1
|
Alam P, Imran M, Ali A, Majid H. Cananga odorata (Ylang-Ylang) Essential Oil Containing Nanoemulgel for the Topical Treatment of Scalp Psoriasis and Dandruff. Gels 2024; 10:303. [PMID: 38786220 PMCID: PMC11121303 DOI: 10.3390/gels10050303] [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: 04/09/2024] [Revised: 04/21/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
This research aimed to evaluate the efficacy of a nanoemulgel (NE) containing Cananga odorata (Ylang-Ylang) oil for managing scalp psoriasis and dandruff through various assessments. The study involved phytochemical screening, characterization, stability testing, in vivo performance evaluation, dermatokinetic analysis, central composite rotatable design (CCRD) optimization, in vitro release profiling, and antioxidant and antimicrobial activity assessment of the NE. The NE exhibited excellent stability and maintained physical parameters over a three-month period. In vivo studies showed no skin irritation, maintenance of skin pH (4.55 to 5.08), and improvement in skin hydration (18.09 to 41.28 AU) and sebum content (26.75 to 5.67 mg/cm2). Dermatokinetic analysis revealed higher skin retention of C. odorata in the NE (epidermis: 71.266 µg/cm2, dermis: 60.179 µg/cm2) compared to conventional formulations. CCRD optimization yielded NE formulations with the desired particle size (195.64 nm), entrapment efficiency (85.51%), and zeta potential (-20.59 mV). In vitro release studies indicated sustained release behavior, and antioxidant and antimicrobial properties were observed. This study demonstrates the stability, skin-friendliness, therapeutic benefits, and controlled release properties of the NE. The NE presents a promising option for various topical applications in treating bacterial and fungal diseases, potentially enhancing drug delivery and treatment outcomes in pharmaceuticals and cosmetics.
Collapse
Affiliation(s)
- Perwez Alam
- Department of Pharmacognosy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Mohd Imran
- R&D Executive, Aimil Pharmaceuticals, New Delhi 110028, India;
| | - Asad Ali
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India;
| | - Haya Majid
- Department of Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi 110062, India;
| |
Collapse
|
2
|
de Sá FAP, Andrade JFM, Miranda TC, Cunha-Filho M, Gelfuso GM, Lapteva M, Kalia YN, Gratieri T. Enhanced topical paromomycin delivery for cutaneous leishmaniasis treatment: Passive and iontophoretic approaches. Int J Pharm 2023; 648:123617. [PMID: 37977289 DOI: 10.1016/j.ijpharm.2023.123617] [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: 11/03/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 11/19/2023]
Abstract
Conventional treatments for cutaneous leishmaniasis, a neglected vector-borne infectious disease, can frequently lead to serious adverse effects. Paromomycin (PAR), an aminoglycoside antibiotic, has been suggested for the topical treatment of disease-related lesions, but even when formulated in high drug-loading dosage forms, presents controversial efficacy. The presence of five ionizable amino groups hinder its passive cutaneous penetration but make PAR an excellent candidate for iontophoretic delivery. The objective of this study was to verify the feasibility of using iontophoresis for cutaneous PAR delivery and to propose a topical passive drug delivery system that could be applied between iontophoretic treatments. For this, in vitro iontophoretic experiments evaluated different application durations (10, 30, and 360 min), current densities (0.1, 0.25, and 0.5 mA/cm2), PAR concentrations (0.5 and 1.0 %), and skin models (intact and impaired porcine skin). In addition, 1 % PAR hydrogel had its penetration profile compared to 15 % PAR ointment in passive transport. Results showed iontophoresis could deliver suitable PAR amounts to dermal layers, even in short times and with impaired skin. Biodistribution assays showed both iontophoretic transport and the proposed hydrogel delivered higher PAR amounts to deeper skin layers than conventional ointment, even though applying 15 times less drug. To our knowledge, this is the first report of PAR drug delivery enhancement by iontophoresis. In summary, the association of iontophoresis with a topical application of PAR gel seems appropriate for improving cutaneous leishmaniasis treatment.
Collapse
Affiliation(s)
- Fernando A P de Sá
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), 70910-900, Brasília, DF, Brazil
| | - Jayanaraian F M Andrade
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), 70910-900, Brasília, DF, Brazil
| | - Thamires C Miranda
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), 70910-900, Brasília, DF, Brazil
| | - Marcilio Cunha-Filho
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), 70910-900, Brasília, DF, Brazil
| | - Guilherme M Gelfuso
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), 70910-900, Brasília, DF, Brazil
| | - Maria Lapteva
- School of Pharmaceutical Sciences, University of Geneva, CMU-1 rue Michel Servet, 1211 Geneva, Switzerland
| | - Yogeshvar N Kalia
- School of Pharmaceutical Sciences, University of Geneva, CMU-1 rue Michel Servet, 1211 Geneva, Switzerland
| | - Taís Gratieri
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia (UnB), 70910-900, Brasília, DF, Brazil.
| |
Collapse
|
3
|
Retamiro KM, Nunes KC, Zani AP, Zani CP, Beltran LB, Silva SDO, Garcia FP, Ueda-Nakamura T, Bergamasco R, Nakamura CV. Ionized alkaline water reduces injury in BALB/c mice infected with Leishmania amazonensis. PLoS One 2023; 18:e0280695. [PMID: 37410769 PMCID: PMC10325109 DOI: 10.1371/journal.pone.0280695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/06/2023] [Indexed: 07/08/2023] Open
Abstract
Ionized water has been reported to contribute to the tissue repair process and wound healing. Water purifiers can generate ionized water by means of activated charcoal with silver and minerals, the main purpose of which are to reduce microbiological and physicochemical contaminants. Moreover, when water is subjected to a magnetic field an organization of water molecules occurs due to the presence of mineral salts. The resulting water is thus more alkaline, which has been shown to be non-toxic to mice and can actually prolong survival. Cutaneous leishmaniasis is a neglected tropical disease, caused by obligate uni- and intracellular protozoa belonging to the genus Leishmania, that can manifest in the form of skin lesions. Thus, the objective of this study was to compare the evolution of disease in L. amazonensis-infected BALB/c mice that received tap water (TW) or ionized alkaline water (IAW). As a control, additional groups of mice receiving TW or IAW were also treated with the antileishmanial miltefosine. All mouse groups received either TW or IAW as drinking water 30 days prior to infection and the groups continued to receive the respective drinking water for 4 weeks, after which the blood and plasma were collected. Biochemical assays of aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase, creatinine, urea, glucose, triglycerides, and cholesterol were performed, in addition to hematology tests. There was a significant decrease in the volume of the lesion for groups that received IAW, in which the ingestion of ionized alkaline water favored the non-evolution of the lesion in the footpads of the animals. The results of the blood count and leukogram tests were within the normal values for BALB/c mice demonstrating that ionized water has no toxic effects on blood factors.
Collapse
Affiliation(s)
- Karina Miyuki Retamiro
- Laboratory of Technological Innovation in the Development of Pharmaceuticals and Cosmetics, State University of Maringá, Maringá, Brazil
| | - Karine Campos Nunes
- Laboratory of Technological Innovation in the Development of Pharmaceuticals and Cosmetics, State University of Maringá, Maringá, Brazil
| | - Aline Pinto Zani
- Laboratory of Technological Innovation in the Development of Pharmaceuticals and Cosmetics, State University of Maringá, Maringá, Brazil
| | - Caroline Pinto Zani
- Laboratory of Technological Innovation in the Development of Pharmaceuticals and Cosmetics, State University of Maringá, Maringá, Brazil
| | - Laiza Bergamasco Beltran
- Laboratory of Management, Preservation and Environmental Control, State University of Maringá, Maringá, Brazil
| | - Sueli de Oliveira Silva
- Laboratory of Technological Innovation in the Development of Pharmaceuticals and Cosmetics, State University of Maringá, Maringá, Brazil
| | - Francielle Pelegrin Garcia
- Laboratory of Technological Innovation in the Development of Pharmaceuticals and Cosmetics, State University of Maringá, Maringá, Brazil
| | - Tânia Ueda-Nakamura
- Laboratory of Technological Innovation in the Development of Pharmaceuticals and Cosmetics, State University of Maringá, Maringá, Brazil
| | - Rosangela Bergamasco
- Laboratory of Management, Preservation and Environmental Control, State University of Maringá, Maringá, Brazil
| | - Celso Vataru Nakamura
- Laboratory of Technological Innovation in the Development of Pharmaceuticals and Cosmetics, State University of Maringá, Maringá, Brazil
| |
Collapse
|
4
|
Abstract
Leishmaniasis (visceral and cutaneous), Chagas disease and human African trypanosomiasis cause substantial death and morbidity, particularly in low- and middle-income countries. Although the situation has improved for human African trypanosomiasis, there remains an urgent need for new medicines to treat leishmaniasis and Chagas disease; the clinical development pipeline is particularly sparse for Chagas disease. In this Review, we describe recent advances in our understanding of the biology of the causative pathogens, particularly from the drug discovery perspective, and we explore the progress that has been made in the development of new drug candidates and the identification of promising molecular targets. We also explore the challenges in developing new clinical candidates and discuss potential solutions to overcome such hurdles.
