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Berhe H, Kumar Cinthakunta Sridhar M, Zerihun M, Qvit N. The Potential Use of Peptides in the Fight against Chagas Disease and Leishmaniasis. Pharmaceutics 2024; 16:227. [PMID: 38399281 PMCID: PMC10892537 DOI: 10.3390/pharmaceutics16020227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/28/2023] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
Chagas disease and leishmaniasis are both neglected tropical diseases that affect millions of people around the world. Leishmaniasis is currently the second most widespread vector-borne parasitic disease after malaria. The World Health Organization records approximately 0.7-1 million newly diagnosed leishmaniasis cases each year, resulting in approximately 20,000-30,000 deaths. Also, 25 million people worldwide are at risk of Chagas disease and an estimated 6 million people are infected with Trypanosoma cruzi. Pentavalent antimonials, amphotericin B, miltefosine, paromomycin, and pentamidine are currently used to treat leishmaniasis. Also, nifurtimox and benznidazole are two drugs currently used to treat Chagas disease. These drugs are associated with toxicity problems such as nephrotoxicity and cardiotoxicity, in addition to resistance problems. As a result, the discovery of novel therapeutic agents has emerged as a top priority and a promising alternative. Overall, there is a need for new and effective treatments for Chagas disease and leishmaniasis, as the current drugs have significant limitations. Peptide-based drugs are attractive due to their high selectiveness, effectiveness, low toxicity, and ease of production. This paper reviews the potential use of peptides in the treatment of Chagas disease and leishmaniasis. Several studies have demonstrated that peptides are effective against Chagas disease and leishmaniasis, suggesting their use in drug therapy for these diseases. Overall, peptides have the potential to be effective therapeutic agents against Chagas disease and leishmaniasis, but more research is needed to fully investigate their potential.
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Affiliation(s)
| | | | | | - Nir Qvit
- The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel; (H.B.); (M.K.C.S.); (M.Z.)
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Jamal F, Altaf I, Ahmed G, Asad S, Ahmad H, Zia Q, Azhar A, Farheen S, Shafi T, Karim S, Zubair S, Owais M. Amphotericin B Nano-Assemblies Circumvent Intrinsic Toxicity and Ensure Superior Protection in Experimental Visceral Leishmaniasis with Feeble Toxic Manifestation. Vaccines (Basel) 2023; 11:vaccines11010100. [PMID: 36679946 PMCID: PMC9866558 DOI: 10.3390/vaccines11010100] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
In spite of its high effectiveness in the treatment of both leishmaniasis as well as a range of fungal infections, the free form of the polyene antibiotic amphotericin B (AmB) does not entertain the status of the most preferred drug of choice in clinical settings. The high intrinsic toxicity of the principal drug could be considered the main impedance in the frequent medicinal use of this otherwise very effective antimicrobial agent. Taking into consideration this fact, the pharma industry has introduced many novel dosage forms of AmB to alleviate its toxicity issues. However, the limited production, high cost, requirement for a strict cold chain, and need for parenteral administration are some of the limitations that explicitly compel professionals to look for the development of an alternate dosage form of this important drug. Considering the fact that the nano-size dimensions of drug formulation play an important role in increasing the efficacy of the core drug, we employed a green method for the development of nano-assemblies of AmB (AmB-NA). The as-synthesized AmB-NA manifests desirable pharmacokinetics in the treated animals. The possible mechanistic insight suggested that as-synthesized AmB-NA induces necrosis-mediated cell death and severe mitochondrial dysfunction in L. donovani promastigotes by triggering depolarization of mitochondrial membrane potential. In vivo studies demonstrate a noticeable decline in parasite burden in the spleen, liver, and bone marrow of the experimental BALB/c mice host. In addition to successfully suppressing the Leishmania donovani, the as-formed AmB-NA formulation also modulates the host immune system with predominant Th1 polarization, a key immune defender that facilitates the killing of the intracellular parasite.
