delhi, India
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Dutra BM, Rodrigues NLDC, Fonseca FRM, de Moura TR, Pacheco de Almeida R, de Jesus AR, Abreu TM, Pompeu MMDL, Teixeira CR, Teixeira MJ. CXCL10 immunomodulatory effect against infection caused by an antimony refractory isolate of Leishmania braziliensis in mice. Parasite Immunol 2020; 43:e12805. [PMID: 33131089 DOI: 10.1111/pim.12805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 11/28/2022]
Abstract
Leishmania braziliensis is the main causative agent of American tegumentary leishmaniasis in Brazil. Current treatment includes different drugs that have important side effects and identification of cases of parasite resistance to treatment support the search for new therapeutic strategies. Recent findings have indicated that CXCL10, a chemokine that recruits and activates Th1 cells, NK cells, macrophages, dendritic cells and B lymphocytes, is a potential alternative to treat Leishmania infection. Here, we tested CXCL10 immunotherapy against experimental infection caused by an antimony-resistant isolate of Leishmania braziliensis. Following infection, mice were treated with CXCL10 for 7 days after onset of lesions. We demonstrate that mice treated with CXCL10 controlled lesion progression and parasite burden more efficiently comparing to controls. An increased IFN-γ, IL-10, TGF-β and low IL-4 production combined with a distinct inflammatory infiltrate composed by activated macrophages, lymphocytes and granulomas was observed in the CXCL10-treated group comparing to controls. However, CXCL10 and Glucantime combined therapy did not improve CXCL10-induced protective effect. Our findings reinforce the potential of CXCL10 immunotherapy as an alternative treatment against infection caused by L. braziliensis resistant to conventional chemotherapy.
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Affiliation(s)
- Brunheld Maia Dutra
- Department of Pathology and Legal Medicine, Federal University of Ceará, Fortaleza, Brazil
| | | | | | | | | | - Amélia Ribeiro de Jesus
- Department of Internal Medicine and Pathology, Federal University of Sergipe, Aracajú, Brazil
| | - Ticiana Monteiro Abreu
- Department of Pathology and Legal Medicine, Federal University of Ceará, Fortaleza, Brazil
| | | | | | - Maria Jania Teixeira
- Department of Pathology and Legal Medicine, Federal University of Ceará, Fortaleza, Brazil
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Rebouças-Silva J, Tadini MC, Devequi-Nunes D, Mansur AL, S Silveira-Mattos P, I de Oliveira C, R Formiga F, Berretta AA, Marquele-Oliveira F, Borges VM. Evaluation of in vitro and in vivo Efficacy of a Novel Amphotericin B-Loaded Nanostructured Lipid Carrier in the Treatment of Leishmania braziliensis Infection. Int J Nanomedicine 2020; 15:8659-8672. [PMID: 33177824 PMCID: PMC7652360 DOI: 10.2147/ijn.s262642] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/27/2020] [Indexed: 12/03/2022] Open
Abstract
Background Leishmaniasis is a neglected disease, and the current therapeutic arsenal for its treatment is seriously limited by high cost and toxicity. Nanostructured lipid carriers (NLCs) represent a promising approach due to high drug loading capacity, controlled drug release profiles and superior stability. Here, we explore the efficacy of a unique pH-sensitive amphotericin B-loaded NLC (AmB-NLC) in Leishmania braziliensis infection in vitro and in vivo. Methods and Results AmB-NLC was assessed by dynamic light scattering and atomic force microscopy assays. The carrier showed a spherical shape with a nanometric size of 242.0 ± 18.3 nm. Zeta potential was suggestive of high carrier stability (−42.5 ± 1.5 mV), and the NLC showed ~99% drug encapsulation efficiency (EE%). In biological assays, AmB-NLC presented a similar IC50 as free AmB and conventional AmB deoxycholate (AmB-D) (11.7 ± 1.73; 5.3 ± 0.55 and 13 ± 0.57 ng/mL, respectively), while also presenting higher selectivity index and lower toxicity to host cells, with no observed production of nitric oxide or TNF-α by in vitro assay. Confocal microscopy revealed the rapid uptake of AmB-NLC by infected macrophages after 1h, which, in association with more rapid disruption of AmB-NLC at acidic pH levels, may directly affect intracellular parasites. Leishmanicidal effects were evaluated in vivo in BALB/c mice infected in the ear dermis with L. braziliensis and treated with a pentavalent antimonial (Sb5+), liposomal AmB (AmB-L) or AmB-NLC. After 6 weeks of infection, AmB-NLC treatment resulted in smaller ear lesion size in all treated mice, indicating the efficacy of the novel formulation. Conclusion Here, we preliminarily demonstrate the effectiveness of an innovative and cost-effective AmB-NLC formulation in promoting the killing of intracellular L. braziliensis. This novel carrier system could be a promising alternative for the future treatment of cutaneous leishmaniasis.
