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Rolon M, Hanna E, Vega C, Coronel C, Dea-Ayuela MA, Serrano DR, Lalatsa A. Solid Nanomedicines of Nifurtimox and Benznidazole for the Oral Treatment of Chagas Disease. Pharmaceutics 2022; 14:pharmaceutics14091822. [PMID: 36145570 PMCID: PMC9504116 DOI: 10.3390/pharmaceutics14091822] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
Chagas disease (CD) is a parasitic zoonosis endemic in Central and South America affecting nearly 10 million people, with 100 million people at high risk of contracting the disease. Treatment is only effective when received at the early stages of the disease and it involved two drugs (nifurtimox (NFX) and benznidazole (BNZ)). Both treatments require multiple daily administrations of high doses, suffer from variable efficacy and insufficient efficacy in chronic CD, many side effects, and a very long duration of treatment that results in poor compliance, while combined available therapies that lead to reduced duration of treatment are not available and polypharmacy reduces compliance and increases the cost further. Here we present self-nanoemulsified drug delivery systems (SNEDDS) able to produce easily scalable combined formulations of NFX and BNZ that can allow for tailoring of the dose and can be easily converted to oral solid dosage form by impregnation on mesoporous silica particles. SNEDDS demonstrated an enhanced solubilisation capacity for both drugs as demonstrated by flow-through studies and in vitro lipolysis studies. High loading of SNEDDS to Syloid 244 and 3050 silicas (2:1 w/w) allowed clinically translatable amounts of both NFX and BNZ to be loaded. Tablets prepared from NFX-BNZ combined SNEDDS loaded on Syloid 3050 silicas demonstration near complete dissolution in the flow through cell apparatus compared to NFX and BNZ commercial tablets respectively (Lampit® and Rochagan®). NFX-BNZ-SNEDDS demonstrated nanomolar efficacy in epimastigotes and amastigotes of T. cruzi with acceptable selectivity indexes and demonstrated enhanced survival and reduced parasitaemia in acute murine experimental models of CD. Thus, the results presented here illustrate the ability for an easily scalable and personalised combination oral therapy prepared from GRAS excipients, enabling treatment access worldwide for the treatment of CD.
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Affiliation(s)
- Miriam Rolon
- Centro para el Desarrollo de la Investigacion Científica (CEDIC), Manduvirá 635 entre 15 de Agosto y O’Leary, Asuncion 1255, Paraguay
| | - Eustine Hanna
- Biomaterials, Bio-Engineering and Nanomedicines (BioN) Laboratory, Institute of Biomedical and Biomolecular Sciences, School of Pharmacy and Biomedical Sciences, University of Portsmouth, White Swan Road, Portsmouth PO1 2DT, UK
| | - Celeste Vega
- Centro para el Desarrollo de la Investigacion Científica (CEDIC), Manduvirá 635 entre 15 de Agosto y O’Leary, Asuncion 1255, Paraguay
| | - Cathia Coronel
- Centro para el Desarrollo de la Investigacion Científica (CEDIC), Manduvirá 635 entre 15 de Agosto y O’Leary, Asuncion 1255, Paraguay
| | - Maria Auxiliadora Dea-Ayuela
- Departamento de Farmacia, Facultad de Ciencias de la Salud, Universidad CEU Cardenal Herrera, Edificio Seminario s/n, Moncada, 46113 Valencia, Spain
| | - Dolores R. Serrano
- Department of Pharmaceutics and Food Technology, Instituto Universitario de Farmacia Industrial (IUFI), School of Pharmacy, University Complutense de Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
- Correspondence: (D.R.S.); (A.L.); Tel.: +44-141-548-2675 (A.L.)
| | - Aikaterini Lalatsa
- Biomaterials, Bio-Engineering and Nanomedicines (BioN) Laboratory, Institute of Biomedical and Biomolecular Sciences, School of Pharmacy and Biomedical Sciences, University of Portsmouth, White Swan Road, Portsmouth PO1 2DT, UK
- School of Pharmacy and Biomedical Sciences, John Arbuthnot Building, Robertson Wing, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, UK
- Correspondence: (D.R.S.); (A.L.); Tel.: +44-141-548-2675 (A.L.)
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Pandey RP, Nascimento MS, Moore CE, Raj VS, Kalil J, Cunha-Neto E. New Approaches for the Treatment of Chagas Disease. Curr Drug Targets 2021; 22:835-841. [PMID: 33238855 DOI: 10.2174/1389450121999201124122643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 11/22/2022]
Abstract
Chagas disease, caused by the protozoan Trypanosoma cruzi is a neglected tropical disease with high prevalence (5.7 million in Latin America, WHO 2015), significant burden, and significant morbimortality mostly due to severe heart disorders during the chronic phase of infection. Chagas disease is endemic in Latin America, and medical care for the disease is the major expense for Brazil's Universal Healthcare System (Sistema Único de Saúde (SUS). The efficacy of the available drugs benznidazole and nifurtimox are low for the chronic phase of Chagas disease, the phase in which most patients are diagnosed, and there are frequent side effects, and drug resistance occurs. The rapid deployment of new drug regimens that are effective for the chronic phase treatment is low-cost and less toxic than the currently available therapy, which is a global priority. Repurposing drugs already in clinical use with other combinations would be the fastest and safest strategy for treating Chagas disease patients. We hypothesize that the combined treatment using repurposing drugs with benznidazole will be more efficacious than benznidazole alone. This needs to be tested further both in vitro and in animal models to understand the efficacy of the treatment before performing human clinical trials. We further hypothesize that producing nanoparticle formulation of the drugs can reduce their toxicity and improve therapeutic use.
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Affiliation(s)
- Ramendra Pati Pandey
- Centre for Drug Design Discovery and Development (C4D), SRM University, DelhiNCR, Rajiv Gandhi Education City, Sonepat - 131 029, Haryana, India
| | - Marilda Savoia Nascimento
- Laboratorio de Imunologia, Instituto do Coracao, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Catrin E Moore
- Nuffield Department of Medicine, University of Oxford, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery Old Road Campus, Headington, Oxford, OX3 7LF, United Kingdom
| | - V Samuel Raj
- Centre for Drug Design Discovery and Development (C4D), SRM University, DelhiNCR, Rajiv Gandhi Education City, Sonepat - 131 029, Haryana, India
| | - Jorge Kalil
- Laboratorio de Imunologia, Instituto do Coracao, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Edecio Cunha-Neto
- Laboratorio de Imunologia, Instituto do Coracao, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
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Buckner FS. The Tryp and the Pendulum. EBioMedicine 2021; 64:103188. [PMID: 33493793 PMCID: PMC7823206 DOI: 10.1016/j.ebiom.2020.103188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/11/2020] [Indexed: 11/25/2022] Open
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Vallejo M, Reyes PP, Martinez Garcia M, Gonzalez Garay AG. Trypanocidal drugs for late-stage, symptomatic Chagas disease (Trypanosoma cruzi infection). Cochrane Database Syst Rev 2020; 12:CD004102. [PMID: 33305846 PMCID: PMC8103997 DOI: 10.1002/14651858.cd004102.pub3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND People with Chagas disease may develop progressive and lethal heart conditions. Drugs to eliminate the parasite Trypanosoma cruzi (T cruzi) currently carry limited therapeutic value and are used in the early stages of the disease. Extending the use of these drugs to treat chronic chagasic cardiomyopathy (CCC) has also been proposed. OBJECTIVES To assess the benefits and harms of nitrofurans and trypanocidal drugs for treating late-stage, symptomatic Chagas disease and CCC in terms of blood parasite reduction or clearance, mortality, adverse effects, and quality of life. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and LILACS databases on 12 November 2019. We also searched two clinical trials registers, ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), on 3 December 2019. SELECTION CRITERIA We included randomised controlled trials (RCTs) assessing trypanocidal drugs versus placebo or no treatment for late-stage, symptomatic Chagas disease and CCC. DATA COLLECTION AND ANALYSIS We conducted the reporting of the review according the standard Cochrane methods. Two review authors independently retrieved articles, performed data extraction, and assessed risk of bias. Any disagreements were resolved by a third review author. We contacted study authors for additional information. MAIN RESULTS We included two studies in this review update. One RCT randomly assigned 26 participants to benznidazole 5 mg/kg/day; 27 participants to nifurtimox 5 mg/kg/day; and 24 participants to placebo for 30 days. The second RCT, newly included in this update, randomised 1431 participants to benznidazole 300 mg/day for 40 to 80 days and 1423 participants to placebo. We also identified one ongoing study. Benznidazole compared to placebo At five-year follow-up, low quality of the evidence suggests that there may be a benefit of benznidazole when compared to placebo for clearance or reduction of antibody titres (risk ratio (RR) 1.25, 95% confidence interval (CI) 1.14 to 1.37; 1 trial; 1896 participants). We are uncertain about the effects of benznidazole for the clearance of parasitaemia demonstrated by negative xenodiagnosis, blood culture, and/or molecular assays due to very limited evidence. Low quality of the evidence suggests that when compared to placebo, benznidazole may make little to no difference in the risk of heart failure (RR 0.89, 95% CI 0.69 to 1.14; 1 trial; 2854 participants) and ventricular tachycardia (RR 0.80, 95% CI 0.51 to 1.26; 1 trial; 2854 participants). We found moderate quality of the evidence that adverse events increase with benznidazole when compared to placebo (RR 2.52, 95% CI 2.09 to 3.03; 1 trial; 2854 participants). Adverse effects were observed in 23.9% of patients in the benznidazole group compared to 9.5% in the placebo group. The most frequent adverse effects were: cutaneous rash, gastrointestinal symptoms, and peripheral polyneuropathy. No data were available for the outcomes of pathological demonstration of tissue parasites and quality of life. Nifurtimox compared to placebo Data were only available for this comparison for the outcome clearance or reduction of antibody titres, and we are uncertain about the effect due to very limited evidence. Regarding adverse events, one RCT mentioned in a general manner that nifurtimox caused intense adverse events, without any quantification. AUTHORS' CONCLUSIONS There is insufficient evidence to support the efficacy of the trypanocidal drugs benznidazole and nifurtimox for late-stage, symptomatic Chagas disease and CCC.
