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Rêgo FD, Cardoso CDA, Moreira POL, Nogueira PM, Araújo MS, Borges VM, Laurenti MD, Bartholomeu DC, Reis AB, Monte‐Neto RLD, Soares RP. Leishmania amazonensis from distinct clinical forms/hosts has polymorphisms in Lipophosphoglycans, displays variations in immunomodulatory properties and, susceptibility to antileishmanial drugs. Cell Biol Int 2022; 46:1947-1958. [PMID: 35998255 PMCID: PMC9804363 DOI: 10.1002/cbin.11880] [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: 05/14/2022] [Revised: 07/20/2022] [Accepted: 07/23/2022] [Indexed: 01/05/2023]
Abstract
Lipophosphoglycan (LPG), the major Leishmania glycoconjugate, induces pro-inflammatory/immunosuppressive innate immune responses. Here, we evaluated functional/biochemical LPG properties from six Leishmania amazonensis strains from different hosts/clinical forms. LPGs from three strains (GV02, BA276, and LV79) had higher pro-inflammatory profiles for most of the mediators, including tumor necrosis factor alpha and interleukin 6. For this reason, glycoconjugates from all strains were biochemically characterized and had polymorphisms in their repeat units. They consisted of three types: type I, repeat units devoid of side chains; type II, containing galactosylated side chains; and type III, containing glucosylated side chains. No relationship was observed between LPG type and the pro-inflammatory properties. Finally, to evaluate the susceptibility against antileishmanial agents, two strains with high (GV02, BA276) and one with low (BA336) pro-inflammatory activity were selected for chemotherapeutic tests in THP-1 cells. All analyzed strains were susceptible to amphotericin B (AmB) but displayed various responses against miltefosine (MIL) and glucantime (GLU). The GV02 strain (canine visceral leishmaniasis) had the highest IC50 for MIL (3.34 μM), whereas diffuse leishmaniasis strains (BA276 and BA336) had a higher IC50 for GLU (6.87-12.19 mM). The highest IC50 against MIL shown by the GV02 strain has an impact on clinical management. Miltefosine is the only drug approved for dog treatment in Brazil. Further studies into drug susceptibility of L. amazonensis strains are warranted, especially in areas where dog infection by this species overlaps with those caused by Leishmania infantum.
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Affiliation(s)
- Felipe D. Rêgo
- Biotechnology Applied to Pathogens (BAP), Instituto René RachouFundação Oswaldo Cruz (FIOCRUZ)Belo HorizonteMGBrazil
| | - Camila d. A. Cardoso
- Biotechnology Applied to Pathogens (BAP), Instituto René RachouFundação Oswaldo Cruz (FIOCRUZ)Belo HorizonteMGBrazil
| | - Paulo Otávio L. Moreira
- Biotechnology Applied to Pathogens (BAP), Instituto René RachouFundação Oswaldo Cruz (FIOCRUZ)Belo HorizonteMGBrazil
| | - Paula M. Nogueira
- Biotechnology Applied to Pathogens (BAP), Instituto René RachouFundação Oswaldo Cruz (FIOCRUZ)Belo HorizonteMGBrazil
| | - Márcio S. Araújo
- Biotechnology Applied to Pathogens (BAP), Instituto René RachouFundação Oswaldo Cruz (FIOCRUZ)Belo HorizonteMGBrazil
| | - Valéria Matos Borges
- Laboratory of Inflammation and Bioarkers, Instituto Gonçalo MunizFundação Oswaldo Cruz (FIOCRUZ)SalvadorBABrazil
| | - Márcia D. Laurenti
- Departamento de Patologia, Faculdade de MedicinaUniversidade de São Paulo (USP)São PauloSPBrazil
| | - Daniella C. Bartholomeu
- Departamento de ParasitologiaUniversidade Federal de Minas Gerais (UFMG)Belo HorizonteMGBrazil
| | - Alexandre B. Reis
- Núcleo de Pesquisas em Ciências BiológicasUniversidade Federal de Ouro Preto (UFOP)Ouro PretoMGBrazil
| | - Rubens L. d. Monte‐Neto
- Biotechnology Applied to Pathogens (BAP), Instituto René RachouFundação Oswaldo Cruz (FIOCRUZ)Belo HorizonteMGBrazil
| | - Rodrigo P. Soares
- Biotechnology Applied to Pathogens (BAP), Instituto René RachouFundação Oswaldo Cruz (FIOCRUZ)Belo HorizonteMGBrazil
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Zabala-Peñafiel A, Cysne-Finkelstein L, Conceição-Silva F, Fagundes A, Miranda LDFC, Souza-Silva F, Brandt AAML, Dias-Lopes G, Alves CR. Novel Insights Into Leishmania (Viannia) braziliensis In Vitro Fitness Guided by Temperature Changes Along With Its Subtilisins and Oligopeptidase B. Front Cell Infect Microbiol 2022; 12:805106. [PMID: 35531337 PMCID: PMC9069558 DOI: 10.3389/fcimb.2022.805106] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
Proteases are virulence factors with a recognized impact on the Leishmania spp. life cycle. This study considers a set of analyses measuring phenotypic factors of L. (V.) braziliensis clinical isolates as promastigotes growth curves, murine peritoneal macrophages infection, inflammatory mediators production, and serine proteases gene expression (subtilisin 13: S13, subtilisin 28: S28, oligopeptidase B: OPB) assessing these isolates’ fitness on in vitro conditions. Parasites had different behavior during the early growth phase from day zero to day three, and all isolates reached the stationary growth phase between days four and seven. Macrophages infection showed two tendencies, one of decreased infection rate and number of parasites per macrophage (Infection Index <1000) and another with a constant infection index (≥1400). TNF-α (≥10 pg/mL) detected in infections by 75% of isolates, IL-6 (≥80 pg/mL) by 30% of isolates and low levels of NO (≥0.01µM) in almost all infections. Gene expression showed higher values of S13 (≥2RQ) in the intracellular amastigotes of all the isolates evaluated. On the contrary, S28 expression was low (≤1RQ) in all isolates. OPB expression was different between promastigotes and intracellular amastigotes, being significantly higher (≥2RQ) in the latter form of 58% of the isolates. Predictive structural assays of S13 and OPB were performed to explore temperature influence on gene expression and the encoded proteases. Gene expression data is discussed based on in silico predictions of regulatory regions that show plasticity in the linearity index of secondary structures of S13 and OPB 3’-untranslated regions of mRNA, dependent on temperature changes. While hairpin structures suggest an active region of mRNA for both genes above 26°C, pseudoknot structure found in S13 is an indication of a particular profile of this gene at mammalian host temperatures (37°C). Furthermore, the predicted 3D structures are in accordance with the influence of these temperatures on the catalytic site stability of both enzymes, favoring their action over peptide substrates. Data gathered here suggest that L. (V.) braziliensis serine proteases can be influenced by the temperature conditions affecting parasite fitness throughout its life cycle.
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Affiliation(s)
- Anabel Zabala-Peñafiel
- Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Lea Cysne-Finkelstein
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Fatima Conceição-Silva
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Aline Fagundes
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Luciana de Freitas Campos Miranda
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Franklin Souza-Silva
- Centro de Desenvolvimento Tecnológico em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Universidade Iguaçu, Dom Rodrigo, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Artur A. M. L. Brandt
- Departamento de Computação e Sistemas, Faculdade de Educação Tecnológica do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- Departamento de Ciência da Computação, Univeritas-Rio, Rio de Janeiro, Brazil
| | - Geovane Dias-Lopes
- Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- *Correspondence: Geovane Dias-Lopes, ; Carlos Roberto Alves,
| | - Carlos Roberto Alves
- Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- *Correspondence: Geovane Dias-Lopes, ; Carlos Roberto Alves,
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Pereira LOR, Sousa CS, Ramos HCP, Torres-Santos EC, Pinheiro LS, Alves MR, Cuervo P, Romero GAS, Boité MC, Porrozzi R, Cupolillo E. Insights from Leishmania (Viannia) guyanensis in vitro behavior and intercellular communication. Parasit Vectors 2021; 14:556. [PMID: 34711290 PMCID: PMC8554959 DOI: 10.1186/s13071-021-05057-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pentavalent antimonial-based chemotherapy is the first-line approach for leishmaniasis treatment and disease control. Nevertheless antimony-resistant parasites have been reported in some endemic regions. Treatment refractoriness is complex and is associated with patient- and parasite-related variables. Although amastigotes are the parasite stage in the vertebrate host and, thus, exposed to the drug, the stress caused by trivalent antimony in promastigotes has been shown to promote significant modification in expression of several genes involved in various biological processes, which will ultimately affect parasite behavior. Leishmania (Viannia) guyanensis is one of the main etiological agents in the Amazon Basin region, with a high relapse rate (approximately 25%). METHODS Herein, we conducted several in vitro analyses with L. (V.) guyanensis strains derived from cured and refractory patients after treatment with standardized antimonial therapeutic schemes, in addition to a drug-resistant in vitro-selected strain. Drug sensitivity assessed through Sb(III) half-maximal inhibitory concentration (IC50) assays, growth patterns (with and without drug pressure) and metacyclic-like percentages were determined for all strains and compared to treatment outcomes. Finally, co-cultivation without intercellular contact was followed by parasitic density and Sb(III) IC50 measurements. RESULTS Poor treatment response was correlated with increased Sb(III) IC50 values. The decrease in drug sensitivity was associated with a reduced cell replication rate, increased in vitro growth ability, and higher metacyclic-like proportion. Additionally, in vitro co-cultivation assays demonstrated that intercellular communication enabled lower drug sensitivity and enhanced in vitro growth ability, regardless of direct cell contact. CONCLUSIONS Data concerning drug sensitivity in the Viannia subgenus are emerging, and L. (V.) guyanensis plays a pivotal epidemiological role in Latin America. Therefore, investigating the parasitic features potentially related to relapses is urgent. Altogether, the data presented here indicate that all tested strains of L. (V.) guyanensis displayed an association between treatment outcome and in vitro parameters, especially the drug sensitivity. Remarkably, sharing enhanced growth ability and decreased drug sensitivity, without intercellular communication, were demonstrated.
