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Carneiro BT, Prado MMD, Nogueira IDO, Moreira AN, André CB. Exploring the effectiveness of doxycycline in restorative dentistry: a systematic review of in vitro studies. Odontology 2024:10.1007/s10266-024-00986-2. [PMID: 39133374 DOI: 10.1007/s10266-024-00986-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 07/29/2024] [Indexed: 08/13/2024]
Abstract
This systematic review evaluated the efficacy of doxycycline in MMP inhibition, its antibacterial action, and other properties relevant to dental materials testing. The study protocol was registered at the Open Science Framework ( https://doi.org/10.17605/OSF.IO/ZVK2T ). Reporting was based on PRISMA statement. The search was carried out in the databases: PubMed, Scopus, Web of Science, Embase, Lilacs, and Google Scholar. Articles were restricted to Portuguese, English, and Spanish, with no date limit. In vitro studies were selected based on the following outcomes: DOX antibacterial and anti-metalloproteinase activity and its influence in physico-chemical properties. Two researchers independently selected the articles and collected the data. Of 1507 documents, 82 were fully evaluated and 21 were included. Different forms of doxycycline incorporation were found, both as free form and incorporated into carrier agents. The drug was tested as primers, incorporated in adhesive or glass ionomer cement. No studies were found that evaluated its incorporation in resin composite or resin cement. The results confirmed the therapeutic properties of the medication, with more significant results when incorporated in an adhesive. However, although promising, the use of this substance requires standardization in application methods and adopted concentrations, allowing for more direct comparisons between studies. Furthermore, long-term studies are interesting to conduct, ensuring biocompatibility and complete understanding of long-term effects on dental materials.
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Affiliation(s)
- Bruna Tavares Carneiro
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos 6627 Pampulha, Belo Horizonte, MG, ZIP Code: 31270-901, Brazil.
| | - Marina Minici Dumont Prado
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos 6627 Pampulha, Belo Horizonte, MG, ZIP Code: 31270-901, Brazil
| | - Iara de Oliveira Nogueira
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos 6627 Pampulha, Belo Horizonte, MG, ZIP Code: 31270-901, Brazil
| | - Allyson Nogueira Moreira
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos 6627 Pampulha, Belo Horizonte, MG, ZIP Code: 31270-901, Brazil
| | - Carolina Bosso André
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos 6627 Pampulha, Belo Horizonte, MG, ZIP Code: 31270-901, Brazil
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Ghazi M, Saleh A, Abdallah M, El Masri D, El Masri J, El Ayoubi LM, Hawi J, Jurjus A. Barriers toward xenotransplantation in Arab World. Xenotransplantation 2024; 31:e12852. [PMID: 38526015 DOI: 10.1111/xen.12852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/26/2024]
Abstract
Organ transplant is a crucial therapeutic strategy offering a life-saving and transformative medical intervention. It provides an opportunity to improve their quality of life and increase their lifespan. The shortage of organs remains a critical global challenge, leading to a prolonged waiting times for organ receivers, which contributes to an increase in morbidity and mortality rates. Hence, xenotransplantation offered a promising solution to the global shortage of organs through the use of animal organs, leading to an increase in donor availability, reducing waiting times, minimizing organ trafficking, improving genetic engineering advancements, and driving scientific innovation. Even though xenotransplantation has many benefits in the clinical setting, it has many barriers that are hindering its achievements and constraining its occurrence. Some barriers to xenotransplant are general, such as the immunological barrier, while others are specific to certain regions due to local causes. The Arab region exhibits disparities in clinical settings compared to the global context, marked by the huge economic crisis and a shortage of trained healthcare professionals. Considering the huge resources and advancements needed in the field of xenotransplantation, this review aims to explore the specific barriers toward xenotransplantation in the Arab countries, highlighting the challenges to overcome these barriers.
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Affiliation(s)
- Maya Ghazi
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Aalaa Saleh
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Malak Abdallah
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Diala El Masri
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Faculty of Medicine, University of Balamand, Koura, Lebanon
| | - Jad El Masri
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | | | - Jihad Hawi
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Abdo Jurjus
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Batra N, Acharya S, Ahuja A, Saboo K. Guarding Health: A Comprehensive Review of Nosocomial Infections in Sickle Cell Anemia, a Multifaceted Approach to Prevention. Cureus 2024; 16:e53224. [PMID: 38425631 PMCID: PMC10902742 DOI: 10.7759/cureus.53224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
This comprehensive review explores the complex dynamics of nosocomial infections in individuals with sickle cell anemia (SCA) and advocates for a collaborative strategy to enhance prevention. SCA patients, marked by compromised immunity and susceptibility to infections, face unique challenges that necessitate tailored preventive measures. The review underscores the importance of vaccination, antibiotic prophylaxis, education, and environmental hygiene in mitigating the risk of nosocomial infections. Addressing socioeconomic factors, healthcare system limitations, patient-related issues, and cultural considerations is imperative for effective prevention. The call to action emphasizes the pivotal roles of healthcare professionals, policymakers, researchers, and community engagement in implementing targeted interventions. By fostering a collective effort, this review envisions an improved landscape for infection prevention in SCA patients, enhancing their overall health outcomes and quality of life.
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Affiliation(s)
- Nitish Batra
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Sourya Acharya
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Abhinav Ahuja
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Keyur Saboo
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Spiro J, Wisniewski P, Schwartz J, Smith AG, Burger S, Tilley DH, Maves RC. Doxycycline Prophylaxis for Skin and Soft Tissue Infections in Naval Special Warfare Trainees, United States 1. Emerg Infect Dis 2024; 30:89-95. [PMID: 38146981 PMCID: PMC10756378 DOI: 10.3201/eid3001.230890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
In 2015, several severe cases of skin and soft tissue infection (SSTI) among US Naval Special Warfare trainees prompted the introduction of doxycycline prophylaxis during the highest-risk portion of training, Hell Week. We performed a retrospective analysis of the effect of this intervention on SSTI incidence and resulting hospital admissions during 2013-2020. In total, 3,371 trainees underwent Hell Week training during the study period; 284 SSTIs were diagnosed overall, 29 of which led to hospitalization. After doxycycline prophylaxis was introduced, admission rates for SSTI decreased from 1.37 to 0.64 admissions/100 trainees (p = 0.036). Overall SSTI rates remained stable at 7.42 to 8.86 SSTIs/100 trainees (p = 0.185). Hospitalization rates per diagnosed SSTI decreased from 18.4% to 7.2% (p = 0.009). Average length of hospitalization decreased from 9.01 days to 4.33 days (p = 0.034). Doxycycline prophylaxis was associated with decreased frequency and severity of hospitalization for SSTIs among this population.
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Chan PA, Le Brazidec DL, Becasen JS, Martin H, Kapadia J, Reno H, Bachmann L, Barbee LA. Safety of Longer-Term Doxycycline Use: A Systematic Review and Meta-Analysis With Implications for Bacterial Sexually Transmitted Infection Chemoprophylaxis. Sex Transm Dis 2023; 50:701-712. [PMID: 37732844 PMCID: PMC10592014 DOI: 10.1097/olq.0000000000001865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
BACKGROUND Sexually transmitted infections (STIs) such as syphilis, gonorrhea, and chlamydia have significantly increased over the past decade in the United States. Doxycycline as chemoprophylaxis (i.e., postexposure prophylaxis) offers promise for addressing bacterial STIs. The goal of the current study was to evaluate the safety of longer-term doxycycline use (defined as 8 or more weeks) in the context of potential use as STI chemoprophylaxis through a systematic literature review and meta-analysis. METHODS This review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to search MEDLINE/PubMed for clinical studies published from August 2003 to January 2023 that reported on adverse events with doxycycline use with a focus on side effects and metabolic effects of long-term use. RESULTS A total of 67 studies were included in the systematic review. Overall, studies on longer-term doxycycline use reported 0% to greater than 50% adverse events ranging from mild to severe. Most common adverse events included gastrointestinal symptoms (i.e., nausea, vomiting, and abdominal pain), dermatologic (i.e., rash), and neurological (i.e., headache and dizziness) symptoms. Discontinuation of doxycycline due to adverse events was relatively uncommon in most studies. A meta-analysis of placebo controlled clinical trials (N = 18) revealed that gastrointestinal and dermatological adverse events were more likely to occur in the doxycycline group. CONCLUSIONS Longer-term (8+ weeks) doxycycline use is generally safe and may be associated with minor side effects. Further research is needed on the potential metabolic impact of longer-term doxycycline use.
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Affiliation(s)
- Philip A. Chan
- Department of Medicine, Brown University, Providence, Rhode Island, USA
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Jeffrey S. Becasen
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Harrison Martin
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Jhanavi Kapadia
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Hilary Reno
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Laura Bachmann
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lindley A. Barbee
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Kumar S, Roy V. Repurposing Drugs: An Empowering Approach to Drug Discovery and Development. Drug Res (Stuttg) 2023; 73:481-490. [PMID: 37478892 DOI: 10.1055/a-2095-0826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
Drug discovery and development is a time-consuming and costly procedure that necessitates a substantial effort. Drug repurposing has been suggested as a method for developing medicines that takes less time than developing brand new medications and will be less expensive. Also known as drug repositioning or re-profiling, this strategy has been in use from the time of serendipitous drug discoveries to the modern computer aided drug designing and use of computational chemistry. In the light of the COVID-19 pandemic too, drug repurposing emerged as a ray of hope in the dearth of available medicines. Data availability by electronic recording, libraries, and improvements in computational techniques offer a vital substrate for systemic evaluation of repurposing candidates. In the not-too-distant future, it could be possible to create a global research archive for us to access, thus accelerating the process of drug development and repurposing. This review aims to present the evolution, benefits and drawbacks including current approaches, key players and the legal and regulatory hurdles in the field of drug repurposing. The vast quantities of available data secured in multiple drug databases, assisting in drug repurposing is also discussed.
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Affiliation(s)
- Sahil Kumar
- Pharmacology, ESIC Dental College and Hospital, New Delhi, India
| | - Vandana Roy
- Pharmacology, Maulana Azad Medical College, New Delhi, India
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Pacak CA, Suzuki-Hatano S, Khadir F, Daugherty AL, Sriramvenugopal M, Gosiker BJ, Kang PB, Cade WT. One episode of low intensity aerobic exercise prior to systemic AAV9 administration augments transgene delivery to the heart and skeletal muscle. J Transl Med 2023; 21:748. [PMID: 37875924 PMCID: PMC10598899 DOI: 10.1186/s12967-023-04626-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/13/2023] [Indexed: 10/26/2023] Open
Abstract
INTRODUCTION The promising potential of adeno-associated virus (AAV) gene delivery strategies to treat genetic disorders continues to grow with an additional three AAV-based therapies recently approved by the Food and Drug Administration and dozens of others currently under evaluation in clinical trials. With these developments, it has become increasingly apparent that the high doses currently needed for efficacy carry risks of toxicity and entail enormous manufacturing costs, especially for clinical grade products. Strategies to increase the therapeutic efficacy of AAV-mediated gene delivery and reduce the minimal effective dose would have a substantial impact on this field. We hypothesized that an exercise-induced redistribution of tissue perfusion in the body to favor specific target organs via acute aerobic exercise prior to systemic intravenous (IV) AAV administration could increase efficacy. BACKGROUND Aerobic exercise triggers an array of downstream physiological effects including increased perfusion of heart and skeletal muscle, which we expected could enhance AAV transduction. Prior preclinical studies have shown promising results for a gene therapy approach to treat Barth syndrome (BTHS), a rare monogenic cardioskeletal myopathy, and clinical studies have shown the benefit of low intensity exercise in these patients, making this a suitable disease in which to test the ability of aerobic exercise to enhance AAV transduction. METHODS Wild-type (WT) and BTHS mice were either systemically administered AAV9 or completed one episode of low intensity treadmill exercise immediately prior to systemic administration of AAV9. RESULTS We demonstrate that a single episode of acute low intensity aerobic exercise immediately prior to IV AAV9 administration improves marker transgene delivery in WT mice as compared to mice injected without the exercise pre-treatment. In BTHS mice, prior exercise improved transgene delivery and additionally increased improvement in mitochondrial gene transcription levels and mitochondrial function in the heart and gastrocnemius muscles as compared to mice treated without exercise. CONCLUSIONS Our findings suggest that one episode of acute low intensity aerobic exercise improves AAV9 transduction of heart and skeletal muscle. This low-risk, cost effective intervention could be implemented in clinical trials of individuals with inherited cardioskeletal disease as a potential means of improving patient safety for human gene therapy.
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Affiliation(s)
- Christina A Pacak
- Paul and Sheila Wellstone Muscular Dystrophy Center and Department of Neurology, University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Silveli Suzuki-Hatano
- College of Medicine, Department of Pediatrics, University of Florida, Gainesville, USA
| | - Fatemeh Khadir
- Paul and Sheila Wellstone Muscular Dystrophy Center and Department of Neurology, University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Audrey L Daugherty
- Paul and Sheila Wellstone Muscular Dystrophy Center and Department of Neurology, University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | | | - Bennett J Gosiker
- College of Medicine, Department of Pediatrics, University of Florida, Gainesville, USA
| | - Peter B Kang
- Paul and Sheila Wellstone Muscular Dystrophy Center and Department of Neurology, University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - William Todd Cade
- Physical Therapy Division, Department of Orthopaedic Surgery, Duke University School of Medicine, 311 Trent Drive, Durham, NC, 27710, USA.
