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Rossi NRDLP, Fialho SN, Gouveia ADJ, Ferreira AS, da Silva MA, Martinez LDN, Paula do Nascimento WDS, Gonzaga A, de Medeiros DSS, de Barros NB, de Cássia Alves R, Gonçalves GM, Teles CGB. Quinine and chloroquine: Potential preclinical candidates for the treatment of tegumentary Leishmaniasis. Acta Trop 2024; 252:107143. [PMID: 38331084 DOI: 10.1016/j.actatropica.2024.107143] [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: 11/21/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/10/2024]
Abstract
Leishmaniasis is an endemic disease in more than 90 countries, constituting a relevant public health problem. Limited treatment options, increase in resistance, and therapeutic failure are important aspects for the discovery of new treatment options. Drug repurposing may accelerate the discovery of antiLeishmanial drugs. Recent tests indicating the in vitro potential of antimalarials Leishmania resulted in the design of this study. This study aimed at evaluating the susceptibility of Leishmania (L.) amazonensis to chloroquine (CQ) and quinine (QN), alone or in combination with amphotericin B (AFT) and pentamidine (PTN). In the in vitro tests, first, we evaluated the growth inhibition of 50 % of promastigotes (IC50) and cytotoxicity for HepG2 and THP-1 cells (CC50). The IC50 values of AFT and PNT were below 1 µM, while the IC50 values of CQ and QN ranged between 4 and 13 µM. Concerning cytotoxicity, CC50 values ranged between 7 and 30 µM for AFT and PNT, and between 22 and 157 µM for the antimalarials. We also calculated the Selectivity Index (SI), where AFT and PTN obtained the highest values, while the antimalarias obtained values between 5 and 12. Both antimalarials were additive (ƩFIC 1.05-1.8) in combination with AFT and PTN. For anti-amastigote activity, the drugs obtained the following ICA50 values: AFT (0.26 µM), PNT (2.09 µM), CQ (3.77 µM) and QN (24.5 µM). In the in vivo tests, we observed that the effective dose for the death of 50 % of parasites (ED50) of AFT and CQ were 0.63 mg/kg and 27.29 mg/kg, respectively. When combining CQ with AFT, a decrease in parasitemia was observed, being statistically equal to the naive group. For cytokine quantification, it was observed that CQ, despite presenting anti-inflammatory activity was effective at increasing the production of IFN-γ. Overall, our data indicate that chloroquine will probably be a candidate for repurposing and use in drug combination therapy.
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Affiliation(s)
- Norton Rubens Diunior Lucas Pejara Rossi
- Programa de Pós-Graduação em Biologia Experimental (PGBIOEXP), Fundação Universidade Federal de Rondônia (UNIR), Porto Velho, RO, Brazil; Plataforma de Bioensaios de Malária e Leishmaniose (PBML), Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; Instituto Nacional de Epidemiologia da Amazônia Ocidental - EpiAmO, Brazil.