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Affiliation(s)
- Luiza O R Pereira
- Laboratório de Pesquisa em Leishmanioses, Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
| | - Cíntia S Sousa
- Laboratório de Pesquisa em Leishmanioses, Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Hellen C P Ramos
- Laboratório de Pesquisa em Leishmanioses, Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | | | - Liliane S Pinheiro
- Laboratório de Bioquímica de Tripanossomatídeos, IOC, FIOCRUZ, Rio de Janeiro, Brazil.,Instituto de Saúde e Biotecnologia, Universidade Federal do Amazonas, Campus Coari, Amazonas, Brazil
| | - Marcelo R Alves
- Laboratório de Pesquisa Clínica em DST-AIDS, Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil
| | - Patricia Cuervo
- Laboratório de Pesquisa em Leishmanioses, Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | | | - Mariana C Boité
- Laboratório de Pesquisa em Leishmanioses, Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Renato Porrozzi
- Laboratório de Pesquisa em Leishmanioses, Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Elisa Cupolillo
- Laboratório de Pesquisa em Leishmanioses, Instituto Oswaldo Cruz (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
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In Vitro Susceptibility to Miltefosine of Leishmania infantum (syn. L. chagasi) Isolates from Different Geographical Areas in Brazil. Microorganisms 2021; 9:microorganisms9061228. [PMID: 34198947 PMCID: PMC8228039 DOI: 10.3390/microorganisms9061228] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/22/2021] [Accepted: 06/02/2021] [Indexed: 11/24/2022] Open
Abstract
Treatment of visceral leishmaniasis in Brazil still relies on meglumine antimoniate, with less than ideal efficacy and safety, making new therapeutic tools an urgent need. The oral drug miltefosine was assayed in a phase II clinical trial in Brazil with cure rates lower than previously demonstrated in India. The present study investigated the susceptibility to miltefosine in 73 Brazilian strains of Leishmania infantum from different geographic regions, using intracellular amastigote and promastigote assays. The EC50 for miltefosine of 13 of these strains evaluated in intracellular amastigotes varied between 1.41 and 4.57 μM. The EC50 of the 73 strains determined in promastigotes varied between 5.89 and 23.7 μM. No correlation between in vitro miltefosine susceptibility and the presence of the miltefosine sensitive locus was detected among the tested strains. The relatively low heterogeneity in miltefosine susceptibility observed for the 73 strains tested in this study suggests the absence of decreased susceptibility to miltefosine in Brazilian L. infantum and does not exclude future clinical evaluation of miltefosine for VL treatment in Brazil.
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Espada CR, Albuquerque-Wendt A, Hornillos V, Gluenz E, Coelho AC, Uliana SRB. Ros3 (Lem3p/CDC50) Gene Dosage Is Implicated in Miltefosine Susceptibility in Leishmania (Viannia) braziliensis Clinical Isolates and in Leishmania (Leishmania) major. ACS Infect Dis 2021; 7:849-858. [PMID: 33724800 PMCID: PMC8042657 DOI: 10.1021/acsinfecdis.0c00857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
![]()
The Ros3 protein is a component of
the MT-Ros3 transporter complex,
considered as the main route of miltefosine entry in Leishmania. L. braziliensis clinical isolates presenting differences
in miltefosine susceptibility and uptake were previously shown to
differentially express ros3. In this work, we showed
that the ros3 gene copy number was increased in the
isolate presenting the highest rates of miltefosine uptake and, thus,
the highest susceptibility to this drug. The role of the ros3 gene dosage in miltefosine susceptibility was then investigated
through a modulation of the gene copy number using two distinct approaches:
through an overexpression of ros3 in a tolerant L. braziliensis clinical isolate and in L. major and by generating mono- and diallelic knockouts of this gene in L. major using clustered regularly interspaced short palindromic
repeats (CRISPR) Cas9 (Cas = CRISPR-associated). Although the levels
of ros3 mRNA were increased at least 40-fold in overexpressing
clones, no significant reduction in the half-maximal effective concentration
(EC50) for miltefosine was observed in these parasites.
The partial or complete deletion of ros3 in L. major, in turn, resulted in a significant increase of
3 and 20 times, respectively, in the EC50 to miltefosine.
We unequivocally showed that the ros3 copy number
is one of the factors involved in the differential susceptibility
and uptake of miltefosine.
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Affiliation(s)
- Caroline R. Espada
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Andreia Albuquerque-Wendt
- Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade de Lisboa, Lisboa, Portugal
- Wellcome Centre for Integrative Parasitology, Institute of Infection, Immunity & Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Valentín Hornillos
- Departamento de Química Orgánica, Universidad de Sevilla and Centro de Innovación en Química Avanzada, Sevilla, Spain
| | - Eva Gluenz
- Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Integrative Parasitology, Institute of Infection, Immunity & Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Adriano C. Coelho
- Departamento de Biologia Animal, Instituto de Biologia, Universidade Estadual de Campinas, Campinas, Brazil
| | - Silvia R. B. Uliana
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
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Minori K, Rosa LB, Bonsignore R, Casini A, Miguel DC. Comparing the Antileishmanial Activity of Gold(I) and Gold(III) Compounds in L. amazonensis and L. braziliensis in Vitro. ChemMedChem 2020; 15:2146-2150. [PMID: 32830445 PMCID: PMC7756297 DOI: 10.1002/cmdc.202000536] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Indexed: 12/13/2022]
Abstract
A series of mononuclear coordination or organometallic AuI /AuIII complexes (1-9) have been comparatively studied in vitro for their antileishmanial activity against promastigotes and amastigotes, the clinically relevant parasite form, of Leishmania amazonensis and Leishmania braziliensis. One of the cationic AuI bis-N-heterocyclic carbenes (3) has low EC50 values (ca. 4 μM) in promastigotes cells and no toxicity in host macrophages. Together with two other AuIII complexes (6 and 7), the compound is also extremely effective in intracellular amastigotes from L. amazonensis. Initial mechanistic studies include an evaluation of the gold complexes' effect on L. amazonensis' plasma membrane integrity.
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Affiliation(s)
- Karen Minori
- Department of Animal Biology, Biology InstituteUniversity of Campinas (UNICAMP)Rua Monteiro Lobato, 25513083-862.CampinasSPBrazil
| | - Letícia B. Rosa
- Department of Animal Biology, Biology InstituteUniversity of Campinas (UNICAMP)Rua Monteiro Lobato, 25513083-862.CampinasSPBrazil
| | - Riccardo Bonsignore
- Department of ChemistryTechnical University of Munich (TUM)Lichtenbergstraße 485748Garching b. MünchenGermany
| | - Angela Casini
- Department of ChemistryTechnical University of Munich (TUM)Lichtenbergstraße 485748Garching b. MünchenGermany
| | - Danilo C. Miguel
- Department of Animal Biology, Biology InstituteUniversity of Campinas (UNICAMP)Rua Monteiro Lobato, 25513083-862.CampinasSPBrazil
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Corpas-López V, Tabraue-Chávez M, Sixto-López Y, Panadero-Fajardo S, Alves de Lima Franco F, Domínguez-Seglar JF, Morillas-Márquez F, Franco-Montalbán F, Díaz-Gavilán M, Correa-Basurto J, López-Viota J, López-Viota M, Pérez del Palacio J, de la Cruz M, de Pedro N, Martín-Sánchez J, Gómez-Vidal JA. O-Alkyl Hydroxamates Display Potent and Selective Antileishmanial Activity. J Med Chem 2020; 63:5734-5751. [DOI: 10.1021/acs.jmedchem.9b02016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Victoriano Corpas-López
- Departamento de Parasitologı́a, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, 18071 Granada, Spain
| | - Mavys Tabraue-Chávez
- Departamento de Quı́mica Farmacéutica y Orgánica, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, 18071 Granada, Spain
| | - Yudibeth Sixto-López
- Laboratorio de Diseño y Desarrollo de Nuevos Fármacos y Productos Biotecnológicos, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, 11340 México City, México
| | - Sonia Panadero-Fajardo
- Departamento de Quı́mica Farmacéutica y Orgánica, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, 18071 Granada, Spain
| | - Fernando Alves de Lima Franco
- Departamento de Parasitologı́a, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, 18071 Granada, Spain
| | - José F. Domínguez-Seglar
- Departamento de Quı́mica Farmacéutica y Orgánica, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, 18071 Granada, Spain
| | - Francisco Morillas-Márquez
- Departamento de Parasitologı́a, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, 18071 Granada, Spain
| | - Francisco Franco-Montalbán
- Departamento de Quı́mica Farmacéutica y Orgánica, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, 18071 Granada, Spain
| | - Mónica Díaz-Gavilán
- Departamento de Quı́mica Farmacéutica y Orgánica, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, 18071 Granada, Spain
| | - José Correa-Basurto
- Laboratorio de Diseño y Desarrollo de Nuevos Fármacos y Productos Biotecnológicos, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, 11340 México City, México
| | - Julián López-Viota
- Departamento de Farmacia y Tecnologı́a Farmacéutica, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, 18071 Granada, Spain
| | - Margarita López-Viota
- Departamento de Farmacia y Tecnologı́a Farmacéutica, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, 18071 Granada, Spain
| | | | | | - Nuria de Pedro
- Fundación MEDINA, Parque Tecnológico de la Salud, 18016 Granada, Spain
| | - Joaquina Martín-Sánchez
- Departamento de Parasitologı́a, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, 18071 Granada, Spain
| | - José A. Gómez-Vidal
- Departamento de Quı́mica Farmacéutica y Orgánica, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, 18071 Granada, Spain
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"Cheaper and better": Societal cost savings and budget impact of changing from systemic to intralesional pentavalent antimonials as the first-line treatment for cutaneous leishmaniasis in Bolivia. PLoS Negl Trop Dis 2019; 13:e0007788. [PMID: 31693661 PMCID: PMC6834242 DOI: 10.1371/journal.pntd.0007788] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 09/16/2019] [Indexed: 12/03/2022] Open
Abstract
Introduction Cutaneous leishmaniasis (CL), endemic in Bolivia, mostly affects poor people in rainforest areas. The current first-line treatment consists of systemic pentavalent antimonials (SPA) for 20 days and is paid for by the Ministry of Health (MoH). Long periods of drug shortages and a lack of safe conditions to deliver treatment are challenges to implementation. Intralesional pentavalent antimonials (ILPA) are an alternative to SPA. This study aims to compare the cost of ILPA and SPA, and to estimate the health and economic impacts of changing the first-line treatment for CL in a Bolivian endemic area. Methods The cost-per-patient treated was estimated for SPA and ILPA from the perspectives of the MoH and society. The quantity and unit costs of medications, staff time, transportation and loss of production were obtained through a health facility survey (N = 12), official documents and key informants. A one-way sensitivity analysis was conducted on key parameters to evaluate the robustness of the results. The annual number of patients treated and the budget impact of switching to ILPA as the first-line treatment were estimated under different scenarios of increasing treatment utilization. Costs were reported in 2017 international dollars (1 INT$ = 3.10 BOB). Results Treating CL using ILPA was associated with a cost-saving of $248 per-patient-treated from the MoH perspective, and $688 per-patient-treated from the societal perspective. Switching first-line treatment to ILPA while maintaining the current budget would allow two-and-a-half times the current number of patients to be treated. ILPA remained cost-saving compared to SPA in the sensitivity analysis. Conclusions The results of this study support a shift to ILPA as the first-line treatment for CL in Bolivia and possibly in other South American countries. Cutaneous leishmaniasis is a neglected tropical disease which causes chronic skin ulcers and disproportionally affects the poorest of the poor. The current first-line treatment, based on systemic pentavalent antimonials, is quite toxic for patients but also expensive for governments and patients. Given limited budgets, national decision-makers need to know not only the efficacy of alternative treatments, but also how to maximise the population health impact of available resources. To strengthen the evidence base for the scale-up of effective NTD interventions in the era of universal health coverage, we conducted cost-effectiveness analyses and estimations of population-level impact of the implementation of intralesional pentavalent antimonials as first-line treatment for cutaneous leishmaniasis using realistic scenarios. Our results demonstrate that changing first-line treatment would have considerable economic advantages for patients due to the shorter treatment duration (savings in terms of food, accommodation, transport, productivity loss); and for the national control program due to the reduced use of drugs and staff time. In addition, this change would offer better value for money given that two-and-a-half times the current number of patients could be treated with the current expenditure level if intralesional pentavalent antimonials were offered to eligible patients.