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Affiliation(s)
- Fauzia Jamal
- Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh 202002, India
| | - Ishrat Altaf
- Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh 202002, India
| | - Ghufran Ahmed
- Department of Microbiology, Rajendra Memorial Research Institute of Medical Sciences, Patna 800007, India
| | - Sheikh Asad
- Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh 202002, India
| | - Hira Ahmad
- Department of Zoology, Aligarh Muslim University, Aligarh 202002, India
| | - Qamar Zia
- Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh 202002, India
| | - Asim Azhar
- Neat Meatt Biotech Private Limited, Bio-NEST-UDSC, University of Delhi (South Campus), New Delhi 110021, India
| | - Saba Farheen
- Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh 202002, India
| | - Taj Shafi
- Department of Molecular Biology, Rajendra Memorial Research Institute of Medical Sciences, Patna 800007, India
| | - Shabana Karim
- Department of Botany, Anugrah Narayan College, Patliputra University, Patna 800013, India
| | - Swaleha Zubair
- Department of Computer Science, Aligarh Muslim University, Aligarh 202002, India
| | - Mohammad Owais
- Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh 202002, India
- Correspondence:
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Grifferty G, Shirley H, McGloin J, Kahn J, Orriols A, Wamai R. Vulnerabilities to and the Socioeconomic and Psychosocial Impacts of the Leishmaniases: A Review. Res Rep Trop Med 2021; 12:135-151. [PMID: 34188584 PMCID: PMC8236266 DOI: 10.2147/rrtm.s278138] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/06/2021] [Indexed: 11/23/2022] Open
Abstract
The leishmaniases are a group of four vector-borne neglected tropical diseases (NTDs) with 1.6 billion people in some 100 countries at risk. They occur in certain eco-epidemiological foci that reflect manipulation by human activities, such as migration, urbanization and deforestation, of which poverty, conflict and climate change are key drivers. Given their synergistic impacts, risk factors and the vulnerabilities of poor populations and the launch of a new 2030 roadmap for NTDs in the context of the global sustainability agenda, it is warranted to update the state of knowledge of the leishmaniases and their effects. Using existing literature, we review socioeconomic and psychosocial impacts of leishmaniasis within a framework of risk factors and vulnerabilities to help inform policy interventions. Studies show that poverty is an overarching primary risk factor. Low-income status fosters inadequate housing, malnutrition and lack of sanitation, which create and exacerbate complexities in access to care and treatment outcomes as well as education and awareness. The co-occurrence of the leishmaniases with malnutrition and HIV infection further complicate diagnosis and treatment, leading to poor diagnostic outcomes and therapeutic response. Even with free treatment, households may suffer catastrophic health expenditure from direct and indirect medical costs, which compounds existing financial strain in low-income communities for households and healthcare systems. The dermatological presentations of the leishmaniases may result in long-term severe disfigurement, leading to stigmatization, reduced quality of life, discrimination and mental health issues. A substantial amount of recent literature points to the vulnerability pathways and burden of leishmaniasis on women, in particular, who disproportionately suffer from these impacts. These emerging foci demonstrate a need for continued international efforts to address key risk factors and population vulnerabilities if leishmaniasis control, and ultimately elimination, is to be achieved by 2030.
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Affiliation(s)
- Grace Grifferty
- Department of Biology, Northeastern University, College of Science, Boston, MA, USA
| | - Hugh Shirley
- Department of Biochemistry, Northeastern University, College of Science, Boston, MA, USA.,Program in Medical Education, Harvard Medical School, Boston, MA, USA
| | - Jamie McGloin
- Department of Health Sciences, Northeastern University, Bouvé College of Health Sciences, Boston, MA, USA
| | - Jorja Kahn
- Department of Behavioral Neuroscience, Northeastern University, College of Science, Boston, MA, USA
| | - Adrienne Orriols
- Department of Behavioral Neuroscience, Northeastern University, College of Science, Boston, MA, USA
| | - Richard Wamai
- Department of Cultures, Societies and Global Studies, Northeastern University, College of Social Sciences and Humanities, Integrated Initiative for Global Health, Boston, MA, USA
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Preclinical Assessment of Ursolic Acid Loaded into Nanostructured Lipid Carriers in Experimental Visceral Leishmaniasis. Pharmaceutics 2021; 13:pharmaceutics13060908. [PMID: 34205283 PMCID: PMC8235317 DOI: 10.3390/pharmaceutics13060908] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/08/2021] [Accepted: 06/17/2021] [Indexed: 12/17/2022] Open
Abstract
Ursolic acid, a triterpene produced by plants, displayed leishmanicidal activity in vitro and in vivo; however, the low solubility of this triterpene limits its efficacy. To increase the activity of ursolic acid (UA), this triterpene was entrapped in nanostructured lipid carriers (UA-NLC), physical-chemical parameters were estimated, the toxicity was assayed in healthy golden hamsters, and the efficacy of UA-NLC was studied in experimental visceral leishmanisis. UA-NLC exhibited a spherical shape with a smooth surface with a size of 266 nm. UA-NLC displayed low polydispersity (PDI = 0.18) and good colloidal stability (-29.26 mV). Hamsters treated with UA-NLC did not present morphological changes in visceral organs, and the levels of AST, ALT, urea and creatinine were normal. Animals infected with Leishmania (Leishmania) infantum and treated with UA-NLC showed lower parasitism than the infected controls, animals treated with UA or Amphotericin B (AmB). The therapeutic activity of UA-NLC was associated with the increase in a protective immune response, and it was associated with a high degree of spleen and liver preservation, and the normalization of hepatic and renal functions. These data indicate that the use of lipid nanoparticles as UA carriers can be an interesting strategy for the treatment of leishmaniasis.