Collapse
|
5
|
Zahid F, Batool S, Ud-Din F, Ali Z, Nabi M, Khan S, Salman O, Khan GM. Antileishmanial Agents Co-loaded in Transfersomes with Enhanced Macrophage Uptake and Reduced Toxicity. AAPS PharmSciTech 2022; 23:226. [PMID: 35970966 DOI: 10.1208/s12249-022-02384-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/29/2022] [Indexed: 01/19/2023] Open
Abstract
The prime objective of this study was to develop amphotericin B (AMB) and rifampicin (RIF) co-loaded transfersomal gel (AMB-RIF co-loaded TFG) for effective treatment of cutaneous leishmaniasis (CL). AMB-RIF co-loaded TF was prepared by the thin-film hydration method and was optimized based on particle size, polydispersity index (PDI), zeta potential, entrapment efficiency (%EE), and deformability index. Similarly, AMB-RIF co-loaded TFG was characterized in terms of rheology, spread ability, and pH. In vitro, ex vivo, and in vivo assays were performed to evaluate AMB-RIF co-loaded TF as a potential treatment option for CL. The optimized formulation had vesicles in nanosize range (167 nm) with suitable PDI (0.106), zeta potential (- 19.05 mV), and excellent %EE of RIF (66%) and AMB (85%). Moreover, it had appropriate deformability index (0.952). Additionally, AMB-RIF co-loaded TFG demonstrated suitable rheological behavior for topical application. AMB-RIF co-loaded TF and AMB-RIF co-loaded TFG showed sustained release of the incorporated drugs as compared to AMB-RIF suspension. Furthermore, RIF permeation from AMB-RIF co-loaded TF and AMB-RIF co-loaded TFG was enhanced fivefold and threefold, whereas AMB permeation was enhanced by eightfold and 6.6-fold, respectively. The significantly different IC50, higher CC50, and FIC50 (p < 0.5) showed synergistic antileishmanial potential of AMB-RIF co-loaded TF. Likewise, reduced lesion size and parasitic burden in AMB-RIF co-loaded TF-treated mouse group further established the antileishmanial effect of the optimized formulation. Besides, AMB-RIF co-loaded TFG showed a better safety profile. This study concluded that TFG may be a suitable carrier for co-delivery of AMB-RIF when administered topically for the treatment of CL.
Collapse
Affiliation(s)
- Fatima Zahid
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-I-Azam University, Islamabad, Pakistan
| | - Sibgha Batool
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-I-Azam University, Islamabad, Pakistan
| | - Fakhar Ud-Din
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-I-Azam University, Islamabad, Pakistan.
| | - Zakir Ali
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-I-Azam University, Islamabad, Pakistan
| | - Muhammad Nabi
- Institute of Pharmaceutical Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Salman Khan
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-I-Azam University, Islamabad, Pakistan
| | - Omer Salman
- Department of Pharmacy, Forman Christian University, Lahore, Pakistan
| | - Gul Majid Khan
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-I-Azam University, Islamabad, Pakistan. .,Islamia College University, Peshawar, Khyber Pakhtunkhwa, Pakistan.
| |
Collapse
|
6
|
Wijnant GJ, Dumetz F, Dirkx L, Bulté D, Cuypers B, Van Bocxlaer K, Hendrickx S. Tackling Drug Resistance and Other Causes of Treatment Failure in Leishmaniasis. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.837460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Leishmaniasis is a tropical infectious disease caused by the protozoan Leishmania parasite. The disease is transmitted by female sand flies and, depending on the infecting parasite species, causes either cutaneous (stigmatizing skin lesions), mucocutaneous (destruction of mucous membranes of nose, mouth and throat) or visceral disease (a potentially fatal infection of liver, spleen and bone marrow). Although more than 1 million new cases occur annually, chemotherapeutic options are limited and their efficacy is jeopardized by increasing treatment failure rates and growing drug resistance. To delay the emergence of resistance to existing and new drugs, elucidating the currently unknown causes of variable drug efficacy (related to parasite susceptibility, host immunity and drug pharmacokinetics) and improved use of genotypic and phenotypic tools to define, measure and monitor resistance in the field are critical. This review highlights recent progress in our understanding of drug action and resistance in Leishmania, ongoing challenges (including setbacks related to the COVID-19 pandemic) and provides an overview of possible strategies to tackle this public health challenge.
Collapse
|
7
|
Calvo A, Moreno E, Aldalur I, Sanmartín C, Larrea E, González-Peñas E, Irache JM, Espuelas S. OUP accepted manuscript. J Antimicrob Chemother 2022; 77:1072-1081. [PMID: 35086139 PMCID: PMC9000957 DOI: 10.1093/jac/dkac007] [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: 06/03/2021] [Accepted: 12/18/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives More effective topical treatments remain an unmet need for the localized forms of cutaneous leishmaniasis (CL). The aim of this study was to evaluate the efficacy and safety of a topical berberine cream in BALB/c mice infected with Leishmania major parasites. Methods A cream containing 0.5% berberine-β-glycerophosphate salt and 2.5% menthol was prepared. Its physicochemical and stability properties were determined. The cream was evaluated for its capacity to reduce lesion size and parasitic load as well as to promote wound healing after twice-a-day administration for 35 days. Clinical biochemical profile was used for estimating off-target effects. In vitro time-to-kill curves in L. major-infected macrophages and skin and plasma pharmacokinetics were determined, aiming to establish pharmacokinetic/pharmacodynamic relationships. Results The cream was stable at 40°C for 3 months and at 4°C for at least 8 months. It was able to halt lesion progression in all treated mice. At the end of treatment, parasite load in the skin was reduced by 99.9% (4 log) and genes involved in the wound healing process were up-regulated compared with untreated mice. The observed effects were higher than expected from in vitro time-to-kill kinetic and plasma berberine concentrations, which ranged between 0.07 and 0.22 μM. Conclusions The twice-a-day administration of a topical berberine cream was safe, able to stop parasite progression and improved the appearance of skin CL lesions. The relationship between drug plasma levels and in vivo effect was unclear.
Collapse
Affiliation(s)
- Alba Calvo
- ISTUN Institute of Tropical Health, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Chemistry and Pharmaceutical Technology Department, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
| | - Esther Moreno
- ISTUN Institute of Tropical Health, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Chemistry and Pharmaceutical Technology Department, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Navarra Institute for Health Research, IdisNA, Pamplona, Spain
| | - Irati Aldalur
- ISTUN Institute of Tropical Health, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Chemistry and Pharmaceutical Technology Department, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
| | - Carmen Sanmartín
- ISTUN Institute of Tropical Health, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Chemistry and Pharmaceutical Technology Department, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Navarra Institute for Health Research, IdisNA, Pamplona, Spain
| | - Esther Larrea
- ISTUN Institute of Tropical Health, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Navarra Institute for Health Research, IdisNA, Pamplona, Spain
| | - Elena González-Peñas
- Chemistry and Pharmaceutical Technology Department, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
| | - Juan Manuel Irache
- Chemistry and Pharmaceutical Technology Department, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Navarra Institute for Health Research, IdisNA, Pamplona, Spain
| | - Socorro Espuelas
- ISTUN Institute of Tropical Health, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Chemistry and Pharmaceutical Technology Department, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Navarra Institute for Health Research, IdisNA, Pamplona, Spain
- Corresponding author. E-mail:
| |
Collapse
|
8
|
Amine-Linked Flavonoids as Agents Against Cutaneous Leishmaniasis. Antimicrob Agents Chemother 2021; 65:AAC.02165-20. [PMID: 33685890 PMCID: PMC8092861 DOI: 10.1128/aac.02165-20] [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] [Indexed: 11/20/2022] Open
Abstract
We have designed, synthesized, and characterized a library of 38 novel flavonoid compounds linked with amines. Some of these amine-linked flavonoids have potent in vitro activity against parasites that cause cutaneous leishmaniasis, a tropical disease endemic in 80 countries worldwide. The most promising candidate, FM09h, was highly active with IC50 of 0.3 μM against L. amazonensis, L. tropica and L. braziliensis amastigotes. It was metabolically stable (39% and 66% of FM09h remaining after 30-minute incubation with human and rat liver microsomes respectively). In L. amazonensis LV78 cutaneous leishmaniasis mouse model, intralesional injection of FM09h (10 mg/kg, once every 4 days for 8 times) demonstrated promising effect in reducing the footpad lesion thickness by 72%, displaying an efficacy comparable to SSG (63%).
