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Siewe N, Friedman A. Treatment of leishmaniasis with chemotherapy and vaccine: a mathematical model. JOURNAL OF BIOLOGICAL DYNAMICS 2023; 17:2257746. [PMID: 37733407 DOI: 10.1080/17513758.2023.2257746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023]
Abstract
Leishmaniasis, an infectious disease, manifests itself mostly in two forms, cutaneous leishmaniasis (CL) and, a more severe and potentially deadly form, visceral leishmaniasis (VL). The current control strategy for leishmaniasis relies on chemotherapy drugs such as sodium antimony gluconate (SAG) and meglumine antimoniate (MA). However, all these chemotherapy compounds have poor efficacy, and they are associated with toxicity and other adverse effects, as well as drug resistance. While research in vaccine development for leishmaniasis is continuously progressing, no vaccine is currently available. However, some experimental vaccines such as LEISH-F1+MPL-SE (V) have demonstrated some efficacy when used as drugs for CL patients. In this paper we use a mathematical model to address the following question: To what extent vaccine shots can enhance the efficacy of standard chemotherapy treatment of leishmaniasis? Starting with standard MA treatment of leishmaniasis and combining it with three injections of V , we find, by Day 84, that efficacy increased from 29% to 65-91% depending on the amount of the vaccine. With two or just one injection of V , efficacy is still very high, but there is a definite resurgence of the disease by end-time.
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Affiliation(s)
- Nourridine Siewe
- School of Mathematical Sciences, College of Science, Rochester Institute of Technology, Rochester, NY, USA
| | - Avner Friedman
- Department of Mathematics, The Ohio State University, Columbus, OH, USA
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Saah SA, Sakyi PO, Adu-Poku D, Boadi NO, Djan G, Amponsah D, Devine RNOA, Ayittey K. Docking and Molecular Dynamics Identify Leads against 5 Alpha Reductase 2 for Benign Prostate Hyperplasia Treatment. J CHEM-NY 2023. [DOI: 10.1155/2023/8880213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Steroid 5 alpha-reductase 2 (5αR-2) is a membrane-embedded protein that together with other isoforms plays a key role in the metabolism of steroids. This enzyme catalyzes the reduction of testosterone to the more potent ligand, dihydrotestosterone (DHT) in the prostate. Androgens, testosterone, and DHT play important roles in prostate growth, development, and function. At the same time, both testosterone and DHT have been implicated in the pathogenesis of benign prostate hyperplasia (BPH). Inhibition of the DHT formation, therefore, provides a therapeutic strategy that offers the possibility of preventing, delaying, or treating BPH. Currently, two steroidal drugs that inhibit 5αR-2, dutasteride and finasteride, have been approved for clinical use. These two come at a high cost and also portray undesirable sexual side effects which necessitate the need to find new chemotherapeutic alternatives for the disease. Based on the aforementioned, finasteride and dutasteride were subjected to scaffold hopping, fragment-based de novo design, molecular docking, and molecular dynamics simulations employing databases like ChEMBL, DrugBank, PubChem, ChemSpider, and Zinc15 in the identification of potential hits targeting 5αR-2. Altogether, ten novel compounds targeting 5αR-2 were identified with binding energies lower or comparable to finasteride and dutasteride, the main inhibitors for this target. Molecular docking and molecular dynamics simulations studies identify amino acid residues Glu57, Phe219, Phe223, and Leu224 to be critical for ligand binding and complex stability. The physicochemical and pharmacological profiling suggests the potential of the hit compounds to be drug-like and orally active. Similarly, the quality parameter assessments revealed the hits possess LELP greater than 3 implying their promise as lead-like molecules. The compounds A5, A9, and A10 were, respectively, predicted to treat prostate disorders with Pa (0.188, 0.361, and 0.270) and Pi (0.176, 0.050, and 0.093), while A8 and A9 were found to be associated with BPH treatment with Pa (0.09 and 0.127) and Pi (0.077 and 0.033), respectively. Structural similarity searches via DrugBank identified the drugs faropenem, acemetacin, estradiol valerate, and yohimbine to be useful for BPH treatment suggesting the de novo designed ligands as potential chemotherapeutic agents for treating this disease.
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Meira RDMV, Gomes SLDS, Schaeffer E, Da Silva T, Brito ACDS, Siqueira LM, Inácio JD, Almeida-Amaral EE, Da-Cruz AM, Bezerra-Paiva M, Neves RH, Rodrigues LS, Dutra PML, Costa PRR, da Silva AJM, Da-Silva SAG. Low doses of 3-phenyl-lawsone or meglumine antimoniate delivery by tattooing route are successful in reducing parasite load in cutaneous lesions of Leishmania ( Viannia) braziliensis-infected hamsters. Front Cell Infect Microbiol 2023; 13:1025359. [PMID: 36743305 PMCID: PMC9892647 DOI: 10.3389/fcimb.2023.1025359] [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: 08/22/2022] [Accepted: 01/02/2023] [Indexed: 01/20/2023] Open
Abstract
Current therapeutic ways adopted for the treatment of leishmaniasis are toxic and expensive including parasite resistance is a growing problem. Given this scenario, it is urgent to explore treatment alternatives for leishmaniasis. The aim of this study was to evaluate the effect of 3-phenyl-lawsone (3-PL) naphthoquinone on Leishmania (Viannia) braziliensis infection, both in vitro and in vivo, using two local routes of administration: subcutaneous (higher dose) and tattoo (lower dose). In vitro 3-PL showed low toxicity for macrophages (CC50 >3200 µM/48h) and activity against intracellular amastigotes (IC50 = 193 ± 19 µM/48h) and promastigotes (IC50 = 116 ± 26 µM/72h), in which induced increased ROS generation. Additionally, 3-PL up-regulated the production of cytokines such as tumor necrosis factor alpha (TNF-α), monocyte chemotactic protein 1 (MCP-1), interleukin-6 (IL-6) and IL-10 in infected macrophages. However, the anti-amastigote action was independent of nitric oxide production. Treatment of hamsters infected with L. (V.) braziliensis from one week after infection with 3-PL by subcutaneous (25 µg/Kg) or tattooing (2.5 µg/Kg) route, during 3 weeks (3 times/week) or 2 weeks (2 times/week) significantly decreased the parasite load (p<0.001) in the lesion. The reduction of parasite load by 3-PL treatment was comparable to reference drug meglumine antimoniate administered by the same routes (subcutaneous 1mg/Kg and tattoo 0.1mg/Kg). In addition, treatment started from five weeks after infection with 3-PL per tattoo also decreased the parasite load. These results show the anti-leishmanial effect of 3-PL against L. (V.) braziliensis and its efficacy by subcutaneous (higher dose) and tattoo (lower dose) routes. In addition, this study shows that drug delivery by tattooing the lesion allows the use of lower doses than the conventional subcutaneous route, which may support the development of a new therapeutic strategy that can be adopted for leishmaniasis.