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Ghatak T, Holland RW. State of the Globe: Doxycycline - An Old Wine in a New Bottle for Gram-Negative Sepsis. J Glob Infect Dis 2023; 15:93-94. [PMID: 37800078 PMCID: PMC10549898 DOI: 10.4103/jgid.jgid_139_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 08/26/2023] [Accepted: 08/26/2023] [Indexed: 10/07/2023] Open
Affiliation(s)
- Tanmoy Ghatak
- Department of Emergency Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Reuben W. Holland
- Department of Emergency Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA
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Oware K, Adiema L, Rono B, Violette LR, McClelland RS, Donnell D, Scoville CW, Odoyo J, Baeten JM, Bukusi E, Stewart J. Characteristics of Kenyan women using HIV PrEP enrolled in a randomized trial on doxycycline postexposure prophylaxis for sexually transmitted infection prevention. BMC Womens Health 2023; 23:296. [PMID: 37270546 DOI: 10.1186/s12905-023-02413-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 05/05/2023] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION The global incidence of sexually transmitted infections (STIs) has been rapidly increasing over the past decade, with more than one million curable STIs being acquired daily. Young women in sub-Saharan Africa have a high prevalence and incidence of both curable STIs and HIV. The use of doxycycline as a prophylaxis to prevent STIs is promising; however, clinical trials, to date, have only been conducted among men who have sex with men (MSM) in high-income settings. We describe the characteristics of participants enrolled in the first trial to determine the efficacy of doxycycline post-exposure prophylaxis (PEP) to reduce STI incidence among women taking daily, oral HIV pre-exposure prophylaxis (PrEP). METHODS This is an open-label 1:1 randomized clinical trial on the efficacy of doxycycline PEP compared with standard of care (e.g., quarterly STI screening and treatment) to reduce incident bacterial STIs - Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum - among Kenyan women aged ≥18 and ≤30 years. All were also taking HIV pre-exposure prophylaxis (PrEP). We describe the baseline characteristics, STI prevalence, and STI risk perception of participants. RESULTS Between February 2020 and November 2021, 449 women were enrolled. The median age was 24 years (IQR 21-27), the majority were never married (66.1%), 370 women (82.4%) reported having a primary sex partner, and 33% had sex with new partners in the three months prior to enrolment. Two-thirds (67.5%, 268 women) did not use condoms, 36.7% reported transactional sex, and 43.2% suspected their male partners of having sex with other women. Slightly less than half (45.9%, 206 women) were recently concerned about being exposed to an STI. The prevalence of STIs was 17.9%, with C. trachomatis accounting for the majority of infections. Perceived risk of STIs was not associated with the detection of an STI. CONCLUSION Young cisgender women using HIV PrEP in Kenya and enrolled in a trial of doxycycline postexposure prophylaxis had a high prevalence of curable STIs and represent a target population for an STI prevention intervention.
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Affiliation(s)
- Kevin Oware
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
| | - Lydia Adiema
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Bernard Rono
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Lauren R Violette
- Departments of Medicine (Infectious Diseases), Seattle, United States
- Departments of Epidemiology, Seattle, United States
| | - R Scott McClelland
- Departments of Global Health, University of Washington, Seattle, United States
- Departments of Medicine (Infectious Diseases), Seattle, United States
- Departments of Epidemiology, Seattle, United States
| | - Deborah Donnell
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States
| | - Caitlin W Scoville
- Departments of Global Health, University of Washington, Seattle, United States
| | | | - Jared M Baeten
- Departments of Global Health, University of Washington, Seattle, United States
- Departments of Medicine (Infectious Diseases), Seattle, United States
- Departments of Epidemiology, Seattle, United States
- Gilead Sciences, Foster City, United States
| | - Elizabeth Bukusi
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
- Departments of Global Health, University of Washington, Seattle, United States
- Departments of Obstetrics and Gynaecology, Seattle, United States
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Clay KA, Hartley MG, Whelan AO, Bailey MS, Norville IH. Evaluation of Alternative Doxycycline Antibiotic Regimes in an Inhalational Murine Model of Q Fever. Antibiotics (Basel) 2023; 12:antibiotics12050914. [PMID: 37237817 DOI: 10.3390/antibiotics12050914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
The timing of the initiation of antibiotic treatment has been shown to impact the clinical outcome of many bacterial infections, including Q fever. Delayed, suboptimal or incorrect antibiotic treatment has been shown to result in poor prognosis, resulting in the progression of acute disease to long-term chronic sequalae. Therefore, there is a requirement to identify an optimal, effective therapeutic regimen to treat acute Q fever. In the study, the efficacies of different doxycycline monohydrate regimens (pre-exposure prophylaxis, post-exposure prophylaxis or treatment at symptom onset or resolution) were evaluated in an inhalational murine model of Q fever. Different treatment lengths (7 or 14 days) were also evaluated. Clinical signs and weight loss were monitored during infection and mice were euthanized at different time points to characterize bacterial colonization in the lungs and the dissemination of bacteria to other tissues including the spleen, brain, testes, bone marrow and adipose. Post-exposure prophylaxis or doxycycline treatment starting at symptoms onset reduced clinical signs, and also delayed the systemic clearance of viable bacteria from key tissues. Effective clearance was dependent on the development of an adaptive immune response, but also driven by sufficient bacterial activity to maintain an active immune response. Pre-exposure prophylaxis or post-exposure treatment at the resolution of clinical signs did not improve outcomes. These are the first studies to experimentally evaluate different doxycycline treatment regimens for Q fever and illustrate the need to explore the efficacy of other novel antibiotics.
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Affiliation(s)
- Kate A Clay
- Academic Department, Royal Centre for Defence Medicine (Academia and Research), Birmingham B15 2GW, UK
| | - M Gill Hartley
- CBR Division, Defence Science and Technology Laboratory (Dstl), Porton Down, Salisbury SP4 0JQ, UK
| | - Adam O Whelan
- CBR Division, Defence Science and Technology Laboratory (Dstl), Porton Down, Salisbury SP4 0JQ, UK
| | - Mark S Bailey
- Academic Department, Royal Centre for Defence Medicine (Academia and Research), Birmingham B15 2GW, UK
| | - Isobel H Norville
- CBR Division, Defence Science and Technology Laboratory (Dstl), Porton Down, Salisbury SP4 0JQ, UK
- Department of Biosciences, University of Exeter, Stocker Road, Exeter EX4 4QD, UK
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Miglianico M, Bolscher JM, Vos MW, Koolen KJM, de Bruijni M, Rajagopal DS, Chen E, Kiczun M, Gray D, Campo B, Sauerwein RW, Dechering KJ. Assessment of the drugability of initial malaria infection through miniaturized sporozoite assays and high-throughput screening. Commun Biol 2023; 6:216. [PMID: 36823266 PMCID: PMC9950425 DOI: 10.1038/s42003-023-04599-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/15/2023] [Indexed: 02/25/2023] Open
Abstract
The sporozoite stages of malaria parasites are the primary cause of infection of the vertebrate host and are targeted by (experimental) vaccines. Yet, little is known about their susceptibility to chemical intervention. Phenotypic high-throughput screens have not been feasible due to a lack of in vitro systems. Here we tested 78 marketed and experimental antimalarial compounds in miniaturized assays addressing sporozoite viability, gliding motility, hepatocyte traversal, and intrahepatocytic schizogony. None potently interfered with sporozoite viability or motility but ten compounds acted at the level of schizogony with IC50s < 100 nM. To identify compounds directly targeting sporozoites, we screened 81,000 compounds from the Global Health Diversity and reFRAME libraries in a sporozoite viability assay using a parasite expressing a luciferase reporter driven by the circumsporozoite promoter. The ionophore gramicidin emerged as the single hit from this screening campaign. Its effect on sporozoite viability translated into reduced gliding motility and an inability of sporozoites to invade human primary hepatocytes and develop into hepatic schizonts. While providing proof of concept for a small molecule sporontocidal mode of action, our combined data indicate that liver schizogony is more accessible to chemical intervention by (candidate) antimalarials.
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Affiliation(s)
| | | | | | | | | | | | - Emily Chen
- Calibr, a division of The Scripps Research Institute, La Jolla, California, United States of America
| | - Michael Kiczun
- Drug Discovery Unit, University of Dundee, Dundee, United Kingdom
| | - David Gray
- Drug Discovery Unit, University of Dundee, Dundee, United Kingdom
| | - Brice Campo
- Medicines for Malaria Venture, Geneva, Switzerland
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Velut G, de Laval F, Delon F, d'Oléon A, Douine M, Mosnier E, Mmadi Mrenda B, Dia A, Musset L, Briolant S, Pommier de Santi V. Sharp decrease in malaria incidence among the French armed forces in French Guiana. Travel Med Infect Dis 2023; 52:102547. [PMID: 36740087 DOI: 10.1016/j.tmaid.2023.102547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/12/2023] [Accepted: 02/02/2023] [Indexed: 02/07/2023]
Affiliation(s)
- Guillaume Velut
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France.
| | - Franck de Laval
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France; Aix-Marseille University, INSERM, IRD, SESSTIM (Economic and Social Sciences, Health Systems, and Medical Informatics), Marseille, France
| | - François Delon
- Aix-Marseille University, INSERM, IRD, SESSTIM (Economic and Social Sciences, Health Systems, and Medical Informatics), Marseille, France; Joint Directorate of the Armed Forces Health Service for French Guiana DIASS, Cayenne, French Guiana
| | - Albane d'Oléon
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Maylis Douine
- French West Indies-French Guiana Center for Clinical Investigation, CIC Inserm 1424, DRISP, Cayenne Hospital, Avenue des Flamboyants, Cayenne, French Guiana
| | - Emilie Mosnier
- Aix-Marseille University, INSERM, IRD, SESSTIM (Economic and Social Sciences, Health Systems, and Medical Informatics), Marseille, France
| | - Bakridine Mmadi Mrenda
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Aissata Dia
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Lise Musset
- Laboratory of Parasitology, National Reference Center for Malaria, Institut Pasteur in French Guiana, Collaborating Center for the Surveillance of Resistance to Antimalarial Drugs, Cayenne, French Guiana
| | - Sébastien Briolant
- Parasitology and Entomology Unit, Department of Infectious Diseases, Armed Forces Biomedical Research Institute, Marseille, France; University Hospital Institute Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Vincent Pommier de Santi
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France; University Hospital Institute Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France
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13
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Yadav S, Shah A, Malhotra P. Orange peel-derived Cu 2O/RGO nanocomposite: Mesoporous binary system for degradation of doxycycline in water. ENVIRONMENT, DEVELOPMENT AND SUSTAINABILITY 2023; 26:1-28. [PMID: 36714212 PMCID: PMC9873220 DOI: 10.1007/s10668-022-02895-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/28/2022] [Indexed: 06/18/2023]
Abstract
In recent times, there is a mammoth challenge for the world and mankind to deal with the frequent use and misuse of antibiotics and its casual discard to the water bodies. The scavenging degradation of antibiotics which are no longer in use from the environment is a growing concern and compulsively needs to be addressed. Herein, we have devised a novel and green protocol for the synthesis of Cu2O decorated on reduced graphene oxide (Cu2O/RGO) nanocomposite (NCs) using agro-waste, i.e., orange pomace extract (OPE) as a reducing and stabilizing agent for the degradation of antibiotic. The biogenically synthesized Cu2O/RGO NCs proved to emerge as an excellent degradation catalyst exhibiting efficiency of 98.68% within 15 min and 86.38% within 30 min for 10 mg/L DC concentration assisted by ultrasound waves and solar light respectively in separate reactions. The complete degradation process followed a pseudo-first-order kinetics with a rate constant of 0.29 min- 1 and 0.0542 min- 1 for sonocatalytic and photocatalytic degradation process, respectively. Surface area analysis showed that with the increase in the GO amount, the doxycycline degradation increases. An in-depth mechanistic account of sonocatalytic and photocatalytic process has been discussed followed by a radical scavenging test which validated the major role of the synthesized NCs in the degradation of DC. The extraordinary catalytic indulgence of biogenically synthesized graphene-based nanocatalyst opens newer avenues for future research in green chemistry and catalytic field. Graphical abstract Supplementary Information The online version contains supplementary material available at 10.1007/s10668-022-02895-2.
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Affiliation(s)
- Sushma Yadav
- Department of Chemistry, Daulat Ram College, University of Delhi, Delhi, 110007 India
| | - Anjali Shah
- Department of Chemistry, Daulat Ram College, University of Delhi, Delhi, 110007 India
| | - Priti Malhotra
- Department of Chemistry, Daulat Ram College, University of Delhi, Delhi, 110007 India
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14
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Stambouli N, Driss A, Gargouri F, Bahrini K, Arfaoui B, Abid R, Taamallah K, Hannachi S, Boughariou S, Rebai A, Naas I, Ghanem M, Ammar H, Aichaouia C, Harrathi A, Yousfi MA, Battikh R, Moussa MB, Razgallah R, Ferjani M, Gharsallah H. COVID-19 prophylaxis with doxycycline and zinc in health care workers: a prospective, randomized, double-blind clinical trial. Int J Infect Dis 2022; 122:553-558. [PMID: 35724828 PMCID: PMC9212900 DOI: 10.1016/j.ijid.2022.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/26/2022] [Accepted: 06/13/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES This study aims to assess the efficacy of a combination treatment of doxycycline and zinc in the primary prevention of COVID-19 infection in Tunisian health care workers compared with two control groups. METHODS We conducted a prospective, randomized, double-blind clinical trial over 5 months to determine the efficacy of a preventive combination treatment dose of doxycycline (100 mg/day) and zinc (15 mg/day), compared with a single-dose treatment with doxycycline versus placebo. The effectiveness of preventive treatment was measured by the significant decline in the number of cases of COVID-19 infection and/or a decrease in the viral load as determined by SARS-CoV-2 cycle threshold value using reverse transcription polymerase chain reaction tests. RESULTS We detected a significant decrease of SARS-CoV-2 infection in the group that received both doxycycline and zinc compared with other participants. We also demonstrated that COVID-19 infection was neither associated with diabetes (P = 0.51) nor associated with hypertension (P = 0.99), asthma (P = 0.52), and chronic obstructive pulmonary disease (P = 0.27). CONCLUSION Our findings indicated that preventive therapy reduced the risk of SARS-CoV-2. These results suggest that the combination of doxycycline and zinc has a protective effect in patients with SARS-CoV-2 infection.