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Affiliation(s)
- Maite Vallejo
- Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No. 1. Col. Seccion XVI, Tlalpan, Mexico
| | - Pedro Pa Reyes
- Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No. 1. Col. Seccion XVI, Tlalpan, Mexico
| | - Mireya Martinez Garcia
- Sociomedical Research Unit, Instituto Nacional de Cardiologia, Ignacio Chavez, Mexico City, Mexico
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Madigan R, Majoy S, Ritter K, Luis Concepción J, Márquez ME, Silva SC, Zao CL, Pérez Alvarez A, Rodriguez-Morales AJ, Mogollón-Mendoza AC, Estep JS, Benaím G, Paniz-Mondolfi AE. Investigation of a combination of amiodarone and itraconazole for treatment of American trypanosomiasis (Chagas disease) in dogs. J Am Vet Med Assoc 2020; 255:317-329. [PMID: 31298647 DOI: 10.2460/javma.255.3.317] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate clinical, serologic, parasitological, and histologic outcomes of dogs with naturally occurring Trypanosoma cruzi infection treated for 12 months with amiodarone and itraconazole. ANIMALS 121 dogs from southern Texas and southern Louisiana. PROCEDURES Treatment group dogs (n = 105) received a combination of amiodarone hydrochloride (approx 7.5 mg/kg [3.4 mg/lb], PO, q 24 h, with or without a loading dosage protocol) and itraconazole (approx 10 mg/kg [4.5 mg/lb], PO, q 24 h, adjusted to maintain a plasma concentration of 1 to 2 μg/mL) for 12 months. Control group dogs (n = 16) received no antitrypanosomal medications. Serologic assays for anti-T cruzi antibodies, PCR assays for T cruzi DNA in blood, and physical evaluations were performed 1, 6, 9, 12, and 24 months after study initiation. Adverse events were recorded. Outcomes of interest were recorded and compared between groups. RESULTS 86 of 105 treatment group dogs and 8 of 16 control group dogs survived and completed the study (5/19 and 6/7 deaths of treatment and control group dogs, respectively, were attributed to T cruzi infection). Mean survival time until death attributed to T cruzi was longer (23.19 vs 15.64 months) for the treatment group. Results of PCR assays were negative for all (n = 92) tested treatment group dogs (except for 1 dog at 1 time point) from 6 to 24 months after study initiation. Clinical improvement in ≥ 1 clinical sign was observed in 53 of 54 and 0 of 10 treatment and control group dogs, respectively; adverse drug events were minor and reversible. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested efficacy of this trypanocidal drug combination for the treatment of T cruzi infection in dogs.
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Alarcón de Noya B, Ruiz-Guevara R, Noya O, Castro J, Ossenkopp J, Díaz-Bello Z, Colmenares C, Suárez JA, Noya-Alarcón O, Naranjo L, Gutiérrez H, Quinci G, Torres J. Long-term comparative pharmacovigilance of orally transmitted Chagas disease: first report. Expert Rev Anti Infect Ther 2017; 15:319-325. [PMID: 28132566 DOI: 10.1080/14787210.2017.1286979] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Two old drugs are the only choice against Trypanosoma cruzi and little is known about their secondary effects in the acute stage of oral-transmitted Chagas disease (ChD). METHODS A cross-sectional analytical surveillance study was conducted in a sizable cohort of patients seen during the largest acute foodborne ChD microepidemic registered so far. Individuals were treated with benznidazole (BNZ) or nifurtimox (NFX). 'Common Terminology Criteria for Adverse Events' was assessed to categorize side effects according to severity. RESULTS Out of 176 treatments applied, 79% had one or more adverse effects, which predominated in adults (97.8%) as compared to children (75.5%). Risk of side effects with NFX was significantly higher than BNZ. Four adults and a child treated with NFX had severe side effects (pulmonary infarction, facial paralysis, neutropenia, blurred vision, bone marrow hypoplasia) warranting hospitalization, and drug suspension. Adverse effects frequently reported with NFX were abdominal pain, hyporexia, weight loss, headache, nausea and lymphocytosis, whereas skin rash, neurosensory effects, hyporexia, fatigue, pyrosis, abdominal pain and eosinophilia were observed with BNZ. CONCLUSIONS Frequency and severity of side effects during treatment of acute oral infection by T. cruzi demand direct supervision and close follow-up, even in those asymptomatic, to prevent life-threatening situations.
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Affiliation(s)
- Belkisyolé Alarcón de Noya
- a Sección de Inmunología, Instituto de Medicina Tropical, Facultad de Medicina , Universidad Central de Venezuela (IMT-FM-UCV) , Caracas , Venezuela
| | - Raiza Ruiz-Guevara
- b Cátedra de Parasitología , Escuela de Medicina 'Luís Razetti', FM-UCV , Caracas , Venezuela
| | - Oscar Noya
- c Sección de Biohelmintiasis , IMT-FM-UCV , Caracas , Venezuela.,d Centro para Estudios sobre Malaria , Instituto de Altos Estudios 'Dr. Arnoldo Gabaldón', Instituto Nacional de Higiene 'Rafael Rangel', Ministerio del Poder Popular para la Salud , Caracas , Venezuela
| | - Julio Castro
- e Sección de Infectología , IMT-FM-UCV , Caracas , Venezuela
| | - John Ossenkopp
- e Sección de Infectología , IMT-FM-UCV , Caracas , Venezuela
| | - Zoraida Díaz-Bello
- a Sección de Inmunología, Instituto de Medicina Tropical, Facultad de Medicina , Universidad Central de Venezuela (IMT-FM-UCV) , Caracas , Venezuela
| | - Cecilia Colmenares
- a Sección de Inmunología, Instituto de Medicina Tropical, Facultad de Medicina , Universidad Central de Venezuela (IMT-FM-UCV) , Caracas , Venezuela.,b Cátedra de Parasitología , Escuela de Medicina 'Luís Razetti', FM-UCV , Caracas , Venezuela
| | | | | | - Laura Naranjo
- e Sección de Infectología , IMT-FM-UCV , Caracas , Venezuela
| | - Humberto Gutiérrez
- g Cátedra de Pediatría , Escuela 'Luis Razetti', FM-UCV , Caracas , Venezuela
| | - Giuseppa Quinci
- h Instituto Municipal de Cooperación y Atención de la Salud (IMCAS) , Salud Chacao. Alcaldía del Municipio Chacao , Caracas , Venezuela
| | - Jaime Torres
- e Sección de Infectología , IMT-FM-UCV , Caracas , Venezuela
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Rodriguez JB, Falcone BN, Szajnman SH. Detection and treatment ofTrypanosoma cruzi: a patent review (2011-2015). Expert Opin Ther Pat 2016; 26:993-1015. [DOI: 10.1080/13543776.2016.1209487] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Lazarin-Bidóia D, Desoti VC, Martins SC, Ribeiro FM, Ud Din Z, Rodrigues-Filho E, Ueda-Nakamura T, Nakamura CV, de Oliveira Silva S. Dibenzylideneacetones Are Potent Trypanocidal Compounds That Affect the Trypanosoma cruzi Redox System. Antimicrob Agents Chemother 2016; 60:890-903. [PMID: 26596953 PMCID: PMC4750705 DOI: 10.1128/aac.01360-15] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 11/19/2015] [Indexed: 12/30/2022] Open
Abstract
Despite ongoing efforts, the available treatments for Chagas' disease are still unsatisfactory, especially in the chronic phase of the disease. Our previous study reported the strong trypanocidal activity of the dibenzylideneacetones A3K2A1 and A3K2A3 against Trypanosoma cruzi (Z. Ud Din, T. P. Fill, F. F. de Assis, D. Lazarin-Bidóia, V. Kaplum, F. P. Garcia, C. V. Nakamura, K. T. de Oliveira, and E. Rodrigues-Filho, Bioorg Med Chem 22:1121-1127, 2014, http://dx.doi.org/10.1016/j.bmc.2013.12.020). In the present study, we investigated the mechanisms of action of these compounds that are involved in parasite death. We showed that A3K2A1 and A3K2A3 induced oxidative stress in the three parasitic forms, especially trypomastigotes, reflected by an increase in oxidant species production and depletion of the endogenous antioxidant system. This oxidative imbalance culminated in damage in essential cell structures of T. cruzi, reflected by lipid peroxidation and DNA fragmentation. Consequently, A3K2A1 and A3K2A3 induced vital alterations in T. cruzi, leading to parasite death through the three pathways, apoptosis, autophagy, and necrosis.
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Affiliation(s)
- Danielle Lazarin-Bidóia
- Programa de Pós Graduação em Ciências Farmacêuticas, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | - Vânia Cristina Desoti
- Programa de Pós Graduação em Ciências Farmacêuticas, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | - Solange Cardoso Martins
- Programa de Pós-graduação em Ciências Biológicas, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | - Fabianne Martins Ribeiro
- Programa de Pós Graduação em Ciências Farmacêuticas, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | - Zia Ud Din
- LaBioMMi, Departamento de Química, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Edson Rodrigues-Filho
- LaBioMMi, Departamento de Química, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Tânia Ueda-Nakamura
- Programa de Pós Graduação em Ciências Farmacêuticas, Universidade Estadual de Maringá, Maringá, Paraná, Brazil Departamento de Ciências Básicas da Saúde, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | - Celso Vataru Nakamura
- Programa de Pós Graduação em Ciências Farmacêuticas, Universidade Estadual de Maringá, Maringá, Paraná, Brazil Programa de Pós-graduação em Ciências Biológicas, Universidade Estadual de Maringá, Maringá, Paraná, Brazil Departamento de Ciências Básicas da Saúde, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | - Sueli de Oliveira Silva
- Programa de Pós Graduação em Ciências Farmacêuticas, Universidade Estadual de Maringá, Maringá, Paraná, Brazil Departamento de Ciências Básicas da Saúde, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
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Guedes PMM, Silva GK, Gutierrez FRS, Silva JS. Current status of Chagas disease chemotherapy. Expert Rev Anti Infect Ther 2014; 9:609-20. [DOI: 10.1586/eri.11.31] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lepesheva GI. Design or screening of drugs for the treatment of Chagas disease: what shows the most promise? Expert Opin Drug Discov 2013; 8:1479-89. [PMID: 24079515 PMCID: PMC3867292 DOI: 10.1517/17460441.2013.845554] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Endemic in Latin America, Chagas disease is now becoming a serious global health problem, and yet has no financial viability for the pharmaceutical industry and remains incurable. In 2012, two antimycotic drugs inhibitors of fungal sterol 14α-demethylase (CYP51) - posaconazole and ravuconazole - entered clinical trials. Availability of the X-ray structure of the orthologous enzyme from the causative agent of the disease, protozoan parasite Trypanosoma cruzi, determined in complexes with posaconazole as well as with several experimental protozoa-specific CYP51 inhibitors opens an excellent opportunity to improve the situation. AREAS COVERED This article summarizes the information available in PubMed and Google on the outcomes of treatment of the chronic Chagas disease. It also outlines the major features of the T. cruzi CYP51 structure and the possible structure-based strategies for rational design of novel T. cruzi specific drugs. EXPERT OPINION There is no doubt that screenings for alternative drug-like molecules as well as mining the T. cruzi genome for novel drug targets are of great value and might eventually lead to groundbreaking discoveries. However, all newly identified molecules must proceed through the long, expensive and low-yielding drug optimization process, and all novel potential drug targets must be validated in terms of their essentiality and druggability. CYP51 is already a well-validated and highly successful target for clinical and agricultural antifungals. With minimal investments into the final stages of their development/trials, T. cruzi-specific CYP51 inhibitors can provide an immediate treatment for Chagas disease, either on their own or in combination with the currently available drugs.
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Affiliation(s)
- Galina I Lepesheva
- Vanderbilt University, Institute for Global Health, School of Medicine, Center for Structural Biology, Department of Biochemistry , 622 RRB, 23rd at Pierce, Nashville, TN 37232 , USA +1 615 343 1373 ; +1 615 322 4349 ;
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Braga SFP, Alves ÉVP, Ferreira RS, Fradico JRB, Lage PS, Duarte MC, Ribeiro TG, Júnior PAS, Romanha AJ, Tonini ML, Steindel M, Coelho EF, de Oliveira RB. Synthesis and evaluation of the antiparasitic activity of bis-(arylmethylidene) cycloalkanones. Eur J Med Chem 2013; 71:282-9. [PMID: 24321832 DOI: 10.1016/j.ejmech.2013.11.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 11/02/2013] [Accepted: 11/07/2013] [Indexed: 11/27/2022]
Abstract
A series of bis-(arylmethylidene)-cycloalkanones was synthesized by cross-aldol condensation. The activity of the compounds was evaluated against amastigotes forms of Trypanosoma cruzi and promastigotes forms of Leishmania amazonensis. The cytotoxicity of the active compounds on uninfected fibroblasts or macrophages was established in vitro to evaluate the selectivity of their antiparasitic effects. Six compounds displayed trypanocidal activity against amastigotes intracellular forms of T. cruzi with IC₅₀ values ranging from 7.0 to 249 μM. Besides these six compounds, eight other molecules exhibited significant leishmanicidal activity (IC₅₀ values ranging from 0.6 to 110.4 μM). Two compounds can be considered as promising antiparasitic lead molecules because they showed IC₅₀ values in the low-micromolar range (≤1.2 μM) with an adequate SI (≥19.9). To understand the mechanism of action of these compounds, two possible molecular targets were investigated: trypanothione reductase (TR) and cruzain.