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Assis TMD, Rabello A, Cota G. Economic evaluations addressing diagnosis and treatment strategies for neglected tropical diseases: an overview. Rev Inst Med Trop Sao Paulo 2021; 63:e41. [PMID: 34037157 PMCID: PMC8149103 DOI: 10.1590/s1678-9946202163041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 04/23/2021] [Indexed: 11/22/2022] Open
Abstract
Neglected tropical diseases (NTDs) are those affecting vulnerable people and
causing additional social and economic burden. The aim of this study was to
carry out a general overview of the health economic assessments involving the
diagnosis and treatment of six NTDs: cutaneous leishmaniasis (CL), Chagas
disease, cysticercosis, filariasis, schistosomiasis and visceral leishmaniasis
(VL). The literature search was based on two of the main medical literature
databases (Medline and SciELO) and identified 46 studies. Twenty-six studies
(57%) addressed therapeutic strategies, while other 20 (43%) assessed diagnostic
or both diagnostic and therapeutic approaches. The studies were published
between 1994 and 2021, and 57% of them (26/46) were carried out in four
countries. Cost-effectiveness analyses were conducted in 59% (27/46) of the
studies. Economic studies of NTDs have timidly increased in recent years.
Despite the improvement of analytical methods, completeness and accuracy of
information, there are few new technologies applied to NTDs and public health
systems. In addition, economic studies for NTDs are concentrated in a few
countries. Thus, this review points out the need for investment in research,
development and training of human resources dedicated to the economic analysis
in health, especially on NTDs, as a strategy to reduce inequalities by
optimizing the use of health resources.
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Affiliation(s)
- Tália Machado de Assis
- Fundação Oswaldo Cruz, Instituto René Rachou, Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, Minas Gerais, Brazil.,Centro Federal de Educação Tecnológica de Minas Gerais, Contagem, Minas Gerais, Brazil
| | - Ana Rabello
- Fundação Oswaldo Cruz, Instituto René Rachou, Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, Minas Gerais, Brazil
| | - Gláucia Cota
- Fundação Oswaldo Cruz, Instituto René Rachou, Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, Minas Gerais, Brazil
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Carvalho JDP, de Assis TM, Simões TC, Cota G. Estimating direct costs of the treatment for mucosal leishmaniasis in Brazil. Rev Soc Bras Med Trop 2021; 54:e04542020. [PMID: 33533816 PMCID: PMC7849328 DOI: 10.1590/0037-8682-0454-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/15/2020] [Indexed: 04/01/2024] Open
Abstract
INTRODUCTION The objective of this study was to estimate the direct medical costs of the treatment for mucosal leishmaniasis (ML) using three therapeutic approaches in the Brazilian context. METHODS We performed this economic assessment from the perspective of the Brazilian public healthcare system. The following therapeutic approaches were evaluated: meglumine antimoniate, liposomal amphotericin B, and miltefosine. Direct medical costs were estimated considering four treatment components: a) drug, b) combined medical products, c) procedures, and d) complementary tests. RESULTS Treatment with meglumine antimoniate had the lowest average cost per patient (US$ 167.66), followed by miltefosine (US$ 259.92) in the outpatient treatment regimen. The average cost of treatment with liposomal amphotericin B was US$ 715.35 both in inpatient regimen. In all estimates, the drugs accounted for more than 60% of the total cost for each treatment approach. CONCLUSIONS These results demonstrate the marked differences in costs between the therapeutic alternatives for ML. In addition to efficacy rates and costs related to adverse events, our data have the potential to support a complete cost-effectiveness study in the future. Complete analyses comparing costs and benefits for interventions will assist health managers in choosing drugs for ML treatment in Brazil as well as in establishing effective public health policies.