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Affiliation(s)
- Nejla Stambouli
- General Directorate of Military Health,Research Unit UR17DN05, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Corresponding author:
| | - Adel Driss
- Department of Physiology, Morehouse School of Medicine, Atlanta GA, USA
| | - Faten Gargouri
- General Directorate of Military Health,Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia
| | - Khadija Bahrini
- Research Unit UR17DN05, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia
| | - Bilel Arfaoui
- Department of Internal Medicine, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia
| | - Rim Abid
- Department of Infectious Disease, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia
| | - Karima Taamallah
- Department of cardiology, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia
| | - Souha Hannachi
- Department of Infectious Disease, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia
| | - Sana Boughariou
- Department of Intensive Care, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia
| | - Aicha Rebai
- Department of Intensive Care, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia
| | - Imen Naas
- Department of Intensive Care, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia
| | - Mohamed Ghanem
- Department of Gastroenterology, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia
| | | | - Chiraz Aichaouia
- Department of Pneumology, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia
| | | | - Mohamed Ali Yousfi
- Department of Pharmacy, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia
| | - Riadh Battikh
- Department of Infectious Disease, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia
| | - Mohamed Ben Moussa
- Laboratory of Virology, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia
| | - Rabie Razgallah
- Research Unit UR17DN05, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia
| | - Mustapha Ferjani
- General Directorate of Military Health,Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia
| | - Hédi Gharsallah
- Department of Intensive Care, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Research Unit UR17DN05, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia, Military Hospital of Tunis, 1008 Mont fleury, Tunis, Tunisia,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunisia,Details of “OD-doxy-PNV-COVID-19 Trial” investigators are given in the Appendix
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15
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Di Bartolomeo L, Irrera N, Campo GM, Borgia F, Motolese A, Vaccaro F, Squadrito F, Altavilla D, Condorelli AG, Motolese A, Vaccaro M. Drug-Induced Photosensitivity: Clinical Types of Phototoxicity and Photoallergy and Pathogenetic Mechanisms. FRONTIERS IN ALLERGY 2022; 3:876695. [PMID: 36238932 PMCID: PMC9552952 DOI: 10.3389/falgy.2022.876695] [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: 02/15/2022] [Accepted: 05/16/2022] [Indexed: 01/19/2023] Open
Abstract
Drug-induced photosensitivity (DIP) is a common cutaneous adverse drug reaction, resulting from the interaction of ultraviolet radiations, mostly ultraviolet A, with drugs. DIP includes phototoxicity and photoallergy. A phototoxic reaction is obtained when topical and systemic drugs or their metabolites absorb light inducing a direct cellular damage, while a photoallergic reaction takes place when the interaction between drugs and ultraviolet radiations causes an immune cutaneous response. Clinically, phototoxicity is immediate and appears as an exaggerated sunburn, whereas photoallergy is a delayed eczematous reaction. DIP may show several clinical subtypes. In this mini-review we report the pathogenetic mechanisms and causative drugs of DIP. We offer a detailed description of DIP clinical features in its classical and unusual subtypes, such as hyperpigmentation/dyschromia, pseudoporphyria, photo-onycolysis, eruptive teleangiectasia, pellagra-like reaction, lichenoid reaction, photodistributed erythema multiforme and subacute/chronic cutaneous lupus erythematosus. We described how physicians may early recognize and manage DIP, including diagnostic tests to rule out similar conditions. We made suggestions on how to improve sun exposure behaviors of patients at risk of DIP by means of an aware use of sunscreens, protective clothing and recent technologic tools. We highlighted the lack of sun safety programs addressed to patients at risk of DIP, who need a formal education about their condition.
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Affiliation(s)
- Luca Di Bartolomeo
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, Pharmacology, University of Messina, Messina, Italy
| | - Giuseppe Maurizio Campo
- Laboratory of Clinical Biochemistry, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Francesco Borgia
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy
| | - Alfonso Motolese
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy
| | - Federico Vaccaro
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Squadrito
- Department of Clinical and Experimental Medicine, Pharmacology, University of Messina, Messina, Italy
| | - Domenica Altavilla
- Department of Clinical and Experimental Medicine, Pharmacology, University of Messina, Messina, Italy
| | - Alessandra Grazia Condorelli
- S.C. Dermatologia, Azienda USL di Reggio Emilia-IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
- *Correspondence: Alessandra Grazia Condorelli
| | - Alberico Motolese
- S.C. Dermatologia, Azienda USL di Reggio Emilia-IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Mario Vaccaro
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy
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16
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Stewart J, Bukusi E, Sesay FA, Oware K, Donnell D, Soge OO, Celum C, Odoyo J, Kwena ZA, Scoville CW, Violette LR, Morrison S, Simoni J, McClelland RS, Barnabas R, Gandhi M, Baeten JM. Doxycycline post-exposure prophylaxis for prevention of sexually transmitted infections among Kenyan women using HIV pre-exposure prophylaxis: study protocol for an open-label randomized trial. Trials 2022; 23:495. [PMID: 35710444 PMCID: PMC9201793 DOI: 10.1186/s13063-022-06458-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/09/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Women in Africa face disproportionate risk of human immunodeficiency virus (HIV) acquisition, accounting for more than half of new infections in Africa and similarly face a disproportionate burden of sexually transmitted infections (STIs). Very high STI prevalence is being observed globally, especially among people taking pre-exposure prophylaxis (PrEP) for HIV prevention. Doxycycline post-exposure prophylaxis (dPEP) has been proposed as an STI prevention strategy to reduce chlamydia, syphilis, and possibly gonorrhea, and trials are ongoing among cisgender men who have sex with men (MSM) and transgender women who are taking PrEP in high-income settings. We designed and describe here the first open-label trial to determine the effectiveness of dPEP to reduce STI incidence among cisgender women. METHODS We are conducting an open-label 1:1 randomized trial of dPEP versus standard of care (STI screening and treatment and risk-reduction counseling without dPEP) among 446 Kenyan women aged ≥ 18 and ≤ 30 years old women taking PrEP. Women are followed for 12 months, with quarterly STI testing, treatment, and adherence counseling. The primary trial outcome will be the combined incidence of Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum, compared between the randomized groups. We will also assess dPEP acceptability, tolerability, safety, impact on sexual behavior, adherence, and occurrence of antimicrobial resistance (AMR) in N. gonorrhoeae and C. trachomatis isolates. Finally, we will estimate cost per incident STI case and complications averted accounting for nonadherence and benefits relative AMR or side effects. DISCUSSION The results of this trial may have immediate implications for the global epidemic of STIs and sexual health. If effective, dPEP could put STI prevention into women's hands. While dPEP may be able to prevent STIs, it carries important risks that could counter its benefits; global debate about the balance of these potential risks and benefits requires data to inform policy and implementation and our study aims to fill this gap. TRIAL REGISTRATION ClinicalTrials.gov NCT04050540 .
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Affiliation(s)
- Jenell Stewart
- Department of Global Health, University of Washington, Box 359931, 325 Ninth Ave, WA 98104 Seattle, USA
- Department of Medicine (Infectious Diseases), University of Washington, Seattle, USA
| | - Elizabeth Bukusi
- Department of Global Health, University of Washington, Box 359931, 325 Ninth Ave, WA 98104 Seattle, USA
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Fredericka A. Sesay
- Department of Global Health, University of Washington, Box 359931, 325 Ninth Ave, WA 98104 Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | - Kevin Oware
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Deborah Donnell
- Department of Global Health, University of Washington, Box 359931, 325 Ninth Ave, WA 98104 Seattle, USA
- Department of Biostatistics, University of Washington, Seattle, USA
| | - Olusegun O. Soge
- Department of Global Health, University of Washington, Box 359931, 325 Ninth Ave, WA 98104 Seattle, USA
- Department of Medicine (Infectious Diseases), University of Washington, Seattle, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, USA
| | - Connie Celum
- Department of Global Health, University of Washington, Box 359931, 325 Ninth Ave, WA 98104 Seattle, USA
- Department of Medicine (Infectious Diseases), University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | | | | | - Caitlin W. Scoville
- Department of Global Health, University of Washington, Box 359931, 325 Ninth Ave, WA 98104 Seattle, USA
| | - Lauren R. Violette
- Department of Medicine (Infectious Diseases), University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | - Susan Morrison
- Department of Global Health, University of Washington, Box 359931, 325 Ninth Ave, WA 98104 Seattle, USA
| | - Jane Simoni
- Department of Psychology, University of Washington, Seattle, USA
| | - R. Scott McClelland
- Department of Global Health, University of Washington, Box 359931, 325 Ninth Ave, WA 98104 Seattle, USA
- Department of Medicine (Infectious Diseases), University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | - Ruanne Barnabas
- Department of Global Health, University of Washington, Box 359931, 325 Ninth Ave, WA 98104 Seattle, USA
- Department of Medicine (Infectious Diseases), University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | - Monica Gandhi
- Department of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, USA
| | - Jared M. Baeten
- Department of Global Health, University of Washington, Box 359931, 325 Ninth Ave, WA 98104 Seattle, USA
- Department of Medicine (Infectious Diseases), University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
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17
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Clark RL. Safety of Treating Malaria with Artemisinin-Based Combination Therapy in the First Trimester of Pregnancy. Reprod Toxicol 2022; 111:204-210. [PMID: 35667524 DOI: 10.1016/j.reprotox.2022.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022]
Abstract
There have been recent calls for the use of artemisinin-based combination therapies (ACTs) for uncomplicated malaria in the first trimester of pregnancy. Nevertheless, the 2021 WHO Guidelines for Malaria reaffirmed their position that there is not adequate clinical safety data on artemisinins to support that usage. The WHO's position is consistent with several issues with the existing clinical data. First, first trimester safety results from multiple ACTs were lumped in a meta-analysis which does not demonstrate that each of the included ACTs is equally safe. Second, safety results from all periods of the first trimester were lumped in the meta-analysis which does not demonstrate the same level of safety for all subperiods, particularly gestational Weeks 6 to 8 which is likely to be the most sensitive period. Third, even if there is evidence of a lack of an effect on miscarriage for a particular ACT, it does not follow then there are no developmental effects for any ACT. In monkeys, artesunate caused marked embryonal anemia leading to embryo death but the long-term consequences of lower levels of embryonal anemia are not known. Fourth, there have been advances in the sensitivity and usage of rapid diagnostic tests that will lead to diagnoses of malaria earlier in gestation which is less well studied and more likely sensitive to artemisinins. Any clinical studies of the safety of ACTs in the first trimester need to evaluate the results of treatment with individual ACTs during different 1- to 2-week periods of the first trimester.
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18
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Roome A, Gouli S, Yodsuwan R, Victory J, Collins C, Jenkins P, Scribani M, Krupa N, Freilich D, Gadomski A. Tick magnets: The occupational risk of tick-borne disease exposure in forestry workers in New York. Health Sci Rep 2022; 5:e509. [PMID: 35229053 PMCID: PMC8864501 DOI: 10.1002/hsr2.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/05/2022] [Accepted: 01/17/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Outdoor workers, such as forestry workers, are at an increased risk for contracting tick-borne diseases due to their prolonged time spent in tick habitats. Although well studied in Europe, no studies have been conducted with forestry workers in the Northeastern United States since 1990s. METHODS Full-time forestry workers and two comparison groups (volunteer firefighter/first responders and indoor/healthcare workers) within New York State Department of Environmental Conservation Regions 3, 4, 5, 6, and 7 were recruited for this cross-sectional seroprevalence study. Blood draws were conducted to test for antibodies to Lyme, anaplasmosis, babesiosis, and ehrlichiosis. Surveys were administered to determine personal risk factors and protective behaviors. RESULTS Between November 2020 and May 2021, 256 (105 forestry, 101 firefighter/first responder, and 50 indoor/healthcare) workers participated in this study. Forestry workers had a probability of testing positive nearly twice as high for any tick-borne disease (14%) compared to firefighter/first responders (8%) and to indoor workers (6%); however, this difference was not statistically significant (P = .140). Forestry workers were more likely to find embedded ticks on themselves (f = 33.26, P < .0001 vs both comparison groups) and to have been previously diagnosed with a tick-borne disease (P = .001 vs firefighter/first responders, P = .090 vs indoor/healthcare workers). CONCLUSIONS This pilot study suggests a higher proportion of tick-borne disease risk among forestry workers compared to firefighters/first responders and indoor/healthcare workers with lesser exposure. A larger study to confirm or refute this pilot data could help optimize mitigation/prevention strategies.