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Affiliation(s)
- Jéssica Rebouças-Silva
- Laboratory of Inflammation and Biomarkers, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.,Postgraduate Program in Pathology, Faculty of Medicine of Bahia, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Maraine Catarina Tadini
- Eleve Science Research and Development, Ribeirão Preto, São Paulo, Brazil.,Department of Chemistry, Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Danielle Devequi-Nunes
- Laboratory of Inflammation and Biomarkers, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.,Laboratory of Pharmaceutical Formulations, SENAI Institute of Innovation in Advanced Health Systems, Salvador, Bahia, Brazil
| | - Ana Luíza Mansur
- Eleve Science Research and Development, Ribeirão Preto, São Paulo, Brazil
| | - Paulo S Silveira-Mattos
- Laboratory of Inflammation and Biomarkers, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.,Postgraduate Program in Pathology, Faculty of Medicine of Bahia, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Camila I de Oliveira
- Postgraduate Program in Pathology, Faculty of Medicine of Bahia, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.,Laboratory of Vector-Borne Infectious Diseases, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Fábio R Formiga
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil.,Postgraduate Program in Applied Cellular and Molecular Biology, University of Pernambuco (UPE), Recife, Pernambuco, Brazil
| | - Andresa A Berretta
- Laboratory of Research, Development and Innovation, Apis Flora Industrial e Comercial Ltda, Ribeirão Preto, São Paulo, Brazil
| | | | - Valéria M Borges
- Laboratory of Inflammation and Biomarkers, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.,Postgraduate Program in Pathology, Faculty of Medicine of Bahia, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
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Avendaño C, Patarroyo MA. Loop-Mediated Isothermal Amplification as Point-of-Care Diagnosis for Neglected Parasitic Infections. Int J Mol Sci 2020; 21:ijms21217981. [PMID: 33126446 PMCID: PMC7662217 DOI: 10.3390/ijms21217981] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022] Open
Abstract
The World Health Organisation (WHO) has placed twenty diseases into a group known as neglected tropical diseases (NTDs), twelve of them being parasitic diseases: Chagas’ disease, cysticercosis/taeniasis, echinococcosis, food-borne trematodiasis, human African trypanosomiasis (sleeping sickness), leishmaniasis, lymphatic filariasis, onchocerciasis (river blindness), schistosomiasis, soil-transmitted helminthiasis (ascariasis, hookworm, trichuriasis), guinea-worm and scabies. Such diseases affect millions of people in developing countries where one of the main problems concerning the control of these diseases is diagnosis-based due to the most affected areas usually being far from laboratories having suitable infrastructure and/or being equipped with sophisticated equipment. Advances have been made during the last two decades regarding standardising and introducing techniques enabling diagnoses to be made in remote places, i.e., the loop-mediated isothermal amplification (LAMP) technique. This technique’s advantages include being able to perform it using simple equipment, diagnosis made directly in the field, low cost of each test and the technique’s high specificity. Using this technique could thus contribute toward neglected parasite infection (NPI) control and eradication programmes. This review describes the advances made to date regarding LAMP tests, as it has been found that even though several studies have been conducted concerning most NPI, information is scarce for others.
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Affiliation(s)
- Catalina Avendaño
- Animal Science Faculty, Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A.), Bogotá 111166, Colombia;
| | - Manuel Alfonso Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá 111321, Colombia
- Basic Sciences Department, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 112111, Colombia
- Correspondence: ; Tel.: +57-1-3244672
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Vacas A, Fernández-Rubio C, Larrea E, Peña-Guerrero J, Nguewa PA. LmjF.22.0810 from Leishmania major Modulates the Th2-Type Immune Response and Is Involved in Leishmaniasis Outcome. Biomedicines 2020; 8:biomedicines8110452. [PMID: 33114674 PMCID: PMC7692454 DOI: 10.3390/biomedicines8110452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 11/16/2022] Open
Abstract
A novel serine/threonine protein kinase, LmjF.22.0810, was recently described in Leishmania major. After generating an L. major cell line overexpressing LmjF.22.0810 (named LmJ3OE), the ability of this novel protein to modulate the Th2-type immune response was analyzed. Our results suggest that the protein kinase LmjF.22.0810 might be involved in leishmaniasis outcomes. Indeed, our study outlined the LmJ3OE parasites infectivity in vitro and in vivo. Transgenic parasites displayed lower phagocytosis rates in vitro, and their promastigote forms exhibited lower expression levels of virulence factors compared to their counterparts in control parasites. In addition, LmJ3OE parasites developed significantly smaller footpad swelling in susceptible BALB/c mice. Hematoxylin-eosin staining allowed the observation of a lower inflammatory infiltrate in the footpad from LmJ3OE-infected mice compared to animals inoculated with control parasites. Gene expression of Th2-associated cytokines and effectors revealed a dramatically lower induction in interleukin (IL)-4, IL-10, and arginase 1 (ARG1) mRNA levels at the beginning of the swelling; no expression change was found in Th1-associated cytokines except for IL-12. Accordingly, such results were validated by immunohistochemistry studies, illustrating a weaker expression of ARG1 and a similar induction for inducible NO synthase (iNOS) in footpads from LmJ3OE-infected mice compared to control L. major infected animals. Furthermore, the parasite burden was lower in footpads from LmJ3OE-infected mice. Our analysis indicated that such significant smaller footpad swellings might be due to an impairment of the Th2 immune response that subsequently benefits Th1 prevalence. Altogether, these studies depict LmjF.22.0810 as a potential modulator of host immune responses to Leishmania. Finally, this promising target might be involved in the modulation of infection outcome.