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9
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Souza Ribeiro Costa J, Medeiros M, Yamashiro-Kanashiro EH, Rocha MC, Cotrim PC, Stephano MA, Lancellotti M, Tavares GD, Oliveira-Nascimento L. Biodegradable nanocarriers coated with polymyxin B: Evaluation of leishmanicidal and antibacterial potential. PLoS Negl Trop Dis 2019; 13:e0007388. [PMID: 31042710 PMCID: PMC6513107 DOI: 10.1371/journal.pntd.0007388] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 05/13/2019] [Accepted: 04/13/2019] [Indexed: 11/18/2022] Open
Abstract
Most treatments of leishmaniasis require hospitalization and present side effects or parasite resistance; innovations in drug formulation/reposition can overcome these barriers and must be pursued to increase therapeutic alternatives. Therefore, we tested polymyxin B (polB) potential to kill Leishmania amazonensis, adsorbed or not in PBCA nanoparticles (PBCAnp), which could augment polB internalization in infected macrophages. PBCAnps were fabricated by anionic polymerization and analyzed by Dynamic Light Scattering (size, ζ potential), Nanoparticle Tracking Analysis (size/concentration), vertical diffusion cell (release rate), drug incorporation (indirect method, protein determination) and in vitro cell viability. Nanoparticles coated with polB (PBCAnp-polB) presented an adequate size of 261.5 ± 25.9 nm, low PDI and ζ of 1.79 ± 0.17 mV (stable for 45 days, at least). The 50% drug release from PBCAnp-polB was 6-7 times slower than the free polB, which favors a prolonged and desired release profile. Concerning in vitro evaluations, polB alone reduced in vitro amastigote infection of macrophages (10 μg/mL) without complete parasite elimination, even at higher concentrations. This behavior limits its future application to adjuvant leishmanicidal therapy or antimicrobial coating of carriers. The nanocarrier PBCAnp also presented leishmanicidal effect and surpassed polB activity; however, no antimicrobial activity was detected. PolB maintained its activity against E. coli, Pseudomonas and Klebsiella, adding antimicrobial properties to the nanoparticles. Thus, this coated drug delivery system, described for the first time, demonstrated antileishmanial and antimicrobial properties. The bactericidal feature helps with concomitant prevention/treatment of secondary infections that worst ulcers induced by cutaneous L. amazonensis, ultimately ending in disfiguring or disabling lesions.
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Affiliation(s)
- Juliana Souza Ribeiro Costa
- Department of Biochemistry and Tissue Biology, Biology Institute, University of Campinas, Campinas, São Paulo, Brazil
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Marília Medeiros
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | | | - Mussya Cisotto Rocha
- Tropical Medicine Institute, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Paulo Cesar Cotrim
- Tropical Medicine Institute, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Marco Antonio Stephano
- School of Pharmaceutical Sciences, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Marcelo Lancellotti
- Department of Biochemistry and Tissue Biology, Biology Institute, University of Campinas, Campinas, São Paulo, Brazil
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | | | - Laura Oliveira-Nascimento
- Department of Biochemistry and Tissue Biology, Biology Institute, University of Campinas, Campinas, São Paulo, Brazil
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, São Paulo, Brazil
- * E-mail:
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10
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Alexandrino-Junior F, Silva KGDHE, Freire MCLC, Lione VDOF, Cardoso EA, Marcelino HR, Genre J, Oliveira AGD, Egito ESTD. A Functional Wound Dressing as a Potential Treatment for Cutaneous Leishmaniasis. Pharmaceutics 2019; 11:E200. [PMID: 31052360 PMCID: PMC6571773 DOI: 10.3390/pharmaceutics11050200] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/18/2019] [Accepted: 03/21/2019] [Indexed: 12/24/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a parasitic disease characterized by progressive skin sores. Currently, treatments for CL are limited to parenteral administration of the drug, which presents severe adverse effects and low cure rates. Therefore, this study aimed to develop poly(vinyl-alcohol) (PVA) hydrogels containing Amphotericin B (AmB) intended for topical treatment of CL. Hydrogels were evaluated in vitro for their potential to eliminate promastigote forms of Leishmania spp., to prevent secondary infections, to maintain appropriate healing conditions, and to offer suitable biocompatibility. AmB was incorporated into the system in its non-crystalline state, allowing it to swell more and faster than the system without the drug. Furthermore, the AmB release profile showed a continuous and controlled behavior following Higuchi´s kinetic model. AmB-loaded-PVA-hydrogels (PVA-AmB) also showed efficient antifungal and leishmanicidal activity, no cytotoxic potential for VERO cells, microbial impermeability and water vapor permeability compatible with the healthy skin's physiological needs. Indeed, these results revealed the potential of PVA-AmB to prevent secondary infections and to maintain a favorable environment for the healing process. Hence, these results suggest that PVA-AmB could be a suitable and efficient new therapeutic approach for the topical treatment of CL.
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Affiliation(s)
- Francisco Alexandrino-Junior
- Programa de Pós-Graduação em Nanotecnologia Farmacêutica (PPgNANOFARMA), Universidade Federal do Rio Grande do Norte (UFRN), Nata/RN 59012-570, Brazil.
| | | | | | | | - Elisama Azevedo Cardoso
- Faculdade de Farmácia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro/RJ 21941-902, Brazil.
| | | | - Julieta Genre
- Faculdade de Farmácia, Universidade Federal do Rio Grande do Norte (UFRN), Nata/RN 59012-570, Brazil.
| | - Anselmo Gomes de Oliveira
- Departamento de Fármacos e Medicamentos, Universidade Estadual Paulista (UNESP), Araraquara/SP 14800-903, Brazil.
| | - Eryvaldo Sócrates Tabosa do Egito
- Programa de Pós-Graduação em Nanotecnologia Farmacêutica (PPgNANOFARMA), Universidade Federal do Rio Grande do Norte (UFRN), Nata/RN 59012-570, Brazil.
- Faculdade de Farmácia, Universidade Federal do Rio Grande do Norte (UFRN), Nata/RN 59012-570, Brazil.
- Laboratório de Sistemas Dispersos (LaSiD), Departamento de Farmácia, Universidade Federal do Rio Grande do Norte (UFRN), Rua General Gustavo Cordeiro de Farias s/n, Petrópolis, Nata/RN 59012-570, Brazil.
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11
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Romero AH, Rodríguez N, Oviedo H, Lopez SE. Antileismanial activity, mechanism of action study and molecular docking of 1,4‐bis(substituted benzalhydrazino)phthalazines. Arch Pharm (Weinheim) 2019; 352:e1800299. [DOI: 10.1002/ardp.201800299] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/04/2019] [Accepted: 02/09/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Angel H. Romero
- Cátedra de Química General, Facultad de FarmaciaUniversidad Central de VenezuelaCaracas Venezuela
- Laboratorio de Ingeniería GenéticaInstituto de Biomedicina, Hospital VargasCaracas Venezuela
- Laboratorio de Química Medicinal y Heterociclos, Departamento de QuímicaUniversidad Simón BolívarSartenejas, Baruta Venezuela
| | - Noris Rodríguez
- Laboratorio de Ingeniería GenéticaInstituto de Biomedicina, Hospital VargasCaracas Venezuela
| | - Henry Oviedo
- Laboratorio de Ingeniería GenéticaInstituto de Biomedicina, Hospital VargasCaracas Venezuela
| | - Simón E. Lopez
- Department of ChemistryUniversity of FloridaGainesville Florida
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12
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Espada CR, Magalhães RM, Cruz MC, Machado PR, Schriefer A, Carvalho EM, Hornillos V, Alves JM, Cruz AK, Coelho AC, Uliana SRB. Investigation of the pathways related to intrinsic miltefosine tolerance in Leishmania (Viannia) braziliensis clinical isolates reveals differences in drug uptake. INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE 2019; 11:139-147. [PMID: 30850347 PMCID: PMC6904789 DOI: 10.1016/j.ijpddr.2019.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/11/2019] [Accepted: 02/18/2019] [Indexed: 12/26/2022]
Abstract
In Brazil, cutaneous leishmaniasis is caused predominantly by L. (V.) braziliensis. The few therapeutic drugs available exhibit several limitations, mainly related to drug toxicity and reduced efficacy in some regions. Miltefosine (MF), the only oral drug available for leishmaniasis treatment, is not widely available and has not yet been approved for human use in Brazil. Our group previously reported the existence of differential susceptibility among L. (V.) braziliensis clinical isolates. In this work, we further characterized three of these isolates of L. (V.) braziliensis chosen because they exhibited the lowest and the highest MF half maximal inhibitory concentrations and were therefore considered less tolerant or more tolerant, respectively. Uptake of MF, and also of phosphocholine, were found to be significantly different in more tolerant parasites compared to the less sensitive isolate, which raised the hypothesis of differences in the MF transport complex Miltefosine Transporter (MT)-Ros3. Although some polymorphisms in those genes were found, they did not correlate with the drug susceptibility phenotype. Drug efflux and compartmentalization were similar in the isolates tested, and amphotericin B susceptibility was retained in MF tolerant parasites, suggesting that increased fitness was also not the basis of observed differences. Transcriptomic analysis revealed that Ros3 mRNA levels were upregulated in the sensitive strain compared to the tolerant ones. Increased mRNA abundance in more tolerant isolates was validated by quantitative PCR. Our results suggest that differential gene expression of the MT transporter complex is the basis of the differential susceptibility in these unselected, naturally occurring parasites. Brazilian L. (V.) braziliensis isolates vary in mitefosine susceptibility. Diminished drug internalization was observed in more tolerant isolates. Drug susceptibility did not correlate with SNPs in MT-Ros3 genes. Drug efflux and compartmentalization were similar in the isolates tested. Increased drug sensitivity is accompanied by Ros3 mRNA upregulation.