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Affiliation(s)
| | - Sara Lins da Silva Gomes
- Laboratório de Catálise Orgânica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Edgar Schaeffer
- Laboratório de Catálise Orgânica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thayssa Da Silva
- Laboratório de Imunofarmacologia Parasitária, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Larissa Moreira Siqueira
- Laboratório de Imunofarmacologia Parasitária, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Job Domingos Inácio
- Laboratório de Bioquímica de Tripanosomatídeos, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Alda Maria Da-Cruz
- Disciplina de Parasitologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil,Laboratório Interdisciplinar de Pesquisas Médicas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Milla Bezerra-Paiva
- Laboratório Interdisciplinar de Pesquisas Médicas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Renata Heisler Neves
- Laboratório de Helmintologia Romero Lascasas Porto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luciana Silva Rodrigues
- Laboratório de Imunopatologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Silvia Amaral Gonçalves Da-Silva
- Laboratório de Imunofarmacologia Parasitária, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil,*Correspondence: Silvia Amaral Gonçalves Da-Silva,
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In-Vitro Leishmanicidal Activity and Molecular Docking Simulations of a Flavonoid Isolated from Pistacia integerrima Stew ex Brandis. J FOOD QUALITY 2022. [DOI: 10.1155/2022/6003869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Pistacia integerrima Stew ex Brandis is a valued medicinal plant used for curing various diseases such as diarrhea, fever, liver disorder, pain, asthma, and inflammation. The aim of this study was the isolation of bioactive leishmanicidal agents from the methanolic extract. The methanolic extract led to the isolation of flavonoids 3,5,7,4/-tetrahydroxy-flavanone (1). The extract and isolated compound 1 were tested for antileishmanial effect. The extract showed a percent effect of 63.09 with an IC50 value (49.32 µM). The isolated compound 1 was more leishmanicidal than the extract with a percent growth inhibition of 68.09. We have performed docking studies on two antileishmanial targets; homology modeled dihydrofolate reductase (DHFR) and pteridine reductase (PTR1) from Leishmania major (L. major). Interaction with important residues of the studied enzymes revealed the possible mechanism of in-vitro activity against promastigotes of L. major.
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Gurjar D, Kumar Patra S, Bodhale N, Lenka N, Saha B. Leishmania intercepts IFN-γR signaling at multiple levels in macrophages. Cytokine 2022; 157:155956. [PMID: 35785668 DOI: 10.1016/j.cyto.2022.155956] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/13/2022] [Accepted: 06/24/2022] [Indexed: 11/26/2022]
Abstract
IFN-γ, a type 2 interferon and a cytokine, is critical for both innate and adaptive immunity. IFN-γ binds to the IFN-γRs on the cell membrane of macrophages, signals through JAK1-STAT-1 pathway and induces IFN-γ-stimulated genes (ISGs). As Leishmania amastigotes reside and replicate within macrophages, IFN-γ mediated macrophage activation eventuate in Leishmania elimination. As befits the principle of parasitism, the impaired IFN-γ responsiveness in macrophages ensures Leishmania survival. IFN-γ responsiveness is a function of integrated molecular events at multiple levels in the cells that express IFN-γ receptors. In Leishmania-infected macrophages, reduced IFN-γRα expression, impaired IFN-γRα and IFN-γRβ hetero-dimerization due to altered membrane lipid composition, reduced JAK-1 and STAT-1 phosphorylation but increased STAT-1 degradation and impaired ISGs induction collectively determine the IFN-γ responsiveness and the efficacy of IFN-γ induced antileishmanial function of macrophages. Therefore, parasite load is not only decided by the levels of IFN-γ produced but also by the IFN-γ responsiveness. Indeed, in Leishmania-infected patients, IFN-γ is produced but IFN-γ signalling is downregulated. However, the molecular mechanisms of IFN-γ responsiveness remain unclear. Therefore, we review the current understanding of IFN-γ responsiveness of Leishmania-infected macrophages.
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Affiliation(s)
- Dhiraj Gurjar
- National Centre for Cell Science, Ganeshkhind, Pune 411007, India
| | | | - Neelam Bodhale
- National Centre for Cell Science, Ganeshkhind, Pune 411007, India
| | - Nibedita Lenka
- National Centre for Cell Science, Ganeshkhind, Pune 411007, India.
| | - Bhaskar Saha
- National Centre for Cell Science, Ganeshkhind, Pune 411007, India.
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Kumari S, Kumar V, Tiwari RK, Ravidas V, Pandey K, Kumar A. - Amphotericin B: A drug of choice for Visceral Leishmaniasis. Acta Trop 2022; 235:106661. [PMID: 35998680 DOI: 10.1016/j.actatropica.2022.106661] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 11/01/2022]
Abstract
Visceral leishmaniasis or Kala-azar is a vector-borne disease caused by an intracellular parasite of the genus leishmania. In India, Amphotericin B (AmB) is a first-line medication for treating leishmaniasis. After a large-scale resistance to pentavalent antimony therapy developed in Bihar state, it was rediscovered as an effective treatment for Leishmania donovani infection. AmB which binds to the ergosterol of protozoan cells causes a change in membrane integrity resulting in ions leakage, and ultimately leading to cell death. The treatment effect of liposomal AmB can be seen more quickly than deoxycholate AmB because, it has some toxic effects, but liposomal AmB is significantly less toxic. Evidence from studies suggested that ABLC (Abelcet) and ABCD (Amphotec) are as effective as L-AmB but Liposomal form (Ambisome) is a more widely accepted treatment option than conventional ones. Nevertheless, the world needs some way more efficient antileishmanial drugs that are less toxic and less expensive for people living with parasitic infections caused by Leishmania. So, academics, researchers, and sponsors need to focus on finding such drugs. This review provides a summary of the chemical, pharmacokinetic, drug-target interactions, stability, dose efficacy, and many other characteristics of the AmB and their various formulations. We have also highlighted the clinically significant aspects of PKDL and VL co-infection with HIV/TB.
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Affiliation(s)
- Shobha Kumari
- Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna 800007, Bihar, India
| | - Vikash Kumar
- Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna 800007, Bihar, India
| | - Ritesh Kumar Tiwari
- Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna 800007, Bihar, India
| | - Vidyanand Ravidas
- Department of Clinical Medicine, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna 800007, Bihar, India
| | - Krishna Pandey
- Department of Clinical Medicine, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna 800007, Bihar, India
| | - Ashish Kumar
- Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna 800007, Bihar, India.
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Gulin JEN, Bisio MMC, Rocco D, Altcheh J, Solana ME, García-Bournissen F. Miltefosine and Benznidazole Combination Improve Anti-Trypanosoma cruzi In Vitro and In Vivo Efficacy. Front Cell Infect Microbiol 2022; 12:855119. [PMID: 35865815 PMCID: PMC9294734 DOI: 10.3389/fcimb.2022.855119] [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: 01/14/2022] [Accepted: 05/16/2022] [Indexed: 11/29/2022] Open
Abstract
Drug repurposing and combination therapy have been proposed as cost-effective strategies to improve Chagas disease treatment. Miltefosine (MLT), a synthetic alkylphospholipid initially developed for breast cancer and repositioned for leishmaniasis, is a promising candidate against Trypanosoma cruzi infection. This study evaluates the efficacy of MLT as a monodrug and combined with benznidazole (BZ) in both in vitro and in vivo models of infection with T. cruzi (VD strain, DTU TcVI). MLT exhibited in vitro activity on amastigotes and trypomastigotes with values of IC50 = 0.51 µM (0.48 µM; 0,55 µM) and LC50 = 31.17 µM (29.56 µM; 32.87 µM), respectively. Drug interaction was studied with the fixed-ration method. The sum of the fractional inhibitory concentrations (ΣFICs) resulted in ∑FIC= 0.45 for trypomastigotes and ∑FIC= 0.71 for amastigotes, suggesting in vitro synergistic and additive effects, respectively. No cytotoxic effects on host cells were observed. MLT efficacy was also evaluated in a murine model of acute infection alone or combined with BZ. Treatment was well tolerated with few adverse effects, and all treated animals displayed significantly lower mean peak parasitemia and mortality than infected non-treated controls (p<0.05). The in vivo studies showed that MLT led to a dose-dependent parasitostatic effect as monotherapy which could be improved by combining with BZ, preventing parasitemia rebound after a stringent immunosuppression protocol. These results support MLT activity in clinically relevant stages from T. cruzi, and it is the first report of positive interaction with BZ, providing further support for evaluating combined schemes using MLT and exploring synthetic alkylphospholipids as drug candidates.