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Affiliation(s)
- Andrés Vacas
- Department of Microbiology and Parasitology, ISTUN Institute of Tropical Health, IdiSNA (Navarra Institute for Health Research), University of Navarra, E-31008 Pamplona, Navarra, Spain; (A.V.); (C.F.-R.); (J.P.-G.)
| | - Celia Fernández-Rubio
- Department of Microbiology and Parasitology, ISTUN Institute of Tropical Health, IdiSNA (Navarra Institute for Health Research), University of Navarra, E-31008 Pamplona, Navarra, Spain; (A.V.); (C.F.-R.); (J.P.-G.)
| | - Esther Larrea
- ISTUN Institute of Tropical Health, Navarra Institute for Health Research (IdiSNA), University of Navarra, E-31008 Pamplona, Navarra, Spain;
| | - José Peña-Guerrero
- Department of Microbiology and Parasitology, ISTUN Institute of Tropical Health, IdiSNA (Navarra Institute for Health Research), University of Navarra, E-31008 Pamplona, Navarra, Spain; (A.V.); (C.F.-R.); (J.P.-G.)
| | - Paul A. Nguewa
- Department of Microbiology and Parasitology, ISTUN Institute of Tropical Health, IdiSNA (Navarra Institute for Health Research), University of Navarra, E-31008 Pamplona, Navarra, Spain; (A.V.); (C.F.-R.); (J.P.-G.)
- Correspondence: ; Tel.: +34-948-425-600 (ext. 6434)
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Roatt BM, de Oliveira Cardoso JM, De Brito RCF, Coura-Vital W, de Oliveira Aguiar-Soares RD, Reis AB. Recent advances and new strategies on leishmaniasis treatment. Appl Microbiol Biotechnol 2020; 104:8965-8977. [PMID: 32875362 DOI: 10.1007/s00253-020-10856-w] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/13/2020] [Accepted: 08/23/2020] [Indexed: 12/18/2022]
Abstract
Leishmaniasis is one of the most important tropical neglected diseases according to the World Health Organization. Even after more than a century, we still have few drugs for the disease therapy and their great toxicity and side effects put in check the treatment control program around the world. Moreover, the emergence of strains resistant to conventional drugs, co-infections such as HIV/Leishmania spp., the small therapeutic arsenal (pentavalent antimonials, amphotericin B and formulations, and miltefosine), and the low investment for the discovery/development of new drugs force researchers and world health agencies to seek new strategies to combat and control this important neglected disease. In this context, the aim of this review is to summarize new advances and new strategies used on leishmaniasis therapy addressing alternative and innovative treatment paths such as physical and local/topical therapies, combination or multi-drug uses, immunomodulation, drug repurposing, and the nanotechnology-based drug delivery systems.Key points• The treatment of leishmaniasis is a challenge for global health agencies.• Toxicity, side effects, reduced therapeutic arsenal, and drug resistance are the main problems.• New strategies and recent advances on leishmaniasis treatment are urgent.• Immunomodulators, nanotechnology, and drug repurposing are the future of leishmaniasis treatment.
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Affiliation(s)
- Bruno Mendes Roatt
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, 35400-000, Brazil.,Departamento de Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, 35400-000, Brazil.,Instituto de Ciência e Tecnologia de Doenças Tropicais (INCT-DT), Salvador, Bahia, Brazil
| | - Jamille Mirelle de Oliveira Cardoso
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, 35400-000, Brazil
| | - Rory Cristiane Fortes De Brito
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, 35400-000, Brazil
| | - Wendel Coura-Vital
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, 35400-000, Brazil.,Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, 35400-00, Brazil
| | - Rodrigo Dian de Oliveira Aguiar-Soares
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, 35400-000, Brazil.,Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, 35400-00, Brazil
| | - Alexandre Barbosa Reis
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, 35400-000, Brazil. .,Instituto de Ciência e Tecnologia de Doenças Tropicais (INCT-DT), Salvador, Bahia, Brazil. .,Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, 35400-00, Brazil.
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Martínez-Flórez A, Martori C, Monteagudo PL, Rodriguez F, Alberola J, Rodríguez-Cortés A. Sirolimus enhances the protection achieved by a DNA vaccine against Leishmania infantum. Parasit Vectors 2020; 13:294. [PMID: 32517744 PMCID: PMC7282043 DOI: 10.1186/s13071-020-04165-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 06/02/2020] [Indexed: 01/10/2023] Open
Abstract
Background Leishmaniases are a group of neglected tropical parasitic diseases, mainly affecting vulnerable populations of countries with poor socioeconomic status. Development of efficient vaccines is a priority due to the increasing incidence of drug resistance and toxicity to current treatments. In the search for a safe and efficient protective vaccine for human and dog visceral leishmaniases, we analyzed the suitability of the immunomodulatory drug sirolimus (SIR) to boost a preventive DNA vaccine against leishmaniasis. SIR is an already marketed drug that has been described to boost immune protection against different disease models and has also emerged as a promising therapeutic drug against L. major. Methods Syrian hamsters were treated with SIR concomitantly with the administration of a DNA vaccine formulation consisting in four plasmids carrying the Leishmania genes LACK, TRYP, PAPLE22 and KMPII, respectively. Two weeks after the last vaccination, the animals were infected intraperitoneally with L. infantum parasites. Five weeks post-infection the parasite load was measured by real-time PCR in target tissues and immune response was evaluated by determining anti-Leishmania specific antibodies in combination with cytokine expression in the spleen. Results Our results show that the DNA vaccine itself efficiently reduced the burden of parasites in the skin (P = 0.0004) and lymph nodes (P = 0.0452). SIR administration also enhanced the protection by reducing the parasite load in the spleen (P = 0.0004). Vaccinated animals with or without SIR co-treatment showed lower IFN-γ expression levels than those found in the spleen of control animals. mRNA expression levels of NOS2 and IL-10 were found to be significantly higher in the vaccinated plus SIR treated group. Conclusions Co-administration of SIR enhances a DNA vaccination regimen against L. infantum, improving the reduction of parasite load in skin, lymph node and spleen. The analysis of immune markers in the spleen after challenge suggests that the trend to recover naïve levels of IFN-γ and IL-10, and the concurrent higher expression of NOS2, may be responsible for the protection induced by our vaccine co-administered with SIR.![]()
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Affiliation(s)
- Alba Martínez-Flórez
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Clara Martori
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Paula L Monteagudo
- Centre de Recerca En Sanitat Animal (CReSA), Institut de Recerca i Tecnologia Agroalimentàries (IRTA), Campus UAB, Bellaterra, 08193, Barcelona, Spain.,Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Fernando Rodriguez
- Centre de Recerca En Sanitat Animal (CReSA), Institut de Recerca i Tecnologia Agroalimentàries (IRTA), Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - Jordi Alberola
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Alhelí Rodríguez-Cortés
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.