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Affiliation(s)
- Amanda Roome
- Research InstituteBassett Medical CenterCooperstownNew YorkUSA
- Northeast Center for Occupational Health and SafetyBassett Medical CenterCooperstownNew YorkUSA
| | - Sugam Gouli
- Research InstituteBassett Medical CenterCooperstownNew YorkUSA
| | | | | | - Casie Collins
- HealthWorksBassett Medical CenterCooperstownNew YorkUSA
| | - Paul Jenkins
- Research InstituteBassett Medical CenterCooperstownNew YorkUSA
- Northeast Center for Occupational Health and SafetyBassett Medical CenterCooperstownNew YorkUSA
| | | | - Nicole Krupa
- Research InstituteBassett Medical CenterCooperstownNew YorkUSA
| | - Daniel Freilich
- Research InstituteBassett Medical CenterCooperstownNew YorkUSA
| | - Anne Gadomski
- Research InstituteBassett Medical CenterCooperstownNew YorkUSA
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19
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Greene J, Segaran A, Lord S. Targeting OXPHOS and the electronic transport chain in cancer; molecular and therapeutic implications. Semin Cancer Biol 2022; 86:851-859. [PMID: 35122973 DOI: 10.1016/j.semcancer.2022.02.002] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/29/2022] [Accepted: 02/01/2022] [Indexed: 12/11/2022]
Abstract
Oxidative phosphorylation (OXPHOS) takes place in mitochondria and is the process whereby cells use carbon fuels and oxygen to generate ATP. Formerly OXPHOS was thought to be reduced in tumours and that glycolysis was the critical pathway for generation of ATP but it is now clear that OXPHOS, at least in many tumour types, plays a critical role in delivering the bioenergetic and macromolecular anabolic requirements of cancer cells. There is now great interest in targeting the OXPHOS and the electron transport chain for cancer therapy and in this review article we describe current therapeutic approaches and challenges.
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Affiliation(s)
- John Greene
- Department of Oncology, University of Oxford, Churchill Hospital, Oxford, United Kingdom
| | - Ashvina Segaran
- Ludwig Institute for Cancer Research, University of Oxford, Old Road Campus Research Building, Oxford, United Kingdom
| | - Simon Lord
- Department of Oncology, University of Oxford, Churchill Hospital, Oxford, United Kingdom.
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20
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Foster A. Post-artesunate delayed hemolysis after treatment of malaria with intravenous artesunate: A case study. IDCases 2022; 27:e01418. [PMID: 35145859 PMCID: PMC8816658 DOI: 10.1016/j.idcr.2022.e01418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/20/2022] [Accepted: 01/22/2022] [Indexed: 12/04/2022] Open
Abstract
Delayed hemolysis is an uncommon reaction to intravenous artesunate for the treatment of severe malaria. We report a case of a patient who developed severe malaria after initial improper treatment, thus requiring IV artesunate therapy. Delayed hemolytic anemia then occurred and was monitored for weeks after completion of treatment.
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Affiliation(s)
- Abigail Foster
- Internal Medicine of Tampa Bay 508 S Habana Ave Ste 335, Tampa, FL 33609, USA
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21
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Kingston DGI, Cassera MB. Antimalarial Natural Products. PROGRESS IN THE CHEMISTRY OF ORGANIC NATURAL PRODUCTS 2022; 117:1-106. [PMID: 34977998 DOI: 10.1007/978-3-030-89873-1_1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Natural products have made a crucial and unique contribution to human health, and this is especially true in the case of malaria, where the natural products quinine and artemisinin and their derivatives and analogues, have saved millions of lives. The need for new drugs to treat malaria is still urgent, since the most dangerous malaria parasite, Plasmodium falciparum, has become resistant to quinine and most of its derivatives and is becoming resistant to artemisinin and its derivatives. This volume begins with a short history of malaria and follows this with a summary of its biology. It then traces the fascinating history of the discovery of quinine for malaria treatment and then describes quinine's biosynthesis, its mechanism of action, and its clinical use, concluding with a discussion of synthetic antimalarial agents based on quinine's structure. The volume then covers the discovery of artemisinin and its development as the source of the most effective current antimalarial drug, including summaries of its synthesis and biosynthesis, its mechanism of action, and its clinical use and resistance. A short discussion of other clinically used antimalarial natural products leads to a detailed treatment of other natural products with significant antiplasmodial activity, classified by compound type. Although the search for new antimalarial natural products from Nature's combinatorial library is challenging, it is very likely to yield new antimalarial drugs. The chapter thus ends by identifying over ten natural products with development potential as clinical antimalarial agents.
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Affiliation(s)
- David G I Kingston
- Department of Chemistry and the Virginia Tech Center for Drug Discovery, Virginia Tech, Blacksburg, VA, 24061, USA.
| | - Maria Belen Cassera
- Department of Biochemistry and Molecular Biology, and Center for Tropical and Emerging Global Diseases (CTEGD), University of Georgia, Athens, GA, 30602, USA
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22
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Truong R, Tang V, Grennan T, Tan DHS. OUP accepted manuscript. JAC Antimicrob Resist 2022; 4:dlac009. [PMID: 35198979 PMCID: PMC8855662 DOI: 10.1093/jacamr/dlac009] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/17/2022] [Indexed: 11/12/2022] Open
Abstract
Objectives Methods Results Conclusions
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Affiliation(s)
- Robinson Truong
- Faculty of Medicine, University of Toronto, 1 King’s College Cir, Toronto, ON M5S 1A8, Canada
- Centre for Urban Health Solutions, St. Michael’s Hospital, 209 Victoria St, Toronto, ON M5B 1T8, Canada
| | - Vincent Tang
- Faculty of Medicine, University of Toronto, 1 King’s College Cir, Toronto, ON M5S 1A8, Canada
| | - Troy Grennan
- BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC V5Z 4R4, Canada
- Division of Infectious Diseases and Department of Medicine, University of British Columbia, 317–2194 Health Sciences Mall, Vancouver, BC V6 T 1Z3, Canada
| | - Darrell H. S. Tan
- Faculty of Medicine, University of Toronto, 1 King’s College Cir, Toronto, ON M5S 1A8, Canada
- Centre for Urban Health Solutions, St. Michael’s Hospital, 209 Victoria St, Toronto, ON M5B 1T8, Canada
- Division of Infectious Diseases, St. Michael’s Hospital, 36 Queen St E, Toronto, ON M5B 1W8, Canada
- Department of Medicine, St. Michael’s Hospital, 36 Queen St E, Toronto, ON M5B 1W8, Canada
- Corresponding author. E-mail:
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Chowdhury A, Sajid M, Jahan N, Adelusi TI, Maitra P, Yin G, Wu X, Gao Y, Wang S. A secondary approach with conventional medicines and supplements to recuperate current COVID-19 status. Biomed Pharmacother 2021; 142:111956. [PMID: 34332377 PMCID: PMC8313489 DOI: 10.1016/j.biopha.2021.111956] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/15/2021] [Accepted: 07/20/2021] [Indexed: 01/18/2023] Open
Abstract
Novel coronavirus 2019 (COVID-19) is a zoonosis that revised the global economic and societal progress since early 2020. The SARS-CoV-2 has been recognized as the responsible pathogen for COVID-19 with high infection and mortality rate potential. It has spread in 192 countries and infected about 1.5% of the world population, and still, a proper therapeutic approach is not unveiled. COVID-19 indication starts with fever to shortness of breathing, leading to ICU admission with the ventilation support in severe conditions. Besides the symptomatic mainstay clinical therapeutic approach, only Remdesivir has been approved by the FDA. Several pharmaceutical companies claimed different vaccines with exceptionally high efficacy (90-95%) against COVID-19; how long these vaccines can protect and long-term safety with the new variants are unpredictable. After the worldwide spread of the COVID-19 pandemic, numerous clinical trials with different phases are being performed to find the most appropriate solution to this condition. Some of these trials with old FDA-approved drugs showed promising results. In this review, we have precisely compiled the efforts to curb the disease and discussed the clinical findings of Ivermectin, Doxycycline, Vitamin-D, Vitamin-C, Zinc, and cannabidiol and their combinations. Additionally, the correlation of these molecules on the prophylactic and diseased ministration against COVID-19 has been explored.
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Affiliation(s)
- Apu Chowdhury
- Faculty of Materials and Chemical Engineering, Yibin University, Yibin, Sichuan 644000, China
| | - Muhammad Sajid
- Faculty of Materials and Chemical Engineering, Yibin University, Yibin, Sichuan 644000, China
| | - Nabila Jahan
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Temitope Isaac Adelusi
- Computational Biology/Drug Discovery Laboratory, Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Pulak Maitra
- Faculty of Materials and Chemical Engineering, Yibin University, Yibin, Sichuan 644000, China
| | - Guolian Yin
- Faculty of Materials and Chemical Engineering, Yibin University, Yibin, Sichuan 644000, China
| | - Xudong Wu
- Faculty of Materials and Chemical Engineering, Yibin University, Yibin, Sichuan 644000, China
| | - Yuan Gao
- Faculty of Materials and Chemical Engineering, Yibin University, Yibin, Sichuan 644000, China
| | - Sicen Wang
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
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24
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Caldara M, Marmiroli N. Antimicrobial Properties of Antidepressants and Antipsychotics-Possibilities and Implications. Pharmaceuticals (Basel) 2021; 14:ph14090915. [PMID: 34577614 PMCID: PMC8470654 DOI: 10.3390/ph14090915] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 12/13/2022] Open
Abstract
The spreading of antibiotic resistance is responsible annually for over 700,000 deaths worldwide, and the prevision is that this number will increase exponentially. The identification of new antimicrobial treatments is a challenge that requires scientists all over the world to collaborate. Developing new drugs is an extremely long and costly process, but it could be paralleled by drug repositioning. The latter aims at identifying new clinical targets of an “old” drug that has already been tested, approved, and even marketed. This approach is very intriguing as it could reduce costs and speed up approval timelines, since data from preclinical studies and on pharmacokinetics, pharmacodynamics, and toxicity are already available. Antidepressants and antipsychotics have been described to inhibit planktonic and sessile growth of different yeasts and bacteria. The main findings in the field are discussed in this critical review, along with the description of the possible microbial targets of these molecules. Considering their antimicrobial activity, the manuscript highlights important implications that the administration of antidepressants and antipsychotics may have on the gut microbiome.
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Affiliation(s)
- Marina Caldara
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11/A, 43124 Parma, Italy;
- Interdepartmental Center SITEIA.PARMA, University of Parma, Parco Area delle Scienze 181/A, 43124 Parma, Italy
- Correspondence:
| | - Nelson Marmiroli
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11/A, 43124 Parma, Italy;
- Interdepartmental Center SITEIA.PARMA, University of Parma, Parco Area delle Scienze 181/A, 43124 Parma, Italy
- Italian National Interuniversity Consortium for Environmental Sciences (CINSA), University of Parma, 43124 Parma, Italy
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25
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Agudelo Higuita NI, White BP, Franco-Paredes C, McGhee MA. An update on prevention of malaria in travelers. Ther Adv Infect Dis 2021; 8:20499361211040690. [PMID: 34484736 PMCID: PMC8408895 DOI: 10.1177/20499361211040690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/02/2021] [Indexed: 11/20/2022] Open
Abstract
Malaria, a parasitic disease caused by protozoa belonging to the genus Plasmodium, continues to represent a formidable public health challenge. Despite being a preventable disease, cases reported among travelers have continued to increase in recent decades. Protection of travelers against malaria, a potentially life-threatening disease, is of paramount importance, and it is therefore necessary for healthcare professionals to be up to date with the most recent recommendations. The present review provides an update of the existent measures for malaria prevention among travelers.
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Affiliation(s)
| | - Bryan Pinckney White
- Infectious Diseases Clinical Pharmacist, Oklahoma University Medical Center, Oklahoma City, OK, USA
| | - Carlos Franco-Paredes
- Department of Medicine, University of Colorado Denver School of Medicine, Aurora, CO, USA
| | - Miranda Ann McGhee
- Department of Medicine, Section of Infectious Diseases, University of Oklahoma Health Science Center, 800 Stanton L. Young Blvd., Suite 7300, Oklahoma City, OK 73104, USA
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26
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Vendramin R, Katopodi V, Cinque S, Konnova A, Knezevic Z, Adnane S, Verheyden Y, Karras P, Demesmaeker E, Bosisio FM, Kucera L, Rozman J, Gladwyn-Ng I, Rizzotto L, Dassi E, Millevoi S, Bechter O, Marine JC, Leucci E. Activation of the integrated stress response confers vulnerability to mitoribosome-targeting antibiotics in melanoma. J Exp Med 2021; 218:e20210571. [PMID: 34287642 PMCID: PMC8424468 DOI: 10.1084/jem.20210571] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/10/2021] [Accepted: 06/16/2021] [Indexed: 12/15/2022] Open
Abstract
The ability to adapt to environmental stress, including therapeutic insult, contributes to tumor evolution and drug resistance. In suboptimal conditions, the integrated stress response (ISR) promotes survival by dampening cytosolic translation. We show that ISR-dependent survival also relies on a concomitant up-regulation of mitochondrial protein synthesis, a vulnerability that can be exploited using mitoribosome-targeting antibiotics. Accordingly, such agents sensitized to MAPK inhibition, thus preventing the development of resistance in BRAFV600E melanoma models. Additionally, this treatment compromised the growth of melanomas that exhibited elevated ISR activity and resistance to both immunotherapy and targeted therapy. In keeping with this, pharmacological inactivation of ISR, or silencing of ATF4, rescued the antitumoral response to the tetracyclines. Moreover, a melanoma patient exposed to doxycycline experienced complete and long-lasting response of a treatment-resistant lesion. Our study indicates that the repurposing of mitoribosome-targeting antibiotics offers a rational salvage strategy for targeted therapy in BRAF mutant melanoma and a therapeutic option for NRAS-driven and immunotherapy-resistant tumors.