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Affiliation(s)
- Julián Ernesto Nicolás Gulin
- Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas (IMIPP), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)-Gobierno de la Ciudad de Buenos Aires (GCBA), Servicio de Parasitología y Enfermedad de Chagas, Hospital de Niños “Dr. Ricardo Gutiérrez, Ministerio de Salud, Buenos Aires, Argentina
- Instituto de Investigaciones Biomédicas (INBIOMED), Facultad de Medicina Universidad de Buenos Aires (UBA) – CONICET, Buenos Aires, Argentina
| | - Margarita María Catalina Bisio
- Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas (IMIPP), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)-Gobierno de la Ciudad de Buenos Aires (GCBA), Servicio de Parasitología y Enfermedad de Chagas, Hospital de Niños “Dr. Ricardo Gutiérrez, Ministerio de Salud, Buenos Aires, Argentina
- Instituto Nacional de Parasitología (INP) ‘Dr. Mario Fatala Chaben’-Administración Nacional de Laboratorios e Institutos de Salud (ANLIS) ‘Dr. Carlos G. Malbrán’, CONICET, Buenos Aires, Argentina
| | - Daniela Rocco
- Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas (IMIPP), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)-Gobierno de la Ciudad de Buenos Aires (GCBA), Servicio de Parasitología y Enfermedad de Chagas, Hospital de Niños “Dr. Ricardo Gutiérrez, Ministerio de Salud, Buenos Aires, Argentina
| | - Jaime Altcheh
- Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas (IMIPP), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)-Gobierno de la Ciudad de Buenos Aires (GCBA), Servicio de Parasitología y Enfermedad de Chagas, Hospital de Niños “Dr. Ricardo Gutiérrez, Ministerio de Salud, Buenos Aires, Argentina
| | - María Elisa Solana
- Instituto de Microbiología y Parasitología Médica (IMPaM), Universidad de Buenos Aires, Buenos Aires, Argentina
- Departamento de Ciencias Básicas, Universidad Nacional de Luján, Buenos Aires, Argentina
| | - Facundo García-Bournissen
- Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas (IMIPP), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)-Gobierno de la Ciudad de Buenos Aires (GCBA), Servicio de Parasitología y Enfermedad de Chagas, Hospital de Niños “Dr. Ricardo Gutiérrez, Ministerio de Salud, Buenos Aires, Argentina
- Division of Pediatric Clinical Pharmacology, Department of Pediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
- *Correspondence: Facundo García-Bournissen,
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Gouveia ALA, Santos FAB, Alves LC, Cruz-Filho IJ, Silva PR, Jacob ITT, Soares JCS, Santos DKDN, Souza TRCL, Oliveira JF, Lima MDCA. Thiazolidine derivatives: In vitro toxicity assessment against promastigote and amastigote forms of Leishmania infantum and ultrastructural study. Exp Parasitol 2022; 236-237:108253. [PMID: 35381223 DOI: 10.1016/j.exppara.2022.108253] [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: 08/03/2021] [Revised: 02/08/2022] [Accepted: 03/30/2022] [Indexed: 11/04/2022]
Abstract
Neglected diseases, such as Leishmaniasis, constitute a group of communicable diseases that occur mainly in tropical countries. Considered a public health problem with limited treatment. Therefore, there is a need for new therapies. In this sense, our proposal was to evaluate in vitro two series of thiazolidine compounds (7a-7e and 8a-8e) against Leishmania infantum. We performed in vitro evaluations through macrophage cytotoxicity assays (J774) and nitric oxide production, activity against promastigotes and amastigotes, as well as ultrastructural analyzes in promastigotes. In the evaluation of cytotoxicity, the thiazolidine compounds presented CC50 values between 8.52 and 126.83 μM. Regarding the evaluation against the promastigote forms, the IC50 values ranged between 0.42 and 142.43 μM. Compound 7a was the most promising, as it had the lowest IC50. The parasites treated with compound 7a showed several changes, such as cell body shrinkage, shortening and loss of the flagellum, intense mitochondrial edema and cytoplasmic vacuolization, leading the parasite to cell inviability. In assays against the amastigote forms, the compound showed a low IC50 (0.65 μM). These results indicate that compound 7a was efficient for both evolutionary forms of the parasite. In silico studies suggest that the compound has good oral bioavailability. These results show that compound 7a is a potential drug candidate for the treatment of Leishmaniasis.
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Affiliation(s)
- Allana L A Gouveia
- Federal University of Pernambuco, Department of Antibiotics, Center for Biosciences, 50.670-420, Recife, PE, Brazil
| | - Fábio A B Santos
- Aggeu Magalhães Institut. Oswaldo Cruz Foundation (IAM-FIOCRUZ), 50670-420, Recife, PE, Brazil
| | - Luiz C Alves
- Aggeu Magalhães Institut. Oswaldo Cruz Foundation (IAM-FIOCRUZ), 50670-420, Recife, PE, Brazil
| | - Iranildo José Cruz-Filho
- Federal University of Pernambuco, Department of Antibiotics, Center for Biosciences, 50.670-420, Recife, PE, Brazil
| | - Paula R Silva
- Federal University of Pernambuco, Department of Antibiotics, Center for Biosciences, 50.670-420, Recife, PE, Brazil
| | - Iris T T Jacob
- Federal University of Pernambuco, Department of Antibiotics, Center for Biosciences, 50.670-420, Recife, PE, Brazil
| | - José Cleberson S Soares
- Federal University of Pernambuco, Department of Antibiotics, Center for Biosciences, 50.670-420, Recife, PE, Brazil
| | - Dayane K D N Santos
- Federal University of Pernambuco, Department of Antibiotics, Center for Biosciences, 50.670-420, Recife, PE, Brazil
| | - Tulio Ricardo C L Souza
- Rural University of Pernambuco, Academic Unit of Belo Jardim, 55156-580, Belo Jardim, PE, Brazil
| | - Jamerson F Oliveira
- University for the International Integration of Afro-Brazilian Lusophony (UNILAB), 62790-970, Redenção, CE, Brazil
| | - Maria do Carmo A Lima
- Federal University of Pernambuco, Department of Antibiotics, Center for Biosciences, 50.670-420, Recife, PE, Brazil.
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Zijlstra EE. Precision Medicine in Control of Visceral Leishmaniasis Caused by L. donovani. Front Cell Infect Microbiol 2021; 11:707619. [PMID: 34858865 PMCID: PMC8630745 DOI: 10.3389/fcimb.2021.707619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/28/2021] [Indexed: 11/30/2022] Open
Abstract
Precision medicine and precision global health in visceral leishmaniasis (VL) have not yet been described and could take into account how all known determinants improve diagnostics and treatment for the individual patient. Precision public health would lead to the right intervention in each VL endemic population for control, based on relevant population-based data, vector exposures, reservoirs, socio-economic factors and other determinants. In anthroponotic VL caused by L. donovani, precision may currently be targeted to the regional level in nosogeographic entities that are defined by the interplay of the circulating parasite, the reservoir and the sand fly vector. From this 5 major priorities arise: diagnosis, treatment, PKDL, asymptomatic infection and transmission. These 5 priorities share the immune responses of infection with L. donovani as an important final common pathway, for which innovative new genomic and non-genomic tools in various disciplines have become available that provide new insights in clinical management and in control. From this, further precision may be defined for groups (e.g. children, women, pregnancy, HIV-VL co-infection), and eventually targeted to the individual level.