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Leishmaniasis immunopathology-impact on design and use of vaccines, diagnostics and drugs. Semin Immunopathol 2020; 42:247-264. [PMID: 32152715 DOI: 10.1007/s00281-020-00788-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/03/2020] [Indexed: 12/18/2022]
Abstract
Leishmaniasis is a disease complex caused by 20 species of protozoan parasites belonging to the genus Leishmania. In humans, it has two main clinical forms, visceral leishmaniasis (VL) and cutaneous or tegumentary leishmaniasis (CL), as well as several other cutaneous manifestations in a minority of cases. In the mammalian host Leishmania parasites infect different populations of macrophages where they multiply and survive in the phagolysosomal compartment. The progression of both VL and CL depends on the maintenance of a parasite-specific immunosuppressive state based around this host macrophage infection. The complexity and variation of immune responses and immunopathology in humans and the different host interactions of the different Leishmania species has an impact upon the effectiveness of vaccines, diagnostics and drugs.
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Tunes LG, Morato RE, Garcia A, Schmitz V, Steindel M, Corrêa-Junior JD, Dos Santos HF, Frézard F, de Almeida MV, Silva H, Moretti NS, de Barros ALB, do Monte-Neto RL. Preclinical Gold Complexes as Oral Drug Candidates to Treat Leishmaniasis Are Potent Trypanothione Reductase Inhibitors. ACS Infect Dis 2020; 6:1121-1139. [PMID: 32283915 DOI: 10.1021/acsinfecdis.9b00505] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The drugs currently used to treat leishmaniases have limitations concerning cost, efficacy, and safety, making the search for new therapeutic approaches urgent. We found that the gold(I)-derived complexes were active against L. infantum and L. braziliensis intracellular amastigotes with IC50 values ranging from 0.5 to 5.5 μM. All gold(I) complexes were potent inhibitors of trypanothione reductase (TR), with enzyme IC50 values ranging from 1 to 7.8 μM. Triethylphosphine-derived complexes enhanced reactive oxygen species (ROS) production and decreased mitochondrial respiration after 2 h of exposure, indicating that gold(I) complexes cause oxidative stress by direct ROS production, by causing mitochondrial damage or by impairing TR activity and thus accumulating ROS. There was no cross-resistance to antimony; in fact, SbR (antimony-resistant mutants) strains were hypersensitive to some of the complexes. BALB/c mice infected with luciferase-expressing L. braziliensis or L. amazonensis and treated orally with 12.5 mg/kg/day of AdT Et (3) or AdO Et (4) presented reduced lesion size and parasite burden, as revealed by bioimaging. The combination of (3) and miltefosine allowed for a 50% reduction in miltefosine treatment time. Complexes 3 and 4 presented favorable pharmacokinetic and toxicity profiles that encourage further drug development studies. Gold(I) complexes are promising antileishmanial agents, with a potential for therapeutic use, including in leishmaniasis caused by antimony-resistant parasites.