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Affiliation(s)
- Saulo F P Braga
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos 6627, Belo Horizonte 31.270-901, MG, Brazil
| | - Érika V P Alves
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos 6627, Belo Horizonte 31.270-901, MG, Brazil
| | - Rafaela S Ferreira
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos 6627, Belo Horizonte 31.270-901, MG, Brazil
| | - Jordana R B Fradico
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos 6627, Belo Horizonte 31.270-901, MG, Brazil
| | - Paula S Lage
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana C Duarte
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Tatiana G Ribeiro
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos 6627, Belo Horizonte 31.270-901, MG, Brazil
| | - Policarpo A S Júnior
- Centro de Pesquisas René Rachou, FIOCRUZ, Avenida Augusto de Lima, 1.715, Barro Preto, Belo Horizonte 30.190-002, MG, Brazil
| | - Alvaro J Romanha
- Centro de Pesquisas René Rachou, FIOCRUZ, Avenida Augusto de Lima, 1.715, Barro Preto, Belo Horizonte 30.190-002, MG, Brazil
| | - Maiko L Tonini
- Departamento de Microbiologia, Imunologia e Parasitologia, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Setor F, Bloco A, Florianópolis 88.040-970, SC, Brazil
| | - Mário Steindel
- Departamento de Microbiologia, Imunologia e Parasitologia, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Setor F, Bloco A, Florianópolis 88.040-970, SC, Brazil
| | - Eduardo F Coelho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Renata B de Oliveira
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos 6627, Belo Horizonte 31.270-901, MG, Brazil.
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Design, synthesis and biological evaluation of WC-9 analogs as antiparasitic agents. Eur J Med Chem 2013; 69:480-9. [PMID: 24090919 DOI: 10.1016/j.ejmech.2013.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 09/03/2013] [Accepted: 09/05/2013] [Indexed: 11/20/2022]
Abstract
As a part of our project pointed at the search of new safe chemotherapeutic and chemoprophylactic agents against parasitic diseases, several compounds structurally related to 4-phenoxyphenoxyethyl thiocyanate (WC-9), which were modified at the terminal aromatic ring, were designed, synthesized and evaluated as antiproliferative agents against Trypanosoma cruzi, the parasite responsible of American trypanosomiasis (Chagas disease) and Toxoplasma gondii, the etiological agent of toxoplasmosis. Most of the synthetic analogs exhibited similar antiparasitic activity being slightly more potent than the reference compound WC-9. For example, the nitro derivative 13 showed an ED₅₀ value of 5.2 μM. Interestingly, the regioisomer of WC-9, compound 36 showed similar inhibitory action than WC-9 indicating that para-phenyl substitution pattern is not necessarily required for biological activity. The biological evaluation against T. gondii was also very promising. The ED₅₀ values corresponding for 13, 36 and 37 were at the very low micromolar level against tachyzoites of T. gondii.
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13
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Rodriguez JB, Szajnman SH. New antibacterials for the treatment of toxoplasmosis; a patent review. Expert Opin Ther Pat 2012; 22:311-33. [PMID: 22404108 DOI: 10.1517/13543776.2012.668886] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Toxoplasma gondii is an opportunistic protozoan parasite responsible for toxoplasmosis. T. gondii is able to infect a wide range of hosts, particularly humans and warm-blooded animals. Toxoplasmosis can be considered as one of the most prevalent parasitic diseases affecting close to one billion people worldwide, but its current chemotherapy is still deficient and is only effective in the acute phase of the disease. AREAS COVERED This review covers different approaches to toxoplasmosis chemotherapy focused on the metabolic differences between the host and the parasite. Selective action on different targets such as the isoprenoid pathway, dihydrofolate reductase, T. gondii adenosine kinase, different antibacterials, T. gondii histone deacetylase and calcium-dependent protein kinases is discussed. EXPERT OPINION A new and safe chemotherapy is needed, as T. gondii causes serious morbidity and mortality in pregnant women and immunodeficient patients undergoing chemotherapy. A particular drawback of the available treatments is the lack of efficacy against the tissue cyst of the parasite. During this review a broad scope of several attractive targets for drug design have been presented. In this context, the isoprenoid pathway, dihydrofolate reductase, T. gondii histone deacetylase are promising molecular targets.
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Affiliation(s)
- Juan Bautista Rodriguez
- Universidad de Buenos Aires, Química Orgánica & UMYMFOR (CONICET-FCEyN), Facultad de Ciencias Exactas y Naturales, Pab 2, Ciudad Universitaria, Buenos Aires, C1428EHA, Argentina.
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14
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Experimental chemotherapy and approaches to drug discovery for Trypanosoma cruzi infection. ADVANCES IN PARASITOLOGY 2011; 75:89-119. [PMID: 21820553 DOI: 10.1016/b978-0-12-385863-4.00005-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In the 100 years since the discovery of Chagas disease, only two drugs have been developed and introduced into clinical practice, and these drugs were introduced over 40 years ago. The tools of drug discovery have improved dramatically in the interim; however, this has not translated into new drugs for Chagas disease. This has been largely because the main practitioners of drug discovery are pharmaceutical companies who are not financially motivated to invest in Chagas disease and other "orphan" diseases. As a result, it has largely been up to academic groups to bring drug candidates through the discovery pipeline and to clinical trials. The difficulty with drug discovery in academia has been the challenge of bringing together the diverse expertise in biology, chemistry, and pharmacology in concerted efforts towards a common goal of developing therapeutics. Funding is often inadequate, but lack of coordination amongst academic investigators with different expertise has also contributed to the slow progress. The purpose of this chapter is to provide an overview of approaches that can be accomplished in academic settings for preclinical drug discovery for Chagas disease. The chapter addresses methods of drug screening against Trypanosoma cruzi cultures and in animal models and includes general topics on compound selection, testing for drug-like properties (including oral bioavailability), investigating the pharmacokinetics and toxicity of compounds, and finally providing parameters to help with triaging compounds.
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15
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Lopes MS, Sales Júnior PA, Lopes AGF, Yoshida MI, Silva THAD, Romanha AJ, Alves RJ, Oliveira RBD. The activity of a metronidazole analogue and its β-cyclodextrin complex against Trypanosoma cruzi. Mem Inst Oswaldo Cruz 2011; 106:1055-7. [DOI: 10.1590/s0074-02762011000800027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 08/09/2011] [Indexed: 11/21/2022] Open
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16
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Lopes MS, de Souza Pietra RC, Borgati TF, Romeiro CF, Júnior PA, Romanha AJ, Alves RJ, Souza-Fagundes EM, Fernandes APS, de Oliveira RB. Synthesis and evaluation of the anti parasitic activity of aromatic nitro compounds. Eur J Med Chem 2011; 46:5443-7. [DOI: 10.1016/j.ejmech.2011.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 08/27/2011] [Accepted: 09/01/2011] [Indexed: 11/29/2022]
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17
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Rosso VS, Szajnman SH, Malayil L, Galizzi M, Moreno SNJ, Docampo R, Rodriguez JB. Synthesis and biological evaluation of new 2-alkylaminoethyl-1,1-bisphosphonic acids against Trypanosoma cruzi and Toxoplasma gondii targeting farnesyl diphosphate synthase. Bioorg Med Chem 2011; 19:2211-7. [PMID: 21419634 PMCID: PMC3071284 DOI: 10.1016/j.bmc.2011.02.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 02/16/2011] [Accepted: 02/18/2011] [Indexed: 10/18/2022]
Abstract
The effect of long-chain 2-alkylaminoethyl-1,1-bisphosphonates against proliferation of the clinically more relevant form of Trypanosoma cruzi, the etiologic agent of American trypanosomiasis (Chagas' disease), and against tachyzoites of Toxoplasma gondii was investigated. Particularly, compound 26 proved to be an extremely potent inhibitor against the intracellular form of T. cruzi, exhibiting IC(50) values at the nanomolar range. This cellular activity was associated with a strong inhibition of the enzymatic activity of T. cruzi farnesyl diphosphate synthase (TcFPPS), which constitutes a valid target for Chagas' disease chemotherapy. Compound 26 was an effective agent against T. cruzi (amastigotes) exhibiting an IC(50) value of 0.67 μM, while this compound showed an IC(50) value of 0.81 μM against the target enzyme TcFPPS. This drug was less effective against the enzymatic activity of T. cruzi solanesyl diphosphate synthase TcSPPS showing an IC(50) value of 3.2 μM. Interestingly, compound 26 was also very effective against T. gondii (tachyzoites) exhibiting IC(50) values of 6.23 μM. This cellular activity was also related to the inhibition of the enzymatic activity towards the target enzyme TgFPPS (IC(50)=0.093 μM) As bisphosphonate-containing compounds are FDA-approved drugs for the treatment of bone resorption disorders, their potential low toxicity makes them good candidates to control different tropical diseases.
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Affiliation(s)
- Valeria S Rosso
- Departamento de Química Orgánica and UMYMFOR (CONICET-FCEyN), Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Pabellón 2, Ciudad Universitaria, C1428EHA Buenos Aires, Argentina
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18
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Jimenez-Coello M, Guzman-Marin E, Perez-Gutierrez S, Polanco-Hernandez GM, Acosta-Viana KY. Antitrypanosomal activity of Senna villosa in infected BALB/c mice with Trypanosoma cruzi during the sub acute phase of infection. AFRICAN JOURNAL OF TRADITIONAL, COMPLEMENTARY, AND ALTERNATIVE MEDICINES : AJTCAM 2011; 8:164-9. [PMID: 22754070 DOI: 10.4314/ajtcam.v8i5s.21] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Antitrypanosomal activity of chloroform extract of Senna villosa leaves was evaluated in the sub acute phase of mice infected with Trypanosoma cruzi. Oral doses of 3.3, 6.6 and 13.2 µg/g were tested during 15 days on infected mice BALB/c, beginning treatment 40 days after infection to evaluate specifically the antitrypanosomal activity over the amastigote form of the parasite. Two different amount of parasites (100 and 500) were inoculated to 25 mice for each doses tested. At the end of the assay the animals were sacrificed and cardiac and skeletal tissue sections were stained with hematoxylin-eosin (HE) for identification and quantification of amastigote nest. In mice infected with 100 parasites, a significant reduction in the number of amastigote nest was observed in cardiac tissue of treated animals at all doses evaluated (p<0.05). An important reduction of amastigote nest was also observed in treated animals and infected with 500 parasites in comparison with no treated mice or treated with allopurinol.
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Affiliation(s)
- Matilde Jimenez-Coello
- Laboratorio de Biología Celular, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autonoma de Yucatán, Merida Yucatan, Mexico.
