1
|
de Jong MK, van Eijk D, Broere F, Piek CJ. Owners' experiences of administering meglumine antimoniate injections to dogs with leishmaniosis: An online questionnaire study. Vet Rec 2024; 194:e4089. [PMID: 38809570 DOI: 10.1002/vetr.4089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 03/07/2024] [Accepted: 03/19/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND This study examined the experiences of owners of dogs with leishmaniosis who treated their dogs with daily subcutaneous meglumine antimoniate injections. The owners' perceived ease of administering the injections, the occurrence of problems and the effects on the owners and on the dog‒owner bond were evaluated. METHODS Dogs prescribed meglumine antimoniate as a treatment for leishmaniosis were identified using the database of the veterinary pharmacy of the Faculty of Veterinary Medicine, Utrecht University. An online questionnaire was sent to the owners of these dogs to evaluate the perceived ease of administering the injections, the occurrence of problems and the effects on the owner and the dog-owner bond. RESULTS Responses were received from 64 dog owners. Most respondents (78%) reported that administering the injections was not difficult. Pain or the development of nodules at the injection site was reported in 50% and 40% of the dogs, respectively. Polyuria was reported in 44% of the dogs. Some owners reported that administering the injections had a negative impact on their psychological wellbeing (20%), and some would have liked more veterinary support (11%). LIMITATIONS Some questions were answered by a limited number of people, and their responses may not be representative. CONCLUSION Dog owners remain highly motivated to persevere with meglumine antimoniate treatment and are willing to administer the injections themselves. The availability of active support when needed during the therapy cycle may further improve their acceptance of and confidence in giving the injections.
Collapse
Affiliation(s)
- Marja K de Jong
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Demy van Eijk
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Femke Broere
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Christine J Piek
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
2
|
de Lana M, Giunchetti RC. Dogs as a Model for Chemotherapy of Chagas Disease and Leishmaniasis. Curr Pharm Des 2021; 27:1741-1756. [PMID: 33371843 DOI: 10.2174/1381612826666201228142703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 10/22/2020] [Accepted: 11/02/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Dogs are natural reservoir of Chagas disease (CD) and leishmaniasis and have been used for studies of these infections as they develop different clinical forms of these diseases similar to humans. OBJECTIVE This article describes publications on the dog model relative to CD and leishmaniasis chemotherapy. METHODS The search of articles was based on PubMed, Scopus and MESH using the keywords: dog, Trypanosoma cruzi, treatment (T. cruzi chemotherapy analysis), Leishmania chagasi, Leishmania infantum, canine visceral leishmaniasis, treatment (Leishmania chemotherapy evaluation). RESULTS Benznidazole and nifurtimox were used as a reference in the treatment of CD and in combination with other compounds. Eleven out of the fifteen studies have authors from the same team, using similar protocols and post-treatment evaluations, which assured more reproducibility and credibility. Twenty leishmaniasis studies, especially on visceral leishmaniasis, presenting at least one parasitological analysis tested in distinct monochemotherapy and polychemotherapy approaches were accessed. Data demonstrated that polychemotherapy was more effective in improving the clinical signs and parasitism control. CONCLUSION The benefits of treatment in terms of reducing or eliminating lesions and/or cardiac dysfunctions were demonstrated at acute and/or chronic phases relative to parasite load and/or the T. cruzi strain resistance to treatment. BZ presented better therapeutic results than the two EBI compounds evaluated. Although treatment of the canine visceral leishmaniasis was not able to induce complete parasite clearance, it can improve clinical recovery. Thus, the dog is a good model for CD and leishmaniasis studies of chemotherapy and may be indicated for pre-clinical trials of new treatments.