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Affiliation(s)
- Eduard E Zijlstra
- Clinical Sciences, Rotterdam Centre for Tropical Medicine, Rotterdam, Netherlands
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Varma DM, Redding EA, Bachelder EM, Ainslie KM. Nano- and Microformulations to Advance Therapies for Visceral Leishmaniasis. ACS Biomater Sci Eng 2020; 7:1725-1741. [PMID: 33966377 PMCID: PMC10372633 DOI: 10.1021/acsbiomaterials.0c01132] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Visceral leishmaniasis (VL) is a deadly, vector-borne, neglected tropical disease endemic to arid parts of the world and is caused by a protozoan parasite of the genus Leishmania. Chemotherapy is the primary treatment for this systemic disease, and multiple potent therapies exist against this intracellular parasite. However, several factors, such as systemic toxicity, high costs, arduous treatment regimen, and rising drug resistance, are barriers for effective therapy against VL. Material-based platforms have the potential to revolutionize chemotherapy for leishmaniasis by imparting a better pharmacokinetic profile and creating patient-friendly routes of administration, while also lowering the risk for drug resistance. This review highlights promising drug delivery strategies and novel therapies that have been evaluated in preclinical models, demonstrating the potential to advance chemotherapy for VL.
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Affiliation(s)
- Devika M. Varma
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Elizabeth A. Redding
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Eric M. Bachelder
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Kristy M. Ainslie
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
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Jafarzadeh A, Jafarzadeh S, Sharifi I, Aminizadeh N, Nozari P, Nemati M. The importance of T cell-derived cytokines in post-kala-azar dermal leishmaniasis. Cytokine 2020; 147:155321. [PMID: 33039255 DOI: 10.1016/j.cyto.2020.155321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 09/18/2020] [Accepted: 09/25/2020] [Indexed: 12/17/2022]
Abstract
Infection with the same species of Leishmania (L)donovani causes different manifestations including visceral leishmaniasis (VL) and post kala-azar dermal leishmaniasis (PKDL), indicating that the host-related immunological parameters perform a decisive role in the pathogenesis of diseases. As PKDL is a reservoir of the parasite, a better understanding of the host immune responses is necessary to restrict the L. donovani transmission. The proper local production of Th1 cell-related cytokines (including IFN-γ, TNF-α and IL-12), Th17 cell-derived cytokines (such as IL-17A, IL-17F and IL-22), and CD8+ cytotoxic T lymphocyte (CTL)-derived IFN-γ are protective against PKDL. However, dominant production of regulatory CD4+ T cell-derived cytokines (such as IL-10 and TGF-β), Th2 cell-derived cytokines (such as IL-4/IL-13), M2 macrophage-derived cytokines (such as IL-4 and IL-10), keratinocyte-derived IL-10, regulatory CD8+ T cell-derived IL-10, and dendritic cell-derived IL-10, IL-27 and IL-21 can contribute to the parasite persistence and PKDL development. Understanding of the T cell-related cytokine network within PKDL lesions gives rise to novel insights concerning the role of each cytokine in the protection or susceptibility to disease. Manipulation of the cytokine network can be considered as an interesting immunotherapeutic strategy for the treatment of L. donovani-mediated PKDL.
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Affiliation(s)
- Abdollah Jafarzadeh
- Department of Immunology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran; Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
| | - Sara Jafarzadeh
- Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Najmeh Aminizadeh
- Department of Histology, School of Medicine, Islamic Azad University Branch of Kerman, Kerman, Iran
| | - Parvin Nozari
- Department of Immunology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Nemati
- Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Department of Haematology and Laboratory Sciences, School of Para-Medicine, Kerman University of Medical Sciences, Kerman, Iran
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12
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Queiroz CM, de Oliveira Filho GB, Espíndola JWP, do Nascimento AV, Aliança ASDS, de Lorena VMB, Feitosa APS, da Silva PR, Alves LC, Leite ACL, Brayner FA. Thiosemicarbazone and thiazole: in vitro evaluation of leishmanicidal and ultrastructural activity on Leishmania infantum. Med Chem Res 2020. [DOI: 10.1007/s00044-020-02619-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Majumder N, Ganguly S, Ghosh AK, Kundu S, Banerjee A, Saha S. Chlorogenic acid acts upon
Leishmania donovani
arresting cell cycle and modulating cytokines and nitric oxide in vitro. Parasite Immunol 2020; 42:e12719. [DOI: 10.1111/pim.12719] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 03/18/2020] [Accepted: 03/20/2020] [Indexed: 12/20/2022]
Affiliation(s)
| | | | | | - Shreetoma Kundu
- Department of Biotechnology Visva‐Bharati Santiniketan India
| | | | - Samiran Saha
- Department of Biotechnology Visva‐Bharati Santiniketan India
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14
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André S, Rodrigues V, Pemberton S, Laforge M, Fortier Y, Cordeiro-da-Silva A, MacDougall J, Estaquier J. Antileishmanial Drugs Modulate IL-12 Expression and Inflammasome Activation in Primary Human Cells. THE JOURNAL OF IMMUNOLOGY 2020; 204:1869-1880. [PMID: 32132181 DOI: 10.4049/jimmunol.1900590] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 02/02/2020] [Indexed: 01/10/2023]
Abstract
Leishmaniases are neglected tropical diseases. The treatment of leishmaniasis relies exclusively on chemotherapy including amphotericin B (AmB), miltefosine (hexadecylphosphocholine), and pentamidine. Besides the fact that these molecules are harmful for patients, little is known about the impact of such antileishmanial drugs on primary human cells in relation to immune function. The present study demonstrates that all antileishmanial drugs inhibit CD4 and CD8 T cell proliferation at the doses that are not related to increased cell death. Our results highlight that antileishmanial drugs have an impact on monocytes by altering the expression of IL-12 induced by LPS, whereas only AmB induced IL-10 secretion; both cytokines are essential in regulating Th1 cell-mediated immunity. Interestingly, IL-12 and anti-IL-10 Abs improved T cell proliferation inhibited by AmB. Furthermore, our results show that in contrast to hexadecylphosphocholine and pentamidine, AmB induced gene expression of the inflammasome pathway. Thus, AmB induced IL-1β and IL-18 secretions, which are reduced by specific inhibitors of caspase activation (Q-VD) and NLRP3 activation (MCC950). Our results reveal previously underestimated effects of antileishmanial drugs on primary human cells.