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Affiliation(s)
- Caroline R Espada
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Rubens M Magalhães
- Departamento de Biologia Celular e Molecular e Bioagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Mario C Cruz
- Centro de Facilidades para Apoio a Pesquisa, CEFAP-USP, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo R Machado
- Serviço de Imunologia, HUPES, Universidade Federal da Bahia, Salvador, Brazil
| | - Albert Schriefer
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Edgar M Carvalho
- Serviço de Imunologia, HUPES, Universidade Federal da Bahia, Salvador, Brazil; Centro de Pesquisas Gonçalo Moniz, Fiocruz-Bahia, Salvador, Brazil
| | - Valentín Hornillos
- Departamento de Química Orgánica, Universidad de Sevilla and Centro de Innovación en Química Avanzada (ORFEO-CINQA), Sevilla, Spain
| | - João M Alves
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Angela K Cruz
- Departamento de Biologia Celular e Molecular e Bioagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Adriano C Coelho
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Silvia R B Uliana
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil.
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13
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Alcântara LM, Ferreira TCS, Gadelha FR, Miguel DC. Challenges in drug discovery targeting TriTryp diseases with an emphasis on leishmaniasis. INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE 2018; 8:430-439. [PMID: 30293058 PMCID: PMC6195035 DOI: 10.1016/j.ijpddr.2018.09.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 01/24/2023]
Abstract
Tritryps diseases are devastating parasitic neglected infections caused by Leishmania spp., Trypanosoma cruzi and Trypanosoma brucei subspecies. Together, these parasites affect more than 30 million people worldwide and cause high mortality and morbidity. Leishmaniasis comprises a complex group of diseases with clinical manifestation ranging from cutaneous lesions to systemic visceral damage. Antimonials, the first-choice drugs used to treat leishmaniasis, lead to high toxicity and carry significant contraindications limiting its use. Drug-resistant parasite strains are also a matter for increasing concern, especially in areas with very limited resources. The current scenario calls for novel and/or improvement of existing therapeutics as key research priorities in the field. Although several studies have shown advances in drug discovery towards leishmaniasis in recent years, key knowledge gaps in drug discovery pipelines still need to be addressed. In this review we discuss not only scientific and non-scientific bottlenecks in drug development, but also the central role of public-private partnerships for a successful campaign for novel treatment options against this devastating disease. Treatment options targeting TriTryp diseases are limited. Scientific and non-scientific bottlenecks need to be unveiled for the development of new treatments. Private and public sector partnership is key to allow advances in bench-to-bedside science.
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Affiliation(s)
- Laura M Alcântara
- Biology Institute, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Thalita C S Ferreira
- Biology Institute, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Fernanda R Gadelha
- Biology Institute, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Danilo C Miguel
- Biology Institute, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil.
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14
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Franco-Muñoz C, Manjarrés-Estremor M, Ovalle-Bracho C. Intraspecies differences in natural susceptibility to amphotericine B of clinical isolates of Leishmania subgenus Viannia. PLoS One 2018; 13:e0196247. [PMID: 29698432 PMCID: PMC5919572 DOI: 10.1371/journal.pone.0196247] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 03/08/2018] [Indexed: 12/18/2022] Open
Abstract
Amphotericin B (AmB) is a recommended medication for the treatment of cutaneous and mucosal leishmaniasis in cases of therapeutic failure with first-line medications; however, little is known about the in vitro susceptibility to AmB of clinical isolates of the subgenus Viannia, which is most prevalent in South America. This work aimed to determine the in vitro susceptibility profiles to AmB of clinical isolates of the species L. (V.) panamensis, L. (V.) guyanensis and L. (V.) braziliensis. In vitro susceptibility to AmB was evaluated for 65 isolates. Macrophages derived from the U937 cell line were infected with promastigotes and exposed to different AmB concentrations. After 96 hours, the number of intracellular amastigotes was quantified by qPCR, and median effective concentration (EC50) was determined using the PROBIT model. The controls included sensitive strains and experimentally derived less sensitive strains generated in vitro, which presented EC50 values up to 7.57-fold higher than the values of the sensitive strains. The isolates were classified into groups according to their in vitro susceptibility profiles using Ward’s hierarchical method. The susceptibility to AmB differed in an intraspecies-specific manner as follows: 28.21% (11/39) of L. (V.) panamensis strains, 50% (3/6) of L. (V.) guyanensis strains and 34.61% (9/26) of L. (V.) braziliensis strains were classified as less sensitive. The latter subset featured three susceptibility groups. We identified Colombian isolates with different AmB susceptibility profiles. In addition, the capacity of species of subgenus Viannia to develop lower susceptibility to AmB was demonstrated in vitro. These new findings should be considered in the pharmacovigilance of AmB in Colombia and South America.
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Affiliation(s)
- Carlos Franco-Muñoz
- Hospital Universitario Centro Dermatológico Federico Lleras Acosta E.S.E., Bogotá D.C., Colombia
| | - Merab Manjarrés-Estremor
- Hospital Universitario Centro Dermatológico Federico Lleras Acosta E.S.E., Bogotá D.C., Colombia
| | - Clemencia Ovalle-Bracho
- Hospital Universitario Centro Dermatológico Federico Lleras Acosta E.S.E., Bogotá D.C., Colombia
- * E-mail:
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15
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Silva SC, Guimarães LH, Silva JA, Magalhães V, Medina L, Queiroz A, Machado PRL, Schriefer A. Molecular epidemiology and in vitro evidence suggest that Leishmania braziliensis strain helps determine antimony response among American tegumenary leishmaniasis patients. Acta Trop 2018; 178:34-39. [PMID: 29042262 DOI: 10.1016/j.actatropica.2017.10.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/21/2017] [Accepted: 10/13/2017] [Indexed: 11/18/2022]
Abstract
Antimony is the first line drug for treating American tegumentary leishmaniasis (ATL) in Brazil. In this country, Leishmania braziliensis causes at least three distinct forms of disease: localized cutaneous (CL), mucosal (ML) and disseminated leishmaniasis (DL). All forms can be found in Corte de Pedra, Northeast Brazil. ML and DL respond poorly to antimony, in contrast to CL. The L. braziliensis population causing ATL in Corte de Pedra is genetically very diverse, with strains of the parasite associating with the clinical form of leishmaniasis. We tested the hypotheses that antimony refractoriness is associated with L. braziliensis genotypes, and that parasites from ML and DL present greater in vitro resistance to antimony than L. braziliensis from CL. Comparison of geographic coordinates of living sites between antimony responders and non-responders by Cusick and Edward́s test showed that refractoriness and responsiveness to the drug were similarly wide spread in the region (p>0.05). Parasites were then genotyped by sequencing a locus starting at position 425,451 on chromosome 28, which is polymorphic among L. braziliensis of Corte de Pedra. Haplotype CC- in CHR28/425,451 was associated with risk of treatment failure among CL patients (Fisheŕs exact test, p=0.03, odds ratio=4.65). This haplotype could not be found among parasites from ML or DL. Finally, sensitivity to antimony was evaluated exposing L. braziliensis promastigotes to increasing concentrations of meglumine antimoniate in vitro. Parasites from ML and DL were more resistant to antimony at doses of 2mg/100μL and beyond than those isolated from CL (Fisher's exact test, p=0.02 and p=0.004, respectively). The intrinsically lower susceptibility of L. brazliensis from ML and DL to antimony parallels what is observed for patients' responsiveness in the field. This finding reinforces that ML and DL patients would benefit from initiating treatment with drugs currently considered as second line, like amphotericin B.
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Affiliation(s)
- Silvana C Silva
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Brazil
| | - Luiz Henrique Guimarães
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Brazil; Universidade Federal do Sul da Bahia, Brazil
| | - Juliana A Silva
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Brazil
| | - Viviane Magalhães
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Brazil
| | - Lilian Medina
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Brazil
| | - Adriano Queiroz
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Brazil
| | - Paulo Roberto L Machado
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Brazil
| | - Albert Schriefer
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Brazil; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Brazil; Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Brazil.
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16
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Espada CR, Ribeiro-Dias F, Dorta ML, Pereira LIDA, Carvalho EMD, Machado PR, Schriefer A, Yokoyama-Yasunaka JKU, Coelho AC, Uliana SRB. Susceptibility to Miltefosine in Brazilian Clinical Isolates of Leishmania ( Viannia) braziliensis. Am J Trop Med Hyg 2017; 96:656-659. [PMID: 28070006 DOI: 10.4269/ajtmh.16-0811] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Leishmania (Viannia) braziliensis is the main causative species of tegumentary leishmaniasis in Brazil. In this study, we evaluated the susceptibility of 16 clinical isolates of L. (V.) braziliensis from different regions of Brazil to miltefosine in vitro. Half-maximal inhibitory concentrations of miltefosine varied from 22.9 to 144.2 μM against promastigotes and from 0.3 to 4.2 μM against intracellular amastigotes. No significant differences were found between isolates of different geographical origins. A clear correlation between the EC50 against promastigotes and amastigotes within each isolate was found. These findings contribute to the evaluation of miltefosine's potential and limitations for the treatment of tegumentary leishmaniasis in Brazil.