Collapse
Affiliation(s)
- Marta de Lana
- Programa de Pos-Graduacao em Ciencias Farmaceuticas (CiPHARMA), Escola de Farmacia, Programa Pos-Graduacao em de Ciencias Biologicas, Nucleo de Pesquisas em Ciencias Biologicas (NUPEB), Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG, Brazil
| | - Rodolfo Cordeiro Giunchetti
- Departamento de Morfologia, Instituto de Ciencias Biologicas (ICB), Universidade Federal de Minas Gerais, MG, Brazil
| |
Collapse
|
3
|
Miret JA, Moreno J, Nieto J, Carter KC, Mullen AB, Ambros L, Rodríguez C, San Andrés MI, González F. Antileishmanial efficacy and tolerability of combined treatment with non-ionic surfactant vesicle formulations of sodium stibogluconate and paromomycin in dogs. Exp Parasitol 2020; 220:108033. [PMID: 33166530 DOI: 10.1016/j.exppara.2020.108033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/30/2020] [Accepted: 10/28/2020] [Indexed: 10/23/2022]
Abstract
Infection with Leishmania infantum causes the disease visceral leishmaniasis (VL), which is a serious clinical and veterinary problem. The drugs used to treat canine leishmaniasis (CanL) do not cause complete parasite clearance; they can be toxic, and emerging drug resistance in parasite populations limits their clinical utility. Therefore, in this study we have evaluated the toxicity and efficacy of joint treatment with a 1:1 mixture of sodium stibogluconate-NIV (SSG-NIV, 10 mg Sbv/day) and paromomycin-NIV (PMM-NIV, 10 mg PMM/kg/day), given intravenously daily for seven days from day 270 post-infection, to nine-month-old female beagle dogs (n = 6) experimentally infected with Leishmania infantum. Treatment significantly improved the clinical symptoms of VL infection in all the treated dogs, reduced parasite burdens in lymph nodes and bone marrow, and all symptomatic treated dogs, were asymptomatic at 90 days post-treatment. Treatment was associated with a progressive and significant decrease in specific IgG anti-Leishmania antibodies using parasite soluble antigen (p < 0.01) or rK39 (p < 0.01) as the target antigen. In addition, all dogs were classified as parasite negative based on Leishmania nested PCR and quantitative real time PCR tests and as well as an inability to culture of promastigote parasites from lymph nodes and bone marrow tissue samples taken at day 90 post-treatment. However, treatment did not cure the dogs as parasites were detected at 10 months post-treatment, indicating that a different dosing regimen is required to cause long term cure or prevent relapse.
Collapse
Affiliation(s)
- Jorge A Miret
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Dr. Cecilio Báez casi Dr. Gaspar Villamayor. Campus UNA, CP 2169, San Lorenzo, Paraguay.
| | - Javier Moreno
- WHO Collaborating Center for Leishmaniasis, Centro Nacional Microbiología, Instituto de Salud Carlos III. Crta, Majadahonda a Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain
| | - Javier Nieto
- WHO Collaborating Center for Leishmaniasis, Centro Nacional Microbiología, Instituto de Salud Carlos III. Crta, Majadahonda a Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain
| | - Katharine C Carter
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Catedral St Glasgow G 4 ORE, Glasgow, United Kingdom
| | - Alexander B Mullen
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Catedral St Glasgow G 4 ORE, Glasgow, United Kingdom
| | - Luis Ambros
- Cátedra de Farmacología, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires. Av. Chorroarin 280, Buenos Aires, Argentina
| | - Casilda Rodríguez
- Cátedra de Farmacología, Facultad de Veterinaria, Universidad Complutense de Madrid, Avenida Puerta del Hierro s/n, Ciudad Universitaria, 28040, Madrid, Spain
| | - Manuel Ignacio San Andrés
- Cátedra de Farmacología, Facultad de Veterinaria, Universidad Complutense de Madrid, Avenida Puerta del Hierro s/n, Ciudad Universitaria, 28040, Madrid, Spain
| | - Fernando González
- Cátedra de Farmacología, Facultad de Veterinaria, Universidad Complutense de Madrid, Avenida Puerta del Hierro s/n, Ciudad Universitaria, 28040, Madrid, Spain
| |
Collapse
|
4
|
Borborema SET, Osso JA, Andrade HFD, Nascimento ND. Biodistribution of meglumine antimoniate in healthy and Leishmania (Leishmania) infantum chagasi-infected BALB/c mice. Mem Inst Oswaldo Cruz 2014; 108:623-30. [PMID: 23903979 PMCID: PMC3970594 DOI: 10.1590/0074-0276108052013014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 05/28/2013] [Indexed: 11/29/2022] Open
Abstract
Pentavalent antimonials such as meglumine antimoniate (MA) are the
primary treatments for leishmaniasis, a complex disease caused by protozoan
parasites of the genus Leishmania . Despite over 70 years of
clinical use, their mechanisms of action, toxicity and pharmacokinetics have not
been fully elucidated. Radiotracer studies performed on animals have the
potential to play a major role in pharmaceutical development. The aims of this
study were to prepare an antimony radiotracer by neutron irradiation of MA and
to determine the biodistribution of MA in healthy and Leishmania
(Leishmania) infantum chagasi-infected mice. MA
(Glucantime(r)) was neutron irradiated inside the IEA-R1 nuclear
reactor, producing two radioisotopes, 122Sb and 124Sb, with high radionuclidic
purity and good specific activity. This irradiated compound presented
anti-leishmanial activity similar to that of non-irradiated MA in both in vitro
and in vivo evaluations. In the biodistribution studies, healthy mice showed
higher uptake of antimony in the liver than infected mice and elimination
occurred primarily through biliary excretion, with a small proportion of the
drug excreted by the kidneys. The serum kinetic curve was bi-exponential, with
two compartments: the central compartment and another compartment associated
with drug excretion. Radiotracers, which can be easily produced by neutron
irradiation, were demonstrated to be an interesting tool for answering several
questions regarding antimonial pharmacokinetics and chemotherapy.