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19
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Romanha AJ, Castro SLD, Soeiro MDNC, Lannes-Vieira J, Ribeiro I, Talvani A, Bourdin B, Blum B, Olivieri B, Zani C, Spadafora C, Chiari E, Chatelain E, Chaves G, Calzada JE, Bustamante JM, Freitas-Junior LH, Romero LI, Bahia MT, Lotrowska M, Soares M, Andrade SG, Armstrong T, Degrave W, Andrade ZDA. In vitro and in vivo experimental models for drug screening and development for Chagas disease. Mem Inst Oswaldo Cruz 2010; 105:233-8. [PMID: 20428688 DOI: 10.1590/s0074-02762010000200022] [Citation(s) in RCA: 271] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Accepted: 01/26/2010] [Indexed: 11/22/2022] Open
Abstract
Chagas disease, a neglected illness, affects nearly 12-14 million people in endemic areas of Latin America. Although the occurrence of acute cases sharply has declined due to Southern Cone Initiative efforts to control vector transmission, there still remain serious challenges, including the maintenance of sustainable public policies for Chagas disease control and the urgent need for better drugs to treat chagasic patients. Since the introduction of benznidazole and nifurtimox approximately 40 years ago, many natural and synthetic compounds have been assayed against Trypanosoma cruzi, yet only a few compounds have advanced to clinical trials. This reflects, at least in part, the lack of consensus regarding appropriate in vitro and in vivo screening protocols as well as the lack of biomarkers for treating parasitaemia. The development of more effective drugs requires (i) the identification and validation of parasite targets, (ii) compounds to be screened against the targets or the whole parasite and (iii) a panel of minimum standardised procedures to advance leading compounds to clinical trials. This third aim was the topic of the workshop entitled Experimental Models in Drug Screening and Development for Chagas Disease, held in Rio de Janeiro, Brazil, on the 25th and 26th of November 2008 by the Fiocruz Program for Research and Technological Development on Chagas Disease and Drugs for Neglected Diseases Initiative. During the meeting, the minimum steps, requirements and decision gates for the determination of the efficacy of novel drugs for T. cruzi control were evaluated by interdisciplinary experts and an in vitro and in vivo flowchart was designed to serve as a general and standardised protocol for screening potential drugs for the treatment of Chagas disease.
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Affiliation(s)
- Alvaro José Romanha
- Programa Integrado de Doença de Chagas, Fiocruz, Rio de Janeiro, RJ, Brasil.
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20
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Urbina JA. Specific chemotherapy of Chagas disease: relevance, current limitations and new approaches. Acta Trop 2010; 115:55-68. [PMID: 19900395 DOI: 10.1016/j.actatropica.2009.10.023] [Citation(s) in RCA: 323] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Revised: 10/22/2009] [Accepted: 10/26/2009] [Indexed: 01/31/2023]
Abstract
A critical review of the development of specific chemotherapeutic approaches for the management of American Trypanosomiasis or Chagas disease is presented, including controversies on the pathogenesis of the disease, the initial efforts that led to the development of currently available drugs (nifurtimox and benznidazole), limitations of these therapies and novel approaches for the development of anti-Trypanosoma cruzi drugs, based on our growing understanding of the biology of this parasite. Among the later, the most promising approaches are ergosterol biosynthesis inhibitors such as posaconazole and ravuconazole, poised to enter clinical trials for chronic Chagas disease in the short term; inhibitors of cruzipain, the main cysteine protease of T. cruzi, essential for its survival and proliferation in vitro and in vivo; bisphosphonates, metabolic stable pyrophosphate analogs that have trypanocidal activity through the inhibition of the parasite's farnesyl-pyrophosphate synthase or hexokinase; inhibitors of trypanothione synthesis and redox metabolism and inhibitors of hypoxanthine-guanine phosphoribosyl-transferase, an essential enzyme for purine salvage in T. cruzi and related organisms. Finally, the economic and political challenges faced by development of drugs for the treatment of neglected tropical diseases, which afflict almost exclusively poor populations in developing countries, are analyzed and recent potential solutions for this conundrum are discussed.
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21
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Jimenez-Coello M, Acosta-Viana KY, Guzman-Marin E, Perez Gonzalez C, Salud Perez Gutierrez M. Anti-trypanosomal activity of (8-hydroxymethylen)-trieicosanyl acetate against infective forms of Trypanosoma cruzi. PHARMACEUTICAL BIOLOGY 2010; 48:666-671. [PMID: 20645740 DOI: 10.3109/13880200903241853] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The activity of an (8-hydroxymethylen)-trieicosanyl acetate compound obtained from chloroform extracts of Senna villosa (Mill.) H.S. Irwin & Barneby (Leguminosae) against Trypanosoma cruzi was evaluated in vivo. Oral doses of 2.1, 8.4, and 33.6 microg/g were tested for 28 days in BALB/c mice infected with T. cruzi. Reduced parasitemia levels of 70.5%, 73.8%, and 80.9%, respectively, were observed. A significant reduction in amastigote nests was detected in the cardiac tissue of treated animals at doses of 8.4 and 33.6 microg/g. The LD50 of (8-hydroxymethylen)-trieicosanyl acetate was impossible to determine because none of the animals died, even at oral doses of 5000 microg/g; consequently, it was impossible to determine the acute oral toxicity in vivo.
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Affiliation(s)
- Matilde Jimenez-Coello
- Laboratorio de Biologia Celular, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autonoma de Yucatan, Merida, Yucatan, Mexico
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22
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Herrera C, Vallejos GA, Loaiza R, Zeledón R, Urbina A, Sepúlveda-Boza S. In vitro activity of thienyl-2-nitropropene compounds against Trypanosoma cruzi. Mem Inst Oswaldo Cruz 2010; 104:980-5. [PMID: 20027464 DOI: 10.1590/s0074-02762009000700007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Accepted: 08/24/2009] [Indexed: 11/21/2022] Open
Abstract
The in vitro activity of four 2-nitropropene derivatives, 1-(3-benzothienyl)-2-nitropropene (N1), 1-(3-thienyl)-2-nitropropene (N2), 1-(5-bromo-2-thienyl)-2-nitropropene (N3) and 1-(4-bromo-2-thienyl)-2-nitropropene (N4), were tested against cultures of the parasite Trypanosoma cruzi. Cytotoxicity studies were performed using Vero cells. The blood trypomastigotes, amastigotes and epimastigotes showed differential degrees of sensitivity towards the four tested compounds; the highest activity against the epimastigotes and blood tripomastigotes was exhibited by N1, followed by N3, N4 and finally N2. In contrast, whereas the compounds N1, N3 and N4 exerted similar magnitudes of activity against amastigotes, N2 was found to be a much less potent compound. According to our results, the compound N1 had the highest level of activity (IC50: 0.6 microM) against epimastigotes.
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Affiliation(s)
- Cristina Herrera
- Instituto de Investigaciones Farmacéuticas, Facultad de Farmacia, Universidad de Costa Rica, San José, Costa Rica.
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McKerrow JH, Doyle PS, Engel JC, Podust LM, Robertson SA, Ferreira R, Saxton T, Arkin M, Kerr ID, Brinen LS, Craik CS. Two approaches to discovering and developing new drugs for Chagas disease. Mem Inst Oswaldo Cruz 2010; 104 Suppl 1:263-9. [PMID: 19753483 DOI: 10.1590/s0074-02762009000900034] [Citation(s) in RCA: 119] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Accepted: 06/09/2009] [Indexed: 11/21/2022] Open
Abstract
This review will focus on two general approaches carried out at the Sandler Center, University of California, San Francisco, to address the challenge of developing new drugs for the treatment of Chagas disease. The first approach is target-based drug discovery, and two specific targets, cytochrome P450 CYP51 and cruzain (aka cruzipain), are discussed. A 'proof of concept' molecule, the vinyl sulfone inhibitor K777, is now a clinical candidate. The preclinical assessment compliance for filing as an Investigational New Drug with the United States Food and Drug Administration (FDA) is presented, and an outline of potential clinical trials is given. The second approach to identifying new drug leads is parasite phenotypic screens in culture. The development of an assay allowing high throughput screening of Trypanosoma cruzi amastigotes in skeletal muscle cells is presented. This screen has the advantage of not requiring specific strains of parasites, so it could be used with field isolates, drug resistant strains or laboratory strains. It is optimized for robotic liquid handling and has been validated through a screen of a library of FDA-approved drugs identifying 65 hits.
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Affiliation(s)
- J H McKerrow
- Sandler Center at Mission Bay, University of California, San Francisco, CA 94158-2330, USA.
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24
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Urbina JA. Ergosterol biosynthesis and drug development for Chagas disease. Mem Inst Oswaldo Cruz 2010; 104 Suppl 1:311-8. [PMID: 19753490 DOI: 10.1590/s0074-02762009000900041] [Citation(s) in RCA: 146] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Accepted: 05/18/2009] [Indexed: 12/13/2022] Open
Abstract
This article presents an overview of the currently available drugs nifurtimox (NFX) and benznidazole (BZN) used against Trypanosoma cruzi, the aetiological agent of Chagas disease; herein we discuss their limitations along with potential alternatives with a focus on ergosterol biosynthesis inhibitors (EBI). These compounds are currently the most advanced candidates for new anti-T. cruzi agents given that they block de novo production of 24-alkyl-sterols, which are essential for parasite survival and cannot be replaced by a host's own cholesterol. Among these compounds, new triazole derivatives that inhibit the parasite's C14alpha sterol demethylase are the most promising, as they have been shown to have curative activity in murine models of acute and chronic Chagas disease and are active against NFX and BZN-resistant T. cruzi strains; among this class of compounds, posaconazole (Schering-Plough Research Institute) and ravuconazole (Eisai Company) are poised for clinical trials in Chagas disease patients in the short term. Other T. cruzi-specific EBI, with in vitro and in vivo potency, include squalene synthase, lanosterol synthase and squalene epoxidase-inhibitors as well as compounds with dual mechanisms of action (ergosterol biosynthesis inhibition and free radical generation), but they are less advanced in their development process. The main putative advantages of EBI over currently available therapies include their higher potency and selectivity in both acute and chronic infections, activity against NFX and BZN-resistant T. cruzi strains, and much better tolerability and safety profiles. Limitations may include complexity and cost of manufacture of the new compounds. As for any new drug, such compounds will require extensive clinical testing before being introduced for clinical use, and the complexity of such studies, particularly in chronic patients, will be compounded by the current limitations in the verification of true parasitological cures for T. cruzi infections.
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Affiliation(s)
- Julio A Urbina
- Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela.
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25
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Gutierrez FRS, Mineo TWP, Pavanelli WR, Guedes PMM, Silva JS. The effects of nitric oxide on the immune system during Trypanosoma cruzi infection. Mem Inst Oswaldo Cruz 2010; 104 Suppl 1:236-45. [PMID: 19753479 DOI: 10.1590/s0074-02762009000900030] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Accepted: 05/29/2009] [Indexed: 01/08/2023] Open
Abstract
Trypanosoma cruzi infection triggers substantial production of nitric oxide (NO), which has been shown to have protective and toxic effects on the host's immune system. Sensing of trypomastigotes by phagocytes activates the inducible NO-synthase (NOS2) pathway, which produces NO and is largely responsible for macrophage-mediated killing of T. cruzi. NO is also responsible for modulating virtually all steps of innate and adaptive immunity. However, NO can also cause oxidative stress, which is especially damaging to the host due to increased tissue damage. The cytokines IFN-gamma and TNF-alpha, as well as chemokines, are strong inducers of NOS2 and are produced in large amounts during T. cruzi acute infection. Conversely, TGF-beta and IL-10 negatively regulate NO production. Here we discuss the recent evidence describing the mechanisms by which NO is able to exert its antimicrobial and immune regulatory effects, the mechanisms involved in the oxidative stress response during infection and the implications of NO for the development of therapeutic strategies against T. cruzi.