Collapse
|
9
|
Van Bocxlaer K, McArthur KN, Harris A, Alavijeh M, Braillard S, Mowbray CE, Croft SL. Film-Forming Systems for the Delivery of DNDI-0690 to Treat Cutaneous Leishmaniasis. Pharmaceutics 2021; 13:516. [PMID: 33918099 PMCID: PMC8069359 DOI: 10.3390/pharmaceutics13040516] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 11/18/2022] Open
Abstract
In cutaneous leishmaniasis (CL), parasites reside in the dermis, creating an opportunity for local drug administration potentially reducing adverse effects and improving treatment adherence compared to current therapies. Polymeric film-forming systems (FFSs) are directly applied to the skin and form a thin film as the solvent evaporates. In contrast to conventional topical dosage forms, FFSs strongly adhere to the skin, favouring sustained drug delivery to the affected site, reducing the need for frequent applications, and enhancing patient compliance. This study reports the first investigation of the use of film-forming systems for the delivery of DNDI-0690, a nitroimidazole compound with potent activity against CL-causing Leishmania species. A total of seven polymers with or without plasticiser were evaluated for drying time, stickiness, film-flexibility, and cosmetic attributes; three FFSs yielded a positive evaluation for all test parameters. The impact of each of these FFSs on the permeation of the model skin permeant hydrocortisone (hydrocortisone, 1% (w/v) across the Strat-M membrane was evaluated, and the formulations resulting in the highest and lowest permeation flux (Klucel LF with triethyl citrate and Eudragit RS with dibutyl sebacate, respectively) were selected as the FFS vehicle for DNDI-0690. The release and skin distribution of the drug upon application to Leishmania-infected and uninfected BALB/c mouse skin were examined using Franz diffusion cells followed by an evaluation of the efficacy of both DNDI-0690 FFSs (1% (w/v)) in an experimental CL model. Whereas the Eudragit film resulted in a higher permeation of DNDI-0690, the Klucel film was able to deposit four times more drug into the skin, where the parasite resides. Of the FFSs formulations, only the Eudragit system resulted in a reduced parasite load, but not reduced lesion size, when compared to the vehicle only control. Whereas drug delivery into the skin was successfully modulated using different FFS systems, the FFS systems selected were not effective for the topical application of DNDI-0690. The convenience and aesthetic of FFS systems alongside their ability to modulate drug delivery to and into the skin merit further investigation using other promising antileishmanial drugs.
Collapse
Affiliation(s)
- Katrien Van Bocxlaer
- Department of Biology, York Biomedical Research Institute, University of York, York YO10 5DD, UK
| | - Kerri-Nicola McArthur
- Pharmidex Pharmaceutical Services Ltd., London EC2V 8AU, UK; (K.-N.M.); (A.H.); (M.A.)
| | - Andy Harris
- Pharmidex Pharmaceutical Services Ltd., London EC2V 8AU, UK; (K.-N.M.); (A.H.); (M.A.)
| | - Mo Alavijeh
- Pharmidex Pharmaceutical Services Ltd., London EC2V 8AU, UK; (K.-N.M.); (A.H.); (M.A.)
| | - Stéphanie Braillard
- Drugs for Neglected Diseases initiative (DNDi), 1202 Geneva, Switzerland; (S.B.); (C.E.M.)
| | - Charles E. Mowbray
- Drugs for Neglected Diseases initiative (DNDi), 1202 Geneva, Switzerland; (S.B.); (C.E.M.)
| | - Simon L. Croft
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| |
Collapse
|
10
|
Carvalheiro M, Vieira J, Faria-Silva C, Marto J, Simões S. Amphotericin B-loaded deformable lipid vesicles for topical treatment of cutaneous leishmaniasis skin lesions. Drug Deliv Transl Res 2021; 11:717-728. [PMID: 33534106 DOI: 10.1007/s13346-021-00910-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
Cutaneous leishmaniasis (CL), the most common clinical form of human leishmaniasis, is a non-fatal chronic and disabling disease characterized by erythema and nodular or ulcerative skin lesions that may cause permanent scars and disfigurement. Topical drug delivery represents a simple and efficacious approach to treat CL skin lesions. The association of drugs with nanocarrier systems enhances their permeation properties and increases the drug amount available in the dermis. Here, a deformable lipid vesicle (DLV) was optimized for the topical administration of Amphotericin B (AmB), with the aim of studying and understanding the advantages of this type of delivery system in the transport of a drug through the skin layers. AmB-DVL were characterized in terms of incorporation parameters, stability, and elasticity, and evaluated in vitro for their permeation properties, cytotoxicity, and anti-leishmanial activity. The AmB-DVL exhibited a translucent fluid gel-like aspect and a yellow color, a mean size of 132 nm (PdI ≤ 0.1), zeta potential values around zero (mV), and an AmB incorporation efficiency of 95%. Permeation and penetration assays suggest that AmB-DLV are suitable for topical administration since AmB was detected in the epidermal and dermal skin layers. AmB-DVL was able to reduce promastigote viability in a dose-dependent manner, as well as the number of intracellular amastigotes in THP-1 macrophages. Selectivity index (SI) value for AmB-DLV was considerably higher than that observed for free AmB. Results suggest that DLV may represent an attractive vehicle for dermal delivery of AmB and a new low-cost and safe therapeutic option in CL treatment.
Collapse
Affiliation(s)
- Manuela Carvalheiro
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003, Lisboa, Portugal
| | - Jennifer Vieira
- Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003, Lisboa, Portugal
| | - Catarina Faria-Silva
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003, Lisboa, Portugal
| | - Joana Marto
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003, Lisboa, Portugal
| | - Sandra Simões
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003, Lisboa, Portugal.
| |
Collapse
|
11
|
Van Bocxlaer K, Croft SL. Pharmacokinetics and pharmacodynamics in the treatment of cutaneous leishmaniasis - challenges and opportunities. RSC Med Chem 2021; 12:472-482. [PMID: 34041488 PMCID: PMC8128043 DOI: 10.1039/d0md00343c] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/11/2020] [Indexed: 12/11/2022] Open
Abstract
Pharmacological efficacy is obtained when adequate concentrations of a potent drug reach the target site. In cutaneous leishmaniasis, a heterogeneous disease characterised by a variety of skin manifestations from simple nodules, skin discoloration, plaques to extensive disseminated forms, the parasites are found in the dermal layers of the skin. Treatment thus involves the release of the active compound from the formulation (administered either topically or systemically), it's permeation into the skin, accumulation by the local macrophages and further transport into the phagolysosome of the macrophage. The pharmacodynamic activity of a drug against the parasite is relatively straight forward to evaluate both in vivo and in vitro. The pharmacokinetic processes taking place inside the skin are more complex to elucidate due to the multi-lamellar structure of the skin, heterogeneous distribution of drugs within the tissue, the difficulty of accessing the site of infection complicating sampling and the lack of surrogate markers reflecting the activity of a drug in the skin. This review will discuss the difficulties encountered when investigating drug distribution, PK PD relationships and efficacy in the skin with a focus on cutaneous leishmaniasis treatment.
Collapse
Affiliation(s)
- Katrien Van Bocxlaer
- Department of Biology, York Biomedical Research Institute, University of York York YO10 5DD UK +44 (0) 19 0432 8855
| | - Simon L Croft
- Department of Infection Biology, London School of Hygiene & Tropical Medicine London WC1E 7HT UK
| |
Collapse
|
12
|
Fernández-García R, Statts L, de Jesus JA, Dea-Ayuela MA, Bautista L, Simão R, Bolás-Fernández F, Ballesteros MP, Laurenti MD, Passero LFD, Lalatsa A, Serrano DR. Ultradeformable Lipid Vesicles Localize Amphotericin B in the Dermis for the Treatment of Infectious Skin Diseases. ACS Infect Dis 2020; 6:2647-2660. [PMID: 32810398 DOI: 10.1021/acsinfecdis.0c00293] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Cutaneous fungal and parasitic diseases remain challenging to treat, as available therapies are unable to permeate the skin barrier. Thus, treatment options rely on systemic therapy, which fail to produce high local drug concentrations but can lead to significant systemic toxicity. Amphotericin B (AmB) is highly efficacious in the treatment of both fungal and parasitic diseases such as cutaneous leishmaniasis but is reserved for parenteral administration in patients with severe pathophysiology. Here, we have designed and optimized AmB-transfersomes [93.5% encapsulation efficiency, 150 nm size, and good colloidal stability (-35.02 mV)] that can remain physicochemically stable (>90% drug content) at room temperature and 4 °C over 6 months when lyophilized and stored under desiccated conditions. AmB-transfersomes possessed good permeability across mouse skin (4.91 ± 0.41 μg/cm2/h) and 10-fold higher permeability across synthetic Strat-M membranes. In vivo studies after a single topical application in mice showed permeability and accumulation within the dermis (>25 μg AmB/g skin 6 h postadministration), indicating the delivery of therapeutic amounts of AmB for mycoses and cutaneous leishmaniasis, while a single daily administration in Leishmania (Leishmania) amazonensis infected mice over 10 days, resulted in excellent efficacy (98% reduction in Leishmania parasites). Combining the application of AmB-transfersomes with metallic microneedles in vivo increased the levels in the SC and dermis but was unlikely to elicit transdermal levels. In conclusion, AmB-transfersomes are promising and stable topical nanomedicines that can be readily translated for parasitic and fungal infectious diseases.