Collapse
Affiliation(s)
- Samanta Etel Treiger Borborema
- Centro de Biotecnologia, Instituto de Pesquisas Energéticas e Nucleares, Comissão Nacional de Energia Nuclear, São Paulo, SP, Brasil.
| | | | | | | |
Collapse
|
5
|
Friedrich K, Vieira FA, Porrozzi R, Marchevsky RS, Miekeley N, Grimaldi G, Paumgartten FJR. Disposition of antimony in rhesus monkeys infected with Leishmania braziliensis and treated with meglumine antimoniate. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2012; 75:63-75. [PMID: 22129235 DOI: 10.1080/15287394.2012.624826] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Antimony (Sb) disposition and toxicity was evaluated in Leishmania braziliensis-infected monkeys (Macaca mulatta) treated with a 21-d course of low (LOW) or standard (STD) meglumine antimoniate (MA) dosage regimens (5 or 20 mg Sb(V)/kg body weight/d im). Antimony levels in biological matrices were determined by inductively coupled plasma mass spectrometry (ICPMS), while on-line ion chromatography coupled to ICPMS was used to separate and quantify Sb species in plasma. Nadir Sb levels rose steadily from 19.6 ± 4 and 65.1 ± 17.4 ng/g, 24 h after the first injection, up to 27.4 ± 5.8 and 95.7 ± 6.6 ng/g, 24 h after the 21st dose in LOW and SDT groups, respectively. Subsequently, Sb plasma levels gradually declined with a terminal elimination phase half-life of 35.8 d. Antimony speciation in plasma on posttreatment days 1-9 indicated that as total Sb levels declined, proportion of Sb(V) remained nearly constant (11-20%), while proportion of Sb(III) rose from 5% (d 1) to 50% (d 9). Plasma [Sb]/erythrocyte [Sb] ratio was >1 until 12 h after dosing and reversed thereafter. Tissue Sb concentrations (posttreatment days 55 and 95) were as follows: >1000 ng/g in thyroid, nails, liver, gall bladder and spleen; >200 and <1000 ng/g in lymph nodes, kidneys, adrenals, bones, skeletal muscles, heart and skin; and <200 ng/g in various brain structures, thymus, stomach, colon, pancreas. and teeth. Results from this study are therefore consistent with view that Sb(V) is reduced to Sb(III), the active form, within cells from where it is slowly eliminated. Localization of Sb active forms in the thyroid gland and liver and the pathophysiological consequences of marked Sb accumulation in these tissues warrant further studies.