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Affiliation(s)
- Fredy R S Gutierrez
- Departamento de Bioquímica e Imunologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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26
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Nitric oxide donor trans-[RuCl([15]aneN)NO] as a possible therapeutic approach for Chagas' disease. Br J Pharmacol 2010; 160:270-82. [PMID: 20128813 DOI: 10.1111/j.1476-5381.2009.00576.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Benznidazole (Bz) is the therapy currently available for clinical treatment of Chagas' disease. However, many strains of Trypanosoma cruzi parasites are naturally resistant. Nitric oxide (NO) produced by activated macrophages is crucial to the intracellular killing of parasites. Here, we investigate the in vitro and in vivo activities against T. cruzi, of the NO donor, trans-[RuCl([15]aneN(4))NO](2+). EXPERIMENTAL APPROACH Trans-[RuCl([15]aneN(4))NO](2+)was incubated with a partially drug-resistant T. cruzi Y strain and the anti-proliferative (epimastigote form) and trypanocidal activities (trypomastigote and amastigote) evaluated. Mice were treated during the acute phase of Chagas' disease. The anti-T. cruzi activity was evaluated by parasitaemia, survival rate, cardiac parasitism, myocarditis and the curative rate. KEY RESULTS Trans-[RuCl([15]aneN(4))NO](2+) was 10- and 100-fold more active than Bz against amastigotes and trypomastigotes respectively. Further, trans-[RuCl([15]aneN(4))NO](2+) (0.1 mM) induced 100% of trypanocidal activity (trypomastigotes forms) in vitro. Trans-[RuCl([15]aneN(4))NO](2+) induced permanent suppression of parasitaemia and 100% survival in a murine model of acute Chagas' disease. When the drugs were given alone, parasitological cures were confirmed in only 30 and 40% of the animals treated with the NO donor (3.33 micromol.kg(-1).day(-1)) and Bz (385 micromol.kg(-1).day(-1)), respectively, but when given together, 80% of the animals were parasitologically cured. The cured animals showed an absence of myocarditis and a normalisation of cytokine production in the sera. In addition, no in vitro toxicity was observed at the tested doses. CONCLUSIONS AND IMPLICATIONS These findings indicate that trans-[RuCl([15]aneN(4))NO](2+)is a promising lead compound for the treatment of human Chagas' disease.
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Cuervo P, Domont GB, De Jesus JB. Proteomics of trypanosomatids of human medical importance. J Proteomics 2010; 73:845-67. [PMID: 20056176 DOI: 10.1016/j.jprot.2009.12.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2009] [Accepted: 12/18/2009] [Indexed: 12/31/2022]
Abstract
Leishmania spp., Trypanosoma cruzi, and Trypanosoma brucei are protozoan parasites that cause a spectrum of fatal human diseases around the world. Recent completion of the genomic sequencing of these parasites has enormous relevance to the study of their biology and the pathogenesis of the diseases they cause because it opens the door to high-throughput proteomic technologies. This review encompasses studies using diverse proteomic approaches with these organisms to describe and catalogue global protein profiles, reveal changes in protein expression during development, elucidate the subcellular localisation of gene products, and evaluate host-parasite interactions.
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Affiliation(s)
- Patricia Cuervo
- Laboratorio de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
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28
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Aguirre-Alvarado C, Zaragoza-Martínez F, Rodríguez-Páez L, Téllez-Rendón JL, Nogueda B, Baeza I, Wong C. Trypanocidal activity of the ethyl esters of N-propyl and N-isopropyl oxamates on intracellular amastigotes of Trypanosoma cruzi acute infected mice. J Enzyme Inhib Med Chem 2009; 25:111-5. [DOI: 10.3109/14756360903027741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Charmina Aguirre-Alvarado
- Departamento de Bioquímica, Escuela Nacional de Ciencias Biológicas–Instituto Politécnico Nacional, Mexico City, Mexico
| | - Fabiola Zaragoza-Martínez
- Departamento de Parasitología, Escuela Nacional de Ciencias Biológicas–Instituto Politécnico Nacional, Mexico City, Mexico
| | - Lorena Rodríguez-Páez
- Departamento de Bioquímica, Escuela Nacional de Ciencias Biológicas–Instituto Politécnico Nacional, Mexico City, Mexico
| | - Juan Luis Téllez-Rendón
- Departamento de Parasitología, Escuela Nacional de Ciencias Biológicas–Instituto Politécnico Nacional, Mexico City, Mexico
| | - Benjamín Nogueda
- Departamento de Parasitología, Escuela Nacional de Ciencias Biológicas–Instituto Politécnico Nacional, Mexico City, Mexico
| | - Isabel Baeza
- Departamento de Bioquímica, Escuela Nacional de Ciencias Biológicas–Instituto Politécnico Nacional, Mexico City, Mexico
| | - Carlos Wong
- Departamento de Bioquímica, Escuela Nacional de Ciencias Biológicas–Instituto Politécnico Nacional, Mexico City, Mexico
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Molecular modeling studies and in vitro bioactivity evaluation of a set of novel 5-nitro-heterocyclic derivatives as anti-T. cruzi agents. Bioorg Med Chem 2009; 17:2673-9. [DOI: 10.1016/j.bmc.2009.02.056] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Revised: 02/26/2009] [Accepted: 02/27/2009] [Indexed: 11/21/2022]
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Vera-DiVaio MA, Freitas AC, Castro HC, de Albuquerque S, Cabral LM, Rodrigues CR, Albuquerque MG, Martins RC, Henriques MG, Dias LR. Synthesis, antichagasic in vitro evaluation, cytotoxicity assays, molecular modeling and SAR/QSAR studies of a 2-phenyl-3-(1-phenyl-1H-pyrazol-4-yl)-acrylic acid benzylidene-carbohydrazide series. Bioorg Med Chem 2009; 17:295-302. [PMID: 19036592 DOI: 10.1016/j.bmc.2008.10.085] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2008] [Revised: 10/30/2008] [Accepted: 10/31/2008] [Indexed: 10/21/2022]
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Aguirre-Alvarado C, Zaragoza-Martínez F, Rodríguez-Páez L, Nogueda B, Baeza I, Wong C. In vitro and in vivo trypanocidal activity of the ethyl esters of N-allyl and N-propyl oxamates using different Trypanosoma cruzi strains. J Enzyme Inhib Med Chem 2008; 22:227-33. [PMID: 17518350 DOI: 10.1080/14756360601051233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The trypanocidal activity of N-allyl (NAOx) and N-propyl (NPOx) oxamates and that of the ethyl esters ofN-allyl (Et-NAOx) and N-propyl (Et-NPOx) oxamates were tested on cultured epimastigotes (in vitro) and murine trypanosomiasis (in vivo) using five different T. cruzi strains. NAOx and NPOx did not penetrate intact epimastigotes and therefore we were not able to detect any trypanocidal effect with these oxamates. Whereas the ethyl esters (Et-NAOx and Et-NPOx), acting as prodrugs, exhibited in vitro and in vivo trypanocidal activity on the five tested T. cruzi strains. On the contrary, when Nifurtimox and Benznidazole used as reference drugs were tested, we found that only three of the five tested T cruzi strains were affected, whereas the other two strains, Miguz and Compostela, were resistant to the in vitro and in vivo trypanocidal activity of these compounds.
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Affiliation(s)
- Charmina Aguirre-Alvarado
- Departamento de Bioquímica, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Apartado Postal 4-129, Admon. 4, México City 06401, México
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Andrade HM, Murta SMF, Chapeaurouge A, Perales J, Nirdé P, Romanha AJ. Proteomic Analysis of Trypanosoma cruzi Resistance to Benznidazole. J Proteome Res 2008; 7:2357-67. [DOI: 10.1021/pr700659m] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Hélida M. Andrade
- Laboratório de Parasitologia Celular e Molecular, Centro de Pesquisa René Rachou/FIOCRUZ, Brazil, Universidade Federal do Paiuí, Lab Imunogenética e Biologia Molecular, Teresina, Piauí, Brazil, Laboratório de Toxinologia, Departamento de Fisiologia e Farmacodinâmica, Instituto Oswaldo Cruz/FIOCRUZ, Brazil, and INSERM U540, 60 rue de Navacelles, 34090 Montpellier, France
| | - Silvane M. F. Murta
- Laboratório de Parasitologia Celular e Molecular, Centro de Pesquisa René Rachou/FIOCRUZ, Brazil, Universidade Federal do Paiuí, Lab Imunogenética e Biologia Molecular, Teresina, Piauí, Brazil, Laboratório de Toxinologia, Departamento de Fisiologia e Farmacodinâmica, Instituto Oswaldo Cruz/FIOCRUZ, Brazil, and INSERM U540, 60 rue de Navacelles, 34090 Montpellier, France
| | - Alex Chapeaurouge
- Laboratório de Parasitologia Celular e Molecular, Centro de Pesquisa René Rachou/FIOCRUZ, Brazil, Universidade Federal do Paiuí, Lab Imunogenética e Biologia Molecular, Teresina, Piauí, Brazil, Laboratório de Toxinologia, Departamento de Fisiologia e Farmacodinâmica, Instituto Oswaldo Cruz/FIOCRUZ, Brazil, and INSERM U540, 60 rue de Navacelles, 34090 Montpellier, France
| | - Jonas Perales
- Laboratório de Parasitologia Celular e Molecular, Centro de Pesquisa René Rachou/FIOCRUZ, Brazil, Universidade Federal do Paiuí, Lab Imunogenética e Biologia Molecular, Teresina, Piauí, Brazil, Laboratório de Toxinologia, Departamento de Fisiologia e Farmacodinâmica, Instituto Oswaldo Cruz/FIOCRUZ, Brazil, and INSERM U540, 60 rue de Navacelles, 34090 Montpellier, France
| | - Phillipe Nirdé
- Laboratório de Parasitologia Celular e Molecular, Centro de Pesquisa René Rachou/FIOCRUZ, Brazil, Universidade Federal do Paiuí, Lab Imunogenética e Biologia Molecular, Teresina, Piauí, Brazil, Laboratório de Toxinologia, Departamento de Fisiologia e Farmacodinâmica, Instituto Oswaldo Cruz/FIOCRUZ, Brazil, and INSERM U540, 60 rue de Navacelles, 34090 Montpellier, France
| | - Alvaro J. Romanha
- Laboratório de Parasitologia Celular e Molecular, Centro de Pesquisa René Rachou/FIOCRUZ, Brazil, Universidade Federal do Paiuí, Lab Imunogenética e Biologia Molecular, Teresina, Piauí, Brazil, Laboratório de Toxinologia, Departamento de Fisiologia e Farmacodinâmica, Instituto Oswaldo Cruz/FIOCRUZ, Brazil, and INSERM U540, 60 rue de Navacelles, 34090 Montpellier, France
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Franco-Paredes C, Rouphael N, Méndez J, Folch E, Rodríguez-Morales AJ, Santos JI, Hurst JW. Cardiac manifestations of parasitic infections part 1: overview and immunopathogenesis. Clin Cardiol 2007; 30:195-9. [PMID: 17443654 PMCID: PMC6653029 DOI: 10.1002/clc.12] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Parasitic infections produce a wide spectrum of cardiac manifestations. They may involve various anatomic structures of the heart and are manifested clinically as myocarditis, cardiomyopathies, pericarditis, or pulmonary hypertension in many resource-constrained settings. However, many parasitic infections involving the heart may also be currently diagnosed in developed countries due to growing worldwide travel, blood transfusions, and increasing numbers of immunosuppression states such as organ transplantation, use of immunosuppressive agents, or HIV/AIDS. Clinicians anywhere in the globe need to be aware of the potential cardiac manifestations of parasitic diseases. This is part one of a three-part series discussing parasites of the heart. In this section, we provide a general overview and immunopathogenesis of parasitic infections of the heart.