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Affiliation(s)
- Luiza G. Tunes
- Instituto René Rachou/Fiocruz Minas−Fundação Oswaldo Cruz, Belo Horizonte 30190-009, Brasil
| | - Roberta E. Morato
- Instituto René Rachou/Fiocruz Minas−Fundação Oswaldo Cruz, Belo Horizonte 30190-009, Brasil
| | - Adriana Garcia
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Juiz de Fora, Juiz de Fora 36036-900, Brasil
| | - Vinicius Schmitz
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Juiz de Fora, Juiz de Fora 36036-900, Brasil
| | - Mario Steindel
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de Santa Catarina, Florianópolis 88040-900, Brasil
| | - José D. Corrêa-Junior
- Departamento de Morfologia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brasil
| | - Hélio F. Dos Santos
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Juiz de Fora, Juiz de Fora 36036-900, Brasil
| | - Frédéric Frézard
- Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brasil
| | - Mauro V. de Almeida
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Juiz de Fora, Juiz de Fora 36036-900, Brasil
| | - Heveline Silva
- Departamento de Química, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brasil
| | - Nilmar S. Moretti
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo 04023-062, Brasil
| | - André L. B. de Barros
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brasil
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Gonçalves AAM, Leite JC, Resende LA, Mariano RMDS, Silveira P, Melo-Júnior OADO, Ribeiro HS, de Oliveira DS, Soares DF, Santos TAP, Marques AF, Galdino AS, Martins-Filho OA, Dutra WO, da Silveira-Lemos D, Giunchetti RC. An Overview of Immunotherapeutic Approaches Against Canine Visceral Leishmaniasis: What Has Been Tested on Dogs and a New Perspective on Improving Treatment Efficacy. Front Cell Infect Microbiol 2019; 9:427. [PMID: 31921703 PMCID: PMC6930146 DOI: 10.3389/fcimb.2019.00427] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/29/2019] [Indexed: 12/14/2022] Open
Abstract
Visceral leishmaniasis (VL), caused by digenetic protozoa of the genus Leishmania, is the most severe form of leishmaniasis. Leishmania infantum is one of the species responsible for VL and the disease caused is considered a zoonosis whose main reservoir is the dog. Canine visceral leishmaniasis (CVL) can lead to the death of the animal if left untreated. Furthermore, the available pharmocologial treatment for CVL presents numerous disadvantages, such as relapses, toxicity, drug resistance, and the fact treated animals continue to be reservoirs when treatment fails to achieve parasitological cure. Moreover, the available VL control methods have not been adequate when it comes to controlling parasite transmission. Advances in immune response knowledge in recent years have led to a better understanding of VL pathogenesis, allowing new treatments to be developed based on immune system activation, often referred to as immunotherapy. In fact, well-defined protocols have been described, ranging from the use of immunomodulators to the use of vaccines. This treatment, which can also be associated with chemotherapy, has been shown to be effective in restoring or inducing an adequate immune response to reduce parasitic burden, leading to clinical improvement. This review focuses on immunotherapy directed at dogs infected by L. infantum, including a literature review of what has already been done in dogs. We also introduce a promising strategy to improve the efficacy of immunotherapy.
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Affiliation(s)
- Ana Alice Maia Gonçalves
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Jaqueline Costa Leite
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Lucilene Aparecida Resende
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Reysla Maria da Silveira Mariano
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Patricia Silveira
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Otoni Alves de Oliveira Melo-Júnior
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Helen Silva Ribeiro
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Diana Souza de Oliveira
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Diogo Fonseca Soares
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Thaiza Aline Pereira Santos
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Alexandre Ferreira Marques
- Laboratory of Immuno-Proteome and Parasite Biology, Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Olindo Assis Martins-Filho
- Laboratory of Diagnostic and Monitoring Biomarkers, René Rachou Institute, FIOCRUZ-Minas, Belo Horizonte, Brazil
| | - Walderez Ornelas Dutra
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Denise da Silveira-Lemos
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Rodolfo Cordeiro Giunchetti
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Cao L, Jiang W, Cao S, Zhao P, Liu J, Dong H, Guo Y, Liu Q, Gong P. In vitro leishmanicidal activity of antimicrobial peptide KDEL against Leishmania tarentolae. Acta Biochim Biophys Sin (Shanghai) 2019; 51:1286-1292. [PMID: 31761925 DOI: 10.1093/abbs/gmz128] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Indexed: 11/13/2022] Open
Abstract
Leishmaniasis, caused by the intracellular protozoan parasite Leishmania, remains an important neglected tropical infectious disease. Infection may be lethal if untreated. Currently, the available drugs for the disease are limited by high toxicity and drug resistance. There is an urgent need to develop novel anti-leishmanial strategies. Antimicrobial peptides (AMPs) have been described as the first-line immune defense against pathogenic microbes and are being developed as emerging anti-parasitic therapies. In the present study, we showed the anti-leishmanial activity of the synthetic 4-amino acid peptide lysine, aspartic acid, glutamic acid, and leucine (KDEL), the endoplasmic reticulum retention sequence, against Leishmania tarentolae promastigote and amastigote. Different concentrations of KDEL peptides were incubated with promastigotes, MTT viability assay, and promastigote assay were carried out. Macrophages infected with GFP-transfected L. tarentolae promastigotes were incubated with KDEL peptides, and the anti-amastigote activity of the KDEL peptides was measured by fluorescence microscopy. The damage of L. tarentolae was observed by light microscopy and electron microscopy. The cell apoptosis was analyzed using the Annexin V-FITC/PI apoptosis detection kit and mitochondrial membrane potential assay kit and by flow cytometry. Results showed that L. tarentolae was susceptible to KDEL peptides in a dose-dependent manner, and KDEL peptides disrupted the surface membrane integrity and caused cell apoptosis. In our study, we found for the first time an AMP KDEL from Pseudomonas aeruginosa and proved its significant therapeutic potential as a novel anti-leishmanial drug.