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Affiliation(s)
- Roberto Vendramin
- Laboratory for RNA Cancer Biology, Department of Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Vicky Katopodi
- Laboratory for RNA Cancer Biology, Department of Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Sonia Cinque
- Laboratory for RNA Cancer Biology, Department of Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Angelina Konnova
- Laboratory for RNA Cancer Biology, Department of Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Zorica Knezevic
- Laboratory for RNA Cancer Biology, Department of Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Sara Adnane
- Laboratory for RNA Cancer Biology, Department of Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Yvessa Verheyden
- Laboratory for RNA Cancer Biology, Department of Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Panagiotis Karras
- Laboratory for Molecular Cancer Biology, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie, Leuven, Belgium
- Department of Oncology, Laboratory for Molecular Cancer Biology, Katholieke Universiteit Leuven, Belgium
| | - Ewout Demesmaeker
- Laboratory for RNA Cancer Biology, Department of Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | - Lukas Kucera
- Czech Centre for Phenogenomics, Institute of Molecular Genetics of the Czech Academy of Sciences, Vestec, Czech Republic
| | - Jan Rozman
- Czech Centre for Phenogenomics, Institute of Molecular Genetics of the Czech Academy of Sciences, Vestec, Czech Republic
| | | | - Lara Rizzotto
- Trace, Leuven Cancer Institute, Katholieke Universiteit Leuven, Belgium
| | - Erik Dassi
- Laboratory of RNA Regulatory Networks, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Stefania Millevoi
- Cancer Research Centre of Toulouse, Institut national de la santé et de la recherche médicale Joint Research Unit 1037, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Laboratoire d’Excellence “TOUCAN,” Toulouse, France
| | - Oliver Bechter
- Department of General Medical Oncology, Leuven Cancer Institute, Universitair Ziekenhuis Leuven, Leuven, Belgium
| | - Jean-Christophe Marine
- Laboratory for Molecular Cancer Biology, Center for Cancer Biology, Vlaams Instituut voor Biotechnologie, Leuven, Belgium
- Department of Oncology, Laboratory for Molecular Cancer Biology, Katholieke Universiteit Leuven, Belgium
| | - Eleonora Leucci
- Laboratory for RNA Cancer Biology, Department of Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
- Trace, Leuven Cancer Institute, Katholieke Universiteit Leuven, Belgium
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Dowarah J, Marak BN, Yadav UCS, Singh VP. Potential drug development and therapeutic approaches for clinical intervention in COVID-19. Bioorg Chem 2021; 114:105016. [PMID: 34144277 PMCID: PMC8143914 DOI: 10.1016/j.bioorg.2021.105016] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 05/20/2021] [Indexed: 01/25/2023]
Abstract
While the vaccination is now available to many countries and will slowly dissipate to others, effective therapeutics for COVID-19 is still illusive. The SARS-CoV-2 pandemic has posed an unprecedented challenge to researchers, scientists, and clinicians and affected the wellbeing of millions of people worldwide. Since the beginning of the pandemic, a multitude of existing anti-viral, antibiotic, antimalarial, and anticancer drugs have been tested, and some have shown potency in the treatment and management of COVID-19, albeit others failed to leave any positive impact and a few also became controversial as they showed mixed clinical outcomes. In the present article, we have brought together some of the candidate therapeutic drugs being repurposed or used in the clinical trials and discussed their clinical efficacy and safety for COVID-19.
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Affiliation(s)
- Jayanta Dowarah
- Department of Chemistry, School of Physical Sciences, Mizoram University, Aizawl 796004, Mizoram, India
| | - Brilliant N Marak
- Department of Chemistry, School of Physical Sciences, Mizoram University, Aizawl 796004, Mizoram, India
| | | | - Ved Prakash Singh
- Department of Chemistry, School of Physical Sciences, Mizoram University, Aizawl 796004, Mizoram, India; Department of Industrial Chemistry, School of Physical Sciences, Mizoram University, Aizawl 796004, Mizoram, India.
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28
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Javelle E, Mayet A, Million M, Levasseur A, Allodji RS, Marimoutou C, Lavagna C, Desplans J, Fournier PE, Raoult D, Texier G. Gut Microbiota in Military International Travelers with Doxycycline Malaria Prophylaxis: Towards the Risk of a Simpson Paradox in the Human Microbiome Field. Pathogens 2021; 10:pathogens10081063. [PMID: 34451527 PMCID: PMC8400693 DOI: 10.3390/pathogens10081063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 11/16/2022] Open
Abstract
Dysbiosis, developed upon antibiotic administration, results in loss of diversity and shifts in the abundance of gut microbes. Doxycycline is a tetracycline antibiotic widely used for malaria prophylaxis in travelers. We prospectively studied changes in the fecal microbiota of 15 French soldiers after a 4-month mission to Mali with doxycycline malaria prophylaxis, compared to changes in the microbiota of 28 soldiers deployed to Iraq and Lebanon without doxycycline. Stool samples were collected with clinical data before and after missions, and 16S rRNA sequenced on MiSeq targeting the V3-V4 region. Doxycycline exposure resulted in increased alpha-biodiversity and no significant beta-dissimilarities. It led to expansion in Bacteroides, with a reduction in Bifidobacterium and Lactobacillus, as in the group deployed without doxycycline. Doxycycline did not alter the community structure and was specifically associated with a reduction in Escherichia and expression of Rothia. Differences in the microbiota existed at baseline between military units but not within the studied groups. This group-effect highlighted the risk of a Simpson paradox in microbiome studies.
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Affiliation(s)
- Emilie Javelle
- Laveran Military Teaching Hospital, Boulevard Alphonse Laveran, 13013 Marseille, France
- IRD, AP-HM, SSA, VITROME, Aix Marseille University, 13000 Marseille, France; (P.E.F.); (G.T.)
- IHU-Méditerranée Infection, 19–21 Boulevard Alphonse Laveran, 13013 Marseille, France; (M.M.); (A.L.); (D.R.)
- Correspondence: ; Tel.: +33-(0)6-32-41-99-03; Fax: +33-(0)4-13-73-24-02
| | - Aurélie Mayet
- Centre d’Epidémiologie et de Santé Publique des Armées (CESPA), 13014 Marseille, France; (A.M.); (C.M.); (C.L.); (J.D.)
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Aix Marseille University, 13000 Marseille, France
| | - Matthieu Million
- IHU-Méditerranée Infection, 19–21 Boulevard Alphonse Laveran, 13013 Marseille, France; (M.M.); (A.L.); (D.R.)
- IRD, AP-HM, SSA, MEPHI, Aix Marseille University, 13000 Marseille, France
| | - Anthony Levasseur
- IHU-Méditerranée Infection, 19–21 Boulevard Alphonse Laveran, 13013 Marseille, France; (M.M.); (A.L.); (D.R.)
- Centre d’Epidémiologie et de Santé Publique des Armées (CESPA), 13014 Marseille, France; (A.M.); (C.M.); (C.L.); (J.D.)
- IRD, AP-HM, SSA, MEPHI, Aix Marseille University, 13000 Marseille, France
| | - Rodrigue S. Allodji
- Radiation Epidemiology Team, CESP, Inserm U1018, 94800 Villejuif, France;
- Université Paris-Saclay, UVSQ, Inserm, CESP, 94807 Villejuif, France
- Department of Research, Gustave Roussy, 94800 Villejuif, France
| | - Catherine Marimoutou
- Centre d’Epidémiologie et de Santé Publique des Armées (CESPA), 13014 Marseille, France; (A.M.); (C.M.); (C.L.); (J.D.)
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Aix Marseille University, 13000 Marseille, France
- CIC Inserm 1410, CHU de La Réunion, 97400 La Réunion, France
| | - Chrystel Lavagna
- Centre d’Epidémiologie et de Santé Publique des Armées (CESPA), 13014 Marseille, France; (A.M.); (C.M.); (C.L.); (J.D.)
| | - Jérôme Desplans
- Centre d’Epidémiologie et de Santé Publique des Armées (CESPA), 13014 Marseille, France; (A.M.); (C.M.); (C.L.); (J.D.)
| | - Pierre Edouard Fournier
- IRD, AP-HM, SSA, VITROME, Aix Marseille University, 13000 Marseille, France; (P.E.F.); (G.T.)
- IHU-Méditerranée Infection, 19–21 Boulevard Alphonse Laveran, 13013 Marseille, France; (M.M.); (A.L.); (D.R.)
| | - Didier Raoult
- IHU-Méditerranée Infection, 19–21 Boulevard Alphonse Laveran, 13013 Marseille, France; (M.M.); (A.L.); (D.R.)
- IRD, AP-HM, SSA, MEPHI, Aix Marseille University, 13000 Marseille, France
| | - Gaëtan Texier
- IRD, AP-HM, SSA, VITROME, Aix Marseille University, 13000 Marseille, France; (P.E.F.); (G.T.)
- Centre d’Epidémiologie et de Santé Publique des Armées (CESPA), 13014 Marseille, France; (A.M.); (C.M.); (C.L.); (J.D.)
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Bharate SS. Modulation of biopharmaceutical properties of acidic drugs using cationic counterions: A critical analysis of FDA-approved pharmaceutical salts. Int J Pharm 2021; 607:120993. [PMID: 34390812 DOI: 10.1016/j.ijpharm.2021.120993] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/27/2021] [Accepted: 08/08/2021] [Indexed: 01/01/2023]
Abstract
Salification has a successful track record in modulating the biopharmaceutical properties of drugs. This is evident from the significant share (40%) of pharmaceutical salts in FDA-approved drugs in the past 80-years. Based on the ionic nature of drugs, the corresponding cationic or anionic counterions are employed for salification. This review aims to provide the contribution of cationic counterions in FDA-approved drugs from 1939 to 2020. The analysis of 80-years data has shown that the 7.1% of the FDA-approved drugs comprise cationic counterions (98 pharmaceutical salts). Heparin sodium is the pioneering drug in the history of pharmaceutical salts that was approved in 1939 as an anticoagulant medication. Inorganic (sodium, calcium, potassium, magnesium, silver), as well as organic (tromethamine, meglumine, erbumine) cationic counterions, were used in FDA-approved drugs with a major share by sodium (76 drugs). The technical superiority of cationic salts over other salt forms and the parent drug is also exemplified using case studies.
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Affiliation(s)
- Sonali S Bharate
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai 400056, India.
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30
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Yi YW, Park NY, Park JI, Seong YS, Hong YB. Doxycycline potentiates the anti-proliferation effects of gemcitabine in pancreatic cancer cells. Am J Cancer Res 2021; 11:3515-3536. [PMID: 34354858 PMCID: PMC8332860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/13/2021] [Indexed: 06/13/2023] Open
Abstract
Gemcitabine is often recommended as a first-line treatment for patients with metastatic pancreatic cancer. However, gemcitabine resistance is a major challenge in the treatment of pancreatic ductal adenocarcinoma. Our group serendipitously identified the role of doxycycline as a potentiator of gemcitabine efficacy in pancreatic cancer cells. Doxycycline and gemcitabine co-treatment was significantly more cytotoxic to pancreatic cancer cells compared to gemcitabine alone. Interestingly, doxycycline only exerted synergistic effects when coupled with gemcitabine as opposed to other conventional chemotherapeutics including nucleoside analogs. The anti-clonogenic effects of gemcitabine on pancreatic cancer cells were also enhanced by doxycycline. According to cell cycle analyses, doxycycline prolonged gemcitabine-mediated S phase cell cycle arrest. Further, gene expression profiling analyses indicated that a small set of genes involved in cell cycle regulation were uniquely modulated by gemcitabine and doxycycline co-treatment compared to gemcitabine alone. Western blot analyses indicated that several cell cycle-related proteins, including cyclin D1, p21, and DNA damage inducible transcript 4 (DDIT4), were further modulated by doxycycline and gemcitabine co-treatment. Taken together, our findings indicate that doxycycline enhances the effects of gemcitabine on cell cycle progression, thus rendering pancreatic cancer cells more sensitive to gemcitabine. However, additional studies are required to assess the mechanisms of doxycycline and gemcitabine synergism, which might lead to novel treatment options for pancreatic cancer.