Collapse
Affiliation(s)
| | - Larry Statts
- Biomaterials, Bio-engineering and Nanomedicines (BioN) Laboratory, Institute of Biomedical and Biomolecular Sciences, School of Pharmacy and Pharmaceutical Sciences, University of Portsmouth, St. Michael’s Building, White Swan Road, Portsmouth, United Kingdom
| | - Jéssica A. de Jesus
- Laboratory of Pathology of Infectious Diseases (LIM-50), Medical School, University of São Paulo, Avenida Dr. Arnaldo 455, 01246903 Cerqueira César, SP, Brazil
| | - Maria Auxiliadora Dea-Ayuela
- Departamento de Farmacia, Facultad de Ciencias de la Salud, Universidad CEU Cardenal Herrera, Carrer Santiago Ramón y Cajal s/n, 46113 Valencia, Spain
| | - Liliana Bautista
- Biomaterials, Bio-engineering and Nanomedicines (BioN) Laboratory, Institute of Biomedical and Biomolecular Sciences, School of Pharmacy and Pharmaceutical Sciences, University of Portsmouth, St. Michael’s Building, White Swan Road, Portsmouth, United Kingdom
| | | | | | | | - Marcia Dalastra Laurenti
- Laboratory of Pathology of Infectious Diseases (LIM-50), Medical School, University of São Paulo, Avenida Dr. Arnaldo 455, 01246903 Cerqueira César, SP, Brazil
| | - Luiz F. D. Passero
- São Paulo State University (UNESP), Institute of Biosciences, São Vicente Praça Infante Dom Henrique s/n, 11330-900 São Vicente, SP, Brazil
- São Paulo State University (UNESP), Institute for Advanced Studies of Ocean, São Vicente Av. João Francisco Bensdorp 1178, 11350-011 São Vicente, SP (Brazil)
| | - Aikaterini Lalatsa
- Biomaterials, Bio-engineering and Nanomedicines (BioN) Laboratory, Institute of Biomedical and Biomolecular Sciences, School of Pharmacy and Pharmaceutical Sciences, University of Portsmouth, St. Michael’s Building, White Swan Road, Portsmouth, United Kingdom
| | | |
Collapse
|
13
|
Riezk A, Van Bocxlaer K, Yardley V, Murdan S, Croft SL. Activity of Amphotericin B-Loaded Chitosan Nanoparticles against Experimental Cutaneous Leishmaniasis. Molecules 2020; 25:E4002. [PMID: 32887341 PMCID: PMC7504813 DOI: 10.3390/molecules25174002] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/20/2020] [Accepted: 08/26/2020] [Indexed: 12/19/2022] Open
Abstract
Chitosan nanoparticles have gained attention as drug delivery systems (DDS) in the medical field as they are both biodegradable and biocompatible with reported antimicrobial and anti-leishmanial activities. We investigated the application of chitosan nanoparticles as a DDS for the treatment of cutaneous leishmaniasis (CL) by preparing two types of chitosan nanoparticles: positively charged with tripolyphosphate sodium (TPP) and negatively charged with dextran sulphate. Amphotericin B (AmB) was incorporated into these nanoparticles. Both types of AmB-loaded nanoparticles demonstrated in vitro activity against Leishmania major intracellular amastigotes, with similar activity to unencapsulated AmB, but with a significant lower toxicity to KB-cells and red blood cells. In murine models of CL caused by L. major, intravenous administration of AmB-loaded chitosan-TPP nanoparticles (Size = 69 ± 8 nm, Zeta potential = 25.5 ± 1 mV, 5 mg/kg/for 10 days on alternate days) showed a significantly higher efficacy than AmBisome® (10 mg/kg/for 10 days on alternate days) in terms of reduction of lesion size and parasite load (measured by both bioluminescence and qPCR). Poor drug permeation into and through mouse skin, using Franz diffusion cells, showed that AmB-loaded chitosan nanoparticles are not appropriate candidates for topical treatment of CL.
Collapse
Affiliation(s)
- Alaa Riezk
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK or (A.R.); (K.V.B.); (V.Y.)
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, London WC1N 1AX, UK;
| | - Katrien Van Bocxlaer
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK or (A.R.); (K.V.B.); (V.Y.)
- Department of Biology, York Biomedical Research Institute, University of York, York YO10 5DD, UK
| | - Vanessa Yardley
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK or (A.R.); (K.V.B.); (V.Y.)
| | - Sudaxshina Murdan
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, London WC1N 1AX, UK;
| | - Simon L. Croft
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK or (A.R.); (K.V.B.); (V.Y.)
| |
Collapse
|
14
|
Lalatsa A, Statts L, Adriana de Jesus J, Adewusi O, Auxiliadora Dea-Ayuela M, Bolas-Fernandez F, Dalastra Laurenti M, Felipe Domingues Passero L, Serrano DR. Topical buparvaquone nano-enabled hydrogels for cutaneous leishmaniasis. Int J Pharm 2020; 588:119734. [PMID: 32777535 DOI: 10.1016/j.ijpharm.2020.119734] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/19/2020] [Accepted: 08/01/2020] [Indexed: 01/09/2023]
Abstract
Leishmaniasis is a neglected disease presenting cutaneous, mucosal and visceral forms and affecting an estimated 12 million mostly low-income people. Treatment of cutaneous leishmaniasis (CL) is recommended to expedite healing, reduce risk of scarring, prevent parasite dissemination to other mucocutaneous (common with New World species) or visceral forms and reduce the chance of relapse, but remains an unmet need. Available treatments are painful, prolonged (>20 days) and require hospitalisation, which increases the cost of therapy. Here we present the development of optimised topical self-nanoemulsifying drug delivery systems (SNEDDS) loaded with buparvaquone (BPQ, a hydroxynapthoquinone from the open Malaria Box) for the treatment of CL from New World species. The administration of topical BPQ-SNEDDS gels for 7 days resulted in a reduction of parasite load of 99.989 ± 0.019% similar to the decrease achieved with intralesionally administered Glucantime® (99.873 ± 0.204%) in a L. amazonensis BALB/c model. In vivo efficacy was supported by ex vivo permeability and in vivo tape stripping studies. BPQ-SNEDDS and their hydrogels demonstrated linear flux across non-infected CD-1 mouse skin ex vivo of 182.4 ± 63.0 μg cm-2 h-1 and 57.6 ± 10.8 μg cm-2 h-1 respectively localising BPQ within the skin in clinically effective concentrations (227.0 ± 45.9 μg and 103.8 ± 33.8 μg) respectively. These levels are therapeutic as BPQ-SNEDDS and their gels showed nanomolar in vitro efficacy against L. amazonensis and L. braziliensis amastigotes with excellent selectivity index toward parasites versus murine macrophages. In vivo tape stripping experiments indicated localisation of BPQ within the stratum corneum and dermis. Histology studies confirmed the reduction of parasitism and indicated healing in animals treated with BPQ-SNEDDS hydrogels. These results highlight the potential clinical capability of nano-enabled BPQ hydrogels towards a non-invasive treatment for CL.
Collapse
Affiliation(s)
- Aikaterini Lalatsa
- Biomaterials, Bio-engineering and Nanomedicines (BioN) Laboratory, Institute of Biomedical and Biomolecular Sciences, School of Pharmacy and Biomedical Sciences, University of Portsmouth, White Swan Road, Portsmouth PO1 2DT, UK.
| | - Larry Statts
- Biomaterials, Bio-engineering and Nanomedicines (BioN) Laboratory, Institute of Biomedical and Biomolecular Sciences, School of Pharmacy and Biomedical Sciences, University of Portsmouth, White Swan Road, Portsmouth PO1 2DT, UK
| | - Jéssica Adriana de Jesus
- Laboratory of Pathology of Infectious Diseases (LIM-50), Medical School, University of São Paulo, Avenida Dr. Arnaldo 455, 01246903 Cerqueira César, SP, Brazil
| | - Olivia Adewusi
- Biomaterials, Bio-engineering and Nanomedicines (BioN) Laboratory, Institute of Biomedical and Biomolecular Sciences, School of Pharmacy and Biomedical Sciences, University of Portsmouth, White Swan Road, Portsmouth PO1 2DT, UK
| | - Maria Auxiliadora Dea-Ayuela
- Departamento de Farmacia, Facultad de Ciencias de la Salud, Universidad CEU Cardenal Herrera, Edificio Seminario s/n, 46113-Moncada, Valencia, Spain
| | - Francisco Bolas-Fernandez
- Departament of Microbiology and Parasitology, School of Pharmacy, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
| | - Marcia Dalastra Laurenti
- Laboratory of Pathology of Infectious Diseases (LIM-50), Medical School, University of São Paulo, Avenida Dr. Arnaldo 455, 01246903 Cerqueira César, SP, Brazil
| | - Luiz Felipe Domingues Passero
- Laboratory of Pathology of Infectious Diseases (LIM-50), Medical School, University of São Paulo, Avenida Dr. Arnaldo 455, 01246903 Cerqueira César, SP, Brazil; Institute of Biosciences, São Paulo State University (UNESP), Praça Infante Dom Henrique s/n, 11330-900 São Vicente, SP, Brazil
| | - Dolores R Serrano
- Institute for Advanced Studies of Ocean Biosciences, São Paulo State University (UNESP), Av. João Francisco Bensdorp, 1178, 11350-011 São Vicente, SP, Brazil; Departament of Pharmaceutics and Food Technology and Instituto Universitario de Farmacia Industrial (IUFI), School of Pharmacy, University Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
| |
Collapse
|
15
|
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: 46] [Impact Index Per Article: 11.5] [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.