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Affiliation(s)
- Lili Cao
- Key Laboratory of Zoonosis Research by Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
- Department of Parasite, Jilin Academy of Animal Husbandry and Veterinary Medicine, Changchun 130062, China
| | - Weina Jiang
- Department of Pathology, Qingdao Municipal Hospital, Qingdao 266071, China
| | - Songgao Cao
- Pingdu People’s Hospital, Qingdao 266700, China
| | - Panpan Zhao
- Key Laboratory of Zoonosis Research by Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Juan Liu
- Pingdu People’s Hospital, Qingdao 266700, China
| | - Hang Dong
- Department of Parasite, Jilin Academy of Animal Husbandry and Veterinary Medicine, Changchun 130062, China
| | - Yanbing Guo
- Department of Parasite, Jilin Academy of Animal Husbandry and Veterinary Medicine, Changchun 130062, China
| | - Quan Liu
- College of Life Sciences and Engineering, Foshan University, Foshan 528000, China
| | - Pengtao Gong
- Key Laboratory of Zoonosis Research by Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
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Serbate Borges Portela Á, Margotto Bertollo C, da Silva Praxedes MF, Silva Brasileiro SA, Moreira Reis AM, Parreiras Martins MA. Adverse reactions to meglumine antimoniate in Brazilian inpatients with visceral leishmaniases: A case series. J Clin Pharm Ther 2019; 45:573-576. [PMID: 31793023 DOI: 10.1111/jcpt.13089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/30/2019] [Accepted: 11/07/2019] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVES Adverse drug reactions (ADR) related to the treatment of visceral leishmaniasis (VL) can cause severe clinical complications. We report a case series of ADR in hospitalized VL patients on meglumine antimoniate (MA). CASE DESCRIPTION Seven cases of patients taking MA had at least one objective evidence for suspected ADR, including electrocardiographic, laboratory or clinical alteration. WHAT IS NEW AND CONCLUSION Meglumine antimoniate is highly toxic. Adherence to treatment guidelines is important. Pharmacists working in multidisciplinary teams may contribute to early detection and management of MA therapy-related ADR.
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Affiliation(s)
| | | | - Marcus Fernando da Silva Praxedes
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus, Brazil
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43
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de Souza LMB, Carvalho J, Bates MD, Petterle RR, Thomaz-Soccol V, Bates PA. Production of a kinesin-related recombinant protein (Lbk39) from Leishmania braziliensis by Leishmania tarentolae promastigotes and its application in the serodiagnosis of leishmaniasis. One Health 2019; 8:100111. [PMID: 31788531 PMCID: PMC6879997 DOI: 10.1016/j.onehlt.2019.100111] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/22/2019] [Accepted: 10/29/2019] [Indexed: 11/24/2022] Open
Abstract
The leishmaniases are multifactorial zoonotic diseases requiring a multidisciplinary One Health approach for diagnosis and control. For leishmaniasis diagnosis, here we describe production of a new recombinant protein based on a kinesin-related gene of Leishmania braziliensis (Lbk39), which shows 59% amino acid identity to the L. infantum homologue. The Lbk39 gene was synthesized, inserted into the pLEXSY-sat2 vector and transfected into L. tarentolae cells by electroporation. Culturing was carried out, and the secreted recombinant protein with a C-terminal histidine tag purified using nickel affinity chromatography on the culture supernatant, yielding a final product at 0.4 mg/mL. An indirect enzyme linked immunosorbent assay (ELISA) was standardised using sera from 74 Brazilian patients with cutaneous leishmaniasis and 11 with visceral leishmaniasis. Optimal ELISA conditions were established for the Lbk39 antigen in comparison with a crude extract from L. braziliensis. The sensitivity, specificity analysis and receiver operating characteristic (ROC) curve were determined with a significance level of 5%. The ROC curve showed a good accuracy with an area under curve (AUC) = 0.967, p < 0.001 (0.941-0.993) for CL patients and an AUC = 100 (100-100) for VL patients. The values of sensitivity and specificity were 88 and 98% for CL and 100 and 100% for VL, respectively. The study showed good production and expression of the target protein and has generated a potential new antigen for the diagnosis of leishmaniasis.
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Affiliation(s)
- Lígia Moraes Barizon de Souza
- Laboratory of Molecular Biology, Department of Bioprocess Engineering and Biotechnology, Universidade Federal do Paraná, Avenida Coronel Francisco Heráclito dos Santos, 210 – Usina Piloto B, 81531-970 Curitiba, Paraná, Brazil
| | - Joyce Carvalho
- Laboratory of Molecular Biology, Department of Bioprocess Engineering and Biotechnology, Universidade Federal do Paraná, Avenida Coronel Francisco Heráclito dos Santos, 210 – Usina Piloto B, 81531-970 Curitiba, Paraná, Brazil
| | - Michelle D. Bates
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YQ, UK
| | - Ricardo Rasmussen Petterle
- Nucleus of Medical Education, Department of Community Health, Universidade Federal do Paraná, Rua Padre Camargo, 280 – 7th floor, 80060-240 Curitiba, Paraná, Brazil
| | - Vanete Thomaz-Soccol
- Laboratory of Molecular Biology, Department of Bioprocess Engineering and Biotechnology, Universidade Federal do Paraná, Avenida Coronel Francisco Heráclito dos Santos, 210 – Usina Piloto B, 81531-970 Curitiba, Paraná, Brazil
| | - Paul Andrew Bates
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YQ, UK
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Johansen MB, Jemec GB, Fabricius S. Effective treatment with photodynamic therapy of cutaneous leishmaniasis: A case report. Dermatol Ther 2019; 32:e13022. [DOI: 10.1111/dth.13022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 07/04/2019] [Accepted: 07/11/2019] [Indexed: 12/22/2022]
Affiliation(s)
| | - Gregor B.E. Jemec
- Department of DermatologyZealand University Hospital Roskilde Denmark
| | - Susanne Fabricius
- Department of DermatologyZealand University Hospital Roskilde Denmark
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Route map for the discovery and pre-clinical development of new drugs and treatments for cutaneous leishmaniasis. INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE 2019; 11:106-117. [PMID: 31320296 PMCID: PMC6904839 DOI: 10.1016/j.ijpddr.2019.06.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/16/2019] [Accepted: 06/17/2019] [Indexed: 12/11/2022]
Abstract
Although there have been significant advances in the treatment of visceral leishmaniasis (VL) and several novel compounds are currently in pre-clinical and clinical development for this manifestation of leishmaniasis, there have been limited advances in drug research and development (R & D) for cutaneous leishmaniasis (CL). Here we review the need for new treatments for CL, describe in vitro and in vivo assays, models and approaches taken over the past decade to establish a pathway for the discovery, and pre-clinical development of new drugs for CL. These recent advances include novel mouse models of infection using bioluminescent Leishmania, the introduction of PK/PD approaches to skin infection, and defined pre-clinical candidate profiles.