Collapse
Affiliation(s)
- Karen Friedrich
- Laboratory of Environmental Toxicology, National School of Public Health, Rio de Janeiro, Brazil
| | | | | | | | | | | | | |
Collapse
|
6
|
Frézard F, Demicheli C. New delivery strategies for the old pentavalent antimonial drugs. Expert Opin Drug Deliv 2010; 7:1343-58. [DOI: 10.1517/17425247.2010.529897] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
7
|
Oliva G, Roura X, Crotti A, Maroli M, Castagnaro M, Gradoni L, Lubas G, Paltrinieri S, Zatelli A, Zini E. Guidelines for treatment of leishmaniasis in dogs. J Am Vet Med Assoc 2010; 236:1192-8. [PMID: 20513197 DOI: 10.2460/javma.236.11.1192] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Gaetano Oliva
- Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, University of Naples, 80137 Naples, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Ribeiro RR, Ferreira WA, Martins PS, Neto RLM, Rocha OGF, Le Moyec L, Demicheli C, Frézard F. Prolonged absorption of antimony(V) by the oral route from non-inclusion meglumine antimoniateâβ-cyclodextrin conjugates. Biopharm Drug Dispos 2009; 31:109-19. [DOI: 10.1002/bdd.695] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
9
|
Frézard F, Martins PS, Barbosa MC, Pimenta AM, Ferreira WA, de Melo JE, Mangrum JB, Demicheli C. New insights into the chemical structure and composition of the pentavalent antimonial drugs, meglumine antimonate and sodium stibogluconate. J Inorg Biochem 2008; 102:656-65. [DOI: 10.1016/j.jinorgbio.2007.10.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Revised: 10/15/2007] [Accepted: 10/18/2007] [Indexed: 11/28/2022]
|
10
|
Radwan MA, Al Jaser MH, Al Rayes ZR. The effects of induced diabetes and cutaneous Leishmania infection on the pharmacokinetics of antimony in hamsters. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2007; 101:133-42. [PMID: 17316499 DOI: 10.1179/136485907x154520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Patients with certain diseases appear to be at greater risk of developing adverse drug interactions, either because of the disease state itself or the drugs used to treat it. The effects of streptozotocin-induced diabetes and/or cutaneous Leishmania major infection on the pharmacokinetics of antimony (SbV) have now been investigated, in hamsters treated with sodium stibogluconate (Pentostam). The animals were randomly divided into five groups, each of 20 hamsters, known as D (for diabetes without leishmaniasis), DL (diabetes induced prior to the leishmaniasis), L (leishmaniasis without diabetes), LD (diabetes induced after leishmanial infection) and C (the control group, of animals with neither diabetes nor leishmaniasis). After its diabetes and/or leishmaniasis (if any) was established, each animal was given an intramuscular dose of sodium stibogluconate (80 mg/kg) each day for 3 weeks. Blood samples were collected after the first or last doses, to allow the pharmacokinetic parameters of SbV after single and multiple dosing to be compared. Although the between-dose interval (24 h) was more than 10 times longer than the terminal elimination rate constant (t1/2) at steady state, there was a significant increase in the mean peak SbV concentration (Cmax), as the result of multiple dosing, in all five groups (P<0.001 for each). The hamsters with diabetes showed the least accumulation of SbV in their blood, whether or not they were infected with L. major. In the non-diabetic animals of groups L and C, the apparent total clearance of SbV (CL/F) was decreased by multiple dosing, being, respectively, 34.5% and 23.0% lower after the 21st dose than after the first. An increase in urine volume was the reason for the significant increase in CL/F in group D (P<0.001), and this offset the decrease in CL/F seen in the L group, resulting in no change in CL/F in the animals of the DL group. Three weeks of antileishmanial treatment produced no significant reductions in the leishmanial lesions on the parasite-inoculated foot-pads of the hamsters in the L or DL groups but such reductions were detected in the animals of the LD group (P<0.001). In conclusion, it appears that the administration of SbV over a few weeks may cause renal toxicity and, in clinical use, should therefore be accompanied by the regular monitoring of renal function. A cautious increase in SbV dosing may be necessary for the effective treatment of L. major (and perhaps other species of Leishmania) in diabetic patients.
Collapse
Affiliation(s)
- M A Radwan
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 22452, Riyadh 11495, Saudi Arabia.
| | | | | |
Collapse
|
11
|
Schettini DA, Ribeiro RR, Demicheli C, Rocha OGF, Melo MN, Michalick MSM, Frézard F. Improved targeting of antimony to the bone marrow of dogs using liposomes of reduced size. Int J Pharm 2006; 315:140-7. [PMID: 16549281 DOI: 10.1016/j.ijpharm.2006.01.048] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2005] [Revised: 01/16/2006] [Accepted: 01/17/2006] [Indexed: 11/15/2022]
Abstract
A novel liposomal formulation of meglumine antimoniate (MA), consisting of vesicles of reduced size, has been evaluated in dogs with visceral leishmaniasis to determine its pharmacokinetics as well as the impact of vesicle size on the targeting of antimony to the bone marrow. Encapsulation of MA in liposomes was achieved through freeze-drying of empty liposomes in the presence of sucrose and rehydration with a solution of MA. The resulting formulation, with a mean vesicle diameter of about 400 nm, was given to mongrel dogs with visceral leishmaniasis as an i.v. bolus injection at 4.2 mgSb/kg of body weight. The pharmacokinetics of antimony were assessed in the blood and in organs of the mononuclear phagocyte system and compared to those achieved with the free drug and the drug encapsulated in large sized liposomes (mean diameter of 1200 nm). The targeting of antimony to the bone marrow was improved (approximately three-fold) with the novel liposomal formulation, when compared to the formulation of MA in large sized liposomes. This study provides the first direct experimental evidence that passive targeting of liposomes to the bone marrow of dogs is improved by the reduction of vesicle size from the micron to the nanometer scale.