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Affiliation(s)
- Sonia André
- INSERM-U1124, Paris University, 75006 Paris, France
| | | | - Sarah Pemberton
- INSERM-U1124, Paris University, 75006 Paris, France.,Photeomix, 93160 Noisy Le Grand, France
| | | | | | - Anabela Cordeiro-da-Silva
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal.,Instituto de Biologia Molecular e Celular da Universidade do Porto, 450-313 Porto, Portugal.,Departamento de Ciências Biológicas, Faculdade de Farmácia, Universidade do Porto, 450-313 Porto, Portugal; and
| | | | - Jérôme Estaquier
- INSERM-U1124, Paris University, 75006 Paris, France; .,Centre de Recherche du Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, Quebec G1V 4G2, Canada
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15
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Álvarez-Bardón M, Pérez-Pertejo Y, Ordóñez C, Sepúlveda-Crespo D, Carballeira NM, Tekwani BL, Murugesan S, Martinez-Valladares M, García-Estrada C, Reguera RM, Balaña-Fouce R. Screening Marine Natural Products for New Drug Leads against Trypanosomatids and Malaria. Mar Drugs 2020; 18:E187. [PMID: 32244488 PMCID: PMC7230869 DOI: 10.3390/md18040187] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 02/06/2023] Open
Abstract
Neglected Tropical Diseases (NTD) represent a serious threat to humans, especially for those living in poor or developing countries. Almost one-sixth of the world population is at risk of suffering from these diseases and many thousands die because of NTDs, to which we should add the sanitary, labor and social issues that hinder the economic development of these countries. Protozoan-borne diseases are responsible for more than one million deaths every year. Visceral leishmaniasis, Chagas disease or sleeping sickness are among the most lethal NTDs. Despite not being considered an NTD by the World Health Organization (WHO), malaria must be added to this sinister group. Malaria, caused by the apicomplexan parasite Plasmodium falciparum, is responsible for thousands of deaths each year. The treatment of this disease has been losing effectiveness year after year. Many of the medicines currently in use are obsolete due to their gradual loss of efficacy, their intrinsic toxicity and the emergence of drug resistance or a lack of adherence to treatment. Therefore, there is an urgent and global need for new drugs. Despite this, the scant interest shown by most of the stakeholders involved in the pharmaceutical industry makes our present therapeutic arsenal scarce, and until recently, the search for new drugs has not been seriously addressed. The sources of new drugs for these and other pathologies include natural products, synthetic molecules or repurposing drugs. The most frequent sources of natural products are microorganisms, e.g., bacteria, fungi, yeasts, algae and plants, which are able to synthesize many drugs that are currently in use (e.g. antimicrobials, antitumor, immunosuppressants, etc.). The marine environment is another well-established source of bioactive natural products, with recent applications against parasites, bacteria and other pathogens which affect humans and animals. Drug discovery techniques have rapidly advanced since the beginning of the millennium. The combination of novel techniques that include the genetic modification of pathogens, bioimaging and robotics has given rise to the standardization of High-Performance Screening platforms in the discovery of drugs. These advancements have accelerated the discovery of new chemical entities with antiparasitic effects. This review presents critical updates regarding the use of High-Throughput Screening (HTS) in the discovery of drugs for NTDs transmitted by protozoa, including malaria, and its application in the discovery of new drugs of marine origin.
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Affiliation(s)
- María Álvarez-Bardón
- Department of Biomedical Sciences; University of León, 24071 León, Spain; (M.Á.-B.); (Y.P.-P.); (C.O.); (D.S.-C.); (R.M.R.)
| | - Yolanda Pérez-Pertejo
- Department of Biomedical Sciences; University of León, 24071 León, Spain; (M.Á.-B.); (Y.P.-P.); (C.O.); (D.S.-C.); (R.M.R.)
| | - César Ordóñez
- Department of Biomedical Sciences; University of León, 24071 León, Spain; (M.Á.-B.); (Y.P.-P.); (C.O.); (D.S.-C.); (R.M.R.)
| | - Daniel Sepúlveda-Crespo
- Department of Biomedical Sciences; University of León, 24071 León, Spain; (M.Á.-B.); (Y.P.-P.); (C.O.); (D.S.-C.); (R.M.R.)
| | - Nestor M. Carballeira
- Department of Chemistry, University of Puerto Rico, Río Piedras 00925-2537, San Juan, Puerto Rico;
| | - Babu L. Tekwani
- Department of Infectious Diseases, Division of Drug Discovery, Southern Research, Birmingham, AL 35205, USA;
| | - Sankaranarayanan Murugesan
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani Campus, Vidya Vihar, Pilani 333031, India;
| | - Maria Martinez-Valladares
- Department of Animal Health, Instituto de Ganadería de Montaña (CSIC-Universidad de León), Grulleros, 24346 León, Spain;
| | - Carlos García-Estrada
- INBIOTEC (Instituto de Biotecnología de León), Avda. Real 1-Parque Científico de León, 24006 León, Spain;
| | - Rosa M. Reguera
- Department of Biomedical Sciences; University of León, 24071 León, Spain; (M.Á.-B.); (Y.P.-P.); (C.O.); (D.S.-C.); (R.M.R.)
| | - Rafael Balaña-Fouce
- Department of Biomedical Sciences; University of León, 24071 León, Spain; (M.Á.-B.); (Y.P.-P.); (C.O.); (D.S.-C.); (R.M.R.)
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16
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Systematic Review of Host-Mediated Activity of Miltefosine in Leishmaniasis through Immunomodulation. Antimicrob Agents Chemother 2019; 63:AAC.02507-18. [PMID: 31036692 PMCID: PMC6591591 DOI: 10.1128/aac.02507-18] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 04/22/2019] [Indexed: 12/12/2022] Open
Abstract
Host immune responses are pivotal for the successful treatment of the leishmaniases, a spectrum of infections caused by Leishmania parasites. Previous studies speculated that augmenting cytokines associated with a type 1 T-helper cell (Th1) response is necessary to combat severe forms of leishmaniasis, and it has been hypothesized that the antileishmanial drug miltefosine is capable of immunomodulation and induction of Th1 cytokines. Host immune responses are pivotal for the successful treatment of the leishmaniases, a spectrum of infections caused by Leishmania parasites. Previous studies speculated that augmenting cytokines associated with a type 1 T-helper cell (Th1) response is necessary to combat severe forms of leishmaniasis, and it has been hypothesized that the antileishmanial drug miltefosine is capable of immunomodulation and induction of Th1 cytokines. A better understanding of the immunomodulatory effects of miltefosine is central to providing a rationale regarding synergistic mechanisms of activity to combine miltefosine optimally with other conventional and future antileishmanials that are currently under development. Therefore, a systematic literature search was performed to evaluate to what extent and how miltefosine influences the host Th1 response. Miltefosine’s effects observed in both a preclinical and a clinical context associated with immunomodulation in the treatment of leishmaniasis are evaluated in this review. A total of 27 studies were included in the analysis. Based on the current evidence, miltefosine is not only capable of inducing direct parasite killing but also of modulating the host immunity. Our findings suggest that miltefosine-induced activation of Th1 cytokines, particularly represented by increased gamma interferon (IFN-γ) and interleukin 12 (IL-12), is essential to prevail over the Leishmania-driven Th2 response. Differences in miltefosine-induced host-mediated effects between in vitro, ex vivo, animal model, and human studies are further discussed. All things considered, an effective treatment with miltefosine is acquired by enhanced functional Th1 cytokine responses and may further be enhanced in combination with immunostimulatory agents.
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17
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Abstract
Abstract
Leishmaniasis is a group of zoonotic diseases caused by a trypanosomatid parasite mostly in impoverished populations of low-income countries. In their different forms, leishmaniasis is prevalent in more than 98 countries all over the world and approximately 360-million people are at risk. Since no vaccine is currently available to prevent any form of the disease, the control strategy of leishmaniasis mainly relies on early case detection followed by adequate pharmacological treatment that may improve the prognosis and can reduce transmission. A handful of compounds and formulations are available for the treatment of leishmaniasis in humans, but only few of them are currently in use since most of these agents are associated with toxicity problems such as nephrotoxicity and cardiotoxicity in addition to resistance problems. In recent decades, very few novel drugs, new formulations of standard drugs or combinations of them have been approved against leishmaniasis. This review highlights the current drugs and combinations that are used medical practice and recent advances in new treatments against leishmaniasis that were pointed out in the recent 2nd Conference, Global Challenges in Neglected Tropical Diseases, held in San Juan, Puerto Rico in June 2018, emphasizing the plethora of new families of molecules that are bridging the gap between preclinical and first-in-man trials in next future.