Collapse
|
16
|
Topical Amphotericin B Semisolid Dosage Form for Cutaneous Leishmaniasis: Physicochemical Characterization, Ex Vivo Skin Permeation and Biological Activity. Pharmaceutics 2020; 12:pharmaceutics12020149. [PMID: 32059430 PMCID: PMC7076632 DOI: 10.3390/pharmaceutics12020149] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/09/2020] [Accepted: 02/10/2020] [Indexed: 12/13/2022] Open
Abstract
Amphotericin B (AmB) is a potent antifungal successfully used intravenously to treat visceral leishmaniasis but depending on the Leishmania infecting species, it is not always recommended against cutaneous leishmaniasis (CL). To address the need for alternative topical treatments of CL, the aim of this study was to elaborate and characterize an AmB gel. The physicochemical properties, stability, rheology and in vivo tolerance were assayed. Release and permeation studies were performed on nylon membranes and human skin, respectively. Toxicity was evaluated in macrophage and keratinocyte cell lines, and the activity against promastigotes and intracellular amastigotes of Leishmania infantum was studied. The AmB gel remained stable for a period of two months, with optimal properties for topical use and no apparent toxic effect on the cell lines. High amounts of AmB were found in damaged and non-damaged skin (1230.10 ± 331.52 and 2484.57 ± 439.12 µg/g/cm2, respectively) and they were above the IC50 of AmB for amastigotes. Although there were no differences in the in vitro anti-leishmanial activity between the AmB solution and gel, the formulation resulted in a higher amount of AmB being retained in the skin, and is therefore a candidate for further studies of in vivo efficacy.
Collapse
|
17
|
Van Bocxlaer K, Caridha D, Black C, Vesely B, Leed S, Sciotti RJ, Wijnant GJ, Yardley V, Braillard S, Mowbray CE, Ioset JR, Croft SL. Novel benzoxaborole, nitroimidazole and aminopyrazoles with activity against experimental cutaneous leishmaniasis. Int J Parasitol Drugs Drug Resist 2019; 11:129-138. [PMID: 30922847 PMCID: PMC6904836 DOI: 10.1016/j.ijpddr.2019.02.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/06/2019] [Accepted: 02/12/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Drugs for Neglected Diseases initiative (DNDi) has identified three chemical lead series, the nitroimidazoles, benzoxaboroles and aminopyrazoles, as innovative treatments for visceral leishmaniasis. The leads discovered using phenotypic screening, were optimised following disease- and compound-specific criteria. Several leads of each series were progressed and preclinical drug candidates have been nominated. Here we evaluate the efficacy of the lead compounds of each of these three chemical classes in in vitro and in vivo models of cutaneous leishmaniasis. METHODS The in vitro activity of fifty-five compounds was evaluated against the intracellular amastigotes of L. major, L. aethiopica, L. amazonensis, L. panamensis, L. mexicana and L. tropica. The drugs demonstrating potent activity (EC50 < 5 μM) against at least 4 of 6 species were subsequently evaluated in vivo in different L. major - BALB/c mouse models using a 5 or 10-day treatment with either the oral or topical formulations. Efficacy was expressed as lesion size (measured daily using callipers), parasite load (by quantitative PCR - DNA) and bioluminescence signal reduction relative to the untreated controls. RESULTS The selected drug compounds (3 nitroimidazoles, 1 benzoxaborole and 3 aminopyrazoles) showed consistent and potent activity across a range of Leishmania species that are known to cause CL with EC50 values ranging from 0.29 to 18.3 μM. In all cases, this potent in vitro antileishmanial activity translated into high levels of efficacy with a linear dose-response against murine CL. When administered at 50 mg/kg/day, DNDI-0690 (nitroimidazole), DNDI-1047 (aminopyrazole) and DNDI-6148 (benzoxaborole) all resulted in a significant lesion size reduction (no visible nodule) and an approximate 2-log-fold reduction of the parasite load as measured by qPCR compared to the untreated control. CONCLUSIONS The lead compounds DNDI-0690, DNDI-1047 and DNDI-6148 showed excellent activity across a range of Leishmania species in vitro and against L. major in mice. These compounds offer novel potential drugs for the treatment of CL.
Collapse
Affiliation(s)
- Katrien Van Bocxlaer
- London School of Hygiene & Tropical Medicine, Faculty of Infections and Tropical Diseases, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Diana Caridha
- Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA
| | - Chad Black
- Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA
| | - Brian Vesely
- Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA
| | - Susan Leed
- Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA
| | - Richard J Sciotti
- National Institutes of Health, Office of Biodefense, Research Resources and Translational Research, 5601 Fishers Lane, Bethesda, MD, 20892, USA
| | - Gert-Jan Wijnant
- London School of Hygiene & Tropical Medicine, Faculty of Infections and Tropical Diseases, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Vanessa Yardley
- London School of Hygiene & Tropical Medicine, Faculty of Infections and Tropical Diseases, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Stéphanie Braillard
- Drugs for Neglected Disease initiative (DNDi), Chemin Louis Dunant 15, 1202, Geneva, Switzerland
| | - Charles E Mowbray
- Drugs for Neglected Disease initiative (DNDi), Chemin Louis Dunant 15, 1202, Geneva, Switzerland
| | - Jean-Robert Ioset
- Drugs for Neglected Disease initiative (DNDi), Chemin Louis Dunant 15, 1202, Geneva, Switzerland
| | - Simon L Croft
- London School of Hygiene & Tropical Medicine, Faculty of Infections and Tropical Diseases, Keppel Street, London, WC1E 7HT, United Kingdom.
| |
Collapse
|
18
|
Moreno E, Calvo A, Schwartz J, Navarro-Blasco I, González-Peñas E, Sanmartín C, Irache JM, Espuelas S. Evaluation of Skin Permeation and Retention of Topical Dapsone in Murine Cutaneous Leishmaniasis Lesions. Pharmaceutics 2019; 11:E607. [PMID: 31766282 PMCID: PMC6920985 DOI: 10.3390/pharmaceutics11110607] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 01/30/2023] Open
Abstract
The oral administration of dapsone (DAP) for the treatment of cutaneous leishmaniasis (CL) is effective, although serious hematological side effects limit its use. In this study, we evaluated this drug for the topical treatment of CL. As efficacy depends on potency and skin penetration, we first determined its antileishmanial activity (IC50 = 100 μM) and selectivity index in vitro against Leishmania major-infected macrophages. In order to evaluate the skin penetration ex vivo, we compared an O/W cream containing DAP that had been micronized with a pluronic lecithin emulgel, in which the drug was solubilized with diethylene glycol monoethyl ether. For both formulations we obtained similar low flux values that increased when the stratum corneum and the epidermis were removed. In vivo efficacy studies performed on L. major-infected BALB/c mice revealed that treatment not only failed to cure the lesions but made their evolution and appearance worse. High plasma drug levels were detected and were concomitant with anemia and iron accumulation in the spleen. This side effect was correlated with a reduction of parasite burden in this organ. Our results evidenced that DAP in these formulations does not have an adequate safety index for use in the topical therapy of CL.
Collapse
Affiliation(s)
- Esther Moreno
- ISTUN Institute of Tropical Health, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (E.M.); (A.C.); (J.S.); (C.S.)
- Department of Pharmaceutical Technology and Chemistry, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (E.G.-P.); (J.M.I.)
- IdisNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Alba Calvo
- ISTUN Institute of Tropical Health, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (E.M.); (A.C.); (J.S.); (C.S.)
- Department of Pharmaceutical Technology and Chemistry, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (E.G.-P.); (J.M.I.)
| | - Juana Schwartz
- ISTUN Institute of Tropical Health, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (E.M.); (A.C.); (J.S.); (C.S.)
- Department of Pharmaceutical Technology and Chemistry, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (E.G.-P.); (J.M.I.)
| | - Iñigo Navarro-Blasco
- Department of Chemistry, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain;
| | - Elena González-Peñas
- Department of Pharmaceutical Technology and Chemistry, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (E.G.-P.); (J.M.I.)
| | - Carmen Sanmartín
- ISTUN Institute of Tropical Health, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (E.M.); (A.C.); (J.S.); (C.S.)
- Department of Pharmaceutical Technology and Chemistry, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (E.G.-P.); (J.M.I.)
- IdisNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Juan Manuel Irache
- Department of Pharmaceutical Technology and Chemistry, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (E.G.-P.); (J.M.I.)
- IdisNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Socorro Espuelas
- ISTUN Institute of Tropical Health, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (E.M.); (A.C.); (J.S.); (C.S.)
- Department of Pharmaceutical Technology and Chemistry, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain; (E.G.-P.); (J.M.I.)
- IdisNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| |
Collapse
|
19
|
Pharmacokinetics and Pharmacodynamics of the Nitroimidazole DNDI-0690 in Mouse Models of Cutaneous Leishmaniasis. Antimicrob Agents Chemother 2019; 63:AAC.00829-19. [PMID: 31262757 PMCID: PMC6709472 DOI: 10.1128/aac.00829-19] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 06/20/2019] [Indexed: 01/05/2023] Open
Abstract
The nitroimidazole DNDI-0690 is a clinical drug candidate for visceral leishmaniasis (VL) that also shows potent in vitro and in vivo activity against cutaneous leishmaniasis (CL). To support further development of this compound into a patient-friendly oral or topical formulation for the treatment of CL, we investigated the free drug exposure at the dermal site of infection and subsequent elimination of the causative Leishmania pathogen. This study evaluates the pharmacokinetics (PK) and pharmacodynamics (PD) of DNDI-0690 in mouse models of CL. Skin microdialysis and Franz diffusion cell permeation studies revealed that DNDI-0690 permeated poorly (<1%) into the skin lesion upon topical drug application (0.063% [wt/vol], 30 μl). In contrast, a single oral dose of 50 mg/kg of body weight resulted in the rapid and nearly complete distribution of protein-unbound DNDI-0690 from the plasma into the infected dermis (ratio of the area under the curve [0 to 6 h] of the free DNDI-0690 concentration in skin tissue to blood [fAUC0-6 h, skin tissue/fAUC0-6 h, blood] is greater than 80%). Based on in vivo bioluminescence imaging, two doses of 50 mg/kg DNDI-0690 were sufficient to reduce the Leishmania mexicana parasite load by 100-fold, while 6 such doses were needed to achieve similar killing of L. major; this was confirmed by quantitative PCR. The combination of rapid accumulation and potent activity in the Leishmania-infected dermis indicates the potential of DNDI-0690 as a novel oral treatment for CL.
Collapse
|
20
|
Sousa-Batista AJ, Pacienza-Lima W, Ré MI, Rossi-Bergmann B. Novel and safe single-dose treatment of cutaneous leishmaniasis with implantable amphotericin B-loaded microparticles. INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE 2019; 11:148-155. [PMID: 31331828 PMCID: PMC6904829 DOI: 10.1016/j.ijpddr.2019.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/03/2019] [Accepted: 06/11/2019] [Indexed: 11/19/2022]
Abstract
The development of an effective amphotericin B (AmB) topical formulation to replace the systemically toxic injections currently used in cutaneous leishmaniasis (CL) treatment is challenging due to poor absorption through the skin. Aiming at an effective local chemotherapy, we designed PLGA (poly(lactide-co-glycolide acid) microparticles loaded with deoxycholate amphotericin B (d-AmB) for both macrophage intracellular targeting and sustained extracellular release. For that, d-AmB/PLGA microparticles with sizes ranging from 0.5 μm to 20 μm were synthesized and tested both in vitro and in vivo. In vitro, d-AmB/PLGA was more selectively active against intracellular amastigotes of Leishmania amazonensis than free d-AmB (selectivity index = 50 and 25, respectively). In vivo, the efficacy of a single intralesional (i.l) injection with d-AmB/PLGA was determined in early and established BALB/c mouse ear lesions. In early lesions, a single injection given on day 10 of infection was more effective in controlling parasite growth than eight i.l. injections with free d-AmB, as measured on day 120. Such d-AmB/PLGA injection was also effective in established lesions (day 30), leading to 97% parasite burden reduction, as compared with d-AmB or liposomal AmB (Ambisome®) i.l. injection containing the same AmB dose. Pharmacokinetic studies showed that following d-AmB/PLGA injection, AmB leaked slower from non-infected than infected ears, yet remaining in the ear tissue for as long as 30 days. Of interest, AmB was not detectable in the circulating plasma for at least two weeks of d-AmB/PLGA injection, contrasting with the rapid and durable (2 days) detection after free d-AmB injection. Despite the transient ear swelling and local cell infiltration, no alterations in AST, ALT and creatinine serum levels was induced by d-AmB/PLGA. For its approved components, local efficacy, and single-dose applicability, this novel and safe AmB microparticle depot formulation has strong potential as a new therapy for human CL.
Collapse
Affiliation(s)
- Ariane J Sousa-Batista
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Nanotechnology Engineering Program, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering - COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Wallace Pacienza-Lima
- Nanotechnology Engineering Program, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering - COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Inês Ré
- University of Toulouse, IMT Mines Albi, CNRS, RAPSODEE Center, Jarlard Campus, F-81013, Albi Cedex 09, France
| | - Bartira Rossi-Bergmann
- Nanotechnology Engineering Program, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering - COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| |
Collapse
|
21
|
Synthesis and characterization of radiation cross-linked PVP hydrogels and investigation of its potential as an antileishmanial drug carrier. Polym Bull (Berl) 2019. [DOI: 10.1007/s00289-019-02803-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
22
|
Local Skin Inflammation in Cutaneous Leishmaniasis as a Source of Variable Pharmacokinetics and Therapeutic Efficacy of Liposomal Amphotericin B. Antimicrob Agents Chemother 2018; 62:AAC.00631-18. [PMID: 30082295 PMCID: PMC6153808 DOI: 10.1128/aac.00631-18] [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: 04/02/2018] [Accepted: 08/03/2018] [Indexed: 11/21/2022] Open
Abstract
Disfiguring skin lesions caused by several species of the Leishmania parasite characterize cutaneous leishmaniasis (CL). Successful treatment of CL with intravenous (i.v.) liposomal amphotericin B (LAmB) relies on the presence of adequate antibiotic concentrations at the dermal site of infection within the inflamed skin. Disfiguring skin lesions caused by several species of the Leishmania parasite characterize cutaneous leishmaniasis (CL). Successful treatment of CL with intravenous (i.v.) liposomal amphotericin B (LAmB) relies on the presence of adequate antibiotic concentrations at the dermal site of infection within the inflamed skin. Here, we have investigated the impact of the local skin inflammation on the pharmacokinetics (PK) and efficacy of LAmB in two murine models of localized CL (Leishmania major and Leishmania mexicana) at three different stages of disease (papule, initial nodule, and established nodule). Twenty-four hours after the administration of one 25 mg/kg of body weight LAmB (i.v.) dose to infected BALB/c mice (n = 5), drug accumulation in the skin was found to be dependent on the causative parasite species (L. major > L. mexicana) and the disease stage (papule > initial nodule > established nodule > healthy skin). Elevated tissue drug levels were associated with increased vascular permeability (Evans blue assay) and macrophage infiltration (histomorphometry) in the infected skin, two pathophysiological parameters linked to tissue inflammation. After identical treatment of CL in the two models with 5 × 25 mg/kg LAmB (i.v.), intralesional drug concentrations and reductions in lesion size and parasite load (quantitative PCR [qPCR]) were all ≥2-fold higher for L. major than for L. mexicana. In conclusion, drug penetration of LAmB into CL skin lesions could depend on the disease stage and the causative Leishmania species due to the influence of local tissue inflammation.
Collapse
|
23
|
In Vitro Models for Studying Transport Across Epithelial Tissue Barriers. Ann Biomed Eng 2018; 47:1-21. [DOI: 10.1007/s10439-018-02124-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/28/2018] [Indexed: 12/16/2022]
|
24
|
Peralta MF, Guzmán ML, Pérez AP, Apezteguia GA, Fórmica ML, Romero EL, Olivera ME, Carrer DC. Liposomes can both enhance or reduce drugs penetration through the skin. Sci Rep 2018; 8:13253. [PMID: 30185887 PMCID: PMC6125578 DOI: 10.1038/s41598-018-31693-y] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/22/2018] [Indexed: 12/04/2022] Open
Abstract
The adequate formulation of topical vehicles to treat skin diseases is particularly complex. A desirable formulation should enhance the accumulation of the active drugs in the target tissue (the skin), while avoiding the penetration enhancement to be so large that the drugs reach the systemic circulation in toxic amounts. We have evaluated the transcutaneous penetration of three drugs chosen for their widely variable physicochemical properties: Amphotericin B, Imiquimod and Indole. We incorporated the drugs in fluid or ultra-flexible liposomes. Ultra-flexible liposomes produced enhancement of drug penetration into/through human skin in all cases in comparison with fluid liposomes without detergent, regardless of drug molecular weight. At the same time, our results indicate that liposomes can impede the transcutaneous penetration of molecules, in particular small ones.