Collapse
Affiliation(s)
- Dante A Schettini
- Departamento de Fisiologia e Biofísica, Instituto de Ciências Biológicas, Av. Antônio Carlos 6627, Universidade Federal de Minas Gerais, 31270-901 Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | | | | | | |
Collapse
|
12
|
Miranda ES, Miekeley N, De-Carvalho RR, Paumgartten FJR. Developmental toxicity of meglumine antimoniate and transplacental transfer of antimony in the rat. Reprod Toxicol 2006; 21:292-300. [PMID: 16271447 DOI: 10.1016/j.reprotox.2005.09.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2005] [Revised: 09/02/2005] [Accepted: 09/13/2005] [Indexed: 11/18/2022]
Abstract
Meglumine antimoniate (MA), a pentavalent antimonial (SbV) drug, has been used for the treatment of leishmaniases for over half a century but there is almost no data on its safety and kinetics during pregnancy. This study was undertaken to investigate the developmental toxicity of MA as well as the transplacental transfer of antimony (Sb) in rats. Wistar rats (approximately 20 per group) were treated subcutaneously (s.c.) with MA (0, 75, 150, 300 mg SbV/(kg BW day)) during pregnancy (days 1-20). An untreated control group was evaluated as well. Caesarean sections were performed on day 21 and implantations, living and dead fetuses, and resorptions were recorded. Fetuses were weighed and fixed in Bouin's solution and one-third of each litter was examined for soft-tissue anomalies. The remaining fetuses were cleared and stained with Alizarin red S for skeleton evaluation. No adverse effect of MA on the mothers was noted at any dose level. No embryotoxicity was observed at the lowest dose but, at the highest dose, MA increased embryolethality, reduced fetal weight and augmented the occurrence of some soft-tissue and skeleton variations. Therefore, the no-observed-adverse-effect level for MA-induced embryotoxicity was 75 mg SbV/(kg BW day). In a separate group of rats treated with 300 mg SbV/(kg BW day) s.c. during whole pregnancy, blood (0.2 mL) was taken from the tail vein 1, 2, 4, 6, 12 and 24 h after treatment on day 1 and thereafter every other day immediately before drug injection. Blood was also taken from fetuses removed on day 21, 24h after the last injection of MA. Blood levels of Sb were determined by ICP-MS and results showed that most of administered Sb was eliminated rapidly (in less than 6 h), but nadir blood concentrations increased gradually during treatment from 1 to 2 microg/g, 24h after the first dose, up to approximately 38 microg/g after the 20th dose. Levels of Sb in fetal blood were as high as 10-15 microg/g, i.e. approximately 30% their mothers' nadir levels near term. These findings indicated that repeated administration of MA during gestation led to an accumulation of Sb in mothers and fetuses.
Collapse
Affiliation(s)
- Elaine S Miranda
- Laboratory of Environmental Toxicology, Department of Biological Sciences, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | | | | | | |
Collapse
|
13
|
Abstract
Canine leishmaniasis is caused by Leishmania infantum (syn. L. chagasi, in America) and is transmitted by the bite of phlebotomine sand flies. Infected dogs constitute the main domestic reservoir of the parasite and play a key role in transmission to humans, in which the parasite produces visceral leishmaniasis. The increasing awareness that control of the human disease depends on effective control of canine leishmaniasis has promoted, in the last few years, research into leishmanial infection in dogs. Newly available specific reagents and molecular tools have been applied to the detailed investigation of canine leishmaniasis and important advances have been made in elucidating the epidemiology and pathology of the disease. These new findings have led to better understanding of the disease, and have also helped in the development of new diagnostic methods and control measures against the infection, such as insecticide-impregnated collars for dogs, new drugs and treatment protocols, and second generation vaccines, with the hope of not only reducing the heavy burden of the disease among dogs but also reducing the incidence of human visceral leishmaniasis.