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Abdossamadi Z, Taheri T, Seyed N, Montakhab-Yeganeh H, Zahedifard F, Taslimi Y, Habibzadeh S, Gholami E, Gharibzadeh S, Rafati S. Live Leishmania tarentolae secreting HNP1 as an immunotherapeutic tool against Leishmania infection in BALB/c mice. Immunotherapy 2018; 9:1089-1102. [PMID: 29032739 DOI: 10.2217/imt-2017-0076] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
AIM Several disadvantages about chemotherapy for leishmaniasis has reinforced discovery of novel therapeutic agents especially immunotherapeutics. HNP1, as a member of the mammalian antimicrobial peptides family, is an attractive molecule due to its broad functional spectrum. Here, the in vivo potency of HNP1 in transgenic Leishmania tarentolae as an immunotherapy tool against Leishmania major-infected BALB/c mice was examined. METHODS & RESULTS 3 weeks after infection with L. major, the treatment effect of L. tarentolae-HNP1-EGFP was pursued. The results were promising in respect to parasite load control and Th1 immune response polarization compared with controls. CONCLUSION Immunotherapy by live L. tarentolae secreting HNP1 can elicit cellular immune response in a susceptible mouse model in order to control L. major infection.
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Affiliation(s)
- Zahra Abdossamadi
- Department of Immunotherapy & Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran, 13194
| | - Tahereh Taheri
- Department of Immunotherapy & Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran, 13194
| | - Negar Seyed
- Department of Immunotherapy & Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran, 13194
| | - Hossein Montakhab-Yeganeh
- Department of Immunotherapy & Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran, 13194
| | - Farnaz Zahedifard
- Department of Immunotherapy & Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran, 13194
| | - Yasaman Taslimi
- Department of Immunotherapy & Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran, 13194
| | - Sima Habibzadeh
- Department of Immunotherapy & Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran, 13194
| | - Elham Gholami
- Department of Immunotherapy & Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran, 13194
| | - Safoora Gharibzadeh
- Department of Epidemiology & Biostatistics, Pasteur institute of Iran, Tehran, Iran
| | - Sima Rafati
- Department of Immunotherapy & Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran, 13194
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Akuffo H, Costa C, van Griensven J, Burza S, Moreno J, Herrero M. New insights into leishmaniasis in the immunosuppressed. PLoS Negl Trop Dis 2018; 12:e0006375. [PMID: 29746470 PMCID: PMC5944929 DOI: 10.1371/journal.pntd.0006375] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Immunosuppression contributes significantly to the caseload of visceral leishmaniasis (VL). HIV coinfection, solid organ transplantation, malnutrition, and helminth infections are the most important immunosuppression-related factors. This review briefly describes the challenges of these associations. East Africa and the Indian subcontinent are the places where HIV imposes the highest burden in VL. In the highlands of Northern Ethiopia, migrant rural workers are at a greater risk of coinfection and malnutrition, while in India, HIV reduces the sustainability of a successful elimination programme. As shown from a longitudinal cohort in Madrid, VL is an additional threat to solid organ transplantation. The association with malnutrition is more complex since it can be both a cause and a consequence of VL. Different regimes for therapy and secondary prevention are discussed as well as the role of nutrients on the prophylaxis of VL in poverty-stricken endemic areas.