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Affiliation(s)
- Yong Weon Yi
- Department of Nanobiomedical Science and BK21 PLUS Research Center for Regenerative Medicine, Dankook UniversityCheonan, Korea
| | - Na Young Park
- Department of Translational Biomedical Sciences, Graduate School of Dong-A UniversityBusan 49201, Korea
| | - Joo-In Park
- Department of Translational Biomedical Sciences, Graduate School of Dong-A UniversityBusan 49201, Korea
- Department of Biochemistry, College of Medicine, Dong-A UniversityBusan 49201, Korea
| | - Yeon-Sun Seong
- Department of Nanobiomedical Science and BK21 PLUS Research Center for Regenerative Medicine, Dankook UniversityCheonan, Korea
- Department of Biochemistry, College of Medicine, Dankook UniversityCheonan 31116, Korea
- Graduate School of Convergence Medical Science, Dankook UniversityCheonan 31116, Korea
| | - Young Bin Hong
- Department of Translational Biomedical Sciences, Graduate School of Dong-A UniversityBusan 49201, Korea
- Department of Biochemistry, College of Medicine, Dong-A UniversityBusan 49201, Korea
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Woziwodzka A, Krychowiak-Maśnicka M, Gołuński G, Felberg A, Borowik A, Wyrzykowski D, Piosik J. Modulatory Effects of Caffeine and Pentoxifylline on Aromatic Antibiotics: A Role for Hetero-Complex Formation. Molecules 2021; 26:3628. [PMID: 34198510 PMCID: PMC8231999 DOI: 10.3390/molecules26123628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 01/15/2023] Open
Abstract
Antimicrobial resistance is a major healthcare threat globally. Xanthines, including caffeine and pentoxifylline, are attractive candidates for drug repurposing, given their well-established safety and pharmacological profiles. This study aimed to analyze potential interactions between xanthines and aromatic antibiotics (i.e., tetracycline and ciprofloxacin), and their impact on antibiotic antibacterial activity. UV-vis spectroscopy, statistical-thermodynamical modeling, and isothermal titration calorimetry were used to quantitatively evaluate xanthine-antibiotic interactions. The antibacterial profiles of xanthines, and xanthine-antibiotic mixtures, towards important human pathogens Staphylococcus aureus, Enterococcus faecium, Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae, and Enterobacter cloacae were examined. Caffeine and pentoxifylline directly interact with ciprofloxacin and tetracycline, with neighborhood association constant values of 15.8-45.6 M-1 and enthalpy change values up to -4 kJ·M-1. Caffeine, used in mixtures with tested antibiotics, enhanced their antibacterial activity in most pathogens tested. However, antagonistic effects of caffeine were also observed, but only with ciprofloxacin toward Gram-positive pathogens. Xanthines interact with aromatic antibiotics at the molecular and in vitro antibacterial activity level. Given considerable exposure to caffeine and pentoxifylline, these interactions might be relevant for the effectiveness of antibacterial pharmacotherapy, and may help to identify optimal treatment regimens in the era of multidrug resistance.
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Affiliation(s)
- Anna Woziwodzka
- Laboratory of Biophysics, Intercollegiate Faculty of Biotechnology University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland; (G.G.); (A.F.); (A.B.); (J.P.)
| | - Marta Krychowiak-Maśnicka
- Laboratory of Biologically Active Compounds, Intercollegiate Faculty of Biotechnology University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland;
| | - Grzegorz Gołuński
- Laboratory of Biophysics, Intercollegiate Faculty of Biotechnology University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland; (G.G.); (A.F.); (A.B.); (J.P.)
| | - Anna Felberg
- Laboratory of Biophysics, Intercollegiate Faculty of Biotechnology University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland; (G.G.); (A.F.); (A.B.); (J.P.)
| | - Agnieszka Borowik
- Laboratory of Biophysics, Intercollegiate Faculty of Biotechnology University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland; (G.G.); (A.F.); (A.B.); (J.P.)
| | - Dariusz Wyrzykowski
- Department of Inorganic Biological Chemistry, Faculty of Chemistry, University of Gdansk, 80-308 Gdansk, Poland;
| | - Jacek Piosik
- Laboratory of Biophysics, Intercollegiate Faculty of Biotechnology University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland; (G.G.); (A.F.); (A.B.); (J.P.)
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Pessanha de Carvalho L, Kreidenweiss A, Held J. Drug Repurposing: A Review of Old and New Antibiotics for the Treatment of Malaria: Identifying Antibiotics with a Fast Onset of Antiplasmodial Action. Molecules 2021; 26:2304. [PMID: 33921170 PMCID: PMC8071546 DOI: 10.3390/molecules26082304] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/24/2022] Open
Abstract
Malaria is one of the most life-threatening infectious diseases and constitutes a major health problem, especially in Africa. Although artemisinin combination therapies remain efficacious to treat malaria, the emergence of resistant parasites emphasizes the urgent need of new alternative chemotherapies. One strategy is the repurposing of existing drugs. Herein, we reviewed the antimalarial effects of marketed antibiotics, and described in detail the fast-acting antibiotics that showed activity in nanomolar concentrations. Antibiotics have been used for prophylaxis and treatment of malaria for many years and are of particular interest because they might exert a different mode of action than current antimalarials, and can be used simultaneously to treat concomitant bacterial infections.
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Affiliation(s)
- Lais Pessanha de Carvalho
- Institute of Tropical Medicine, University of Tuebingen, 72074 Tuebingen, Germany; (L.P.d.C.); (A.K.)
| | - Andrea Kreidenweiss
- Institute of Tropical Medicine, University of Tuebingen, 72074 Tuebingen, Germany; (L.P.d.C.); (A.K.)
- Centre de Recherches Medicales de Lambaréné (CERMEL), Lambaréné BP 242, Gabon
| | - Jana Held
- Institute of Tropical Medicine, University of Tuebingen, 72074 Tuebingen, Germany; (L.P.d.C.); (A.K.)
- Centre de Recherches Medicales de Lambaréné (CERMEL), Lambaréné BP 242, Gabon
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Gupta Y, Goicoechea S, Pearce CM, Mathur R, Romero JG, Kwofie SK, Weyenberg MC, Daravath B, Sharma N, Poonam, Akala HM, Kanzok SM, Durvasula R, Rathi B, Kempaiah P. The emerging paradigm of calcium homeostasis as a new therapeutic target for protozoan parasites. Med Res Rev 2021; 42:56-82. [PMID: 33851452 DOI: 10.1002/med.21804] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/10/2020] [Accepted: 03/31/2021] [Indexed: 12/13/2022]
Abstract
Calcium channels (CCs), a group of ubiquitously expressed membrane proteins, are involved in many pathophysiological processes of protozoan parasites. Our understanding of CCs in cell signaling, organelle function, cellular homeostasis, and cell cycle control has led to improved insights into their structure and functions. In this article, we discuss CCs characteristics of five major protozoan parasites Plasmodium, Leishmania, Toxoplasma, Trypanosoma, and Cryptosporidium. We provide a comprehensive review of current antiparasitic drugs and the potential of using CCs as new therapeutic targets. Interestingly, previous studies have demonstrated that human CC modulators can kill or sensitize parasites to antiparasitic drugs. Still, none of the parasite CCs, pumps, or transporters has been validated as drug targets. Information for this review draws from extensive data mining of genome sequences, chemical library screenings, and drug design studies. Parasitic resistance to currently approved therapeutics is a serious and emerging threat to both disease control and management efforts. In this article, we suggest that the disruption of calcium homeostasis may be an effective approach to develop new anti-parasite drug candidates and reduce parasite resistance.
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Affiliation(s)
- Yash Gupta
- Infectious Diseases, Mayo Clinic, Jacksonville, Florida, 32224, USA
| | - Steven Goicoechea
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, USA
| | - Catherine M Pearce
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, USA
| | - Raman Mathur
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, USA
| | - Jesus G Romero
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, USA
| | - Samuel K Kwofie
- Department of Biomedical Engineering, School of Engineering Sciences, College of Basic & Applied Sciences, West African Center for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, College of Basic & Applied Sciences, University of Ghana, Accra, Ghana
| | - Matthew C Weyenberg
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, USA
| | - Bharathi Daravath
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, USA
| | - Neha Sharma
- Department of Chemistry, Hansraj College University Enclave, University of Delhi, Delhi, India
| | - Poonam
- Department of Chemistry, Miranda House University Enclave, University of Delhi, Delhi, India
| | | | - Stefan M Kanzok
- Department of Biology, Loyola University Chicago, Chicago, Illinois, USA
| | - Ravi Durvasula
- Infectious Diseases, Mayo Clinic, Jacksonville, Florida, 32224, USA
| | - Brijesh Rathi
- Department of Chemistry, Hansraj College University Enclave, University of Delhi, Delhi, India
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Usman MA, Usman FI, Abubakar MS, Salman AA, Adamu A, Ibrahim MA. Phytol suppresses parasitemia and ameliorates anaemia and oxidative brain damage in mice infected with Plasmodium berghei. Exp Parasitol 2021; 224:108097. [PMID: 33736972 DOI: 10.1016/j.exppara.2021.108097] [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: 08/20/2020] [Revised: 01/30/2021] [Accepted: 03/08/2021] [Indexed: 01/15/2023]
Abstract
The quest for the development of a novel antimalarial drug informed the decision to subject phytol to in vivo trials following a demonstration of therapeutic potential against chloroquine sensitive strain of Plasmodium falciparum under in vitro condition. On this basis, the in vivo anti-Plasmodium berghei activity of phytol including the ameliorative effects of the compound on P. berghei-associated anaemia and organ damage were investigated. Mice were infected with chloroquine-sensitive strain of P. berghei and were treated with phytol at a dose of 10 and 20 mg/kg body weight (BW) for four days. The levels of parasitemia, packed cell volume and redox sensitive biomarkers of liver, brain and spleen tissues were determined. Our result revealed that phytol significantly (p < 0.05) suppressed the multiplication of P. berghei in a dose-dependent manner. Additionally, the phytol significantly (p < 0.05) ameliorated the P. berghei-induced anaemia and brain damage. Data from the present study demonstrated that phytol has suppressive effect on P. berghei and could ameliorate some P. berghei-induced pathological changes.
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Affiliation(s)
| | | | | | | | - Auwal Adamu
- Department of Biochemistry, Ahmadu Bello University, Zaria, Nigeria
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Recent Hydroxychloroquine Use Is Not Significantly Associated with Positive PCR Results for SARS-CoV-2: A Nationwide Observational Study in South Korea. Viruses 2021; 13:v13020329. [PMID: 33672785 PMCID: PMC7924588 DOI: 10.3390/v13020329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/15/2021] [Accepted: 02/15/2021] [Indexed: 02/06/2023] Open
Abstract
Background: To evaluate the role of hydroxychloroquine (HCQ) as pre-exposure prophylaxis against coronavirus disease 2019 (COVID-19), we investigated the prevalence of positive test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing according to recent HCQ use in patients who had been tested using nationwide health-insurance data of South Korea. Methods: All adults tested for SARS-CoV-2 from 20 January 2020 to 15 May 2020 were identified. HCQ users were defined as patients who had been pretreated with HCQ for at least 30 days until the date of SARS-CoV-2 testing. The prevalence of positive PCR results for SARS-CoV-2 was compared between HCQ users and nonusers. Results: Of a total of 216,686 individuals who had been tested for SARS-CoV-2, 743 (0.3%) were pretreated with HCQ. The prevalence of positive results was not significantly different between HCQ users (2.2%) and nonusers (2.7%; P = 0.35), with an odds ratio of 0.79 (95% confidence interval (CI), 0.48–1.30). Propensity score-matched-cohort analysis showed similar results in terms of the prevalence of positive results (2.2% in HCQ users vs. 3.1% in nonusers; P = 0.18), with an odds ratio of 0.69 (95% CI, 0.40–1.19). The rate of positive PCR was not significantly different in long-term HCQ users (more than 3 or 6 months) compared with nonusers. Conclusions: In this population-based study, recent exposure to HCQ was not significantly associated with a lower risk of SARS-CoV-2 infection. Our data do not support the use of HCQ as pre-exposure prophylaxis against COVID-19.
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Ekasari W, Basuki DR, Arwati H, Wahyuni TS. Antiplasmodial activity of Ethanolic extract of Cassia spectabilis DC leaf and its inhibition effect in Heme detoxification. BMC Complement Med Ther 2021; 21:71. [PMID: 33607987 PMCID: PMC7896390 DOI: 10.1186/s12906-021-03239-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 02/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In previous studies, Cassia spectabilis DC leaf has shown a good antiplasmodial activity. Therefore, this study is a follow-up study of the extract of leaf of C. spectabilis DC on its in vitro and in vivo antiplasmodial activity and mechanism as an antimalarial. METHODS The extract was fractionated, sub-fractionated and isolated to obtain the purified compound. In vitro antiplasmodial activity test against Plasmodium falciparum to find out the active compound. In vivo test against P. berghei ANKA-infected mice was conducted to determine prophylactic activity and antiplasmodial activity either alone or in combination with artesunate. The inhibition of heme detoxification test as one of the antimalarial mechanisms was carried out using the Basilico method. RESULTS The results showed that active antimalarial compound isolated from C. spectabilis DC leaf had a structural pattern that was identical to (-)-7-hydroxycassine. Prophylactic test of 90% ethanolic extract of C. spectabilis DC leaf alone against P. berghei ANKA-infected mice obtained the highest percentage inhibition was 68.61%, while positive control (doxycycline 13 mg/kg) was 73.54%. In combination with artesunate, 150 mg/kg three times a day of C. spectabilis DC (D0-D2) + artesunate (D2) was better than the standard combination of amodiaquine + artesunate where the inhibition percentages were 99.18 and 92.88%, respectively. The IC50 of the extract for the inhibitory activity of heme detoxification was 0.375 mg/ml which was better than chloroquine diphosphate (0.682 mg/ml). CONCLUSION C. spectabilis DC leaf possessed potent antiplasmodial activity and may offer a potential agent for effective and affordable antimalarial phytomedicine.