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Affiliation(s)
- Caroline R Espada
- Laboratório de Leishmanioses, Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Fatima Ribeiro-Dias
- Laboratório de Imunobiologia das Leishmanioses, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Brazil
| | - Miriam L Dorta
- Laboratório de Imunobiologia das Leishmanioses, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Brazil
| | - Ledice Inácia de Araújo Pereira
- Laboratório de Imunobiologia das Leishmanioses, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Brazil
| | - Edgar M de Carvalho
- Centro de Pesquisas Gonçalo Moniz, Fiocruz-Bahia, Salvador, Brazil.,Serviço de Imunologia, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Paulo R Machado
- Serviço de Imunologia, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Albert Schriefer
- Serviço de Imunologia, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Jenicer K U Yokoyama-Yasunaka
- Laboratório de Leishmanioses, Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Adriano C Coelho
- Laboratório de Leishmanioses, Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil.,Departamento de Biologia Animal, Instituto de Biologia, Universidade Estadual de Campinas, Campinas, Brazil
| | - Silvia R B Uliana
- Laboratório de Leishmanioses, Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
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17
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Ginouvès M, Simon S, Nacher M, Demar M, Carme B, Couppié P, Prévot G. In Vitro Sensitivity of Cutaneous Leishmania Promastigote Isolates Circulating in French Guiana to a Set of Drugs. Am J Trop Med Hyg 2017; 96:1143-1150. [PMID: 28167598 DOI: 10.4269/ajtmh.16-0373] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractAnti-leishmaniasis drug resistance is a common problem worldwide. The aim of this study was to inventory the general in vitro level of sensitivity of Leishmania isolates circulating in French Guiana and to highlight potential in vitro pentamidine-resistant isolates. This sensitivity study was conducted on 36 patient-promastigote isolates for seven drugs (amphotericin B, azithromycin, fluconazole, meglumine antimoniate, miltefosine, paromomycin, and pentamidine) using the Cell Counting Kit-8 viability test. The IC50 values obtained were heterogeneous. One isolate exhibited high IC50 values for almost all drugs tested. Pentamidine, which is the first-line treatment in French Guiana, showed efficacy at very low doses (mean of 0.0038 μg/mL). The concordance of the in vitro pentamidine results with the patients' clinical outcomes was 94% (K = 0.82).
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Affiliation(s)
- Marine Ginouvès
- Laboratoire Associé, Centre National de Référence Leishmania, Laboratoire Hospitalo-Universitaire de Parasitologie et Mycologie, General Hospital, Cayenne, French Guiana.,Laboratoire des Ecosystèmes Amazoniens et Pathologie Tropicale (EPaT), Université de Guyane, Labex CEBA, DFR Santé, Cayenne, French Guiana
| | - Stéphane Simon
- Laboratoire des Ecosystèmes Amazoniens et Pathologie Tropicale (EPaT), Université de Guyane, Labex CEBA, DFR Santé, Cayenne, French Guiana.,Laboratoire Associé, Centre National de Référence Leishmania, Laboratoire Hospitalo-Universitaire de Parasitologie et Mycologie, General Hospital, Cayenne, French Guiana
| | - Mathieu Nacher
- Laboratoire des Ecosystèmes Amazoniens et Pathologie Tropicale (EPaT), Université de Guyane, Labex CEBA, DFR Santé, Cayenne, French Guiana.,Centre d'Investigation Clinique Epidémiologie Clinique Antilles Guyane CIC EC 1424, General Hospital, Cayenne, French Guiana
| | - Magalie Demar
- Laboratoire des Ecosystèmes Amazoniens et Pathologie Tropicale (EPaT), Université de Guyane, Labex CEBA, DFR Santé, Cayenne, French Guiana.,Laboratoire Associé, Centre National de Référence Leishmania, Laboratoire Hospitalo-Universitaire de Parasitologie et Mycologie, General Hospital, Cayenne, French Guiana.,Laboratoire Hospitalo-Universitaire de Parasitologie et Mycologie, General Hospital, Cayenne, French Guiana
| | - Bernard Carme
- Laboratoire des Ecosystèmes Amazoniens et Pathologie Tropicale (EPaT), Université de Guyane, Labex CEBA, DFR Santé, Cayenne, French Guiana
| | - Pierre Couppié
- Laboratoire des Ecosystèmes Amazoniens et Pathologie Tropicale (EPaT), Université de Guyane, Labex CEBA, DFR Santé, Cayenne, French Guiana.,Service de Dermatologie, Institut Guyanais de Dermatologie Tropicale, General Hospital, Cayenne, French Guiana
| | - Ghislaine Prévot
- Laboratoire des Ecosystèmes Amazoniens et Pathologie Tropicale (EPaT), Université de Guyane, Labex CEBA, DFR Santé, Cayenne, French Guiana
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de Moura TR, Santos MLB, Braz JM, Santos LFVC, Aragão MT, de Oliveira FA, Santos PL, da Silva ÂM, de Jesus AR, de Almeida RP. Cross-resistance of Leishmania infantum isolates to nitric oxide from patients refractory to antimony treatment, and greater tolerance to antileishmanial responses by macrophages. Parasitol Res 2016; 115:713-21. [PMID: 26481489 DOI: 10.1007/s00436-015-4793-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 10/12/2015] [Indexed: 11/24/2022]
Abstract
Visceral leishmaniasis is a life-threatening disease characterized by intense parasitism of the spleen, liver, and bone marrow. Antimonials have served as front-line antileishmanial therapeutics for decades, but the increasing failure rates under antimonial treatment have challenged the continued use of these drugs. Pentavalent antimonials are known to reinforce the killing mechanisms of macrophages, although the associated mechanism remains unclear. Here, for the first time, we determined whether Leishmania infantum strains isolated from patients refractory to antimony treatment (relapse cases) were cross-resistant to antimonials, liposomal amphotericin B, and/or nitric oxide, and also whether these strains modulate macrophage infection. We selected four clinical isolates from relapse cases and two clinical isolates from antimony-responsive patients (control group) for the present study. The L. infantum promastigotes from all four relapse cases were resistant to trivalent antimonial treatment and nitric oxide, while only one isolate was resistant to liposomal amphotericin B. We evaluated whether the resistant strains from relapse cases showed enhanced infectivity and amastigote survival in macrophages, or macrophage-killing mechanisms in macrophages activated by lipopolysaccharide plus interferon gamma. Infection indexes calculated using macrophages infected with isolates from relapse were higher than those observed with control strains that were stimulated independently. Macrophage infection was higher with L. infantum isolates from relapse cases and correlated with enhanced interleukin 1-β production but showed similar nitrite production. Our results demonstrate that L. infantum field isolates from relapse cases were resistant to antimonials and nitric oxide and that these parasites stimulated inflammatory cytokines and were resistant to macrophage-killing mechanisms, factors that may contribute to disease severity.
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Coelho AC, Oliveira JC, Espada CR, Reimão JQ, Trinconi CT, Uliana SRB. A Luciferase-Expressing Leishmania braziliensis Line That Leads to Sustained Skin Lesions in BALB/c Mice and Allows Monitoring of Miltefosine Treatment Outcome. PLoS Negl Trop Dis 2016; 10:e0004660. [PMID: 27144739 PMCID: PMC4856402 DOI: 10.1371/journal.pntd.0004660] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 04/02/2016] [Indexed: 11/18/2022] Open
Abstract
Background Leishmania braziliensis is the most prevalent species isolated from patients displaying cutaneous and muco-cutaneous leishmaniasis in South America. However, there are difficulties for studying L. braziliensis pathogenesis or response to chemotherapy in vivo due to the natural resistance of most mouse strains to infection with these parasites. The aim of this work was to develop an experimental set up that could be used to assess drug efficacy against L. braziliensis. The model was tested using miltefosine. Methodology/Principal Findings A L. braziliensis line, originally isolated from a cutaneous leishmaniasis patient, was passaged repeatedly in laboratory rodents and further genetically manipulated to express luciferase. Once collected from a culture of parasites freshly transformed from amastigotes, 106 wild type or luciferase-expressing stationary phase promastigotes were inoculated subcutaneously in young BALB/c mice or golden hamsters. In both groups, sustained cutaneous lesions developed at the site of inoculation, no spontaneous self- healing being observed 4 months post-inoculation, if left untreated. Compared to the wild type line features, no difference was noted for the luciferase-transgenic line. Infected animals were treated with 5 or 15 mg/kg/day miltefosine orally for 15 days. At the end of treatment, lesions had regressed and parasites were not detected. However, relapses were observed in animals treated with both doses of miltefosine. Conclusions/Significance Here we described experimental settings for a late-healing model of cutaneous leishmaniasis upon inoculation of a luciferase-expressing L. braziliensis line that can be applied to drug development projects. These settings allowed the monitoring of the transient efficacy of a short-term miltefosine administration. Leishmania braziliensis is the most prevalent species isolated from patients displaying either cutaneous or mucocutaneous leishmaniasis in South America. In this study, we developed a transgenic luciferase-expressing L. braziliensis line. These parasites were passaged in hamsters and mice and then transformed back into promastigotes. Once inoculated subcutaneously in the footpad of young laboratory animals—BALB/c mice or golden hamsters, rapid and sustained footpad thickness increase developed. This experimental model was used to monitor the parasite load fluctuations and the response to miltefosine treatment. Mice were treated orally over a two-week period, starting at week 4 post-inoculation. Though such a regimen was shown to display efficacy, the effect was not sustained and both parasite re-expansion and delayed footpad thickness increase were noticed.
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Affiliation(s)
- Adriano C. Coelho
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Jordana C. Oliveira
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Caroline R. Espada
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Juliana Q. Reimão
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Cristiana T. Trinconi
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Silvia R. B. Uliana
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
- * E-mail:
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Qvit N, Schechtman D, Pena DA, Berti DA, Soares CO, Miao Q, Liang LA, Baron LA, Teh-Poot C, Martínez-Vega P, Ramirez-Sierra MJ, Churchill E, Cunningham AD, Malkovskiy AV, Federspiel NA, Gozzo FC, Torrecilhas AC, Manso Alves MJ, Jardim A, Momar N, Dumonteil E, Mochly-Rosen D. Scaffold proteins LACK and TRACK as potential drug targets in kinetoplastid parasites: Development of inhibitors. INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE 2016; 6:74-84. [PMID: 27054066 PMCID: PMC4805777 DOI: 10.1016/j.ijpddr.2016.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 02/04/2016] [Accepted: 02/08/2016] [Indexed: 01/15/2023]
Abstract
Parasitic diseases cause ∼500,000 deaths annually and remain a major challenge for therapeutic development. Using a rational design based approach, we developed peptide inhibitors with anti-parasitic activity that were derived from the sequences of parasite scaffold proteins LACK (Leishmania's receptor for activated C-kinase) and TRACK (Trypanosomareceptor for activated C-kinase). We hypothesized that sequences in LACK and TRACK that are conserved in the parasites, but not in the mammalian ortholog, RACK (Receptor for activated C-kinase), may be interaction sites for signaling proteins that are critical for the parasites' viability. One of these peptides exhibited leishmanicidal and trypanocidal activity in culture. Moreover, in infected mice, this peptide was also effective in reducing parasitemia and increasing survival without toxic effects. The identified peptide is a promising new anti-parasitic drug lead, as its unique features may limit toxicity and drug-resistance, thus overcoming central limitations of most anti-parasitic drugs. Identified unique short sequences conserved in parasite but not in host orthologue. Peptides corresponding to these sequences are active anti-parasitic drug lead. Cyclization of the peptides generates drug leads for in vivo proof of concept.