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Affiliation(s)
- Janaína de Pina Carvalho
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo de Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Tália Machado de Assis
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo de Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
- Centro Federal de Educação Tecnológica de Minas Gerais, Campus Contagem, Contagem, MG, Brasil
| | - Taynãna César Simões
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo de Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Gláucia Cota
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo de Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
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Phenotype evaluation of human and canine isolates of Leishmania infantum. Comp Immunol Microbiol Infect Dis 2020; 73:101551. [PMID: 33010787 DOI: 10.1016/j.cimid.2020.101551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 12/16/2022]
Abstract
Human visceral leishmaniasis (VL) and canine leishmaniasis (CanL) in countries of South and Central America are caused by Leishmania infantum and has been endemic in Brazil for several years. The parasite biodiversity as well as the pharmacologic properties of drugs and the host species, are involved in the efficacy or inefficacy of leishmaniasis treatments. Although there are substantial number of reports describing the genetic characterization of the clinical field isolates of L. infantum,the phenotypic parameters have been less studied. In this study isolates from human and canine leishmaniasis (Hum1 and Can1) obtained in Campinas, São Paulo state, Brazil were identified as L. infantum. The Hum1 and Can1 isolates exhibited typical promastigote growth pattern. Regarding morphological features Can1 isolate differed in cell size. The infectivity in vitro of both isolatesis lower compared to the reference strain of L. infantum. Moreover, the in vivo infectivity of the three parasites is similar in Balb/c mice. The Hum1 isolate is more sensitive to leishmanial drugs (amphotericin B, miltefosine and glucantime) than the Can1 isolate when inside human macrophages, but not when inside canine macrophages. These findings indicated that L. infantum isolates differs in some phenotypic characteristics.
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Vechi HT, Sousa ASVD, Cunha MAD, Shaw JJ, Luz KG. Case Report: Combination Therapy with Liposomal Amphotericin B, N-Methyl Meglumine Antimoniate, and Pentamidine Isethionate for Disseminated Visceral Leishmaniasis in a Splenectomized Adult Patient. Am J Trop Med Hyg 2020; 102:268-273. [PMID: 31872796 DOI: 10.4269/ajtmh.18-0999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
In immunocompromised patients, visceral leishmaniasis (VL) can present with atypical clinical symptoms that include poor response to treatment. No optimal therapeutic regimen is available for such cases. In a splenectomized male patient, we observed a disseminated form of the disease in the liver, bone marrow, lymph nodes, and gastrointestinal tract. There was an apparent clinical improvement when he was initially treated with liposomal amphotericin B (L-AmB), but this was followed by a relapse involving severe clinical symptoms. He was finally treated successfully with a combination of L-AmB, meglumine antimoniate, and pentamidine isethionate. It is important to include asplenia as an immunosuppressive condition that induces exotic VL pathologies. In such cases, combination anti-Leishmania drug therapy should be considered.
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Affiliation(s)
- Hareton Teixeira Vechi
- Department of Infectious Diseases, Hospital Giselda Trigueiro, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Mirella Alves da Cunha
- Department of Infectious Diseases, Hospital Giselda Trigueiro, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Jeffrey Jon Shaw
- Department of Parasitology, Instituto de Ciências Biomédicas, São Paulo University, São Paulo, São Paulo, Brazil
| | - Kleber Giovanni Luz
- Department of Infectious Diseases, Hospital Giselda Trigueiro, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Tunes LG, Morato RE, Garcia A, Schmitz V, Steindel M, Corrêa-Junior JD, Dos Santos HF, Frézard F, de Almeida MV, Silva H, Moretti NS, de Barros ALB, do Monte-Neto RL. Preclinical Gold Complexes as Oral Drug Candidates to Treat Leishmaniasis Are Potent Trypanothione Reductase Inhibitors. ACS Infect Dis 2020; 6:1121-1139. [PMID: 32283915 DOI: 10.1021/acsinfecdis.9b00505] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The drugs currently used to treat leishmaniases have limitations concerning cost, efficacy, and safety, making the search for new therapeutic approaches urgent. We found that the gold(I)-derived complexes were active against L. infantum and L. braziliensis intracellular amastigotes with IC50 values ranging from 0.5 to 5.5 μM. All gold(I) complexes were potent inhibitors of trypanothione reductase (TR), with enzyme IC50 values ranging from 1 to 7.8 μM. Triethylphosphine-derived complexes enhanced reactive oxygen species (ROS) production and decreased mitochondrial respiration after 2 h of exposure, indicating that gold(I) complexes cause oxidative stress by direct ROS production, by causing mitochondrial damage or by impairing TR activity and thus accumulating ROS. There was no cross-resistance to antimony; in fact, SbR (antimony-resistant mutants) strains were hypersensitive to some of the complexes. BALB/c mice infected with luciferase-expressing L. braziliensis or L. amazonensis and treated orally with 12.5 mg/kg/day of AdT Et (3) or AdO Et (4) presented reduced lesion size and parasite burden, as revealed by bioimaging. The combination of (3) and miltefosine allowed for a 50% reduction in miltefosine treatment time. Complexes 3 and 4 presented favorable pharmacokinetic and toxicity profiles that encourage further drug development studies. Gold(I) complexes are promising antileishmanial agents, with a potential for therapeutic use, including in leishmaniasis caused by antimony-resistant parasites.