Collapse
Affiliation(s)
- Jorge Alvar
- WHO Collaborating Centre for Leishmaniasis, Servicio de Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220-Majadahonda, Madrid, Spain.
| | | | | | | | | |
Collapse
|
14
|
Nieto J, Alvar J, Mullen AB, Carter KC, Rodríguez C, San Andrés MI, San Andrés MD, Baillie AJ, González F. Pharmacokinetics, toxicities, and efficacies of sodium stibogluconate formulations after intravenous administration in animals. Antimicrob Agents Chemother 2003; 47:2781-7. [PMID: 12936974 PMCID: PMC182616 DOI: 10.1128/aac.47.9.2781-2787.2003] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2002] [Revised: 07/27/2002] [Accepted: 06/03/2003] [Indexed: 11/20/2022] Open
Abstract
The pharmacokinetics and toxicities of free sodium stibogluconate (SSG) and two vesicular formulations of this drug (a nonionic surfactant vesicular formulation of SSG [SSG-NIV] and SSG-NIV-dextran) were determined after treatment with a single intravenous dose in healthy dogs and were related to their antileishmanial efficacies in mice. Analysis of the curves of the concentrations in plasma after intravenous administration of SSG and SSG-NIV in dogs showed that both formulations produced similar antimony (Sb) pharmacokinetics. In contrast, treatment with SSG-NIV-dextran significantly modified the pharmacokinetics of the drug. The elimination half-life was four times longer (280 min) than that observed after administration of SSG (71 min) (P = 0.01), and the volume of distribution at steady state (V(SS)) was also increased (V(SS) for SSG, 0.21 liters/kg; V(SS) for SSG-NIV-dextran, 0.34 liters/kg [P = 0.02]), thus indicating that drug encapsulation favors the distribution of Sb into organs and increases its residence time in tissues. This would explain the superior antileishmanial efficacy of this formulation compared to those of the free drug in mice. No signs of toxicity were found in dogs after SSG and SSG-NIV administration. However, SSG-NIV-dextran treatment was associated with short-term toxicity, demonstrated by the development of chills and diarrhea, which cleared by 24 h postdosing, and hepatic dysfunction at 24 h postdosing (P < 0.05). The levels of all the biochemical parameters had returned to normal at 1 month postdosing. No signs of toxicity were observed in mice treated with all three formulations.
Collapse
Affiliation(s)
- J Nieto
- WHO Collaborating Center for Leishmaniasis Servicio de Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.
| | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
Visceral leishmaniosis is a widespread and potentially fatal disease of dogs and humans common in the Mediterranean region, the Middle East, and South America. Canine leishmaniosis is most frequently treated with the drugs meglumine antimoniate, allopurinol, amphotericin B, or a combination of meglumine antimoniate and allopurinol. Therapy with the currently used drugs often achieves temporary clinical improvement and changes in immunologic parameters with restoration of the ability to mount parasite-specific cell mediated responses and decrease in anti-leishmanial antibody titers. However, treatment usually does not prevent relapse of disease or eliminate parasite carriage. Due to the current lack of an ultimate and effective therapy for canine leishmaniosis, new drugs, delivery systems and treatment strategies are necessary to achieve a consistent parasitological cure in infected dogs.
Collapse
Affiliation(s)
- Gad Baneth
- School of Veterinary Medicine, Hebrew University, P.O. Box 12, 76100, Rehovot, Israel.
| | | |
Collapse
|
16
|
Valladares JE, Riera C, González-Ensenyat P, Díez-Cascón A, Ramos G, Solano-Gallego L, Gállego M, Portús M, Arboix M, Alberola J. Long term improvement in the treatment of canine leishmaniosis using an antimony liposomal formulation. Vet Parasitol 2001; 97:15-21. [PMID: 11337123 DOI: 10.1016/s0304-4017(01)00389-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Pharmacokinetic and clinical effectiveness of liposome-encapsulated N-methylglucamine antimoniate (LMA) was performed in dogs suffering from experimental leishmaniosis. LMA was compared with N-methylglucamine antimoniate (MGA), the same drug in its free form. Sb plasma concentrations for LMA were always higher than those for MGA. Mean residence time (MRT), half-life time (t(1/2)) and clearance (Cl) showed that Sb was eliminated slower after liposome administration. The high volume of distribution (Vd) obtained with LMA suggests that Sb could achieve therapeutic concentrations in parasite-infected tissues. Average plasma concentration at steady state (Css(ave)) shows that Sb body concentrations after LMA treatment (9.8 mg/kg Sb, each 24h) would be effective in Leishmania infantum canine infection. Comparing LMA with MGA in a 1-year follow-up we observed no relapses for LMA and total protein and gammaglobulin concentrations were within normal range, while for MGA both began to rise 3 months after treatment. Use of antimonial liposomal formulations may restore effectiveness to an existing drug and reduce toxicity.