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Affiliation(s)
- Nir Qvit
- Department of Chemical and Systems Biology, Stanford University, School of Medicine, Stanford, CA 94305, USA.
| | - Deborah Schechtman
- Department of Chemical and Systems Biology, Stanford University, School of Medicine, Stanford, CA 94305, USA; Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, SP, Brazil
| | | | | | | | - Qianqian Miao
- National Reference Centre for Parasitology, Research Institute of the McGill University, Montreal, Canada
| | - Liying Annie Liang
- National Reference Centre for Parasitology, Research Institute of the McGill University, Montreal, Canada
| | - Lauren A Baron
- Laboratorio de Parasitología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico
| | - Christian Teh-Poot
- Laboratorio de Parasitología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico
| | - Pedro Martínez-Vega
- Laboratorio de Parasitología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico
| | - Maria Jesus Ramirez-Sierra
- Laboratorio de Parasitología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico
| | - Eric Churchill
- Department of Chemical and Systems Biology, Stanford University, School of Medicine, Stanford, CA 94305, USA
| | - Anna D Cunningham
- Department of Chemical and Systems Biology, Stanford University, School of Medicine, Stanford, CA 94305, USA
| | - Andrey V Malkovskiy
- Biomaterials and Advanced Drug Delivery Laboratory, Stanford University, Stanford, CA 94305, USA
| | - Nancy A Federspiel
- Department of Chemical and Systems Biology, Stanford University, School of Medicine, Stanford, CA 94305, USA
| | - Fabio Cesar Gozzo
- Institute of Chemistry, University of Campinas, Campinas, SP, Brazil
| | | | | | - Armando Jardim
- Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Québec, Canada
| | - Ndao Momar
- National Reference Centre for Parasitology, Research Institute of the McGill University, Montreal, Canada
| | - Eric Dumonteil
- Laboratorio de Parasitología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico
| | - Daria Mochly-Rosen
- Department of Chemical and Systems Biology, Stanford University, School of Medicine, Stanford, CA 94305, USA
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Trinconi CT, Reimão JQ, Coelho AC, Uliana SRB. Efficacy of tamoxifen and miltefosine combined therapy for cutaneous leishmaniasis in the murine model of infection withLeishmania amazonensis. J Antimicrob Chemother 2016; 71:1314-22. [DOI: 10.1093/jac/dkv495] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/21/2015] [Indexed: 11/13/2022] Open
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Identification and Biological Characterization of Leishmania (Viannia) guyanensis Isolated from a Patient with Tegumentary Leishmaniasis in Goiás, a Nonendemic Area for This Species in Brazil. BIOMED RESEARCH INTERNATIONAL 2015; 2015:350764. [PMID: 26583102 PMCID: PMC4637049 DOI: 10.1155/2015/350764] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 08/04/2015] [Indexed: 01/08/2023]
Abstract
The aim of this study was to characterize clinical field isolates of Leishmania spp. obtained from patients with American Tegumentary Leishmaniasis (ATL) who live in Goiás state, Brazil. The presumed areas of infection were in Goiás, Tocantins, and Pará states. Three isolates of parasites were identified as L. (Viannia) braziliensis and one as L. (V.) guyanensis. The in vitro growth profiles were found to be similar for all parasites. Nevertheless, in C57BL/6 mice, L. (V.) guyanensis infection was better controlled than L. (V.) braziliensis. Yet in C57BL/6 mice deficient in interferon gamma, L. (V.) guyanensis lesions developed faster than those caused by L. (V.) braziliensis isolates. In BALB/c mice, the development of lesions was similar for isolates from both species; however, on the 11th week of infection, amastigotes could not be observed in macrophages from L. (V.) guyanensis-infected mice. Thus, L. (V.) guyanensis can be circulating in Goiás, a state where autochthonous cases of this species had not yet been reported. Considering the difficulties to differentiate L. (V.) guyanensis from L. (V.) braziliensis at the molecular, morphological, and clinical (human and murine models) levels, the presence of L. (V.) guyanensis infections is possibly underestimated in several regions of Brazil.
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Coelho AC, Trinconi CT, Senra L, Yokoyama-Yasunaka JKU, Uliana SRB. Leishmania is not prone to develop resistance to tamoxifen. INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE 2015; 5:77-83. [PMID: 26150922 PMCID: PMC4486464 DOI: 10.1016/j.ijpddr.2015.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 05/26/2015] [Accepted: 05/28/2015] [Indexed: 01/27/2023]
Abstract
Tamoxifen, an antineoplastic agent, is active in vitro and in vivo against the parasitic protozoa Leishmania. As part of our efforts to unravel this drug's mechanisms of action against the parasite and understand how resistance could arise, we tried to select tamoxifen-resistant Leishmania amazonensis. Three different strategies to generate tamoxifen resistant mutants were used: stepwise increase in drug concentration applied to promastigote cultures, chemical mutagenesis followed by drug selection and treatment of infected mice followed by selection of amastigotes. For amastigote selection, we employed a method with direct plating of parasites recovered from lesions into semi-solid media. Tamoxifen resistant parasites were not rescued by any of these methods. Miltefosine was used as a control in selection experiments and both stepwise selection and chemical mutagenesis allowed successful isolation of miltefosine resistant mutants. These findings are consistent with a multi-target mode of action to explain tamoxifen's leishmanicidal properties. Considering that drug resistance is a major concern in anti-parasitic chemotherapy, these findings support the proposition of using tamoxifen as a partner in drug combination schemes for the treatment of leishmaniasis. Tamoxifen is effective in the treatment of cutaneous and visceral leishmaniasis. Resistance to tamoxifen was not found in promastigotes upon mutagenesis/selection. Resistance to tamoxifen was not detected in amastigotes after in vivo selection. Tamoxifen may be a good partner in drug combination schemes for leishmaniasis.
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Affiliation(s)
- Adriano C Coelho
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, 05508-900, SP, Brazil
| | - Cristiana T Trinconi
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, 05508-900, SP, Brazil
| | - Luisa Senra
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, 05508-900, SP, Brazil
| | - Jenicer K U Yokoyama-Yasunaka
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, 05508-900, SP, Brazil
| | - Silvia R B Uliana
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, 05508-900, SP, Brazil
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Abstract
Leishmania is an infectious protozoan parasite related to African and American trypanosomes. All Leishmania species that are pathogenic to humans can cause dermal disease. When one is confronted with cutaneous leishmaniasis, identification of the causative species is relevant in both clinical and epidemiological studies, case management, and control. This review gives an overview of the currently existing and most used assays for species discrimination, with a critical appraisal of the limitations of each technique. The consensus taxonomy for the genus is outlined, including debatable species designations. Finally, a numerical literature analysis is presented that describes which methods are most used in various countries and regions in the world, and for which purposes.
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Affiliation(s)
- Gert Van der Auwera
- Institute of Tropical Medicine, Department of Biomedical Sciences, Antwerp, Belgium
| | - Jean-Claude Dujardin
- Institute of Tropical Medicine, Department of Biomedical Sciences, Antwerp, Belgium Antwerp University, Department of Biomedical Sciences, Antwerp, Belgium
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In vitro sensitivity of paired Leishmania (Viannia) braziliensis samples isolated before meglumine antimoniate treatment and after treatment failure or reactivation of cutaneous leishmaniasis. DISEASE MARKERS 2015; 2015:943236. [PMID: 25802480 PMCID: PMC4329789 DOI: 10.1155/2015/943236] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 01/09/2015] [Indexed: 11/17/2022]
Abstract
This study evaluated the in vitro sensitivity of paired Leishmania braziliensis samples isolated from the same patient before pentavalent antimonial treatment (Sample A) and after treatment failure or cutaneous leishmaniasis reactivation (Sample B) in patients undergoing intralesional administration or injections (5 mgSb(V)/kg/d) of meglumine antimoniate. Fourteen samples from 7 patients were studied. After 24 h of drug exposure, 50% lethal dose (LD50) values for promastigotes ranged from 0.37 mg/mL to 5.86 mg/mL for samples obtained before treatment (A) and 0.89 mg/mL to 7.80 mg/mL for samples obtained after treatment (B). After 48 h, LD50 values ranged from 0.37 mg/mL to 5.75 mg/mL and 0.70 mg/mL to 7.68 mg/mL for A and B samples, respectively. After 48 h, LD50 values for amastigotes ranged from 11.7 to 44.3 μg/mL for A samples and 13.7 to 52.7 μg/mL for B samples. Of 7 patients, 1 discontinued treatment and 6 were cured after retreatment with amphotericin B (4 cases) or meglumine antimoniate (2 cases). Overall the B samples had higher LD50 values than A samples; however the difference was not significant. These results do not support the hypothesis that low-dose and intralesional treatments induce selection of resistant parasites in vitro and suggest that other factors may influence therapeutic outcome in patients with poor response to initial treatment.
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In vitro metacyclogenesis of Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis clinical field isolates, as evaluated by morphology, complement resistance, and infectivity to human macrophages. BIOMED RESEARCH INTERNATIONAL 2015; 2015:393049. [PMID: 25695070 PMCID: PMC4324811 DOI: 10.1155/2015/393049] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 12/02/2014] [Indexed: 12/27/2022]
Abstract
This study was designed to assess in vitro metacyclogenesis of Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis clinical field isolates obtained from patient lesions (L. braziliensis IMG3 and PPS6m; L. amazonensis MAB6). Metacyclogenesis was evaluated by different criteria, namely, promastigote size (morphometric analysis and flow cytometry), surface modifications (loss of lectin or monoclonal antibody (mAb) binding, complement resistance), and infectivity to human macrophages. Growth curves were similar for all parasites evaluated. The various features analyzed were expressed in a high percentage of promastigotes at 6th and 10th days of culture and a low percentage at the 2nd day. However, in most isolates, these features, considered as markers of metacyclogenesis, seemed to develop with different time courses, since the percentages of metacyclic forms detected with each technique were usually different. Parasites from 6th or 10th day and those negatively selected with lectin or mAb similarly infected human macrophages. From all isolates analyzed, L. amazonensis PH8 and MAB6 showed the highest and the lowest levels of susceptibility, respectively, to leishmanicidal activity of IFN-γ/LPS-activated macrophages. Our results showed that by using different techniques to evaluate different aspects of metacyclogenesis (morphological and biochemical modifications) different percentages of metacyclic promastigotes can be detected in each isolate culture.