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Affiliation(s)
- Luiza G. Tunes
- Instituto René Rachou/Fiocruz Minas−Fundação Oswaldo Cruz, Belo Horizonte 30190-009, Brasil
| | - Roberta E. Morato
- Instituto René Rachou/Fiocruz Minas−Fundação Oswaldo Cruz, Belo Horizonte 30190-009, Brasil
| | - Adriana Garcia
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Juiz de Fora, Juiz de Fora 36036-900, Brasil
| | - Vinicius Schmitz
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Juiz de Fora, Juiz de Fora 36036-900, Brasil
| | - Mario Steindel
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de Santa Catarina, Florianópolis 88040-900, Brasil
| | - José D. Corrêa-Junior
- Departamento de Morfologia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brasil
| | - Hélio F. Dos Santos
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Juiz de Fora, Juiz de Fora 36036-900, Brasil
| | - Frédéric Frézard
- Departamento de Fisiologia e Biofísica, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brasil
| | - Mauro V. de Almeida
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Juiz de Fora, Juiz de Fora 36036-900, Brasil
| | - Heveline Silva
- Departamento de Química, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brasil
| | - Nilmar S. Moretti
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo 04023-062, Brasil
| | - André L. B. de Barros
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brasil
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Scariot DB, Volpato H, Fernandes NS, Lazarin-Bidóia D, Borges O, Sousa MDC, Rosa FA, Jacomini AP, Silva SO, Ueda-Nakamura T, Rubira AF, Nakamura CV. Oral treatment with T6-loaded yeast cell wall particles reduces the parasitemia in murine visceral leishmaniasis model. Sci Rep 2019; 9:20080. [PMID: 31882925 PMCID: PMC6934808 DOI: 10.1038/s41598-019-56647-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 12/16/2019] [Indexed: 01/28/2023] Open
Abstract
Yeast cell wall particles isolated from Saccharomyces cerevisiae (scYCWPs) have a rich constitution of β-glucan derived from the cell wall. After removing intracellular contents, β-glucan molecules are readily recognized by dectin-1 receptors, present on the cytoplasmic membrane surface of the mononuclear phagocytic cells and internalized. Leishmania spp. are obligate intracellular parasites; macrophages are its primary host cells. An experimental murine model of visceral leishmaniasis caused by L. infantum was used to evaluate the antileishmanial activity of oral administration of these particles. A low-water soluble thiophene previously studied in vitro against L. infantum was entrapped into scYCWPs to direct it into the host cell, in order to circumvent the typical pharmacokinetic problems of water-insoluble compounds. We found that scYCWPs + T6 reduced the parasitic burden in the liver and spleen. There was an increase in IFN-γ levels related to nitric oxide production, explaining the reduction of the L. infantum burden in the tissue. Histological analysis did not show signals of tissue inflammation and biochemical analysis from plasma did not indicate signals of cytotoxicity after scYCWPs + T6 treatment. These findings suggested that scYCWPs + T6 administered through oral route reduced the parasitic burden without causing toxic effects, satisfying requirements for development of new strategies to treat leishmaniasis.