Collapse
Affiliation(s)
- Ma F Peralta
- Instituto de Investigación Médica M y M Ferreyra - CONICET- Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ma L Guzmán
- UNITEFA - CONICET, Pharmaceutical Sciences Department, School of Chemistry, National University of Córdoba, Córdoba, Argentina
| | - A P Pérez
- Centro de Investigación y Desarrollo en Nanomedicinas (CIDeN)- Universidad Nacional de Quilmes, Bernal, Argentina
| | - G A Apezteguia
- Centro de Investigación y Desarrollo en Nanomedicinas (CIDeN)- Universidad Nacional de Quilmes, Bernal, Argentina
| | - Ma L Fórmica
- UNITEFA - CONICET, Pharmaceutical Sciences Department, School of Chemistry, National University of Córdoba, Córdoba, Argentina
| | - E L Romero
- Centro de Investigación y Desarrollo en Nanomedicinas (CIDeN)- Universidad Nacional de Quilmes, Bernal, Argentina
| | - Ma E Olivera
- UNITEFA - CONICET, Pharmaceutical Sciences Department, School of Chemistry, National University of Córdoba, Córdoba, Argentina
| | - D C Carrer
- Instituto de Investigación Médica M y M Ferreyra - CONICET- Universidad Nacional de Córdoba, Córdoba, Argentina.
| |
Collapse
|
25
|
Zadeh Mehrizi T, Shafiee Ardestani M, Haji Molla Hoseini M, Khamesipour A, Mosaffa N, Ramezani A. Novel Nanosized Chitosan-Betulinic Acid Against Resistant Leishmania Major and First Clinical Observation of such parasite in Kidney. Sci Rep 2018; 8:11759. [PMID: 30082741 PMCID: PMC6078985 DOI: 10.1038/s41598-018-30103-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 07/24/2018] [Indexed: 12/16/2022] Open
Abstract
Regarding the antiparasitic effects of Betulinic acid (B) against Leishmaniasis, it was loaded into nanochitosan (K) for the first time in order to improve its therapeutic effects and decrease its side effects for the treatment of Leishmania major-infected Balb/c mice. Improvement the therapeutic efficacy of Bas an anti-leishmania agent through increasing the effective dose was achieved by using a novel solvent and phase separation method for K synthesis. The synthesized K with the size of 102 nm and Betulinic acid-nanochitosan (BK) with the size of 124 nm and drug loading efficiency of 93%, cellular uptake of 97.5% with the slow drug release pattern was prepared. To increase the therapeutic dose, a modified 10% acetic acid solvent was used. The in vitro and in vivo results showed that the nanodrug of BK was non toxic by 100% and BK20 mg/kg could completely performed the wound healing and inhibit the parasite in a large extent (P ˂ 0.001) compared to other groups. Therefore, BK could be considered as an alternative regimen for treatment of L. major.
Collapse
Affiliation(s)
| | - Mehdi Shafiee Ardestani
- Department of Radiopharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mostafa Haji Molla Hoseini
- Department of Medical Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Nariman Mosaffa
- Department of Medical Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amitis Ramezani
- Department of Clinical Research, Pasteur Institute of Iran, Tehran, Iran.
| |
Collapse
|
26
|
Mehrizi TZ, Ardestani MS, Khamesipour A, Hoseini MHM, Mosaffa N, Anissian A, Ramezani A. Reduction toxicity of Amphotericin B through loading into a novel nanoformulation of anionic linear globular dendrimer for improve treatment of leishmania major. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:125. [PMID: 30056571 DOI: 10.1007/s10856-018-6122-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/04/2018] [Indexed: 05/21/2023]
Abstract
Amphotericin B (A) as an antileishmanial drug has limited clinical application owing to severe side-effects and low-water solubility. This is the first study reported using Anionic Linear Globular Dendrimer (ALGD) as A carrier for the increase of A solubility rate, decrease its toxicity, and improve its therapeutic effects. ALGD was synthesized and A was loaded into nanoparticles for the first time with the drug-loading efficiency of 82%. Drug loading was confirmed using characterization methods. The drug solubility rate was increased by 478-folds. The results of the study showed that the A toxicity was significantly decreased by 95% in vitro and in vivo environments, which was confirmed by pathology findings and enzymatic evaluation. Furthermore, the nanodrug caused that mortality rate was reached to zero. Moreover, the nanodrug was as potent as the free drug and glucantime (GUL) in reducing the parasite burden and parasite number. These findings indicated the potency of ALGD to decrease the drug side-effects, increase the drug solubility rate, and improve the drug efficacy. Moreover, the nanoformulation was a non-toxic and cost-effective formulation. The conformity between in vitro and in vivo results suggested that the A-loaded ALGD could be considered as a promising candidate in reducing the side-effects of A in leishmaniasis treatment.
Collapse
Affiliation(s)
| | - Mehdi Shafiee Ardestani
- Department of Radiopharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Haji Molla Hoseini
- Department of Medical Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nariman Mosaffa
- Department of Medical Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Anissian
- Veterinary Pathology Department, Islamic Azad University, Abhar branch, Abhar, Iran
| | - Amitis Ramezani
- Department of Clinical Research, Pasteur Institute of Iran, Tehran, Iran.
| |
Collapse
|
27
|
Schwartz J, Moreno E, Calvo A, Blanco L, Fernández-Rubio C, Sanmartín C, Nguewa P, Irache JM, Larrea E, Espuelas S. Combination of paromomycin plus human anti-TNF-α antibodies to control the local inflammatory response in BALB/ mice with cutaneous leishmaniasis lesions. J Dermatol Sci 2018; 92:78-88. [PMID: 30037731 DOI: 10.1016/j.jdermsci.2018.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 07/05/2018] [Accepted: 07/12/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) skin lesions are the result of a deregulated immune response, which is unable to eliminate Leishmania parasites. The control of both, parasites and host immune response, is critical to prevent tissue destruction. The skin ulceration has been correlated with high TNF-α level. OBJECTIVE Because human anti-TNF-α antibodies (Ab) have been successfully assayed in several mice inflammatory diseases, we hypothesized that their anti-inflammatory effect could optimize the healing of CL lesions achieved after topical application of paromomycin (PM), the current chemotherapy against CL. METHODS AND RESULTS We first compared the in vitro efficacy of PM and Ab alone and the drug given in combination with Ab to assess if the Ab could interfere with PM leishmanicidal activity in L. major-infected bone marrow-derived macrophages. The combination therapy had similar antileishmanial activity to the drug alone and showed no influence on NO production, which allows macrophage-mediated parasite killing. Next, we demonstrated in an in vivo model of Imiquimod®-induced inflammation that topical Ab and PM inhibit the infiltration of inflammatory cells in the skin. In the efficacy studies in L. major-infected BALB/c mice, PM combined with Ab led to a sharp infection reduction and showed a stronger anti-inflammatory activity than PM alone. This was confirmed by the down-regulation of TNF-α, IL-1β, iNOS, IL-17, and CCL3 as well as by a decrease of the neutrophilic infiltrate during infection upon treatment with the Ab. CONCLUSIONS In terms of parasite elimination and inflammation reduction, topical application of Ab in combination with PM was more effective than the drug alone.
Collapse
Affiliation(s)
- Juana Schwartz
- Tropical Health Institute, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Pharmacy and Pharmaceutical Technology Department, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Navarra Institute for Health Research, IdisNA, Spain
| | - Esther Moreno
- Tropical Health Institute, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Pharmacy and Pharmaceutical Technology Department, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Navarra Institute for Health Research, IdisNA, Spain; Organic and Pharmaceutical Chemistry Department, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain
| | - Alba Calvo
- Tropical Health Institute, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Pharmacy and Pharmaceutical Technology Department, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Navarra Institute for Health Research, IdisNA, Spain
| | - Laura Blanco
- Tropical Health Institute, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Pharmacy and Pharmaceutical Technology Department, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Navarra Institute for Health Research, IdisNA, Spain
| | - Celia Fernández-Rubio
- Tropical Health Institute, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Navarra Institute for Health Research, IdisNA, Spain; Microbiology and Parasitology Department, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain
| | - Carmen Sanmartín
- Tropical Health Institute, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Navarra Institute for Health Research, IdisNA, Spain; Organic and Pharmaceutical Chemistry Department, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain
| | - Paul Nguewa
- Tropical Health Institute, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Navarra Institute for Health Research, IdisNA, Spain; Microbiology and Parasitology Department, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain
| | - Juan M Irache
- Pharmacy and Pharmaceutical Technology Department, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Navarra Institute for Health Research, IdisNA, Spain
| | - Esther Larrea
- Tropical Health Institute, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Navarra Institute for Health Research, IdisNA, Spain
| | - Socorro Espuelas
- Tropical Health Institute, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Pharmacy and Pharmaceutical Technology Department, University of Navarra, Irunlarrea 1, E-31008, Pamplona, Spain; Navarra Institute for Health Research, IdisNA, Spain.
| |
Collapse
|
28
|
Khalil EA, Alkawareek MY, Othman G, Tbakhi B, Al-Bakri AG. Evaluation of paromomycin sulphate permeation using ex vivo human skin model. Pharm Dev Technol 2018; 24:390-393. [PMID: 29873575 DOI: 10.1080/10837450.2018.1485697] [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: 10/14/2022]
Abstract
Ex vivo evaluation of drug release and skin permeation from topical formulations of antileishmanial drug paromomycin sulphate was carried out using intact full thickness human skin. Potency-based microbiological assay was used for the analysis of paromomycin concentrations. A total percentage drug recovery of 86 ± 26% was obtained. Incubation periods of 1 and 3 h resulted in percentage drug permeation into deep skin layers ranging from 1.3 ± 0.04% to 5.3 ± 2.0% with paraffin-based ointment and from 1.6 ± 0.8% to 3.9 ± 1% with microemulsion-based emulgel. Although a small percentage, this is still significantly higher than those previously reported using animal skin models.