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Coelho AC, Trinconi CT, Costa CHN, Uliana SRB. In vitro and in vivo miltefosine susceptibility of a Leishmania amazonensis isolate from a patient with diffuse cutaneous leishmaniasis. PLoS Negl Trop Dis 2014; 8:e2999. [PMID: 25033218 PMCID: PMC4102453 DOI: 10.1371/journal.pntd.0002999] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 05/31/2014] [Indexed: 11/25/2022] Open
Abstract
Miltefosine was the first oral compound approved for visceral leishmaniasis chemotherapy, and its efficacy against Leishmania donovani has been well documented. Leishmania amazonensis is the second most prevalent species causing cutaneous leishmaniasis and the main etiological agent of diffuse cutaneous leishmaniasis in Brazil. Driven by the necessity of finding alternative therapeutic strategies for a chronic diffuse cutaneous leishmaniasis patient, we evaluated the susceptibility to miltefosine of the Leishmania amazonensis line isolated from this patient, who had not been previously treated with miltefosine. In vitro tests against promastigotes and intracellular amastigotes showed that this parasite isolate was less susceptible to miltefosine than L. amazonensis type strains. Due to this difference in susceptibility, we evaluated whether genes previously associated with miltefosine resistance were involved. No mutations were found in the miltefosine transporter gene or in the Ros3 or pyridoxal kinase genes. These analyses were conducted in parallel with the characterization of L. amazonensis mutant lines selected for miltefosine resistance using a conventional protocol to select resistance in vitro, i.e., exposure of promastigotes to increasing drug concentrations. In these mutant lines, a single nucleotide mutation G852E was found in the miltefosine transporter gene. In vivo studies were also performed to evaluate the correlation between in vitro susceptibility and in vivo efficacy. Miltefosine was effective in the treatment of BALB/c mice infected with the L. amazonensis type strain and with the diffuse cutaneous leishmaniasis isolate. On the other hand, animals infected with the resistant line bearing the mutated miltefosine transporter gene were completely refractory to miltefosine chemotherapy. These data highlight the difficulties in establishing correlations between in vitro susceptibility determinations and response to chemotherapy in vivo. This study contributed to establish that the miltefosine transporter is essential for drug activity in L. amazonensis and a potential molecular marker of miltefosine unresponsiveness in leishmaniasis patients. Leishmania amazonensis is the etiological agent of diffuse cutaneous leishmaniasis. The disease is extremely difficult to treat and frequently relapses once the treatment is interrupted. Although not yet approved in Brazil, miltefosine is an attractive alternative for leishmaniasis treatment due to its oral administration and low incidence of side effects. Here, we evaluated the efficacy of miltefosine against a L. amazonensis line that was isolated from a chronic diffuse cutaneous leishmaniasis patient to ascertain whether miltefosine could be considered as a therapeutic option in this case. Parasites isolated from this patient were less susceptible to miltefosine than a reference strain in vitro. The mechanisms underlying this decreased susceptibility were studied in this natural parasite isolate in parallel with mutant strains selected in vitro for miltefosine resistance. A mutation in the gene encoding the miltefosine transporter was identified in the mutants selected in vitro but not in the line isolated from the patient. Notwithstanding the decreased susceptibility in vitro, when used to treat infected mice, miltefosine was equally effective against the isolate from the patient and the type strain, but completely ineffective against the resistant line.
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Affiliation(s)
- Adriano C. Coelho
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- * E-mail:
| | - Cristiana T. Trinconi
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Carlos H. N. Costa
- Departamento de Medicina Comunitária, Universidade Federal do Piauí, Teresina, Piauí, Brazil
| | - Silvia R. B. Uliana
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, São Paulo, Brazil
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Galdino H, Maldaner AE, Pessoni LL, Soriani FM, Pereira LIDA, Pinto SA, Duarte FB, Gomes CM, Fleuri AKA, Dorta ML, de Oliveira MAP, Teixeira MM, Batista AC, Joosten LAB, Vieira LQ, Ribeiro-Dias F. Interleukin 32γ (IL-32γ) is highly expressed in cutaneous and mucosal lesions of American Tegumentary Leishmaniasis patients: association with tumor necrosis factor (TNF) and IL-10. BMC Infect Dis 2014; 14:249. [PMID: 24884781 PMCID: PMC4026597 DOI: 10.1186/1471-2334-14-249] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 04/14/2014] [Indexed: 11/10/2022] Open
Abstract
Background The interleukin 32 (IL-32) is a proinflammatory cytokine produced by immune and non-immune cells. It can be induced during bacterial and viral infections, but its production was never investigated in protozoan infections. American Tegumentary Leishmaniasis (ATL) is caused by Leishmania protozoan leading to cutaneous, nasal or oral lesions. The aim of this study was to evaluate the expression of IL-32 in cutaneous and mucosal lesions as well as in peripheral blood mononuclear cells (PBMC) exposed to Leishmania (Viannia) braziliensis. Methods IL-32, tumour necrosis factor (TNF) and IL-10 protein expression was evaluated by immunohistochemistry in cutaneous, mucosal lesions and compared to healthy specimens. The isoforms of IL-32α, β, δ, γ mRNA, TNF mRNA and IL-10 mRNA were assessed by qPCR in tissue biopsies of lesions and healthy skin and mucosa. In addition, PBMC from healthy donors were cultured with amastigotes of L. (V.) braziliensis. In lesions, the parasite subgenus was identified by PCR-RFLP. Results We showed that the mRNA expression of IL-32, in particular IL-32γ was similarly up-regulated in lesions of cutaneous (CL) or mucosal (ML) leishmaniasis patients. IL-32 protein was produced by epithelial, endothelial, mononuclear cells and giant cells. The IL-32 protein expression was associated with TNF in ML but not in CL. IL-32 was not associated with IL-10 in both CL and ML. Expression of TNF mRNA was higher in ML than in CL lesions, however levels of IL-10 mRNA were similar in both clinical forms. In all lesions in which the parasite was detected, L. (Viannia) subgenus was identified. Interestingly, L. (V.) braziliensis induced only IL-32γ mRNA expression in PBMC from healthy individuals. Conclusions These data suggest that IL-32 plays a major role in the inflammatory process caused by L. (Viannia) sp or that IL-32 is crucial for controlling the L. (Viannia) sp infection.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Fátima Ribeiro-Dias
- Institute of Tropical Pathology and Public Healthy, Universidade Federal de Goiás, Rua 235 S/N - Setor Universitário, Goiânia 74605-050, Goiás, Brazil.
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Reimão JQ, Miguel DC, Taniwaki NN, Trinconi CT, Yokoyama-Yasunaka JKU, Uliana SRB. Antileishmanial activity of the estrogen receptor modulator raloxifene. PLoS Negl Trop Dis 2014; 8:e2842. [PMID: 24810565 PMCID: PMC4014391 DOI: 10.1371/journal.pntd.0002842] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 03/23/2014] [Indexed: 11/27/2022] Open
Abstract
Background The treatment of leishmaniasis relies mostly on parenteral drugs with potentially serious adverse effects. Additionally, parasite resistance in the treatment of leishmaniasis has been demonstrated for the majority of drugs available, making the search for more effective and less toxic drugs and treatment regimens a priority for the control of leishmaniasis. The aims of this study were to evaluate the antileishmanial activity of raloxifene in vitro and in vivo and to investigate its mechanism of action against Leishmania amazonensis. Methodology/Principal Findings Raloxifene was shown to possess antileishmanial activity in vitro against several species with EC50 values ranging from 30.2 to 38.0 µM against promastigotes and from 8.8 to 16.2 µM against intracellular amastigotes. Raloxifene's mechanism of action was investigated through transmission electron microscopy and labeling with propidium iodide, DiSBAC2(3), rhodamine 123 and monodansylcadaverine. Microscopic examinations showed that raloxifene treated parasites displayed autophagosomes and mitochondrial damage while the plasma membrane remained continuous. Nonetheless, plasma membrane potential was rapidly altered upon raloxifene treatment with initial hyperpolarization followed by depolarization. Loss of mitochondrial membrane potential was also verified. Treatment of L. amazonensis – infected BALB/c mice with raloxifene led to significant decrease in lesion size and parasite burden. Conclusions/Significance The results of this work extend the investigation of selective estrogen receptor modulators as potential candidates for leishmaniasis treatment. The antileishmanial activity of raloxifene was demonstrated in vitro and in vivo. Raloxifene produces functional disorder on the plasma membrane of L. amazonensis promastigotes and leads to functional and morphological disruption of mitochondria, which culminate in cell death. Cutaneous and visceral leishmaniasis are part of the group we call neglected diseases. They are serious conditions that afflict millions in vast regions of the world. These diseases are very difficult to treat. This is due to the scanty choice of effective drugs together with their potentially severe side effects. One way of finding new treatments for these neglected conditions is to repurpose drugs that are already in use to treat other diseases. In this paper, we show that raloxifene, a drug that is used for the treatment of osteoporosis and also as an alternative in the treatment of breast cancer, is active against the causative agents of leishmaniasis and is effective in the treatment of cutaneous leishmaniasis in an experimental model. We also show that the antileishmanial mechanism of action of raloxifene is related to damage to the cell membrane and to the mitochondrion of the parasite.