| | - Saara Neri Fialho
- Plataforma de Bioensaios de Malária e Leishmaniose (PBML), Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; São Lucas Educacional-Afya, Porto Velho, RO, Brazil; Instituto Nacional de Epidemiologia da Amazônia Ocidental - EpiAmO, Brazil; Programa de Pós-Graduação em Biodiversidade e Biotecnologia da Amazônia Legal - BIONORTE, Porto Velho, RO, Brazil
| | - Aurileya de Jesus Gouveia
- Plataforma de Bioensaios de Malária e Leishmaniose (PBML), Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; Instituto Nacional de Epidemiologia da Amazônia Ocidental - EpiAmO, Brazil
| | - Amália Santos Ferreira
- Plataforma de Bioensaios de Malária e Leishmaniose (PBML), Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; Instituto Nacional de Epidemiologia da Amazônia Ocidental - EpiAmO, Brazil
| | | | - Leandro Do Nascimento Martinez
- Programa de Pós-Graduação em Biologia Experimental (PGBIOEXP), Fundação Universidade Federal de Rondônia (UNIR), Porto Velho, RO, Brazil; Plataforma de Bioensaios de Malária e Leishmaniose (PBML), Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; São Lucas Educacional-Afya, Porto Velho, RO, Brazil; Instituto Nacional de Epidemiologia da Amazônia Ocidental - EpiAmO, Brazil
| | - Welington da Silva Paula do Nascimento
- Programa de Pós-Graduação em Biologia Experimental (PGBIOEXP), Fundação Universidade Federal de Rondônia (UNIR), Porto Velho, RO, Brazil; Plataforma de Bioensaios de Malária e Leishmaniose (PBML), Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; Instituto Nacional de Epidemiologia da Amazônia Ocidental - EpiAmO, Brazil
| | - Arlindo Gonzaga
- Plataforma de Bioensaios de Malária e Leishmaniose (PBML), Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; Programa de Pós-Graduação em Biodiversidade e Biotecnologia da Amazônia Legal - BIONORTE, Porto Velho, RO, Brazil
| | | | | | | | - Giselle Martins Gonçalves
- Programa de Pós-Graduação em Biologia Experimental (PGBIOEXP), Fundação Universidade Federal de Rondônia (UNIR), Porto Velho, RO, Brazil
| | - Carolina Garcia Bioni Teles
- Programa de Pós-Graduação em Biologia Experimental (PGBIOEXP), Fundação Universidade Federal de Rondônia (UNIR), Porto Velho, RO, Brazil; Plataforma de Bioensaios de Malária e Leishmaniose (PBML), Fundação Oswaldo Cruz, FIOCRUZ, Unidade Rondônia, Porto Velho, RO, Brazil; São Lucas Educacional-Afya, Porto Velho, RO, Brazil; Instituto Nacional de Epidemiologia da Amazônia Ocidental - EpiAmO, Brazil; Programa de Pós-Graduação em Biodiversidade e Biotecnologia da Amazônia Legal - BIONORTE, Porto Velho, RO, Brazil
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Profiro de Oliveira JH, Arruda IES, Izak Ribeiro de Araújo J, Chaves LL, de La Rocca Soares MF, Soares-Sobrinho JL. Why do few drug delivery systems to combat neglected tropical diseases reach the market? An analysis from the technology's stages. Expert Opin Ther Pat 2021; 32:89-114. [PMID: 34424127 DOI: 10.1080/13543776.2021.1970746] [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: 10/20/2022]
Abstract
INTRODUCTION Many drugs used to combat schistosomiasis, Chagas disease, and leishmaniasis (SCL) have clinical limitations such as: high toxicity to the liver, kidneys and spleen; reproductive, gastrointestinal, and heart disorders; teratogenicity. In this sense, drug delivery systems (DDSs) have been described in the literature as a viable option for overcoming the limitations of these drugs. An analysis of the level of development (TRL) of patents can help in determine the steps that must be taken for promising technologies to reach the market. AREAS COVERED This study aimed to analyze the stage of development of DDSs for the treatment of SCL described in patents. In addition, we try to understand the main reasons why many DDSs do not reach the market. In this study, we examined DDSs for drugs indicated by WHO and treatment of SCL, by performing a search for patents. EXPERT OPINION In this present work we provide arguments that support the hypothesis that there is a lack of integration between academia and industry to finance and continue research, especially the development of clinical studies. We cite the translational research consortia as the potential alternative for developing DDSs to combat NTDs.