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18
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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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19
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Demarchi IG, Terron MDS, Thomazella MV, Mota CA, Gazim ZC, Cortez DAG, Aristides SMA, Silveira TGV, Lonardoni MVC. Antileishmanial and immunomodulatory effects of the essential oil from Tetradenia riparia (Hochstetter) Codd. Parasite Immunol 2016; 38:64-77. [PMID: 26615004 DOI: 10.1111/pim.12297] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 11/24/2015] [Indexed: 12/12/2022]
Abstract
Cutaneous leishmaniasis usually presents therapeutic resistance to antimonials, and the existing therapies for leishmaniasis have many adverse effects and toxicity. Natural products may be regarded as possible candidates for alternative leishmaniasis treatment. The plant Tetradenia riparia has shown promise for the treatment of infectious diseases in folk medicine. We evaluated the antileishmanial activity of an essential oil from T. riparia (TrEO) and the modulatory effects of TrEO on cytokine modulation by peritoneal fluid cells that were infected with L. (L.) amazonensis. Peritoneal fluid cells were infected with Leishmania and incubated with TrEO (30 ng/mL) for 3, 6, and 24 h. Cytokines were screened using semi-quantitative reverse-transcription polymerase chain reaction (RT-PCR) and flow cytometry. Antileishmanial activity was evaluated at 24 h by microscopic counting and quantitative PCR (qPCR). TrEO treatment induced the death of 50% of Leishmania amastigotes (indicated by microscopic counting) and 91% of the parasite load (indicated by qPCR). TrEO inhibited some of the most critical cytokines for parasite growth and the establishment of infection, including granulocyte-macrophage colony-stimulating factor, interleukin-4 (IL-4), IL-10, and tumour necrosis factor. The parasite inhibited interferon-γ and IL-12, and TrEO blocked this inhibition, indicating that these cytokines are critical for activating mechanisms associated with the death and elimination of the parasite. These results suggest that TrEO may be an alternative leishmaniasis therapy when considering its antileishmanial and immunomodulatory activity.
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Affiliation(s)
- Izabel Galhardo Demarchi
- Departamento de Análises Clínicas e Biomedicina, Laboratório de Imunologia Clínica, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | - Mariana de Souza Terron
- Departamento de Análises Clínicas e Biomedicina, Laboratório de Imunologia Clínica, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | - Mateus Vailant Thomazella
- Departamento de Análises Clínicas e Biomedicina, Laboratório de Imunologia Clínica, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | - Camila Alves Mota
- Departamento de Análises Clínicas e Biomedicina, Laboratório de Imunologia Clínica, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | - Zilda Cristiani Gazim
- Departamento de Farmácia, Laboratório de Química de Produtos Naturais da Universidade Paranaense, Umuarama, Paraná, Brazil
| | | | - Sandra Mara Alessi Aristides
- Departamento de Análises Clínicas e Biomedicina, Laboratório de Imunologia Clínica, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | - Thaís Gomes Verzignassi Silveira
- Departamento de Análises Clínicas e Biomedicina, Laboratório de Imunologia Clínica, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | - Maria Valdrinez Campana Lonardoni
- Departamento de Análises Clínicas e Biomedicina, Laboratório de Imunologia Clínica, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
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Saberi S, Arjmand R, Soleimanifard S, Khamesipour A, Hosseini SM, Salehi M, Varshosaz J, Palizban AA, Hejazi SH. In vivo/In vitro immune responses to L. major isolates from patients with no clinical response to Glucantime. Adv Biomed Res 2016; 5:126. [PMID: 27563636 PMCID: PMC4976526 DOI: 10.4103/2277-9175.187000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 10/26/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Leishmaniasis is a major health problem in some endemic areas of tropical and subtropical areas of the world. Interleukin-12 (IL-12) and interferon gamma (IFN-γ) are essential cytokines associated with initiation of Th1 response. The main objective of this study was to evaluate of the type of immune response to L. major isolates from patients with no clinical response to antimonite (Glucantime). MATERIALS AND METHODS This experimental study was carried out during 2013-2014. In the current study Leishmania major were isolated from 10 CL patients with a history of at least one course of treatment with Meglumine antimonate (Sb5). The isolates were used to evaluate in vitro and in vivo response to Sb5. J774 murine macrophage cell line was used for in vitro tests and Balb/c mice was used for in vivo studies. IL-12 gene expression was evaluated using Real-time PCR and IFN-γ serum level was quantified using ELISA technique. SPSS (version: 20), analysis of Covariance (ANCOVA) was used for statistical analysis. RESULTS PCR results confirmed that all 10 isolates were L. major. The mean of IL-12 gene expression in vitro, in vivo and IFN-γ serum levels (pg/ml) after 2 and 3 weeks treatment in vivo, increased significantly following the treatment with Glucantime in the two groups of Balb/c mice infected either with patients' isolates or standard L. major. No significant difference was seen between the patients' isolates and standard species. CONCLUSIONS Although the L. major were isolated from patients with active lesion and no clinical response to Glucantime after at least one courses of Glucantime treatment but in vivo and in vitro immune response of L. major isolates showed no difference between the patients' isolates and standard L. major.
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Affiliation(s)
- Sedigheh Saberi
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, and Department of Parasitology and Mycology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Arjmand
- Medical Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Simindokht Soleimanifard
- Medical Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Hosseini
- Bio-Statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mansoor Salehi
- Biology and Genetics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jaleh Varshosaz
- Pharmaceutics, Novel Drug Delivery Systems Research Center, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Ali Palizban
- Clinical Biochemistry Department, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Hossein Hejazi
- Medical Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Parasitology and Mycology, School of Medicine, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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21
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A Comparison between the Effects of Glucantime, Topical Trichloroacetic Acid 50% plus Glucantime, and Fractional Carbon Dioxide Laser plus Glucantime on Cutaneous Leishmaniasis Lesions. Dermatol Res Pract 2016; 2016:6462804. [PMID: 27148363 PMCID: PMC4842369 DOI: 10.1155/2016/6462804] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 03/14/2016] [Accepted: 03/30/2016] [Indexed: 11/18/2022] Open
Abstract
Background. Cutaneous leishmaniasis is an endemic disease in Iran. Pentavalent antimonial drugs have been the first line of therapy in cutaneous leishmaniasis for many years. However, the cure rate of these agents is still not favorable. This study was carried out to compare the efficacies of intralesional glucantime with topical trichloroacetic acid 50% (TCA 50%) + glucantime and fractional carbon dioxide laser + glucantime in the treatment of cutaneous leishmaniasis. Methods. A total of 90 patients were randomly divided into three groups of 30 to be treated with intralesional injection of glucantime, a combination of topical TCA 50% and glucantime, or a combination of fractional laser and glucantime. The overall clinical improvement and changes in sizes of lesions and scars were assessed and compared among three groups. Results. The mean duration of treatment was 6.1 ± 2.1 weeks in all patients (range: 2–12 weeks) and 6.8 ± 1.7, 5.2 ± 1.0, and 6.3 ± 3.0 weeks in glucantime, topical TCA plus glucantime, and fractional laser plus glucantime groups, respectively (P = 0.011). Complete improvement was observed in 10 (38.5%), 27 (90%), and 20 (87%) patients of glucantime, glucantime + TCA, and glucantime + laser groups, respectively (P < 0.001). Conclusion. Compared to glucantime alone, the combination of intralesional glucantime and TCA 50% or fractional CO2 laser had significantly higher and faster cure rate in patients with cutaneous leishmaniasis.