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Affiliation(s)
- Carlos Franco-Paredes
- Department of Medicine, Division of Infectious Diseases, University School of Medicine, Atlanta, Georgia, USA.
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Chung MC, Ferreira EI, Santos JL, Giarolla J, Rando DG, Almeida AE, Bosquesi PL, Menegon RF, Blau L. Prodrugs for the treatment of neglected diseases. Molecules 2007; 13:616-77. [PMID: 18463559 PMCID: PMC6245083 DOI: 10.3390/molecules13030616] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Revised: 03/12/2008] [Accepted: 03/12/2008] [Indexed: 11/16/2022] Open
Abstract
Recently, World Health Organization (WHO) and Medicins San Frontieres (MSF) proposed a classification of diseases as global, neglected and extremely neglected. Global diseases, such as cancer, cardiovascular and mental (CNS) diseases represent the targets of the majority of the R&D efforts of pharmaceutical companies. Neglected diseases affect millions of people in the world yet existing drug therapy is limited and often inappropriate. Furthermore, extremely neglected diseases affect people living under miserable conditions who barely have access to the bare necessities for survival. Most of these diseases are excluded from the goals of the R&D programs in the pharmaceutical industry and therefore fall outside the pharmaceutical market. About 14 million people,mainly in developing countries, die each year from infectious diseases. From 1975 to 1999,1393 new drugs were approved yet only 1% were for the treatment of neglected diseases[3]. These numbers have not changed until now, so in those countries there is an urgent need for the design and synthesis of new drugs and in this area the prodrug approach is a very interesting field. It provides, among other effects, activity improvements and toxicity decreases for current and new drugs, improving market availability. It is worth noting that it is essential in drug design to save time and money, and prodrug approaches can be considered of high interest in this respect. The present review covers 20 years of research on the design of prodrugs for the treatment of neglected and extremely neglected diseases such as Chagas' disease (American trypanosomiasis), sleeping sickness (African trypanosomiasis), malaria, sickle cell disease, tuberculosis, leishmaniasis and schistosomiasis.
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Affiliation(s)
- Man Chin Chung
- Lapdesf - Laboratório de Desenvolvimento de Fármacos, Departamento de Fármacos e Medicamentos, Faculdade de Ciências Farmacêuticas - UNESP Rodovia Araraquara-Jaú Km 1, 14801-902, Brazil
| | - Elizabeth Igne Ferreira
- LAPEN – Laboratório de Planejamento e Síntese de Quimioterápicos Potencialmente Ativos em Endemias Tropicais, Departamento de Farmácia, Faculdade de Ciências Farmacêuticas – USP/SP, R. Prof. Lineu Prestes, 580, B-13S, Cidade Universitária, São Paulo, 05508-900, Brazil; E-mail:
| | - Jean Leandro Santos
- Lapdesf - Laboratório de Desenvolvimento de Fármacos, Departamento de Fármacos e Medicamentos, Faculdade de Ciências Farmacêuticas - UNESP Rodovia Araraquara-Jaú Km 1, 14801-902, Brazil
- LAPEN – Laboratório de Planejamento e Síntese de Quimioterápicos Potencialmente Ativos em Endemias Tropicais, Departamento de Farmácia, Faculdade de Ciências Farmacêuticas – USP/SP, R. Prof. Lineu Prestes, 580, B-13S, Cidade Universitária, São Paulo, 05508-900, Brazil; E-mail:
| | - Jeanine Giarolla
- LAPEN – Laboratório de Planejamento e Síntese de Quimioterápicos Potencialmente Ativos em Endemias Tropicais, Departamento de Farmácia, Faculdade de Ciências Farmacêuticas – USP/SP, R. Prof. Lineu Prestes, 580, B-13S, Cidade Universitária, São Paulo, 05508-900, Brazil; E-mail:
| | - Daniela Gonçales Rando
- LAPEN – Laboratório de Planejamento e Síntese de Quimioterápicos Potencialmente Ativos em Endemias Tropicais, Departamento de Farmácia, Faculdade de Ciências Farmacêuticas – USP/SP, R. Prof. Lineu Prestes, 580, B-13S, Cidade Universitária, São Paulo, 05508-900, Brazil; E-mail:
| | - Adélia Emília Almeida
- Lapdesf - Laboratório de Desenvolvimento de Fármacos, Departamento de Fármacos e Medicamentos, Faculdade de Ciências Farmacêuticas - UNESP Rodovia Araraquara-Jaú Km 1, 14801-902, Brazil
| | - Priscila Longhin Bosquesi
- Lapdesf - Laboratório de Desenvolvimento de Fármacos, Departamento de Fármacos e Medicamentos, Faculdade de Ciências Farmacêuticas - UNESP Rodovia Araraquara-Jaú Km 1, 14801-902, Brazil
| | - Renato Farina Menegon
- Lapdesf - Laboratório de Desenvolvimento de Fármacos, Departamento de Fármacos e Medicamentos, Faculdade de Ciências Farmacêuticas - UNESP Rodovia Araraquara-Jaú Km 1, 14801-902, Brazil
| | - Lorena Blau
- Lapdesf - Laboratório de Desenvolvimento de Fármacos, Departamento de Fármacos e Medicamentos, Faculdade de Ciências Farmacêuticas - UNESP Rodovia Araraquara-Jaú Km 1, 14801-902, Brazil
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Zaidenberg A, Luong T, Lirussi D, Bleiz J, Del Buono MB, Quijano G, Drut R, Kozubsky L, Marron A, Buschiazzo H. Treatment of experimental chronic chagas disease with trifluralin. Basic Clin Pharmacol Toxicol 2006; 98:351-6. [PMID: 16623857 DOI: 10.1111/j.1742-7843.2006.pto_253.x] [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] [Indexed: 11/27/2022]
Abstract
We tested trifluralin against Trypanosoma cruzi in a model of chronic Chagas disease in mice. CF1 mice (n=148) were intraperitoneally infected with 10(5) trypomastigotes of T. cruzi, H510C8C3 clone. One hundred mice were partially treated with benznidazole. Mortality was 100% at day 41 in the control group (n=48). At day 90 of the chronic disease (74% survival) mice were divided into three groups and treated orally with trifluralin (50 mg/kg/day, n=26), benznidazole (50 mg/kg/day, n=25) and vehicle (peanut oil; control group, n=23) for 60 days. Electrocardiography (under pentobarbital anaesthesia, 30 mg/kg/dose), serologic immunofluorescence and microstrout were performed at the beginning and at the end of the treatment. Mice were sacrificed at day 10 after treatment; cardiac tissue was studied histopathologically and polymerase chain reaction (PCR) was performed. Spontaneous mortality was 30.43%, 3.85% and 4% in the control, trifluralin and benznidazole groups, respectively (significant survival, P=0.03). Microstrouts were negative in all three groups. Negative immunofluorescence titers were 0%, 16% (P=0.05) and 29% (P<0.02) in the control, trifluralin and benznidazole groups, respectively. The prevailing electrocardiographic disorder was prolongation of the PR interval in the control group, which was not significantly altered in trifluralin- and benznidazole-treated mice, suggesting that trifluralin and benznidazole improve or even stop the damage caused by the disease on the conduction system. Trifluralin- and benznidazole-treated animals showed similar histologic patterns of myocarditis. PCR results were negative for benznidazole and trifluralin (100% and 70.8%, respectively). These results show the therapeutic potential of trifluralin in the treatment of chronic Chagas disease.
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Affiliation(s)
- Anibal Zaidenberg
- Institute of Paediatric Research (IDIP-CIC), Children's Hospital "Sor María Ludovica", Argentina.
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Sanchez AM, Jimenez-Ortiz V, Sartor T, Tonn CE, García EE, Nieto M, Burgos MH, Sosa MA. A novel icetexane diterpene, 5-epi-icetexone from Salvia gilliessi is active against Trypanosoma cruzi. Acta Trop 2006; 98:118-24. [PMID: 16647030 DOI: 10.1016/j.actatropica.2005.12.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2005] [Revised: 10/28/2005] [Accepted: 12/28/2005] [Indexed: 10/24/2022]
Abstract
In this work the effect of a novel compound, 5-epi-icetexone (ICTX) obtained from Salvia gilliessi Benth. (Labiatae), is studied on cultured epimastigotes of Trypanosoma cruzi (Tulahuen). It was found that the compound exerts an antiproliferative effect on the parasites at concentrations between 2.8 and 4.2 microM, and similar sensitivity in other strains (Dm28c, CL-Brener and Y-strain). The compound was deleterious at concentrations higher than 4.2 microM, with an estimated IC50 of 6.5+/-0.75 microM, but with low cytotoxicity to mammalian cells. These effects were irreversible, even at short times of exposure to the drug. In solution, ICTX showed to be stable for at least 96 h at 29 degrees C. With cytostatic dose a little percentage of parasites was resistant to the action of ICTX, and they continued growing although with different kinetic. By electron transmission microscopy, at dose of 4.2 microM an external vesiculization was observed on the first day of exposure to the compound, but the parasite cytoplasm became plenty of vacuoles and exhibited nuclear disorganization from the second day of exposure. It was concluded that ICTX is active against T. cruzi and may act by multiple mechanisms. In future, this novel icetexane diterpene may be a good candidate for therapeutic use against Chagas' disease.
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Affiliation(s)
- A M Sanchez
- Instituto de Histología y Embriología, Facultad de Ciencias Medicas, Universidad Nacional de Cuyo, CCcorreo 56, 5500 Mendoza, Argentina
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de Castro AM, Luquetti AO, Rassi A, Chiari E, Galvão LMDC. Detection of parasitemia profiles by blood culture after treatment of human chronic Trypanosoma cruzi infection. Parasitol Res 2006; 99:379-83. [PMID: 16570199 DOI: 10.1007/s00436-006-0172-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2005] [Accepted: 02/28/2006] [Indexed: 10/24/2022]
Abstract
The change in parasitemia profile, measured by sequential blood cultures of 27 benznidazole (Bz) treated patients compared with 13 untreated patients, on the chronic phase of chagas disease, is described. All patients were adults (age limits: 23-88) with positive serology (three tests); 23 of them were females. All patients were submitted to six blood cultures, three before and three after Bz treatment. The parasitemia was classified as nondetected (with three negative blood cultures), medium (one positive culture in three), and high (two or three positive cultures). From the eight patients with nondetected parasitemia before Bz, seven still had the same profile and only one switched to medium; from eight with medium parasitemia, seven shifted to nondetected, and one to high parasitemia. From the 11 patients with high parasitemia before Bz, ten converted to nondetected and only one was positive after Bz. Nineteen of the 27 patients changed the parasitemia profile (70.4%), and the rate of therapeutic failure was 11.1% (3/27) during the first 24 months of follow-up after Bz. The shift to nondetected parasitemia profile was from 8/27 to 24/27 patients after Bz treatment for the first 2 years. Only 46.2% (6/13) of the nontreated individuals changed the parasitemia profile. We conclude that there is a strong trypanocide effect of Bz (88.8%) and a rate of therapeutic failure of 11.1% during the first 2 years after trypanocidal treatment.