Collapse
Affiliation(s)
- J E Valladares
- Departament de Farmacologia i Terapèutica, Facultat de Veterinària, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Abstract
Visceral leishmaniasis is a zoonotic disease that can be transmitted from dogs to humans by a sand-fly vector. Endemic cases of visceral leishmaniasis among dogs in Oklahoma, Texas, and Ohio have been reported. Recent reports of visceral leishmaniasis in Foxhounds in the eastern coastal states has raised new concerns about the importance of this disease in the United States.
Collapse
Affiliation(s)
- S M Eddlestone
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater 74078, USA
| |
Collapse
|
18
|
Denerolle P, Bourdoiseau G. Combination Allopurinol and Antimony Treatment versus Antimony Alone and Allopurinol Alone in the Treatment of Canine Leishmaniasis (96 Cases). J Vet Intern Med 1999. [DOI: 10.1111/j.1939-1676.1999.tb01455.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
19
|
Riera C, Valladares JE, Gállego M, Aisa MJ, Castillejo S, Fisa R, Ribas N, Carrió J, Alberola J, Arboix M. Serological and parasitological follow-up in dogs experimentally infected with Leishmania infantum and treated with meglumine antimoniate. Vet Parasitol 1999; 84:33-47. [PMID: 10435789 DOI: 10.1016/s0304-4017(99)00084-9] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Six healthy beagle dogs were infected with Leishmania infantum (MCAN/ES/92/BCN-83/MON-1) by intravenous inoculation of 5 x 10(7) promastigotes and two others were used as controls. When animals showed clinical signs of disease at 29, 37, 41 and 45 weeks post-infection (p.i.), they were treated with meglumine antimoniate (20.4 mg Sb/kg/12 h) subcutaneously for two periods of 10 days each. Sera were tested periodically for Leishmania antibodies by Dot-ELISA, ELISA and Western blot (WB). Aspirates of popliteal lymph node (PLN), peripheral blood sample (PB) and healthy skin were cultured in NNN and Schneider's medium. PLNs were positive between 8 and 20 weeks p.i. and in one animal PB was positive 6 weeks p.i. Samples of healthy skin, obtained before treatment, were also positive. Dot-ELISA and ELISA detected specific antibodies at an early stage between 4 and 12 weeks p.i and surpassed the cut-off between 16-24 weeks p.i., while the WB was positive between 10-19 weeks p.i. The pattern of bands revealed during the first stages of infection was variable and only in two cases did the positivity start with bands of low molecular weight (12-14 kD); the number of bands increased until 15-24 weeks p.i., after which sera revealed a complete pattern of bands, from 12 to 85 kD, in the antigen of Leishmania. After treatment the clinical improvement of the animals was accompanied by a decrease in antibody titers (Dot-ELISA and ELISA) although the parasites remained in the PLN. This was reflected in the WB by a decrease in the intensity of bands, especially those in the region of 12-30 kD. A new increase in the antibody levels between 3 and 5 months after terminating the therapy was detected in the WB by a restoration of the initial complete pattern of bands.
Collapse
Affiliation(s)
- C Riera
- Department de Microbiologia i Parasitologia Sanitàries, Universitat de Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Sereno D, Cavaleyra M, Zemzoumi K, Maquaire S, Ouaissi A, Lemesre JL. Axenically grown amastigotes of Leishmania infantum used as an in vitro model to investigate the pentavalent antimony mode of action. Antimicrob Agents Chemother 1998; 42:3097-102. [PMID: 9835497 PMCID: PMC106005 DOI: 10.1128/aac.42.12.3097] [Citation(s) in RCA: 108] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The mechanism(s) of activity of pentavalent antimony [Sb(V)] is poorly understood. In a recent study, we have shown that potassium antimonyl tartrate, a trivalent antimonial [Sb(III)], was substantially more potent than Sb(V) against both promastigotes and axenically grown amastigotes of three Leishmania species, supporting the idea of an in vivo metabolic conversion of Sb(V) into Sb(III). We report that amastigotes of Leishmania infantum cultured under axenic conditions were poorly susceptible to meglumine [Glucantime; an Sb(V)], unlike those growing inside THP-1 cells (50% inhibitory concentrations [IC50s], about 1.8 mg/ml and 22 microg/ml, respectively). In order to define more precisely the mode of action of Sb(V) agents in vivo, we first induced in vitro Sb(III) resistance by direct drug pressure on axenically grown amastigotes of L. infantum. Then we determined the susceptibilities of both extracellular and intracellular chemoresistant amastigotes to the Sb(V)-containing drugs meglumine and sodium stibogluconate plus m-chlorocresol (Pentostam). The chemoresistant amastigotes LdiR2, LdiR10, and LdiR20 were 14, 26, and 32 times more resistant to Sb(III), respectively, than the wild-type one (LdiWT). In accordance with the hypothesis described above, we found that intracellular chemoresistant amastigotes were resistant to meglumine [Sb(V)] in proportion to the initial level of Sb(III)-induced resistance. By contrast, Sb(III)-resistant cells were very susceptible to sodium stibogluconate. This lack of cross-resistance is probably due to the presence in this reagent of m-chlorocresol, which we found to be more toxic than Sb(III) to L. infantum amastigotes (IC50s, of 0.54 and 1.32 microg/ml, respectively). Collectively, these results were consistent with the hypothesis of an intramacrophagic metabolic conversion of Sb(V) into trivalent compounds, which in turn became readily toxic to the Leishmania amastigote stage.