Collapse
Affiliation(s)
- Enam A Khalil
- a Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy , The University of Jordan , Amman , Jordan
| | - Mahmoud Y Alkawareek
- a Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy , The University of Jordan , Amman , Jordan
| | - Ghadeer Othman
- a Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy , The University of Jordan , Amman , Jordan
| | - Bayan Tbakhi
- a Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy , The University of Jordan , Amman , Jordan
| | - Amal G Al-Bakri
- a Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy , The University of Jordan , Amman , Jordan
| |
Collapse
|
29
|
Van Bocxlaer K, Gaukel E, Hauser D, Park SH, Schock S, Yardley V, Randolph R, Plattner JJ, Merchant T, Croft SL, Jacobs RT, Wring SA. Topical Treatment for Cutaneous Leishmaniasis: Dermato-Pharmacokinetic Lead Optimization of Benzoxaboroles. Antimicrob Agents Chemother 2018; 62:e02419-17. [PMID: 29507073 PMCID: PMC5923108 DOI: 10.1128/aac.02419-17] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 02/24/2018] [Indexed: 11/20/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is caused by several species of the protozoan parasite Leishmania, affecting an estimated 10 million people worldwide. Previously reported strategies for the development of topical CL treatments have focused primarily on drug permeation and formulation optimization as the means to increase treatment efficacy. Our approach aims to identify compounds with antileishmanial activity and properties consistent with topical administration. Of the test compounds, five benzoxaboroles showed potent activity (50% effective concentration [EC50] < 5 μM) against intracellular amastigotes of at least one Leishmania species and acceptable activity (20 μM < EC50 < 30 μM) against two more species. Benzoxaborole compounds were further prioritized on the basis of the in vitro evaluation of progression criteria related to skin permeation, such as the partition coefficient and solubility. An MDCKII-hMDR1 cell assay showed overall good permeability and no significant interaction with the P-glycoprotein transporter for all substrates except LSH002 and LSH031. The benzoxaboroles were degraded, to some extent, by skin enzymes but had stability superior to that of para-hydroxybenzoate compounds, which are known skin esterase substrates. Evaluation of permeation through reconstructed human epidermis showed LSH002 to be the most permeant, followed by LSH003 and LSH001. Skin disposition studies following finite drug formulation application to mouse skin demonstrated the highest permeation for LSH001, followed by LSH003 and LSH002, with a significantly larger amount of LSH001 than the other compounds being retained in skin. Finally, the efficacy of the leads (LSH001, LSH002, and LSH003) against Leishmania major was tested in vivo LSH001 suppressed lesion growth upon topical application, and LSH003 reduced the lesion size following oral administration.
Collapse
Affiliation(s)
- Katrien Van Bocxlaer
- London School of Hygiene & Tropical Medicine, Faculty of Infections and Tropical Diseases, London, United Kingdom
| | - Eric Gaukel
- Scynexis Inc., Research Triangle Park, North Carolina, USA
| | - Deirdre Hauser
- Scynexis Inc., Research Triangle Park, North Carolina, USA
| | - Seong Hee Park
- Scynexis Inc., Research Triangle Park, North Carolina, USA
| | - Sara Schock
- Scynexis Inc., Research Triangle Park, North Carolina, USA
| | - Vanessa Yardley
- London School of Hygiene & Tropical Medicine, Faculty of Infections and Tropical Diseases, London, United Kingdom
| | - Ryan Randolph
- Scynexis Inc., Research Triangle Park, North Carolina, USA
| | | | - Tejal Merchant
- Anacor Pharmaceuticals, Inc., Palo Alto, California, USA
| | - Simon L Croft
- London School of Hygiene & Tropical Medicine, Faculty of Infections and Tropical Diseases, London, United Kingdom
| | | | | |
Collapse
|
30
|
Sousa-Batista AJ, Arruda-Costa N, Rossi-Bergmann B, Ré MI. Improved drug loading via spray drying of a chalcone implant for local treatment of cutaneous leishmaniasis. Drug Dev Ind Pharm 2018; 44:1473-1480. [DOI: 10.1080/03639045.2018.1461903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Ariane J. Sousa-Batista
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Mines Albi, CNRS, Centre RAPSODEE, Campus Jarlard, Université de Toulouse, Albi, France
| | - Natalia Arruda-Costa
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bartira Rossi-Bergmann
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Inês Ré
- Mines Albi, CNRS, Centre RAPSODEE, Campus Jarlard, Université de Toulouse, Albi, France
| |
Collapse
|
31
|
Antileishmanial and antitrypanosomal drug identification. Emerg Top Life Sci 2017; 1:613-620. [PMID: 33525851 DOI: 10.1042/etls20170103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 11/20/2017] [Accepted: 11/22/2017] [Indexed: 01/01/2023]
Abstract
Although the treatments for human African trypanosomiasis (HAT), leishmaniasis and Chagas disease (CD) still rely on drugs developed several decades ago, there has been significant progress in the identification, development and use of novel drugs and formulations. Notably, there are now two drugs in clinical trial for HAT, fexinidazole and acoziborole; the liposomal amphotericin B formulation AmBisome has become an essential tool for both treatment and control of visceral leishmaniasis; and antifungal triazoles, posoconazole and ravuconazole, together with fexinidazole, have reached clinical trials for CD. Several other novel and diverse candidates are moving through the pipeline; sustained funding for their clinical development will now be the key to bring new safe, oral, shorter-course treatments to the clinic.
Collapse
|
32
|
Abstract
New drugs and treatments for diseases caused by intracellular pathogens, such as leishmaniasis and the Leishmania species, have proved to be some of the most difficult to discover and develop. The focus of discovery research has been on the identification of potent and selective compounds that inhibit target enzymes (or other essential molecules) or are active against the causative pathogen in phenotypic in vitro assays. Although these discovery paradigms remain an essential part of the early stages of the drug R & D pathway, over the past two decades additional emphasis has been given to the challenges needed to ensure that the potential anti-infective drugs distribute to infected tissues, reach the target pathogen within the host cell and exert the appropriate pharmacodynamic effect at these sites. This review will focus on how these challenges are being met in relation to Leishmania and the leishmaniases with lessons learned from drug R & D for other intracellular pathogens.
Collapse
|
33
|
Croft S. Design of treatments for cutaneous and visceral leishmaniasis. Nihon Yakurigaku Zasshi 2017; 149:220-224. [PMID: 28484104 DOI: 10.1254/fpj.149.220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
34
|
Van Bocxlaer K, Yardley V, Murdan S, Croft SL. Topical formulations of miltefosine for cutaneous leishmaniasis in a BALB/c mouse model. ACTA ACUST UNITED AC 2016; 68:862-72. [PMID: 27230300 DOI: 10.1111/jphp.12548] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 02/29/2016] [Indexed: 01/12/2023]
Abstract
UNLABELLED Cutaneous leishmaniasis (CL) is caused by several species of the protozoan parasite Leishmania and affects approximately 10 million people worldwide. Currently available drugs are not ideal due to high cost, toxicity, parenteral administration and suboptimal efficacy. Miltefosine is the only oral treatment (Impavido®) available to treat CL, given over a period of 28 days with common side effects such as vomiting and diarrhoea. OBJECTIVE To explore the local application of miltefosine as a topical formulation to enhance activity and reduce the drug's adverse effects. METHODS The antileishmanial activity of miltefosine was confirmed in vitro against several Leishmania species. The permeation of miltefosine, in different solvents and solvent combinations, through BALB/c mouse skin was evaluated in vitro using Franz diffusion cells. The topical formulations which enabled the highest drug permeation or skin disposition were tested in vivo in BALB/c mice infected with L. major. KEY FINDINGS The overall permeation of miltefosine through skin was low regardless of the solvents used. This was reflected in limited antileishmanial activity of the drug formulations when applied topically in vivo. All topical formulations caused skin irritation. CONCLUSIONS We conclude that miltefosine is not an appropriate candidate for the topical treatment of CL.
Collapse
Affiliation(s)
- Katrien Van Bocxlaer
- Department of Pharmaceutics, UCL School of Pharmacy, London, UK.,Department of Infection and Immunology, London School of Hygiene & Tropical Medicine, London, UK
| | - Vanessa Yardley
- Department of Infection and Immunology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Simon L Croft
- Department of Infection and Immunology, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
35
|
Croft SL. Neglected tropical diseases in the genomics era: re-evaluating the impact of new drugs and mass drug administration. Genome Biol 2016; 17:46. [PMID: 26975569 PMCID: PMC4791878 DOI: 10.1186/s13059-016-0916-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Simon Croft answers Genome Biology's questions on ways to approach neglected tropical diseases in the genomics era, including re-evaluating the impact of new drugs and mass drug administration.
Collapse
Affiliation(s)
- Simon L Croft
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| |
Collapse
|