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Affiliation(s)
- Juliana Q. Reimão
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Danilo C. Miguel
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Noemi N. Taniwaki
- Núcleo de Microscopia Eletrônica, Instituto Adolfo Lutz, São Paulo, Brazil
| | - Cristiana T. Trinconi
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | | | - Silvia R. B. Uliana
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
- * E-mail:
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Combination therapy with tamoxifen and amphotericin B in experimental cutaneous leishmaniasis. Antimicrob Agents Chemother 2014; 58:2608-13. [PMID: 24550333 DOI: 10.1128/aac.01315-13] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Leishmaniasis chemotherapy remains very challenging. The high cost of active drugs, along with the severity of their side effects and the increasing failure rate of the current therapeutic schemes, calls for the discovery of new active drugs and schemes of treatment. The use of combination therapy has gained much attention in recent years as a possible strategy for overcoming the various shortcomings in the present arsenal. We recently described the effectiveness of tamoxifen in murine models of leishmaniasis, and here, we investigated the interactions between tamoxifen and amphotericin B, one of the most potent drugs used in leishmaniasis treatment. The in vitro interactions were indifferent for the association of tamoxifen and amphotericin B. The association was also assayed in vivo in Leishmania amazonensis-infected BALB/c mice and was found to yield at least additive effects at low doses of both drugs.
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Zauli RC, Yokoyama-Yasunaka JK, Miguel DC, Moura AS, Pereira LI, da Silva IA, Lemes LG, Dorta ML, de Oliveira MA, Pitaluga AN, Ishikawa EA, Rodrigues JC, Traub-Cseko YM, Bijovsky AT, Ribeiro-Dias F, Uliana SR. A dysflagellar mutant of Leishmania (Viannia) braziliensis isolated from a cutaneous leishmaniasis patient. Parasit Vectors 2012; 5:11. [PMID: 22236464 PMCID: PMC3271977 DOI: 10.1186/1756-3305-5-11] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 01/11/2012] [Indexed: 11/24/2022] Open
Abstract
Background Parasites of the Leishmania genus alternate between the flagellated extracellular promastigote stage and intracellular amastigotes. Here we report the characterization of a Leishmania isolate, obtained from a cutaneous leishmaniasis patient, which presents peculiar morphological features. Methods The parasite was cultured in vitro and characterized morphologically using optical and electron microscopy. Identification was performed based on monoclonal antibodies and internal ribosomal spacer typing. In vitro macrophage cultures, murine experimental models and sand fly infections were used to evaluate infectivity in vitro and in vivo. Results The isolate was identified as Leishmania (Viannia) braziliensis. In the atypical promastigotes grown in culture, a short flagellum surrounded or interrupted by a protuberance of disorganized material was observed. A normal axoneme was present close to the basal body but without elongation much further outside the flagellar pocket. A disorganized swelling at the precocious end of the axoneme coincided with the lack of a paraflagellar rod structure. The isolate was able to infect macrophages in vitro, induce lesions in BALB/c mice and infect Lutzomyia longipalpis. Conclusions Notwithstanding the lack of an extracellular flagellum, this isolate infects macrophages in vitro and produces lesions when inoculated into mice. Moreover, it is able to colonize phlebotomine sand flies. Considering the importance attributed to the flagellum in the successful infection and survival of Leishmania in the insect midgut and in the invasion of macrophages, these findings may bring new light into the infectious mechanisms of L. (V.) braziliensis.
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Affiliation(s)
- Rogéria C Zauli
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brasil
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do Monte-Neto RL, Coelho AC, Raymond F, Légaré D, Corbeil J, Melo MN, Frézard F, Ouellette M. Gene expression profiling and molecular characterization of antimony resistance in Leishmania amazonensis. PLoS Negl Trop Dis 2011; 5:e1167. [PMID: 21629719 PMCID: PMC3101167 DOI: 10.1371/journal.pntd.0001167] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Accepted: 03/31/2011] [Indexed: 11/21/2022] Open
Abstract
Background Drug resistance is a major problem in leishmaniasis chemotherapy. RNA expression profiling using DNA microarrays is a suitable approach to study simultaneous events leading to a drug-resistance phenotype. Genomic analysis has been performed primarily with Old World Leishmania species and here we investigate molecular alterations in antimony resistance in the New World species L. amazonensis. Methods/Principal Findings We selected populations of L. amazonensis promastigotes for resistance to antimony by step-wise drug pressure. Gene expression of highly resistant mutants was studied using DNA microarrays. RNA expression profiling of antimony-resistant L. amazonensis revealed the overexpression of genes involved in drug resistance including the ABC transporter MRPA and several genes related to thiol metabolism. The MRPA overexpression was validated by quantitative real-time RT-PCR and further analysis revealed that this increased expression was correlated to gene amplification as part of extrachromosomal linear amplicons in some mutants and as part of supernumerary chromosomes in other mutants. The expression of several other genes encoding hypothetical proteins but also nucleobase and glucose transporter encoding genes were found to be modulated. Conclusions/Significance Mechanisms classically found in Old World antimony resistant Leishmania were also highlighted in New World antimony-resistant L. amazonensis. These studies were useful to the identification of resistance molecular markers. Leishmania are unicellular microorganisms that can be transmitted to humans by the bite of sandflies. They cause a spectrum of diseases called leishmaniasis, which are classified as neglected tropical diseases by the World Health Organization. The treatment of leishmaniasis is based on the administration of antimony-containing drugs. These drugs have been used since 1947 and still constitute the mainstay for leishmaniasis treatment in several countries. One of the problems with these compounds is the emergence of resistance. Our work seeks to understand how these parasites become resistant to the drug. We studied antimony-resistant Leishmania amazonensis mutants. We analyzed gene expression at the whole genome level in antimony-resistant parasites and identified mechanisms used by Leishmania for resistance. This work could help us in developing new strategies for treatment in endemic countries where people are unresponsive to antimony-based chemotherapy. The identification of common mechanisms among different species of resistant parasites may also contribute to the development of diagnostic kits to identify and monitor the spread of resistance.
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Affiliation(s)
- Rubens L. do Monte-Neto
- Departamento de Fisiologia e Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
- Centre de Recherche en Infectiologie du Centre de Recherche du CHUL and Département de Microbiologie, Immunologie et Infectiologie, Université Laval, Québec, Québec, Canada
| | - Adriano C. Coelho
- Centre de Recherche en Infectiologie du Centre de Recherche du CHUL and Département de Microbiologie, Immunologie et Infectiologie, Université Laval, Québec, Québec, Canada
| | - Frédéric Raymond
- Centre de Recherche en Infectiologie du Centre de Recherche du CHUL and Département de Microbiologie, Immunologie et Infectiologie, Université Laval, Québec, Québec, Canada
- Département de Médecine Moléculaire Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Danielle Légaré
- Centre de Recherche en Infectiologie du Centre de Recherche du CHUL and Département de Microbiologie, Immunologie et Infectiologie, Université Laval, Québec, Québec, Canada
| | - Jacques Corbeil
- Centre de Recherche en Infectiologie du Centre de Recherche du CHUL and Département de Microbiologie, Immunologie et Infectiologie, Université Laval, Québec, Québec, Canada
- Département de Médecine Moléculaire Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Maria N. Melo
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - Frédéric Frézard
- Departamento de Fisiologia e Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - Marc Ouellette
- Centre de Recherche en Infectiologie du Centre de Recherche du CHUL and Département de Microbiologie, Immunologie et Infectiologie, Université Laval, Québec, Québec, Canada
- * E-mail:
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Depledge DP, MacLean LM, Hodgkinson MR, Smith BA, Jackson AP, Ma S, Uliana SRB, Smith DF. Leishmania-specific surface antigens show sub-genus sequence variation and immune recognition. PLoS Negl Trop Dis 2010; 4:e829. [PMID: 20927190 PMCID: PMC2946902 DOI: 10.1371/journal.pntd.0000829] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 08/31/2010] [Indexed: 11/25/2022] Open
Abstract
Background A family of hydrophilic acylated surface (HASP) proteins, containing extensive and variant amino acid repeats, is expressed at the plasma membrane in infective extracellular (metacyclic) and intracellular (amastigote) stages of Old World Leishmania species. While HASPs are antigenic in the host and can induce protective immune responses, the biological functions of these Leishmania-specific proteins remain unresolved. Previous genome analysis has suggested that parasites of the sub-genus Leishmania (Viannia) have lost HASP genes from their genomes. Methods/Principal Findings We have used molecular and cellular methods to analyse HASP expression in New World Leishmania mexicana complex species and show that, unlike in L. major, these proteins are expressed predominantly following differentiation into amastigotes within macrophages. Further genome analysis has revealed that the L. (Viannia) species, L. (V.) braziliensis, does express HASP-like proteins of low amino acid similarity but with similar biochemical characteristics, from genes present on a region of chromosome 23 that is syntenic with the HASP/SHERP locus in Old World Leishmania species and the L. (L.) mexicana complex. A related gene is also present in Leptomonas seymouri and this may represent the ancestral copy of these Leishmania-genus specific sequences. The L. braziliensis HASP-like proteins (named the orthologous (o) HASPs) are predominantly expressed on the plasma membrane in amastigotes and are recognised by immune sera taken from 4 out of 6 leishmaniasis patients tested in an endemic region of Brazil. Analysis of the repetitive domains of the oHASPs has shown considerable genetic variation in parasite isolates taken from the same patients, suggesting that antigenic change may play a role in immune recognition of this protein family. Conclusions/Significance These findings confirm that antigenic hydrophilic acylated proteins are expressed from genes in the same chromosomal region in species across the genus Leishmania. These proteins are surface-exposed on amastigotes (although L. (L.) major parasites also express HASPB on the metacyclic plasma membrane). The central repetitive domains of the HASPs are highly variant in their amino acid sequences, both within and between species, consistent with a role in immune recognition in the host. Single-celled Leishmania parasites, transmitted by sand flies, infect humans and other mammals in many tropical and sub-tropical regions, giving rise to a spectrum of diseases called the leishmaniases. Species of parasite within the Leishmania genus can be divided into two groups (referred to as sub-genera) that are separated by up to 100 million years of evolution yet are highly related at the genome level. Our research is focused on identifying gene differences between these sub-genera that may identify proteins that impact on the transmission and pathogenicity of different Leishmania species. Here we report the presence of a highly-variant genomic locus (OHL) that was previously described as absent in parasites of the L. (Viannia) subgenus (on the basis of lack of key genes) but is present and well-characterised (as the LmcDNA16 locus) in all members of the alternative subgenus, L. (Leishmania). We demonstrate that the proteins encoded within the LmcDNA16 and OHL loci are similar in their structure and surface localisation in mammalian-infective amastigotes, despite significant differences in their DNA sequences. Most importantly, we demonstrate that the OHL locus proteins, like the HASP proteins from the LmcDNA16 locus, contain highly variable amino acid repeats that are antigenic in man and may therefore contribute to future vaccine development.
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Affiliation(s)
- Daniel P Depledge
- Centre for Immunology and Infection, Department of Biology, Hull York Medical School, University of York, York, United Kingdom
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