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Affiliation(s)
- Débora B Scariot
- Laboratório de Inovação Tecnológica no Desenvolvimento de Fármacos e Cosméticos, State University of Maringá, Maringa, 87020-900, Brazil
| | - Hélito Volpato
- Laboratório de Inovação Tecnológica no Desenvolvimento de Fármacos e Cosméticos, State University of Maringá, Maringa, 87020-900, Brazil
| | - Nilma S Fernandes
- Cellular Biology Graduate Program, State University of Maringá, Maringa, 87020-900, Brazil
| | - Danielle Lazarin-Bidóia
- Laboratório de Inovação Tecnológica no Desenvolvimento de Fármacos e Cosméticos, State University of Maringá, Maringa, 87020-900, Brazil
| | - Olga Borges
- Faculty of Pharmacy, University of Coimbra, Coimbra, 3000-548, Portugal
- CNC - Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, 3000-548, Portugal
| | - Maria do Céu Sousa
- Faculty of Pharmacy, University of Coimbra, Coimbra, 3000-548, Portugal
- CNC - Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, 3000-548, Portugal
| | - Fernanda A Rosa
- Chemistry Department, State University of Maringá, Maringa, 87020-900, Brazil
| | - Andrey P Jacomini
- Chemistry Department, State University of Maringá, Maringa, 87020-900, Brazil
| | - Sueli O Silva
- Laboratório de Inovação Tecnológica no Desenvolvimento de Fármacos e Cosméticos, State University of Maringá, Maringa, 87020-900, Brazil
| | - Tânia Ueda-Nakamura
- Laboratório de Inovação Tecnológica no Desenvolvimento de Fármacos e Cosméticos, State University of Maringá, Maringa, 87020-900, Brazil
| | - Adley F Rubira
- Chemistry Department, State University of Maringá, Maringa, 87020-900, Brazil
| | - Celso V Nakamura
- Laboratório de Inovação Tecnológica no Desenvolvimento de Fármacos e Cosméticos, State University of Maringá, Maringa, 87020-900, Brazil.
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Abo‐zeid Y, Williams GR. The potential anti‐infective applications of metal oxide nanoparticles: A systematic review. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2019; 12:e1592. [DOI: 10.1002/wnan.1592] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 09/01/2019] [Accepted: 09/04/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Yasmin Abo‐zeid
- School of Pharmacy Helwan University Cairo Egypt
- UCL School of Pharmacy University College London London UK
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Scariot DB, Volpato H, Fernandes NDS, Soares EFP, Ueda-Nakamura T, Dias-Filho BP, Din ZU, Rodrigues-Filho E, Rubira AF, Borges O, Sousa MDC, Nakamura CV. Activity and Cell-Death Pathway in Leishmania infantum Induced by Sugiol: Vectorization Using Yeast Cell Wall Particles Obtained From Saccharomyces cerevisiae. Front Cell Infect Microbiol 2019; 9:208. [PMID: 31259161 PMCID: PMC6587907 DOI: 10.3389/fcimb.2019.00208] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/28/2019] [Indexed: 12/22/2022] Open
Abstract
Visceral leishmaniasis, caused by Leishmania infantum, is a neglected tropical disease, to which efforts in the innovation of effective and affordable treatments remain limited, despite the rising incidence in several regions of the world. In this work, the antileishmanial effects of sugiol were investigated in vitro. This compound was isolated from the bark of Cupressus lusitanica and showed promising activity against L. infantum. In spite of the positive results, it is known that the compound is a poorly water-soluble diterpene molecule, which hinders further investigation, especially in preclinical animal studies. Thus, in an alternative delivery method, sugiol was entrapped in glucan-rich particles obtained from Saccharomyces cerevisiae yeast cell walls (YCWPs). To evaluate the activity of sugiol, the experiments were divided into two parts: (i) the in vitro investigation of antileishmanial activity of free sugiol against L. infantum promastigotes after 24, 48, and 72 h of treatment and (ii) the evaluation of antileishmanial activity of sugiol entrapped in glucan-rich particles against intracellular L. infantum amastigotes. Free sugiol induced the cell-death process in promastigotes, which was triggered by enhancing cytosolic calcium level and promoting the autophagy up to the first 24 h. Over time, the presence of autophagic vacuoles became rarer, especially after treatment with lower concentrations of sugiol, but other cellular events intensified, like ROS production, cell shrinkage, and phosphatidylserine exposure. Hyperpolarization of mitochondrial membrane potential was found at 72 h, induced by the mitochondria calcium uptake, causing an increase in ROS production and lipid peroxidation as a consequence. These events resulted in the cell death of promastigotes by secondary necrosis. Sugiol entrapped in glucan-rich particles was specifically recognized by dectin-1 receptor on the plasma membrane of macrophages, the main host cell of Leishmania spp. Electron micrographs revealed particles containing sugiol within the infected macrophages and these particles were active against the intracellular L. infantum amastigotes without affecting the host cell. Therefore, the YCWPs act like a Trojan horse to successfully deliver sugiol into the macrophage, presenting an interesting strategy to deliver water-insoluble drugs to parasitized cells.