Collapse
Affiliation(s)
- D Sereno
- Laboratoire de Biologie Parasitaire, Centre ORSTOM, 34 032 Montpellier Cedex 1, France
| | | | | | | | | | | |
Collapse
|
21
|
Valladares JE, Ruiz De Gopegui R, Riera C, Alberola J, Gállego M, Espada Y, Portús M, Arboix M. Study of haemostatic disorders in experimentally induced leishmaniasis in Beagle dogs. Res Vet Sci 1998; 64:195-8. [PMID: 9690602 DOI: 10.1016/s0034-5288(98)90124-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Haemostatic alterations in dogs experimentally infected with Leishmania infantum were studied before and after therapy with meglumine antimonate. Haemostatic function tests including platelet count, collagen-induced platelet aggregation, prothrombin time, activated partial thromboplastin time, thrombin time, plasma fibrinogen determination, and serum fibrinogen/fibrin degradation products concentration were performed. In the course of infection and before treatment, moderate thrombocytopenia (P<0.00001), decreased collagen induced platelet aggregation (P=0.0003), prolonged thrombin time (P=0.0117) and increased fibrinogen/fibrin degradation products were observed. Statistically significant differences of plasma fibrinogen concentration, prothrombin time, and activated partial thromboplastin time were not encountered. Haemostatic parameters returned to normal values after therapy. The results indicate that Leishmania infection may impair haemostasis suggesting induction of disseminated intravascular coagulation (DIC), and that treating dogs in an early stage of infection may potentially avoid the possibility of developing an uncompensated DIC.
Collapse
Affiliation(s)
- J E Valladares
- Departament de Farmacologia i Terapèutica, Facultat de Veterinària, Universitat Autònoma de Barcelona, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Valladares JE, Riera C, Alberola J, Gállego M, Portús M, Cristòfol C, Franquelo C, Arboix M. Pharmacokinetics of meglumine antimoniate after administration of a multiple dose in dogs experimentally infected with Leishmania infantum. Vet Parasitol 1998; 75:33-40. [PMID: 9566092 DOI: 10.1016/s0304-4017(97)00193-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pharmacokinetics of meglumine antimoniate in dogs with experimentally induced leishmaniosis has been investigated. After infection, dogs received a dose of 75 mg kg-1 of meglumine antimoniate twice daily by subcutaneous injection for 10 days. Blood samples were collected throughout the treatment. No statistical differences were found in the kinetic behaviour of the drug administered as a single dose to healthy dogs and that administered as a multiple dose to infected animals. However, peak plasma concentrations (Cmax) of 30.8 +/- 12.8 micrograms ml-1 found after this dosage regimen were higher than those observed after the single dose administration of 100 mg kg-1 24 h-1. Furthermore, sustained antimony concentrations of 1.14 +/- 0.52 micrograms Sb ml-1 were detected throughout the treatment. No signs of toxicity were found in the animals treated indicating that this regimen would be very appropriate to treat canine leishmaniosis.
Collapse
Affiliation(s)
- J E Valladares
- Departament de Farmacologia i Terapèutica, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Valladares JE, Riera C, Pastor J, Gállego M, Portús M, Arboix M. Hepatobiliar and renal failure in a dog experimentally infected with Leishmania infantum. Vet Rec 1997; 141:574-5. [PMID: 9423240 DOI: 10.1136/vr.141.22.574] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- J E Valladares
- Departament de Farmacologia i Terapèutica, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | | | | | | | | |
Collapse
|