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Kangussu-Marcolino MM, do Rosário MMT, Noseda MD, Duarte MER, Ducatti DRB, Cassolato JEF, Iacomini M, Martinez GR, Rocha MEM, Cadena SMSC, Noleto GR. Acid heteropolysaccharides with potent antileishmanial effects. Int J Biol Macromol 2015; 81:165-70. [DOI: 10.1016/j.ijbiomac.2015.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 05/15/2015] [Accepted: 07/06/2015] [Indexed: 10/23/2022]
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23
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Firdessa R, Good L, Amstalden MC, Chindera K, Kamaruzzaman NF, Schultheis M, Röger B, Hecht N, Oelschlaeger TA, Meinel L, Lühmann T, Moll H. Pathogen- and Host-Directed Antileishmanial Effects Mediated by Polyhexanide (PHMB). PLoS Negl Trop Dis 2015; 9:e0004041. [PMID: 26431058 PMCID: PMC4592236 DOI: 10.1371/journal.pntd.0004041] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 08/06/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is a neglected tropical disease caused by protozoan parasites of the genus Leishmania. CL causes enormous suffering in many countries worldwide. There is no licensed vaccine against CL, and the chemotherapy options show limited efficacy and high toxicity. Localization of the parasites inside host cells is a barrier to most standard chemo- and immune-based interventions. Hence, novel drugs, which are safe, effective and readily accessible to third-world countries and/or drug delivery technologies for effective CL treatments are desperately needed. METHODOLOGY/PRINCIPAL FINDINGS Here we evaluated the antileishmanial properties and delivery potential of polyhexamethylene biguanide (PHMB; polyhexanide), a widely used antimicrobial and wound antiseptic, in the Leishmania model. PHMB showed an inherent antileishmanial activity at submicromolar concentrations. Our data revealed that PHMB kills Leishmania major (L. major) via a dual mechanism involving disruption of membrane integrity and selective chromosome condensation and damage. PHMB's DNA binding and host cell entry properties were further exploited to improve the delivery and immunomodulatory activities of unmethylated cytosine-phosphate-guanine oligodeoxynucleotides (CpG ODN). PHMB spontaneously bound CpG ODN, forming stable nanopolyplexes that enhanced uptake of CpG ODN, potentiated antimicrobial killing and reduced host cell toxicity of PHMB. CONCLUSIONS Given its low cost and long history of safe topical use, PHMB holds promise as a drug for CL therapy and delivery vehicle for nucleic acid immunomodulators.
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Affiliation(s)
- Rebuma Firdessa
- Institute for Molecular Infection Biology, University of Würzburg, Würzburg, Germany
| | - Liam Good
- Royal Veterinary College, University of London, London, United Kingdom
| | | | | | | | - Martina Schultheis
- Institute for Molecular Infection Biology, University of Würzburg, Würzburg, Germany
| | - Bianca Röger
- Institute for Molecular Infection Biology, University of Würzburg, Würzburg, Germany
| | - Nina Hecht
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Würzburg, Germany
| | | | - Lorenz Meinel
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Würzburg, Germany
| | - Tessa Lühmann
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Würzburg, Germany
| | - Heidrun Moll
- Institute for Molecular Infection Biology, University of Würzburg, Würzburg, Germany
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do Amaral AE, Petkowicz CLO, Mercê ALR, Iacomini M, Martinez GR, Merlin Rocha ME, Cadena SMSC, Noleto GR. Leishmanicidal activity of polysaccharides and their oxovanadium(IV/V) complexes. Eur J Med Chem 2014; 90:732-41. [PMID: 25506811 DOI: 10.1016/j.ejmech.2014.12.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 11/21/2014] [Accepted: 12/03/2014] [Indexed: 02/08/2023]
Abstract
The parasites of the genus Leishmania cause a range of leishmaniasis diseases, whose treatment is impaired due to intramacrophage parasites living in the mammalian host. Immunostimulation has been considered an important strategy to leishmaniasis treatment. The immunomodulatory effects of the polysaccharides arabinogalactan (ARAGAL), galactomannan (GMPOLY), and xyloglucan (XGJ), as well as their oxovanadium (IV/V) complexes (ARAGAL:VO, GMPOLY:VO, and XGJ:VO) were evaluated on peritoneal macrophages. At 25 μg/mL of GMPOLY:VO and of XGJ:VO, and 10 μg/mL of ARAGAL:VO, nitric oxide (NO) production by the macrophages was not altered compared with the control group. All polymers increased the production of interleukins 1 beta and 6 (IL-1β and IL-6), but the oxovanadium complexes were more potent activators of these mediators. ARAGAL:VO 10 μg/mL, GMPOLY:VO and XGJ:VO 25 μg/mL led to an increase of 562%, 1054%, and 523% for IL-1β, respectively. For IL-6 at the same concentration, the levels increased by 539% and 794% for ARAGAL:VO and GMPOLY:VO, respectively. Polysaccharides and their oxovanadium complexes exhibited important leishmanicidal effects on amastigotes of Leishmania (L.) amazonensis. The native and complexed polymers reduced the growth of promastigote-form Leishmania by ∼60%. This effect was reached at concentrations 12 times lower than that observed for Glucantime (300 μg/mL promoted an inhibition of ∼60%). The 50% inhibitory concentration (IC50) values for the complexes were determined. XGJ:VO showed the lowest IC50 value (6.2 μg/mL; 0.07 μg/mL of vanadium), which for ARAGAL:VO was 6.5 μg/mL (0.21 μg/mL of vanadium) and 7.3 μg/mL (0.06 μg/mL of vanadium) for GMPOLY:VO. The upregulation of IL-1β and IL-6 release and downregulation of NO production by macrophages and the important leishmanicidal effect are essential to stablish their potential use against this pathology.
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Affiliation(s)
- Alex Evangelista do Amaral
- Departamento de Bioquímica e Biologia Molecular, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | | | | | - Marcelo Iacomini
- Departamento de Bioquímica e Biologia Molecular, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Glaucia Regina Martinez
- Departamento de Bioquímica e Biologia Molecular, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Maria Eliane Merlin Rocha
- Departamento de Bioquímica e Biologia Molecular, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
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Mukherjee S, Mukherjee B, Mukhopadhyay R, Naskar K, Sundar S, Dujardin JC, Roy S. Imipramine exploits histone deacetylase 11 to increase the IL-12/IL-10 ratio in macrophages infected with antimony-resistant Leishmania donovani and clears organ parasites in experimental infection. THE JOURNAL OF IMMUNOLOGY 2014; 193:4083-94. [PMID: 25217162 DOI: 10.4049/jimmunol.1400710] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The efflux of antimony through multidrug resistance protein (MDR)-1 is the key factor in the failure of metalloid treatment in kala-azar patients infected with antimony-resistant Leishmania donovani (Sb(R)LD). Previously we showed that MDR-1 upregulation in Sb(R)LD infection is IL-10-dependent. Imipramine, a drug in use for the treatment of depression and nocturnal enuresis in children, inhibits IL-10 production from Sb(R)LD-infected macrophages (Sb(R)LD-Mϕs) and favors accumulation of surrogates of antimonials. It inhibits IL-10-driven nuclear translocation of c-Fos/c-Jun, critical for enhanced MDR-1 expression. The drug upregulates histone deacetylase 11, which inhibits acetylation of IL-10 promoter, leading to a decrease in IL-10 production from Sb(R)LD-Mϕs. It abrogates Sb(R)LD-mediated p50/c-Rel binding to IL-10 promoter and preferentially recruits p65/RelB to IL-12 p35 and p40 promoters, causing a decrease in IL-10 and overproduction of IL-12 in Sb(R)LD-Mϕs. Histone deacetylase 11 per se does not influence IL-12 promoter activity. Instead, a imipramine-mediated decreased IL-10 level allows optimal IL-12 production in Sb(R)LD-Mϕs. Furthermore, exogenous rIL-12 inhibits intracellular Sb(R)LD replication, which can be mimicked by the presence of Ab to IL-10. This observation indicated that reciprocity exists between IL-10 and IL-12 and that imipramine tips the balance toward an increased IL-12/IL-10 ratio in Sb(R)LD-Mϕs. Oral treatment of infected BALB/c mice with imipramine in combination with sodium stibogluconate cleared organ Sb(R)LD parasites and caused an expansion of the antileishmanial T cell repertoire where sodium stibogluconate alone had no effect. Our study deciphers a detailed molecular mechanism of imipramine-mediated regulation of IL-10/IL-12 reciprocity and its impact on Sb(R)LD clearance from infected hosts.