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Affiliation(s)
- Débora Botura Scariot
- Laboratory of Technological Innovation in Drugs and Cosmetics Development, State University of Maringá, Maringá, Brazil
| | - Hélito Volpato
- Laboratory of Technological Innovation in Drugs and Cosmetics Development, State University of Maringá, Maringá, Brazil
| | - Nilma de Souza Fernandes
- Laboratory of Technological Innovation in Drugs and Cosmetics Development, State University of Maringá, Maringá, Brazil
| | | | - Tânia Ueda-Nakamura
- Laboratory of Technological Innovation in Drugs and Cosmetics Development, State University of Maringá, Maringá, Brazil
| | - Benedito Prado Dias-Filho
- Laboratory of Technological Innovation in Drugs and Cosmetics Development, State University of Maringá, Maringá, Brazil
| | - Zia Ud Din
- Chemistry Department, Federal University of São Carlos, São Carlos, Brazil
| | | | | | - Olga Borges
- Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal.,CNC - Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Maria Do Céu Sousa
- Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal.,CNC - Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Celso Vataru Nakamura
- Laboratory of Technological Innovation in Drugs and Cosmetics Development, State University of Maringá, Maringá, Brazil
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Assis TSMD, Rabello A, Cota G, Werneck GL, Azeredo-da-Silva ALFD. Cost-effectiveness analysis of diagnostic-therapeutic strategies for visceral leishmaniasis in Brazil. Rev Soc Bras Med Trop 2019; 52:e20180272. [PMID: 30994802 DOI: 10.1590/0037-8682-0272-2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 08/30/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Visceral leishmaniasis (VL) is fatal if not diagnosed and treated. This study aimed to estimate the cost-effectiveness of diagnostic-therapeutic alternatives for VL in Brazil. METHODS A decision model estimated the life expectancy and costs of six diagnostic-therapeutic strategies. RESULTS IT LEISH + liposomal amphotericin B emerged the best option, presenting lower costs and higher effectiveness. DAT-LPC + liposomal amphotericin B showed an incremental cost-effectiveness ratio of US$ 326.31 per life year. CONCLUSIONS These findings indicate the feasibility of incorporating DAT and designating liposomal amphotericin B as the first-line drug for VL in Brazil.
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Affiliation(s)
- Tália Santana Machado de Assis
- Centro Federal de Educação Tecnológica de Minas Gerais, Contagem, MG, Brasil.,Grupo de Pesquisa: Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Ana Rabello
- Grupo de Pesquisa: Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Gláucia Cota
- Grupo de Pesquisa: Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Guilherme Loureiro Werneck
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, RJ, Brasil
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Marques CSF, Machado Júnior JB, Andrade LRDM, Andrade LN, Santos ALSD, Cruz MDSPE, Chaud M, Fricks AT, Severino P. Use of pharmaceutical nanotechnology for the treatment of leishmaniasis. Rev Soc Bras Med Trop 2019; 52:e20180246. [PMID: 30994800 DOI: 10.1590/0037-8682-0246-2018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/29/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Leishmaniasis is a global public health concern. Currently available treatments are associated with considerable side effects. The use of nanotechnology has shown promise for improving efficacy and bioavailability and minimizing side effects. METHODS This study investigated available literature, including patents and scientific articles, to identify advances in the use of nanotechnology for the treatment of leishmaniasis. RESULTS Our findings revealed a stable number of patents and scientific articles published over the past five years. CONCLUSIONS There is a need to intensify research on the use of nanotechnology for the treatment of leishmaniasis.