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Affiliation(s)
| | | | | | - Luise Lopes Chaves
- Department of Pharmacy, Federal University of Pernambuco, Recife, Recife-Pernambuco
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Praziquantel in a clay nanoformulation shows more bioavailability and higher efficacy against murine Schistosoma mansoni infection. Antimicrob Agents Chemother 2015; 59:3501-8. [PMID: 25845870 DOI: 10.1128/aac.04875-14] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 03/29/2015] [Indexed: 12/15/2022] Open
Abstract
Consideration of existing compounds always simplifies and shortens the long and difficult process of discovering new drugs specifically for diseases of developing countries, an approach that may add to the significant potential cost savings. This study focused on improving the biological characteristics of the already-existing antischistosomal praziquantel (PZQ) by incorporating it into montmorillonite (MMT) clay as a delivery carrier to overcome its known bioavailability drawbacks. The oral bioavailability of a PZQ-MMT clay nanoformulation and its in vivo efficacy against Schistosoma mansoni were investigated. The PZQ-MMT clay nanoformulation provided a preparation with a controlled release rate, a decrease in crystallinity, and an appreciable reduction in particle size. Uninfected and infected mice treated with PZQ-MMT clay showed 3.61- and 1.96-fold and 2.16- and 1.94-fold increases, respectively, in area under the concentration-time curve from 0 to 8 h (AUC0-8) and maximum concentration of drug in serum (Cmax), with a decrease in elimination rate constant (kel) by 2.84- and 1.35-fold and increases in the absorption rate constant (ka) and half-life (t1/2e) by 2.11- and 1.51-fold and 2.86- and 1.34-fold, respectively, versus the corresponding conventional PZQ-treated groups. This improved bioavailability has been expressed in higher efficacy of the drug, where the dose necessary to kill 50% of the worms was reduced by >3-fold (PZQ 50% effective dose [ED50] was 20.25 mg/kg of body weight for PZQ-MMT clay compared to 74.07 mg/kg for conventional PZQ), with significant reduction in total tissue egg load and increase in total immature, mature, and dead eggs in most of the drug-treated groups. This formulation showed better bioavailability, enhanced antischistosomal efficacy, and a safer profile despite the longer period of residence in the systemic circulation. Although the conventional drug's toxicity was not examined, animal mortality rates were not different between groups receiving the test PZQ-clay nanoformulation and conventional PZQ.
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Bergquist NR, Leonardo LR, Mitchell GF. Vaccine-linked chemotherapy: can schistosomiasis control benefit from an integrated approach? Trends Parasitol 2005; 21:112-7. [PMID: 15734657 DOI: 10.1016/j.pt.2005.01.001] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present strong emphasis on gross organ pathology (liver, kidneys, bladder) in schistosomiasis needs to be replaced with a more balanced view of the disease that also takes into account systemic symptoms that are less easy to assess, such as retarded growth, cognitive development and the effect of continuing low-level blood loss. Access to better estimates of disease burdens, morbidity and mortality is delivering results that bring into question the wisdom of downgrading the impact of the disease. In this scenario, the simplistic approach of exclusive drug treatment might not be sufficient and, in the worst-case scenario, might even exacerbate pathology. To meet this challenge, the repositioning of vaccines within the totality of disease control through the combined use of chemotherapy and vaccination is recommended as the basis for a novel, more-versatile approach to control. Studies on human correlate responses in endemic areas have opened the way to assess the protective value of specific antigens through the cytokine responses and antibodies they elicit. Moreover, vaccine formulations based on novel adjuvants could improve the final outcome through selective manipulation of the immune response. Thus, the tools of vaccine-linked chemotherapy are in principle already available and could shortly be put to the test in clinical trials.
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Abstract
This special supplement of Nature Medicine, directed at the topic of emerging infectious diseases, is very timely. Recent high-profile outbreaks have highlighted the global risk that infectious agents, both new and old, represent for society. The experience of severe acute respiratory syndrome (SARS) shows the risk posed by emerging infectious diseases, but also the power of strongly coordinated global surveillance and public health measures, coupled with scientific research, to keep infection under control1,2. Diseases such as drug-resistant malaria continue to be threats. There is a need to enhance global resources to investigate, detect and respond to emerging infections, and to appropriately coordinate and direct research efforts to meet the challenges presented by these diseases.
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Affiliation(s)
- Robert G Ridley
- UNICEF/UNDP/World Bank Special Program for Research and Training on Tropical Diseases, World Health Organization, Geneva, Switzerland.
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