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Affiliation(s)
- Wiwied Ekasari
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmacy, Universitas Airlangga, Campus C, Mulyorejo Street, Surabaya, 60115, Indonesia.
| | - Dewi Resty Basuki
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmacy, Universitas Airlangga, Campus C, Mulyorejo Street, Surabaya, 60115, Indonesia
| | - Heny Arwati
- Department of Medical Parasitology, Faculty of Medicine, Universitas Airlangga, Campus A, Surabaya, 60132, Indonesia
| | - Tutik Sri Wahyuni
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmacy, Universitas Airlangga, Campus C, Mulyorejo Street, Surabaya, 60115, Indonesia
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Repurposing of existing therapeutics to combat drug-resistant malaria. Biomed Pharmacother 2021; 136:111275. [PMID: 33485067 DOI: 10.1016/j.biopha.2021.111275] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/15/2020] [Accepted: 12/26/2020] [Indexed: 11/21/2022] Open
Abstract
In the era of drug repurposing, speedy discovery of new therapeutic options for the drug-resistant malaria is the best available tactic to reduce the financial load and time in the drug discovery process. Six anticancer drugs, three immunomodulators and four antibiotics were selected for the repositioning against experimental malaria owing to their mode of action and published literature. The efficacy of existing therapeutics was evaluated against chloroquine-resistant in vitro and in vivo strains of Plasmodium falciparum and P. yoelii, respectively. All the pre-existing FDA-approved drugs along with leptin were primarily screened against chloroquine-resistant (PfK1) and drug-sensitive (Pf3D7) strains of P. falciparum using SYBR green-based antiplasmodial assay. Cytotoxic profiling of these therapeutics was achieved on Vero and HepG2 cell lines, and human erythrocytes. Percent blood parasitemia and host survival was determined in chloroquine-resistant P. yoelii N67-infected Swiss mice using appropriate doses of these drugs/immunomodulators. Antimalarial screening together with cytotoxicity data revealed that anticancer drugs, idelalisib and 5-fluorouracil acquired superiority over their counterparts, regorafenib, and tamoxifen, respectively. ROS-inducer anticancer drugs, epirubicin and bleomycin were found toxic for the host. Immunomodulators (imiquimod, lenalidomide and leptin) were safest but less active in in vitro system, however, in P. yoelii-infected mice, they exhibited modest parasite suppression at their respective doses. Among antibiotics, moxifloxacin exhibited better antimalarial prospective than levofloxacin, roxithromycin and erythromycin. 5-Fluorouracil, imiquimod and moxifloxacin displayed 97.64, 81.18 and 91.77 % parasite inhibition in treated animals and attained superiority in their respective groups thus could be exploited further in combination with suitable antimalarials.
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Chemoprotective antimalarials identified through quantitative high-throughput screening of Plasmodium blood and liver stage parasites. Sci Rep 2021; 11:2121. [PMID: 33483532 PMCID: PMC7822874 DOI: 10.1038/s41598-021-81486-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 01/05/2021] [Indexed: 12/20/2022] Open
Abstract
The spread of Plasmodium falciparum parasites resistant to most first-line antimalarials creates an imperative to enrich the drug discovery pipeline, preferably with curative compounds that can also act prophylactically. We report a phenotypic quantitative high-throughput screen (qHTS), based on concentration–response curves, which was designed to identify compounds active against Plasmodium liver and asexual blood stage parasites. Our qHTS screened over 450,000 compounds, tested across a range of 5 to 11 concentrations, for activity against Plasmodium falciparum asexual blood stages. Active compounds were then filtered for unique structures and drug-like properties and subsequently screened in a P. berghei liver stage assay to identify novel dual-active antiplasmodial chemotypes. Hits from thiadiazine and pyrimidine azepine chemotypes were subsequently prioritized for resistance selection studies, yielding distinct mutations in P. falciparum cytochrome b, a validated antimalarial drug target. The thiadiazine chemotype was subjected to an initial medicinal chemistry campaign, yielding a metabolically stable analog with sub-micromolar potency. Our qHTS methodology and resulting dataset provides a large-scale resource to investigate Plasmodium liver and asexual blood stage parasite biology and inform further research to develop novel chemotypes as causal prophylactic antimalarials.
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Allegra C, Failla G, Costanzo L, Mannello F, Montella F, Antignani PL. Reasoned therapeutic protocol in outpatients with COVID-19. INT ANGIOL 2021; 40:170-175. [PMID: 33463975 DOI: 10.23736/s0392-9590.21.04556-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Seventy percent of patients affected by SARS-COV-2 disease are asymptomatic or with symptoms that not required Hospitalization. A prodromal period lasting about 5 days can be identified. In this phase a patient with a positive swab for viral RNA may or may not evolve towards the phase of symptomatic disease. METHODS In this paper we reviewed the literature related to COVID-19 therapy we propose a reasoned treatment protocols in outpatients according to the age and the comorbidity. RESULTS The aim of this study was to reduce the impact of the virus by reducing its ability to attack cells and the inflammatory burden and the prothrombotic effects proposing two therapeutic schemes of proven efficacy according to the age of the patients and the comorbidities. CONCLUSIONS We aimed to reduce worsening of clinical status and hospitalization while protecting patients at home.
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Affiliation(s)
- Claudio Allegra
- Department of Angiology, Union Internationale de Phlebologie (UIP), S.Giovanni Hospital, Rome, Italy
| | - Giacomo Failla
- Unit of Angiology, Department of Cardiovascular Disease, San Marco Hospital, Rodolico, S. Marco University Hospital, University of Catania, Catania, Italy -
| | - Luca Costanzo
- Unit of Angiology, Department of Cardiovascular Disease, San Marco Hospital, Rodolico, S. Marco University Hospital, University of Catania, Catania, Italy
| | - Ferdinando Mannello
- Unit of Clinical Biochemistry, Section of Biochemistry and Biotechnology, Department of Biomolecular Sciences, Carlo Bo University of Urbino, Urbino, Pesaro-Urbino, Italy
| | - Francesco Montella
- Department of Internal Medicine, San Giovanni-Addolorata Hospital, Rome, Italy
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Dousti M, Manzano-Román R, Rashidi S, Barzegar G, Ahmadpour NB, Mohammadi A, Hatam G. A proteomic glimpse into the effect of antimalarial drugs on Plasmodium falciparum proteome towards highlighting possible therapeutic targets. Pathog Dis 2021; 79:ftaa071. [PMID: 33202000 DOI: 10.1093/femspd/ftaa071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/13/2020] [Indexed: 02/07/2023] Open
Abstract
There is no effective vaccine against malaria; therefore, chemotherapy is to date the only choice to fight against this infectious disease. However, there is growing evidences of drug-resistance mechanisms in malaria treatments. Therefore, the identification of new drug targets is an urgent need for the clinical management of the disease. Proteomic approaches offer the chance of determining the effects of antimalarial drugs on the proteome of Plasmodium parasites. Accordingly, we reviewed the effects of antimalarial drugs on the Plasmodium falciparum proteome pointing out the relevance of several proteins as possible drug targets in malaria treatment. In addition, some of the P. falciparum stage-specific altered proteins and parasite-host interactions might play important roles in pathogenicity, survival, invasion and metabolic pathways and thus serve as potential sources of drug targets. In this review, we have identified several proteins, including thioredoxin reductase, helicases, peptidyl-prolyl cis-trans isomerase, endoplasmic reticulum-resident calcium-binding protein, choline/ethanolamine phosphotransferase, purine nucleoside phosphorylase, apical membrane antigen 1, glutamate dehydrogenase, hypoxanthine guanine phosphoribosyl transferase, heat shock protein 70x, knob-associated histidine-rich protein and erythrocyte membrane protein 1, as promising antimalarial drugs targets. Overall, proteomic approaches are able to partially facilitate finding possible drug targets. However, the integration of other 'omics' and specific pharmaceutical techniques with proteomics may increase the therapeutic properties of the critical proteins identified in the P. falciparum proteome.
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Affiliation(s)
- Majid Dousti
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Raúl Manzano-Román
- Proteomics Unit, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007, Salamanca, Spain
| | - Sajad Rashidi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholamreza Barzegar
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Alireza Mohammadi
- Department of Disease Control, Komijan Treatment and Health Network, Arak University of Medical Science, Iran
| | - Gholamreza Hatam
- Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Narendrakumar L, Joseph I, Thomas S. Potential effectiveness and adverse implications of repurposing doxycycline in COVID-19 treatment. Expert Rev Anti Infect Ther 2020; 19:1001-1008. [PMID: 33322952 DOI: 10.1080/14787210.2021.1865803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Introduction: COVID-19 infection with no known-specific drugs or vaccines has impacted mankind and has become beyond precedence. Currently, re-purposing of existing drugs is the only therapeutic option for managing COVID-19 symptoms and associated co-infections to reduce mortality. Antimicrobials as varied as antiparasitic, antiviral, and antibiotics are under various stages of evaluation.Areas covered: Recently, doxycycline, a broad-spectrum antibiotic that has also reported antiviral and anti-inflammatory properties was widely investigated in clinical trials, either alone or in combination with other drugs, and repurposed for COVID-19 treatment. In the review, the potential therapeutic applications of doxycycline in COVID-19 treatment and its potential adverse implications with respect to antimicrobial resistance bestowed by repurposing the antibiotic have been expounded.Expert opinion: 'Fighting disease with already existing antibiotics' and 'antimicrobial resistance progression' are like two arms of a balance that has to be carefully equilibrated. Any imbalance by the inappropriate or indiscriminate use of the repurposed drugs would cause a disastrous increase in antimicrobial resistance (AMR). Hence, cautious parallel assessment of potential long-term consequences of AMR is of great importance to mankind as its impacts would prevail even after the current pandemic.
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Affiliation(s)
- Lekshmi Narendrakumar
- Cholera and Biofilm Research Laboratory, Pathogen Biology Group, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
| | - Iype Joseph
- Cholera and Biofilm Research Laboratory, Pathogen Biology Group, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
| | - Sabu Thomas
- Cholera and Biofilm Research Laboratory, Pathogen Biology Group, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
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Firth A, Prathapan P. Broad-spectrum therapeutics: A new antimicrobial class. CURRENT RESEARCH IN PHARMACOLOGY AND DRUG DISCOVERY 2020; 2:100011. [PMID: 34870144 PMCID: PMC8035643 DOI: 10.1016/j.crphar.2020.100011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 01/29/2023] Open
Abstract
There are currently no emergency treatments for pandemics, yet drug repositioning has emerged as the foremost treatment development strategy for COVID-19, with an aim to identify successful antiviral therapeutics from safe, non-antiviral candidates. These therapeutics include antibiotics such as azithromycin and the antiparasitic nitazoxanide, both of which exhibit antiviral activity. Broad-spectrum therapeutics (BSTs) are a class of antimicrobials active against multiple pathogen types. Establishment of a developmental framework for BSTs will markedly improve global preparedness for future health emergencies.
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Affiliation(s)
- Anton Firth
- New Biochemistry, University of Oxford, South Parks Road, Oxford, OX1 3QU, UK
| | - Praveen Prathapan
- New Biochemistry, University of Oxford, South Parks Road, Oxford, OX1 3QU, UK
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Madhav H, Hoda N. An insight into the recent development of the clinical candidates for the treatment of malaria and their target proteins. Eur J Med Chem 2020; 210:112955. [PMID: 33131885 DOI: 10.1016/j.ejmech.2020.112955] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/08/2020] [Accepted: 10/19/2020] [Indexed: 01/18/2023]
Abstract
Malaria is an endemic disease, prevalent in tropical and subtropical regions which cost half of million deaths annually. The eradication of malaria is one of the global health priority nevertheless, current therapeutic efforts seem to be insufficient due to the emergence of drug resistance towards most of the available drugs, even first-line treatment ACT, unavailability of the vaccine, and lack of drugs with a new mechanism of action. Intensification of antimalarial research in recent years has resulted into the development of single dose multistage therapeutic agents which has advantage of overcoming the antimalarial drug resistance. The present review explored the current progress in the development of new promising antimalarials against prominent target proteins that have the potential to be a clinical candidate. Here, we also reviewed different aspects of drug resistance and highlighted new drug candidates that are currently in a clinical trial or clinical development, along with a few other molecules with excellent antimalarial activity overs ACTs. The summarized scientific value of previous approaches and structural features of antimalarials related to the activity are highlighted that will be helpful for the development of next-generation antimalarials.
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Affiliation(s)
- Hari Madhav
- Drug Design and Synthesis Laboratory, Department of Chemistry, Jamia Millia Islamia (A Central University), New Delhi, 110025, India.
| | - Nasimul Hoda
- Drug Design and Synthesis Laboratory, Department of Chemistry, Jamia Millia Islamia (A Central University), New Delhi, 110025, India.
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Clark RL. Teratogen update: Malaria in pregnancy and the use of antimalarial drugs in the first trimester. Birth Defects Res 2020; 112:1403-1449. [PMID: 33079495 DOI: 10.1002/bdr2.1798] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 02/04/2023]
Abstract
Malaria is a particular problem in pregnancy because of enhanced sensitivity, the possibility of placental malaria, and adverse effects on pregnancy outcome. Artemisinin-containing combination therapies (ACTs) are the most effective antimalarials known. WHO recommends 7-day quinine therapy for uncomplicated Plasmodium falciparum malaria in the first trimester despite the superior tolerability and efficacy of 3-day ACT regimens because artemisinins caused embryolethality and/or cardiovascular malformations at relatively low doses in rats, rabbits, and monkeys. The developmental toxicity of artesunate, artemether, and DHA were similar in rats but artesunate was embryotoxic at lower doses in rabbits (5 mg/kg/day) than artemether (no effect level = 25 mg/kg/day). In clinical studies in Africa, treatment with artemether-lumefantrine in the first trimester was observed to be highly efficacious and the miscarriage rate (≤3.1%) was similar to no antimalarial treatment (2.6%). When data from the first-trimester use of largely artesunate-based therapies in Thailand were pooled together, there was no difference in miscarriage rate compared to quinine. However, individually, artesunate-mefloquine was associated with a higher miscarriage rate (15/71 = 21%) compared to other artemisinin-based therapies including 7-day artesunate + clindamycin (2/50 = 4%) and quinine (92/842 = 11%). Thus, appropriate statistical comparisons of individual ACT groups are needed prior to assuming that they all have the same risk for developmental toxicity. Current limitations in the assessment of the safety of ACTs in the first trimester are a lack of exposures early in gestation (gestational weeks 6-7), limited postnatal evaluation for cardiovascular malformations, and the pooling of all ACTs for the assessment of risk.