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Affiliation(s)
- Sandip Mukherjee
- Department of Infectious Diseases and Immunology, Council of Scientific and Industrial Research-Indian Institute of Chemical Biology, Kolkata 700032, India
| | - Budhaditya Mukherjee
- Department of Infectious Diseases and Immunology, Council of Scientific and Industrial Research-Indian Institute of Chemical Biology, Kolkata 700032, India
| | - Rupkatha Mukhopadhyay
- Department of Infectious Diseases and Immunology, Council of Scientific and Industrial Research-Indian Institute of Chemical Biology, Kolkata 700032, India
| | - Kshudiram Naskar
- Department of Infectious Diseases and Immunology, Council of Scientific and Industrial Research-Indian Institute of Chemical Biology, Kolkata 700032, India
| | - Shyam Sundar
- Institute of Medical Sciences, Benaras Hindu University, Varanasi 221005, India; and
| | | | - Syamal Roy
- Department of Infectious Diseases and Immunology, Council of Scientific and Industrial Research-Indian Institute of Chemical Biology, Kolkata 700032, India;
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Verhaar AP, Wildenberg ME, Peppelenbosch MP, Hommes DW, van den Brink GR. Repurposing miltefosine for the treatment of immune-mediated disease? J Pharmacol Exp Ther 2014; 350:189-95. [PMID: 24833702 DOI: 10.1124/jpet.113.212654] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Miltefosine is an ether lipid that was initially developed for cancer treatment in the early 1980s. Miltefosine largely failed development for oncology, although it was approved for the topical treatment of breast cancer metastasis. It was subsequently discovered that miltefosine is a highly effective treatment of visceral Leishmaniasis, a parasitic disease that affects millions worldwide and causes an estimated 30,000 fatalities each year. Oral treatment with miltefosine is generally well tolerated and has relatively few adverse effects. The exact mechanism of action of miltefosine treatment is still under investigation. Its close resemblance to phospholipids allows it to be quickly taken up by cell membranes and affect related processes, such as lipid metabolism and signaling through lipid rafts. These processes play an important role in the immune response and it comes as no surprise that miltefosine has been successfully tested for the treatment of a number of immune-mediated diseases in preclinical models of disease. Drug repurposing of miltefosine for immune-mediated diseases may provide an opportunity to expand the limited number of drugs that are currently available for therapeutic use.
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Affiliation(s)
- Auke P Verhaar
- Department of Gastroenterology and Hepatology, Tytgat Institute for Liver and Intestinal Research, Academic Medical Center, Amsterdam, The Netherlands (A.P.V., M.E.W., G.R.v.d.B.); Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands (A.P.V., D.W.H.); Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (M.P.P.); and Center for Inflammatory Bowel Diseases, University of California Los Angeles, Los Angeles, California (D.W.H.)
| | - Manon E Wildenberg
- Department of Gastroenterology and Hepatology, Tytgat Institute for Liver and Intestinal Research, Academic Medical Center, Amsterdam, The Netherlands (A.P.V., M.E.W., G.R.v.d.B.); Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands (A.P.V., D.W.H.); Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (M.P.P.); and Center for Inflammatory Bowel Diseases, University of California Los Angeles, Los Angeles, California (D.W.H.)
| | - Maikel P Peppelenbosch
- Department of Gastroenterology and Hepatology, Tytgat Institute for Liver and Intestinal Research, Academic Medical Center, Amsterdam, The Netherlands (A.P.V., M.E.W., G.R.v.d.B.); Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands (A.P.V., D.W.H.); Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (M.P.P.); and Center for Inflammatory Bowel Diseases, University of California Los Angeles, Los Angeles, California (D.W.H.)
| | - Daniel W Hommes
- Department of Gastroenterology and Hepatology, Tytgat Institute for Liver and Intestinal Research, Academic Medical Center, Amsterdam, The Netherlands (A.P.V., M.E.W., G.R.v.d.B.); Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands (A.P.V., D.W.H.); Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (M.P.P.); and Center for Inflammatory Bowel Diseases, University of California Los Angeles, Los Angeles, California (D.W.H.)
| | - Gijs R van den Brink
- Department of Gastroenterology and Hepatology, Tytgat Institute for Liver and Intestinal Research, Academic Medical Center, Amsterdam, The Netherlands (A.P.V., M.E.W., G.R.v.d.B.); Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands (A.P.V., D.W.H.); Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (M.P.P.); and Center for Inflammatory Bowel Diseases, University of California Los Angeles, Los Angeles, California (D.W.H.)
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Vanaerschot M, Dumetz F, Roy S, Ponte-Sucre A, Arevalo J, Dujardin JC. Treatment failure in leishmaniasis: drug-resistance or another (epi-) phenotype? Expert Rev Anti Infect Ther 2014; 12:937-46. [PMID: 24802998 DOI: 10.1586/14787210.2014.916614] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Two major leishmaniasis treatments have shown a significant decrease in effectiveness in the last few decades, mostly in the Indian subcontinent but also in other endemic areas. Drug resistance of Leishmania correlated only partially to treatment failure (TF) of pentavalent antimonials, and has so far proved not to be important for the increased miltefosine relapse rates observed in the Indian subcontinent. While other patient- or drug-related factors could also have played a role, recent studies identified several parasite features such as infectivity and host manipulation skills that might contribute to TF. This perspective aims to discuss how different parasitic features other than drug resistance can contribute to TF of leishmaniasis and how this may vary between different epidemiological contexts.
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Affiliation(s)
- Manu Vanaerschot
- Molecular Parasitology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium
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28
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Lezama-Dávila CM, Pan L, Isaac-Márquez AP, Terrazas C, Oghumu S, Isaac-Márquez R, Pech-Dzib MY, Barbi J, Calomeni E, Parinandi N, Kinghorn AD, Satoskar AR. Pentalinon andrieuxii root extract is effective in the topical treatment of cutaneous leishmaniasis caused by Leishmania mexicana. Phytother Res 2013; 28:909-16. [PMID: 24347110 DOI: 10.1002/ptr.5079] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 09/24/2013] [Accepted: 10/07/2013] [Indexed: 02/03/2023]
Abstract
Cutaneous leishmaniasis (CL) manifests as localized skin lesions, which lead to significant tissue destruction and disfigurement. In the Yucatan Peninsula, Mayan traditional healers use Pentalinon andrieuxii Muell.-Arg. (Apocynaceae) roots for the topical treatment of CL. Here, we studied the effect of P. andrieuxii root hexane extract (PARE) on the parasites and host cells in vitro and examined its efficacy in the topical treatment of CL caused by Leishmania mexicana. PARE exhibited potent antiparasitic activity in vitro against promastigotes as well as amastigotes residing in macrophages. Electron microscopy of PARE-treated parasites revealed direct membrane damage. PARE also activated nuclear factor kappaB and enhanced interferon-γ receptor and MHC class II expression and TNF-α production in macrophages. In addition, PARE induced production of the Th1 promoting cytokine IL-12 in dendritic cells as well as enhanced expression of the co-stimulatory molecules CD40, CD80, and CD86. In vivo studies showed that L. mexicana-infected mice treated by topical application of PARE resulted in the significant reduction in lesion size and parasite burden compared to controls. These findings indicate that PARE could be used as an alternative therapy for the topical treatment of CL.
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Affiliation(s)
- Claudio M Lezama-Dávila
- Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, 43210, USA
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