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Affiliation(s)
- Ana Maria de Castro
- Departamento de Microbiologia, Imunologia, Parasitologia e Patologia do Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, GO, Brazil.
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Reyes PA, Vallejo M. Trypanocidal drugs for late stage, symptomatic Chagas disease (Trypanosoma cruzi infection). Cochrane Database Syst Rev 2005:CD004102. [PMID: 16235350 DOI: 10.1002/14651858.cd004102.pub2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND People with Chagas disease (American Trypanosomiasis) may develop progressive and potentially lethal heart conditions. Drugs to eliminate the causative parasite, Trypanosoma cruzi, currently in use have limited therapeutic value and are used in early stages of the disease. Extending the use of these drugs to treat symptomatic chronic parasitism with chronic Chagasic cardiopathy (CCC) and progressive dilated cardiomyopathy has been proposed. OBJECTIVES To assess the effects (harms and benefits) of nitrofurans and imidazolic trypanocidal drugs for treating late stage chronic Chagas disease and CCC. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library (Issue 3, 2004), MEDLINE (1985-2004), EMBASE (1985-2004), BIREME (1985-2004), LILACS (1985-2004), ARTEMISA (1985-2004), SCIELO (1985-2004). Indexing terms in English and Spanish were used. References obtained were assessed for relevance by two reviewers independently. SELECTION CRITERIA We included randomized controlled clinical trials (RCTs), single or double blind using trypanocidal drugs versus placebo or no treatment in CCC. DATA COLLECTION AND ANALYSIS All articles retrieved were assessed using a predefined check list to determine if they met the inclusion criteria. Two independent reviewers collected data using a pre-designed form piloted on three articles before the review process started. Disagreements were resolved by a third reviewer. If the information was unavailable the articles were excluded. We planned a quantitative analysis of reduction of parasite load whether recorded as a categorical variable or the reduction of specific antibody titers. However insufficient data were available for quantitative analysis. We prepared a qualitative description of data identified. MAIN RESULTS We found only one randomized double blind placebo controlled trial. We also found six uncontrolled or non-randomized studies which were of some relevance and were therefore described. We found insufficient evidence to define the effects of drug treatment for people with CCC. AUTHORS' CONCLUSIONS There is insufficient evidence to support the efficacy of nitrofurans or imidazolic drugs as recommended treatment in CCC and chronic T.cruzi infections, specifically if overt heart disease is present. A well designed randomized controlled trial is necessary to establish if new drugs are suitable for treatment of cardiac patients with CCC.
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Affiliation(s)
- P A Reyes
- Instituto Nacional de Cardiologia "Ignacio Chavez", Juan Badiano No.1, Col Seccion XVI, Tlalpan, Distrito Fedral, Mexico 14080.
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Chena MA, Elizondo S, Rodríguez-Páez L, Nogueda B, Baeza I, Wong C. Trypanocidal activity of N-isopropyl oxamate on cultured epimastigotes and murine trypanosomiasis using different Trypanosoma cruzi strains. J Enzyme Inhib Med Chem 2005; 20:189-97. [PMID: 15968824 DOI: 10.1080/14756360500047019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The trypanocidal activity of N-isopropyl oxamate (NIPOx) and the ethyl ester of N-isopropyl oxamate (Et-NIPOx) were tested on cultured epimastigotes (in vitro) and on murine trypanosomiasis (in vivo) using five different T. cruzi strains. When benznidazole and nifurtimox, used for comparison, were tested we found that only three of these T. cruzi strains were affected, whereas the other two strains, Miguz and Compostela, were resistant to the in vitro and the in vivo trypanocidal activity of these substances. In addition, when NIPOx was tested on cultured epimastigotes and on mice parasitaemia, trypanocidal activity was not obtained on either of these T. cruzi strains. Our experiments strongly suggest that NIPOx does not penetrate intact epimastigotes due to the polarity of its carboxylate whereas Et-NIPOx, acting as a prodrug, exhibited in vitro and in vivo trypanocidal activity in the five tested T. cruzi strains.
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Affiliation(s)
- Miguel A Chena
- Departamento de Bioquímica, Escuela Nacional de Ciencias Biológicas-Instituto Politécnico Nacional, Apartado Postal 4-129, Admon. 4, México City 06401, México
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Lirussi D, Li J, Prieto JM, Gennari M, Buschiazzo H, Ríos JL, Zaidenberg A. Inhibition of Trypanosoma cruzi by plant extracts used in Chinese medicine. Fitoterapia 2004; 75:718-23. [PMID: 15567249 DOI: 10.1016/j.fitote.2004.09.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2004] [Accepted: 09/03/2004] [Indexed: 11/30/2022]
Abstract
In this work, we assessed the effect of extracts obtained from 17 plants used in traditional Chinese medicine. These extracts were tested in vitro with the epimastigote form of Trypanosoma cruzi, clone Bra C(15) C(2), at 27 degrees C in F-29 medium at a concentration of 100 microg/ml in axenic cultures. Allopurinol was used as reference drug. Seven plant extracts showed inhibitory activities lower than 25%. Pueraria lobata, Mahonia beaei, Dictamus dasycarpus, Kochia scoparia, Sophora flavescens and Ligustrum lucidum showed effects with inhibition values between 25% and 60%, whereas Lithospermum erythrorhizon, Saussurea lappa, Melia toosendan and Cinnamomum cassia showed the greatest inhibitory activity of 100%. The IC(50) of these extracts were: 0.4, 2.4, 1.8 and 3.9 microg/ml, respectively. The MTT assay was made and did not show cytotoxic activity. These results allowed us to suggest that L. erythrorhizon, S. lappa, M. toosendan and C. cassia could be a source of new compounds against T. cruzi.
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Affiliation(s)
- D Lirussi
- Cátedra de Farmacología, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Calles 60 y 120, La Plata 1900, Argentina
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Peña-Diaz J, Akbari M, Sundheim O, Farez-Vidal ME, Andersen S, Sneve R, Gonzalez-Pacanowska D, Krokan HE, Slupphaug G. Trypanosoma cruzi contains a single detectable uracil-DNA glycosylase and repairs uracil exclusively via short patch base excision repair. J Mol Biol 2004; 342:787-99. [PMID: 15342237 DOI: 10.1016/j.jmb.2004.07.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2004] [Revised: 07/08/2004] [Accepted: 07/12/2004] [Indexed: 11/23/2022]
Abstract
Enzymes involved in genomic maintenance of human parasites are attractive targets for parasite-specific drugs. The parasitic protozoan Trypanosoma cruzi contains at least two enzymes involved in the protection against potentially mutagenic uracil, a deoxyuridine triphosphate nucleotidohydrolase (dUTPase) and a uracil-DNA glycosylase belonging to the highly conserved UNG-family. Uracil-DNA glycosylase activities excise uracil from DNA and initiate a multistep base-excision repair (BER) pathway to restore the correct nucleotide sequence. Here we report the biochemical characterisation of T.cruzi UNG (TcUNG) and its contribution to the total uracil repair activity in T.cruzi. TcUNG is shown to be the major uracil-DNA glycosylase in T.cruzi. The purified recombinant TcUNG exhibits substrate preference for removal of uracil in the order ssU>U:G>U:A, and has no associated thymine-DNA glycosylase activity. T.cruzi apparently repairs U:G DNA substrate exclusively via short-patch BER, but the DNA polymerase involved surprisingly displays a vertebrate POLdelta-like pattern of inhibition. Back-up UDG activities such as SMUG, TDG and MBD4 were not found, underlying the importance of the TcUNG enzyme in protection against uracil in DNA and as a potential target for drug therapy.
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Affiliation(s)
- Javier Peña-Diaz
- Instituto de Parasitologia y Biomedicina "Lopez Neyra", Consejo Superior de Investigaciones Cientificas, C/Ventanilla 11, 18001 Granada, Spain
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42
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Parker NB, Yang X, Hanke J, Mason KA, Schowen RL, Borchardt RT, Yin DH. Trypanosoma cruzi: molecular cloning and characterization of the S-adenosylhomocysteine hydrolase. Exp Parasitol 2004; 105:149-58. [PMID: 14969692 DOI: 10.1016/j.exppara.2003.10.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2003] [Revised: 09/29/2003] [Accepted: 10/01/2003] [Indexed: 10/26/2022]
Abstract
S-Adenosylhomocysteine (AdoHcy) hydrolase has emerged as an attractive target for antiparasitic drug design because of its role in the regulation of all S-adenosylmethionine-dependent transmethylation reactions, including those reactions crucial for parasite replication. From a genomic DNA library of Trypanosoma cruzi, we have isolated a gene that encodes a polypeptide containing a highly conserved AdoHcy hydrolase consensus sequence. The recombinant T. cruzi enzyme was overexpressed in Escherichia coli and purified as a homotetramer. At pH 7.2 and 37 degrees C, the purified enzyme hydrolyzes AdoHcy to adenosine and homocysteine with a first-order rate constant of 1 s(-1) and synthesizes AdoHcy from adenosine and homocysteine with a pseudo-first-order rate constant of 3 s(-1) in the presence of 1 mM homocysteine. The reversible catalysis depends on the binding of NAD(+) to the enzyme. In spite of the significant structural homology between the parasitic and human AdoHcy hydrolase, the K(d) of 1.3 microM for NAD(+) binding to the T. cruzi enzyme is approximately 11-fold higher than the K(d) (0.12 microM) for NAD(+) binding to the human enzyme.
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Affiliation(s)
- Nathan B Parker
- Department of Molecular Biosciences, The University of Kansas, Lawrence, KS 66045, USA
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43
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Urbina JA, Docampo R. Specific chemotherapy of Chagas disease: controversies and advances. Trends Parasitol 2004; 19:495-501. [PMID: 14580960 DOI: 10.1016/j.pt.2003.09.001] [Citation(s) in RCA: 402] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Julio A Urbina
- Laboratorio de Química Biológica, Centro de Biofísica y Bioquímica, Instituto Venezolano de Investigaciones Cientificas, Apartado Postal 21.827, Caracas 1020A, Venezuela.