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Affiliation(s)
- Robert L Clark
- Artemis Pharmaceutical Research, Saint Augustine, Florida, USA
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45
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Poduri R, Joshi G, Jagadeesh G. Drugs targeting various stages of the SARS-CoV-2 life cycle: Exploring promising drugs for the treatment of Covid-19. Cell Signal 2020; 74:109721. [PMID: 32711111 PMCID: PMC7375293 DOI: 10.1016/j.cellsig.2020.109721] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/19/2020] [Indexed: 01/18/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a positive-sense, single-stranded RNA virus that causes the potentially lethal Covid-19 respiratory tract infection. It does so by binding to host cell angiotensin converting enzyme 2 (ACE2) receptors, leading to endocytosis with the receptor, and subsequently using the host cell's machinery to replicate copies of itself and invade new cells. The extent of the spread of infection in the body is dependent on the pattern of ACE2 expression and overreaction of the immune system. Additionally, by inducing an imbalance in the renin-angiotensin-aldosterone system (RAAS) and the loss of ACE2 would favour the progression of inflammatory and thrombotic processes in the lungs. No drug or vaccine has yet been approved to treat human coronaviruses. Hundreds of clinical trials on existing approved drugs from different classes acting on a multitude of targets in the virus life cycle are ongoing to examine potential effectiveness for the prevention and treatment of the infection. This review summarizes the SARS-CoV-2 virus life cycle in the host cell and provides a biological and pathological point of view for repurposed and experimental drugs for this novel coronavirus. The viral life cycle provides potential targets for drug therapy.
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Affiliation(s)
- Ramarao Poduri
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Bathinda 151001, India.
| | - Gaurav Joshi
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Bathinda 151001, India.
| | - Gowraganahalli Jagadeesh
- Office of Cardiology, Hematology, Endocrinology and Nephrology, CDER, FDA, Silver Spring, MD, USA.
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Computational Chemogenomics Drug Repositioning Strategy Enables the Discovery of Epirubicin as a New Repurposed Hit for Plasmodium falciparum and P. vivax. Antimicrob Agents Chemother 2020; 64:AAC.02041-19. [PMID: 32601162 PMCID: PMC7449180 DOI: 10.1128/aac.02041-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 06/19/2020] [Indexed: 12/13/2022] Open
Abstract
Widespread resistance against antimalarial drugs thwarts current efforts for controlling the disease and urges the discovery of new effective treatments. Drug repositioning is increasingly becoming an attractive strategy since it can reduce costs, risks, and time-to-market. Herein, we have used this strategy to identify novel antimalarial hits. We used a comparative in silico chemogenomics approach to select Plasmodium falciparum and Plasmodium vivax proteins as potential drug targets and analyzed them using a computer-assisted drug repositioning pipeline to identify approved drugs with potential antimalarial activity. Widespread resistance against antimalarial drugs thwarts current efforts for controlling the disease and urges the discovery of new effective treatments. Drug repositioning is increasingly becoming an attractive strategy since it can reduce costs, risks, and time-to-market. Herein, we have used this strategy to identify novel antimalarial hits. We used a comparative in silico chemogenomics approach to select Plasmodium falciparum and Plasmodium vivax proteins as potential drug targets and analyzed them using a computer-assisted drug repositioning pipeline to identify approved drugs with potential antimalarial activity. Among the seven drugs identified as promising antimalarial candidates, the anthracycline epirubicin was selected for further experimental validation. Epirubicin was shown to be potent in vitro against sensitive and multidrug-resistant P. falciparum strains and P. vivax field isolates in the nanomolar range, as well as being effective against an in vivo murine model of Plasmodium yoelii. Transmission-blocking activity was observed for epirubicin in vitro and in vivo. Finally, using yeast-based haploinsufficiency chemical genomic profiling, we aimed to get insights into the mechanism of action of epirubicin. Beyond the target predicted in silico (a DNA gyrase in the apicoplast), functional assays suggested a GlcNac-1-P-transferase (GPT) enzyme as a potential target. Docking calculations predicted the binding mode of epirubicin with DNA gyrase and GPT proteins. Epirubicin is originally an antitumoral agent and presents associated toxicity. However, its antiplasmodial activity against not only P. falciparum but also P. vivax in different stages of the parasite life cycle supports the use of this drug as a scaffold for hit-to-lead optimization in malaria drug discovery.
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Milton P, Hamley JID, Walker M, Basáñez MG. Moxidectin: an oral treatment for human onchocerciasis. Expert Rev Anti Infect Ther 2020; 18:1067-1081. [PMID: 32715787 DOI: 10.1080/14787210.2020.1792772] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Moxidectin is a milbemycin endectocide recently approved for the treatment of human onchocerciasis. Onchocerciasis, earmarked for elimination of transmission, is a filarial infection endemic in Africa, Yemen, and the Amazonian focus straddling Venezuela and Brazil. Concerns over whether the predominant treatment strategy (yearly mass drug administration (MDA) of ivermectin) is sufficient to achieve elimination in all endemic foci have refocussed attention upon alternative treatments. Moxidectin's stronger and longer microfilarial suppression compared to ivermectin in both phase II and III clinical trials indicates its potential as a novel powerful drug for onchocerciasis elimination. AREAS COVERED This work summarizes the chemistry and pharmacology of moxidectin, reviews the phase II and III clinical trials evidence on tolerability, safety, and efficacy of moxidectin versus ivermectin, and discusses the implications of moxidectin's current regulatory status. EXPERT OPINION Moxidectin's superior clinical performance has the potential to substantially reduce times to elimination compared to ivermectin. If donated, moxidectin could mitigate the additional programmatic costs of biannual ivermectin distribution because, unlike other alternatives, it can use the existing community-directed treatment infrastructure. A pediatric indication (for children <12 years) and determination of its usefulness in onchocerciasis-loiasis co-endemic areas will greatly help fulfill the potential of moxidectin for the treatment and elimination of onchocerciasis.
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Affiliation(s)
- Philip Milton
- London Centre for Neglected Tropical Disease Research and MRC Centre for Global Infectious Disease Analysis (MRC GIDA), Department of Infectious Disease Epidemiology, Imperial College London , London, UK
| | - Jonathan I D Hamley
- London Centre for Neglected Tropical Disease Research and MRC Centre for Global Infectious Disease Analysis (MRC GIDA), Department of Infectious Disease Epidemiology, Imperial College London , London, UK
| | - Martin Walker
- London Centre for Neglected Tropical Disease Research and MRC Centre for Global Infectious Disease Analysis (MRC GIDA), Department of Infectious Disease Epidemiology, Imperial College London , London, UK.,London Centre for Neglected Tropical Disease Research, Department of Pathobiology and Population Sciences, Royal Veterinary College , Hatfield, UK
| | - María-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research and MRC Centre for Global Infectious Disease Analysis (MRC GIDA), Department of Infectious Disease Epidemiology, Imperial College London , London, UK
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48
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Nodari R, Corbett Y, Varotto-Boccazzi I, Porretta D, Taramelli D, Epis S, Bandi C. Effects of combined drug treatments on Plasmodium falciparum: In vitro assays with doxycycline, ivermectin and efflux pump inhibitors. PLoS One 2020; 15:e0232171. [PMID: 32324826 PMCID: PMC7179878 DOI: 10.1371/journal.pone.0232171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/08/2020] [Indexed: 12/15/2022] Open
Abstract
There is great concern regarding the rapid emergence and spread of drug-resistance in Plasmodium falciparum, the parasite responsible for the most severe form of human malaria. Parasite populations resistant to some or all the currently available antimalarial treatments are present in different world regions. Considering the need for novel and integrated approaches to control malaria, combinations of drugs were tested on P. falciparum. The primary focus was on doxycycline, an antibiotic that specifically targets the apicoplast of the parasite. In combination with doxycycline, three different drugs known to inhibit efflux pumps (verapamil, elacridar and ivermectin) were tested, with the assumption that they could increase the intracellular concentration of the antibiotic and consequently its efficacy against P. falciparum. We emphasize that elacridar is a third-generation ABC transporters inhibitor, never tested before on malaria parasites. In vitro experiments were performed on asexual stages of two strains of P. falciparum, chloroquine-sensitive (D10) and chloroquine-resistant (W2). Incubation times on asynchronous or synchronous cultures were 72h or 96h, respectively. The antiplasmodial effect (i.e. the IC50) was determined by measuring the activity of the parasite lactate dehydrogenase, while the interaction between drugs was determined through combination index (CI) analyses. Elacridar achieved an IC50 concentration comparable to that of ivermectin, approx. 10-fold lower than that of verapamil, the other tested ABC transporter inhibitor. CI results showed synergistic effect of verapamil plus doxycycline, which is coherent with the starting hypothesis, i.e. that ABC transporters represent potential targets, worth of further investigations, towards the development of companion molecules useful to enhance the efficacy of antimalarial drugs. At the same time, the observed antagonistic effect of doxycycline in combination with ivermectin or elacridar highlighted the importance of drug testing, to avoid the de-facto generation of a sub-dosage, a condition that facilitates the development of drug resistance.
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Affiliation(s)
- Riccardo Nodari
- Department of Biosciences and Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, University of Milan, Milan, Italy
- Centro Interuniversitario di Ricerca sulla Malaria/Italian Malaria Network, Milan, Italy
| | - Yolanda Corbett
- Department of Biosciences and Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, University of Milan, Milan, Italy
- Centro Interuniversitario di Ricerca sulla Malaria/Italian Malaria Network, Milan, Italy
| | - Ilaria Varotto-Boccazzi
- Department of Biosciences and Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, University of Milan, Milan, Italy
- Centro Interuniversitario di Ricerca sulla Malaria/Italian Malaria Network, Milan, Italy
| | - Daniele Porretta
- Department of Environmental Biology, Sapienza University of Rome, Rome, Italy
| | - Donatella Taramelli
- Centro Interuniversitario di Ricerca sulla Malaria/Italian Malaria Network, Milan, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Sara Epis
- Department of Biosciences and Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, University of Milan, Milan, Italy
- Centro Interuniversitario di Ricerca sulla Malaria/Italian Malaria Network, Milan, Italy
| | - Claudio Bandi
- Department of Biosciences and Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, University of Milan, Milan, Italy
- Centro Interuniversitario di Ricerca sulla Malaria/Italian Malaria Network, Milan, Italy
- * E-mail:
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Sexually transmitted infections among African women: an opportunity for combination sexually transmitted infection/HIV prevention. AIDS 2020; 34:651-658. [PMID: 32167988 DOI: 10.1097/qad.0000000000002472] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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50
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Grant JS, Stafylis C, Celum C, Grennan T, Haire B, Kaldor J, Luetkemeyer AF, Saunders JM, Molina JM, Klausner JD. Doxycycline Prophylaxis for Bacterial Sexually Transmitted Infections. Clin Infect Dis 2020; 70:1247-1253. [PMID: 31504345 PMCID: PMC7319058 DOI: 10.1093/cid/ciz866] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 08/29/2019] [Indexed: 02/04/2023] Open
Abstract
Bacterial sexually transmitted infections (STIs) have been increasing over the past 2 decades in gay, bisexual, and other men who have sex with men. With the widespread use of early human immunodeficiency virus (HIV) treatment, which virtually eliminates transmission risk, and the availability of HIV pre-exposure prophylaxis, there have been attitudinal changes regarding HIV infection with resultant increases in sexual contact and declines in condom use. Doxycycline is used for primary prophylaxis in a number of infectious diseases. We conducted a state-of-the-art review to examine the current state of research, knowledge gaps, and challenges around the use of doxycycline prophylaxis to prevent syphilis and other STIs. International academic and government experts met in March 2019 to frame the initial inquiry, which was supplemented by focused literature searches. Two small short-term randomized controlled trials examining doxycycline prophylaxis found high efficacy. Five additional clinical studies are underway or in development. Studies differed in design, population, outcomes, and safety measures. Doxycycline prophylaxis for bacterial STIs shows promise. Better and more robust data are needed on efficacy; target population; community acceptability; behavioral risk compensation; doxycycline dose, regimen, and formulation; long-term safety; antimicrobial resistance; cost-effectiveness; and risk-benefit.
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Affiliation(s)
| | - Chrysovalantis Stafylis
- Division of Infectious Diseases, University of California–Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles, California, USA
| | - Connie Celum
- Department of Global Health, University of Washington, Seattle, Washington DC, USA
- Department of Medicine, University of Washington, Seattle, Washington DC, USA
- Department of Epidemiology, University of Washington, Seattle, Washington DC, USA
| | - Troy Grennan
- British Columbia Centre for Disease Control and Division of Infectious Diseases, University of British Columbia, Vancouver, Canada
| | - Bridget Haire
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - John Kaldor
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Anne F Luetkemeyer
- Zuckerberg San Francisco General, University of California, San Francisco, California, USA
| | - John M Saunders
- Blood Safety, Hepatitis, STI, and HIV Division, National Infection Service, Public Health England, London, United Kingdom
| | - Jean-Michel Molina
- Department of Infectious Diseases, St-Louis Hospital, University of Paris Diderot, Paris, France
- INSERM U944, Paris, France
| | - Jeffrey D Klausner
- Division of Infectious Diseases, University of California–Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles, California, USA
- Department of Epidemiology, University of California–Los Angeles (UCLA), Los Angeles, California, USA
- Fielding School of Public Health, University of California–Los Angeles (UCLA), Los Angeles, California, USA
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