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Affiliation(s)
- Carine Santana Ferreira Marques
- Programa de Pós-Graduação em Biotecnologia Industrial, Universidade Tiradentes, Aracaju, SE, Brasil.,Laboratório de Nanotecnologia e Nanomedicina, Instituto de Tecnologia e Pesquisa, Aracaju, SE, Brasil
| | - Jorge Barreto Machado Júnior
- Programa de Pós-Graduação em Biotecnologia Industrial, Universidade Tiradentes, Aracaju, SE, Brasil.,Laboratório de Nanotecnologia e Nanomedicina, Instituto de Tecnologia e Pesquisa, Aracaju, SE, Brasil
| | - Lucas Rannier de Melo Andrade
- Programa de Pós-Graduação em Biotecnologia Industrial, Universidade Tiradentes, Aracaju, SE, Brasil.,Laboratório de Nanotecnologia e Nanomedicina, Instituto de Tecnologia e Pesquisa, Aracaju, SE, Brasil
| | - Luciana Nalone Andrade
- Programa de Pós-Graduação em Biotecnologia Industrial, Universidade Tiradentes, Aracaju, SE, Brasil.,Laboratório de Nanotecnologia e Nanomedicina, Instituto de Tecnologia e Pesquisa, Aracaju, SE, Brasil
| | | | | | - Marco Chaud
- Laboratório de Biomateriais e Nanotecnologia, Universidade de Sorocaba, Sorocaba, SP, Brasil
| | - Alini Tinoco Fricks
- Programa de Pós-Graduação em Biotecnologia Industrial, Universidade Tiradentes, Aracaju, SE, Brasil.,Laboratório de Nanotecnologia e Nanomedicina, Instituto de Tecnologia e Pesquisa, Aracaju, SE, Brasil
| | - Patrícia Severino
- Programa de Pós-Graduação em Biotecnologia Industrial, Universidade Tiradentes, Aracaju, SE, Brasil.,Laboratório de Nanotecnologia e Nanomedicina, Instituto de Tecnologia e Pesquisa, Aracaju, SE, Brasil
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Cuddihy G, Wasan EK, Di Y, Wasan KM. The Development of Oral Amphotericin B to Treat Systemic Fungal and Parasitic Infections: Has the Myth Been Finally Realized? Pharmaceutics 2019; 11:E99. [PMID: 30813569 PMCID: PMC6470859 DOI: 10.3390/pharmaceutics11030099] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 11/24/2022] Open
Abstract
Parenteral amphotericin B has been considered as first-line therapy in the treatment of systemic fungal and parasitic infections, however its use has been associated with a number of limitations including affordability, accessibility, and an array of systemic toxicities. Until very recently, it has been very challenging to develop a bioavailable formulation of amphotericin B due to its physical chemical properties, limited water and lipid solubility, and poor absorption. This perspective reviews several novel oral Amphotericin B formulations under development that are attempting to overcome these limitations.
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Affiliation(s)
- Grace Cuddihy
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
| | - Ellen K Wasan
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
| | - Yunyun Di
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
| | - Kishor M Wasan
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
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Sunyoto T, Boelaert M, Meheus F. Understanding the economic impact of leishmaniasis on households in endemic countries: a systematic review. Expert Rev Anti Infect Ther 2019; 17:57-69. [PMID: 30513027 DOI: 10.1080/14787210.2019.1555471] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 11/30/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Leishmaniasis is a poverty-related disease that causes a significant socioeconomic burden to affected households. Visceral leishmaniasis is fatal if untreated, yet illness costs may lead to delays in accessing care. Skin manifestations of leishmaniasis cause a psychological burden and even longer treatment trajectories. The objective of this review is to evaluate illness costs associated with leishmaniasis across different settings (Asia, Africa, and Latin America) and the consequences to households. Areas covered: Through a systematic review of cost-of-illness studies, we documented the distribution of costs, the health-seeking behavior, and the consequences of leishmaniasis. We discuss the value of cost-of-illness studies for leishmaniasis. Expert commentary: Despite the free provision of diagnostics and treatment in the public health care sector, out-of-pocket payments remain substantial. There has been progress in addressing the economic burden of leishmaniasis, particularly through the elimination initiative in the Indian subcontinent. Though the illness cost is decreasing due to shorter treatment regimens and better access to care, the situation remains challenging in Africa. Improvement of control tools is critical. There is a need to update cost estimates to inform policy-making and ensure sustainable solutions to reduce financial barriers to leishmaniasis care, especially in pursuing universal health coverage.
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Affiliation(s)
- Temmy Sunyoto
- a Public Health Department , Institute of Tropical Medicine , Antwerpen , Belgium
| | - Marleen Boelaert
- a Public Health Department , Institute of Tropical Medicine , Antwerpen , Belgium
| | - Filip Meheus
- b Early Detection and Prevention Section , International Agency for Research on Cancer , Lyon , France
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