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Affiliation(s)
- Hannah Akuffo
- Swedish International Development Agency (Sida), and Microbiology, Tumor and Cell biology (MTC), Karolinska Institutet, Solna, Sweden
| | - Carlos Costa
- Federal University of Piauí, Teresina-PI, Brazil
- * E-mail:
| | - Johan van Griensven
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Javier Moreno
- World Health Centre (WHO) Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Herrero
- Leishmaniasis, IDM Unit, Neglected Tropical Diseases, WHO, Geneva, Switzerland
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Clemente WT, Mourão PHO, Aguado JM. Current approaches to visceral leishmaniasis treatment in solid organ transplant recipients. Expert Rev Anti Infect Ther 2018; 16:391-397. [PMID: 29737887 DOI: 10.1080/14787210.2018.1473763] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The increasing number of transplants performed worldwide and the growing global mobility with migration and travel to and from developing countries and tropical areas are bringing new challenges for the management of transplant infectious diseases, previously less commonly seen, such as Leishmaniasis. However, in this scenario there is a lack of information and the current knowledge is based on a few studies. The selection of the most appropriate treatment depends on various factors, such as patient profile, Leishmania species, disease extent, drug availability, concomitant infections and previous treatments. Therapeutic options may include different formulations of amphotericin B, pentavalent antimonials, miltefosine and paromomycin, among others. These drugs can be used alone or in combination. Areas covered: This review is a practical guide for Visceral Leishmaniasis (VL) specific treatment in solid organ transplant recipients (SOT), including therapeutic options and assessment of therapy response. Expert commentary: The main challenges for treatment of leishmaniasis in SOT recipients are related to the duration of therapy, curative criteria and secondary prophylaxis. Immunosuppression dose reduction is often recommended, but such decisions must be made on an individual basis. At present, Liposomal Amphotericin B is the best choice for treatment and prophylaxis.
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Affiliation(s)
- Wanessa Trindade Clemente
- a Faculty of Medicine, Departamento de Propedêutica Complementar , Federal University of Minas Gerais (UFMG) , Belo Horizonte , Minas Gerais , Brazil
| | | | - Jose María Aguado
- c Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid , Madrid , Comunidad de Madrid , Spain
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KARUNAWEERA NADIRAD, FERREIRA MARCELOU. Leishmaniasis: current challenges and prospects for elimination with special focus on the South Asian region. Parasitology 2018; 145:425-429. [PMID: 29642962 PMCID: PMC5984138 DOI: 10.1017/s0031182018000471] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Leishmania donovani, the most virulent species of Leishmania, is found in the South Asian region that harbours the majority of visceral leishmaniasis (VL) cases in the world. The traditionally accepted relationships between the causative species of Leishmania and the resultant disease phenotype have been challenged during recent years and have underscored the importance of revisiting the previously established taxonomy with revisions to its classification. The weak voice of the afflicted with decades of neglect by scientists and policy makers have led to the miserably inadequate and slow advancements in product development in the fields of diagnostics, chemotherapeutics and vector control that continue to hinder the effective management and control of this infection. Limitations notwithstanding, the regional drive for the elimination of VL initiated over a decade ago that focused on India, Nepal and Bangladesh, the three main afflicted countries in the Indian subcontinent is therefore, commendable, with the subsequent status reviews and restructuring of strategies possibly even more so. However, the renewed efforts would need to be combined with plans to combat new challenges in the South-Asian region that includes the emergence of atypical parasite variants, in order to realistically achieve the set goal of regional elimination of VL.
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Affiliation(s)
| | - MARCELO U FERREIRA
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, Brazil
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50
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Adriaensen W, Dorlo TPC, Vanham G, Kestens L, Kaye PM, van Griensven J. Immunomodulatory Therapy of Visceral Leishmaniasis in Human Immunodeficiency Virus-Coinfected Patients. Front Immunol 2018; 8:1943. [PMID: 29375567 PMCID: PMC5770372 DOI: 10.3389/fimmu.2017.01943] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/18/2017] [Indexed: 12/23/2022] Open
Abstract
Patients with visceral leishmaniasis (VL)–human immunodeficiency virus (HIV) coinfection experience increased drug toxicity and treatment failure rates compared to VL patients, with more frequent VL relapse and death. In the era of VL elimination strategies, HIV coinfection is progressively becoming a key challenge, because HIV-coinfected patients respond poorly to conventional VL treatment and play an important role in parasite transmission. With limited chemotherapeutic options and a paucity of novel anti-parasitic drugs, new interventions that target host immunity may offer an effective alternative. In this review, we first summarize current views on how VL immunopathology is significantly affected by HIV coinfection. We then review current clinical and promising preclinical immunomodulatory interventions in the field of VL and discuss how these may operate in the context of a concurrent HIV infection. Caveats are formulated as these interventions may unpredictably impact the delicate balance between boosting of beneficial VL-specific responses and deleterious immune activation/hyperinflammation, activation of latent provirus or increased HIV-susceptibility of target cells. Evidence is lacking to prioritize a target molecule and a more detailed account of the immunological status induced by the coinfection as well as surrogate markers of cure and protection are still required. We do, however, argue that virologically suppressed VL patients with a recovered immune system, in whom effective antiretroviral therapy alone is not able to restore protective immunity, can be considered a relevant target group for an immunomodulatory intervention. Finally, we provide perspectives on the translation of novel theories on synergistic immune cell cross-talk into an effective treatment strategy for VL–HIV-coinfected patients.
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Affiliation(s)
- Wim Adriaensen
- Unit of HIV and Neglected Tropical Diseases, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Thomas P C Dorlo
- Department of Pharmacy and Pharmacology, Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Guido Vanham
- Unit of Virology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Luc Kestens
- Unit of Immunology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Paul M Kaye
- Centre for Immunology and Infection, Department of Biology, Hull York Medical School, University of York, Heslington, York, United Kingdom
| | - Johan van Griensven
- Unit of HIV and Neglected Tropical Diseases, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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