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44
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Dumonteil E, Escobedo-Ortegon J, Reyes-Rodriguez N, Arjona-Torres A, Ramirez-Sierra MJ. Immunotherapy of Trypanosoma cruzi infection with DNA vaccines in mice. Infect Immun 2004; 72:46-53. [PMID: 14688079 PMCID: PMC343959 DOI: 10.1128/iai.72.1.46-53.2004] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2003] [Revised: 07/26/2003] [Accepted: 09/26/2003] [Indexed: 11/20/2022] Open
Abstract
The mechanisms involved in the pathology of chronic chagasic cardiomyopathy are still debated, and the controversy has interfered with the development of new treatments and vaccines. Because of the potential of DNA vaccines for immunotherapy of chronic and infectious diseases, we tested if DNA vaccines could control an ongoing Trypanosoma cruzi infection. BALB/c mice were infected with a lethal dose (5 x 10(4) parasites) as a model of acute infection, and then they were treated with two injections of 100 microg of plasmid DNA 1 week apart, beginning on day 5 postinfection. Control mice had high levels of parasitemia and mortality and severe cardiac inflammation, while mice treated with plasmid DNA encoding trypomastigote surface antigen 1 or Tc24 had reduced parasitemia and mild cardiac inflammation and >70% survived the infection. The efficacy of the immunotherapy also was significant when it was delayed until days 10 and 15 after infection. Parasitological analysis of cardiac tissue of surviving mice indicated that most mice still contained detectable parasite kinetoplast DNA but fewer mice contained live parasites, suggesting that there was efficient but not complete parasite elimination. DNA vaccine immunotherapy was also evaluated in CD1 mice infected with a low dose (5 x 10(2) parasites) as a model of chronic infection. Immunotherapy was initiated on day 70 postinfection and resulted in improved survival and reduced cardiac tissue inflammation. These results suggest that DNA vaccines have strong potential for the immunotherapy of T. cruzi infection and may provide new alternatives for the control of Chagas' disease.
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MESH Headings
- Acute Disease
- Animals
- Antibodies, Protozoan/blood
- Antigens, Protozoan/administration & dosage
- Antigens, Protozoan/genetics
- Antigens, Protozoan/immunology
- Chagas Cardiomyopathy/mortality
- Chagas Cardiomyopathy/parasitology
- Chagas Cardiomyopathy/therapy
- Chagas Disease/mortality
- Chagas Disease/parasitology
- Chagas Disease/therapy
- Chronic Disease
- Humans
- Immunotherapy/methods
- Mice
- Mice, Inbred BALB C
- Myocardium/pathology
- Protozoan Vaccines/administration & dosage
- Protozoan Vaccines/genetics
- Protozoan Vaccines/immunology
- Treatment Outcome
- Trypanosoma cruzi/genetics
- Trypanosoma cruzi/immunology
- Vaccines, DNA/administration & dosage
- Vaccines, DNA/immunology
- Variant Surface Glycoproteins, Trypanosoma/administration & dosage
- Variant Surface Glycoproteins, Trypanosoma/genetics
- Variant Surface Glycoproteins, Trypanosoma/immunology
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Affiliation(s)
- Eric Dumonteil
- Laboratorio de Parasitología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico.
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Fakhfakh MA, Fournet A, Prina E, Mouscadet JF, Franck X, Hocquemiller R, Figadère B. Synthesis and biological evaluation of substituted quinolines: potential treatment of protozoal and retroviral co-infections. Bioorg Med Chem 2003; 11:5013-23. [PMID: 14604664 DOI: 10.1016/j.bmc.2003.09.007] [Citation(s) in RCA: 148] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We report the synthesis of substituted quinolines and their in vitro biological evaluation against the causal agents of cutaneous leishmaniasis, visceral leishmaniasis, African trypanosomiasis and Chagas' disease. Furthermore, several quinolines have also been tested for their anti-retroviral activity in HIV-1 infected cells. The structure-activity relationships of these new synthetic compounds are discussed and emphasis was placed on the treatment of leishmania/HIV co-infections.
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Affiliation(s)
- Mohammed A Fakhfakh
- Laboratoire de Pharmacognosie (associé au CNRS-BioCIS), Faculté de Pharmacie, Université Paris-Sud, rue J.B. Clément, 92296, Châtenay-Malabry, France
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46
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Araya JE, Neira I, da Silva S, Mortara RA, Manque P, Cordero E, Sagua H, Loyola A, Bórquez J, Morales G, González J. Diterpenoids from Azorella compacta (Umbelliferae) active on Trypanosoma cruzi. Mem Inst Oswaldo Cruz 2003; 98:413-8. [PMID: 12886426 DOI: 10.1590/s0074-02762003000300022] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The anti-Trypanosoma cruzi activity of natural products isolated from Azorella compacta was evaluated, with particular emphasis on their effect against intracellular amastigotes. Five diterpenoids from A. compacta derived from mulinane and azorellane were isolated and identified. Only two products, named azorellanol (Y-2) and mulin-11,3-dien-20-oic acid (Y-5), showed trypanocidal activity against all stages of T. cruzi including intracellular amastigotes. At 10 M, these compounds displayed a strong lytic activity. It ranged from 88.4 0.6 to 99.0 1 % for all strains and stages evaluate, with an IC50 /18 h values of 20-84 M and 41-87 M, respectively. The development of intracellular amastigotes was also inhibited by nearly 60% at 25 M. The trypanocidal molecules Y-2 and Y-5 did show different degrees of cytotoxicity depending on the cell line tested, with an IC50 /24 h ranging from 33.2 to 161.2 M. We evaluated the effect of diterpenoids against intracellular T. cruzi forms by immunofluorescent identification of a specific membrane molecular marker (Ssp-4 antigen) of the T. cruzi amastigote forms. The accuracy and reproducibility of the measurements were found to be outstanding when examined by confocal microscopy.
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Affiliation(s)
- Jorge E Araya
- Unidad de Parasitolog a, Departamento de Tecnolog a M dica, Universidad de Antofagasta
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Urbina JA, Payares G, Sanoja C, Molina J, Lira R, Brener Z, Romanha AJ. Parasitological cure of acute and chronic experimental Chagas disease using the long-acting experimental triazole TAK-187. Activity against drug-resistant Trypanosoma cruzi strains. Int J Antimicrob Agents 2003; 21:39-48. [PMID: 12507836 DOI: 10.1016/s0924-8579(02)00274-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We investigated the activity of TAK-187, an experimental antifungal triazole with a long terminal half-life in several experimental animals, against Trypanosoma cruzi. In vitro studies showed that the minimal inhibitory concentration (MIC) against the (extracellular) epimastigote form was 0.3-1 microM, while the corresponding concentration against clinically relevant intracellular amastigotes was 1 nM. At the MIC the endogenous epimastigote C4,14-desmethyl sterols were replaced by di- and tri-methylated sterols, supporting the notion that the primary target of TAK-187 is the parasite's sterol C14alpha demethylase. We investigated the in vivo activity of the compound in a murine model of acute Chagas disease, using T. cruzi strains with different susceptibilities to the drugs currently used clinically (nitrofurans and nitroimidazoles). It was found that TAK-187 given orally at 20 mg/kg induced complete protection against death and high levels (60-100%) of parasitological cures, independently of the infecting strain and even when administered every other day (e.o.d.), consistent with its long terminal half-life in mice. Other experiments, using longer treatment periods were carried out in both acute and chronic models of the disease and showed that TAK-187 given at 10-20 mg/kg e.o.d. induced 80-100% survival with 80-100% of parasitological cures of survivors in both models. No toxic side effects were observed in any of the experimental protocols. TAK-187 is a potent anti-T. cruzi compound with trypanocidal activity in vivo and should be considered for further studies as a potential specific treatment of human Chagas disease.
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Affiliation(s)
- Julio A Urbina
- Laboratorio de Química Biológica, Centro de Biofísica y Bioquímica, Instituto Venezolano de Investigaciones Científicas, Apartado 21827, Caracas 1020A, Venezuela.
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48
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Oliveira RB, Passos APF, Alves RO, Romanha AJ, Prado MAF, de Souza Filho JD, Alves RJ. In vitro evaluation of the activity of aromatic nitrocompounds against Trypanosoma cruzi. Mem Inst Oswaldo Cruz 2003; 98:141-4. [PMID: 12700872 DOI: 10.1590/s0074-02762003000100018] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Fourteen compounds were evaluated for their activity against Trypanosoma cruzi blood stream forms at the concentration of 500 g/ml. Six compounds were active and re-tested at lower concentrations.
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Affiliation(s)
- Renata B Oliveira
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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49
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Urbina JA, Payares G, Sanoja C, Lira R, Romanha AJ. In vitro and in vivo activities of ravuconazole on Trypanosoma cruzi, the causative agent of Chagas disease. Int J Antimicrob Agents 2003; 21:27-38. [PMID: 12507835 DOI: 10.1016/s0924-8579(02)00273-x] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Ravuconazole is an experimental triazole derivative with potent and broad-spectrum antifungal activity and a remarkably long half-life in humans. In this work, we investigated the in vitro and in vivo activities of this compound against Trypanosoma cruzi. Ravuconazole showed very potent in vitro anti-T. cruzi activity with minimal inhibitory concentrations (MIC) of 300 and 1 nM against the extracellular epimastigote and intracellular amastigote forms, respectively. As with other azole derivatives, ravuconazole at the MIC led to an essentially complete depletion of the epimastigotes' endogenous C4,14-desmethyl sterols and their replacement by di- and tri-methylated sterols. In murine acute models of acute Chagas disease, it was found that ravuconazole treatment led to high levels of parasitological cures, but only when given twice a day (b.i.d.), consistent with its short terminal half-life in mice (4 h). Furthermore, it was found that this curative activity was restricted towards nitrofuran/nitroimidazole-susceptible (CL) and partially drug-resistant (Y) strains of T. cruzi, with no curative activity in animals infected with the fully drug-resistant Colombiana strain. No curative activity occurred in a chronic model of the disease. No toxic side effects were observed resulting from treatment with the triazole. Ravuconazole is a very potent and specific anti-T. cruzi agent in vitro but its in vivo activity in mice is limited, probably due to its unfavourable pharmacokinetic properties in this animal model. However, these results do not necessarily rule out the potential utility of ravuconazole in the treatment of human T. cruzi infections.
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Affiliation(s)
- Julio A Urbina
- Laboratorio de Química Biológica, Centro de Biofísica y Bioquímica, Instituto Venezolano de Investigaciones Científicas, Apartado 21827, Caracas 1020A, Venezuela.
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50
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Schinella GR, Tournier HA, Prieto JM, Ríos JL, Buschiazzo H, Zaidenberg A. Inhibition of Trypanosoma cruzi growth by medical plant extracts. Fitoterapia 2002; 73:569-75. [PMID: 12490214 DOI: 10.1016/s0367-326x(02)00246-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study describes the screening of extracts obtained from 18 plants and two fungi used in the Chinese and Mediterranean traditional medicines on epimastigote forms of Trypanosoma cruzi. The extracts were tested against epimastigote of T. cruzi Bra C15C2 clone in vitro at 27 degrees C and at a concentration of 250 microg/ml in axenic culture. Angelica dahurica, A. pubescens, A. sinensis, Astragalus membranaceus, Coptis chinensis, Haplophyllum hispanicum, Phellodendron amurense, Poria cocos, Ranunculus sceleratus and Scutellaria baicalensis showed significant effects against the parasite with a percentage of growth inhibition between 20 and 100%. C. chinensis and R. sceleratus showed the greatest activity with IC(50) values of 1.7 microg/ml for C. chinensis and 10.7 microg/ml for R. sceleratus. These activities are greater than that of allopurinol. C. chinesis and R. sceleratus extracts did not show cytotoxic effects on rat polimorphonuclear cells using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide and lactic dehydrogenase assays. These results allowed us to suggest that R. sceleratus and C. chinensis could be a source of new compounds clinically active against T. cruzi.
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Affiliation(s)
- G R Schinella
- Cátedra de Farmacología, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Calles 60 y 120, La Plata 1900, Argentina.
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