Pharmacokinetic and parasitological evaluation of the bone marrow of dogs with visceral leishmaniasis submitted to multiple dose treatment with liposome-encapsulated meglumine antimoniate

The aim of the present study was to evaluate the impact of a multiple dose regimen of a liposomal formulation of meglumine antimoniate (LMA) on the pharmacokinetics of antimony in the bone marrow of dogs with visceral leishmaniasis and on the ability of LMA to eliminate parasites from this tissue. Dogs naturally infected with Leishmania chagasi received 4 intravenous doses of either LMA (6.5 mg antimony/kg body weight, N = 9), or empty liposomes (at the same lipid dose as LMA, N = 9) at 4-day intervals. A third group of animals was untreated (N = 8). Before each administration and at different times after treatment, bone marrow was obtained and analyzed for antimony level (LMA group) by electrothermal atomic absorption spectrometry, and for the presence of Leishmania parasites (all groups). There was a significant increase of antimony concentration from 0.76 microg/kg wet organ (4 days after the first dose) to 2.07 microg/kg (4 days after the fourth dose) and a half-life of 4 days for antimony elimination from the bone marrow. Treatment with LMA significantly reduced the number of dogs positive for parasites (with at least one amastigote per 1000 host cells) compared to controls (positive dogs 30 days after treatment: 0 of 9 in the LMA group, 3 of 9 in the group treated with empty liposomes and 3 of 8 in the untreated group). However, complete elimination of parasites was not achieved. In conclusion, the present study showed that multiple dose treatment with LMA was effective in improving antimony levels in the bone marrow of dogs with visceral leishmaniasis and in reducing the number of positive animals, even though it was not sufficient to achieve complete elimination of parasites.

Distribution of liposome-encapsulated antimony in dogs

The achievement of complete cure in dogs with visceral leishmaniasis is currently a great challenge, since dogs are the main reservoir for the transmission of visceral leishmaniasis to humans and they respond poorly to conventional treatment with pentavalent antimonials. In order to improve the efficacy of treatment, we developed a novel formulation for meglumine antimoniate based on the encapsulation of this drug in freeze-dried liposomes (LMA). The aim of the present study was to evaluate the biodistribution of antimony (Sb) in dogs following a single intravenous bolus injection of LMA. Four healthy male mongrel dogs received LMA at 3.8 mg Sb/kg body weight and were sacrificed 3, 48 and 96 h and 7 days later. Antimony was determined in the blood, liver, spleen and bone marrow. In the bone marrow, the highest Sb concentration was observed at 3 h (2.8 microg/g wet weight) whereas in the liver and spleen it was demonstrated at 48 h (43.6 and 102.4 microg/g, respectively). In these organs, Sb concentrations decreased gradually and reached levels of 19.1 microg/g (liver), 28.1 microg/g (spleen) and 0.2 microg/g (bone marrow) after 7 days. Our data suggest that the critical organ for the treatment with LMA could be the bone marrow, since it has low Sb levels and, presumably, high rates of Sb elimination. A multiple dose treatment with LMA seems to be necessary for complete elimination of parasites from bone marrow in dogs with visceral leishmaniasis.

Glutathione-induced conversion of pentavalent antimony to trivalent antimony in meglumine antimoniate

The standard treatment of human leishmaniases involves the use of pentavalent antimony [Sb(V)] compounds, including meglumine antimoniate. The mode of action of these compounds has not been fully elucidated. The possibility that Sb(III) is involved has been suggested; however, the biomolecule that may induce the conversion of Sb(V) to Sb(III) has not yet been identified. In the present study, we investigated both the ability of reduced glutathione (GSH) to promote the reduction of Sb(V) into Sb(III) in meglumine antimoniate and the effects of pH and temperature on this transformation. GSH did promote the reduction of Sb(V) into Sb(III) in a dose-dependent manner. When GSH and meglumine antimoniate were incubated together at a GSH/Sb molar ratio superior or equal to 5:1, all antimony was encountered in the reduced form, indicating a stoichiometry of 5:1 between GSH and Sb(V) in the reaction. The reaction between Sb(V) and GSH was favored at an acidic pH (pH 5) and an elevated temperature (37 degrees C), conditions found within the phagolysosome, in which Leishmania resides. For instance, about 30% of the Sb(V) (concentration, 2mM) was converted to Sb(III) following incubation for 3 days with 10 mM GSH at pH 5 and 37 degrees C. Our data support the hypothesis that Sb(V) would be converted by GSH, or a related thiol compound, to more toxic Sb(III) in the phagolysosome of macrophages.

Novel methods for the encapsulation of meglumine antimoniate into liposomes

The antimonial drug, meglumine antimoniate, was successfully encapsulated in dehydration-rehydration vesicles and in freeze-dried empty liposomes (FDELs). High encapsulation efficiencies (from 28 to 58%) and low weight ratios of lipids to encapsulated antimony (from 1:0.15 to 1:0.3) were achieved. These formulations, contrary to those obtained by conventional methods, can be stored as intermediate lyophilized forms and reconstituted just before use. The efficacy of FDEL-encapsulated meglumine antimoniate was evaluated in hamsters experimentally infected with Leishmania chagasi. A significant reduction of liver parasite burdens was observed in animals treated with this preparation, when compared to control animals treated with empty liposomes. In contrast, free meglumine antimoniate was found to be inefficient when administered at a comparable dose of antimony. This novel liposome-based meglumine antimoniate formulation appears to be promising as a pharmaceutical product for the treatment of visceral leishmaniasis.

Physico-chemical characterization of meglumine antimoniate

The leishmanicidal drug, meglumine antimoniate (MA), has been synthesized by the reaction of antimony oxyhydrated and N-methyl glucamine. Infrared and solid state NMR 13C analysis of MA and the ligand strongly suggests that antimony binds to N-methyl glucamine through the oxygen of C-3 carbon. Potentiometric titration indicated that, between pH 4.5 and 7.5, MA exists in the zwitterionic form.

Metal complexes of anhydrotetracycline. 2. Absorption and circular dichroism study of Mg(II), Al(III), and Fe(III) complexes. Possible influence of the Mg(II) complex on the toxic side effects of tetracycline

Anhydrotetracycline (AHTC) is the major toxic decomposition product of the antibiotic tetracycline. The complexation of AHTC to Mg(II), Al(III), and Fe(III) was studied in aqueous medium using absorption and circular dichroism measurements. The study of the Mg(II)-AHTC interactions at pH 7 indicated the formation of the MHL and M2L species in which an Mg(II) ion is coordinated to the C11 and C12 oxygens of the BCD ring system. In the M2L species, a second metal ion coordinates to the N4 and O3 positions on ring A, inducing the ligand to adopt the "twisted" conformation. At pH 4, an MHL species is formed with Al(III) by complexation of the metal ion to O11 and O12. At pH 1, Fe(III) forms an MH2L species, probably by coordination of the metal to 012 and 01. The stability constants of all species were calculated. The possible participation of Mg(II) in the mechanism of toxicity of tetracycline is suggested.

Chirality of the interaction of mithramycin with phosphatidylcholine-bilayer membranes in the presence of Mg2+ or Zn2+

Binding of the antitumor compound mithramycin to dipalmitoyl-sn-glycerophosphocholine and dimyristoyl-sn-glycerophosphocholine (Myr2GroPCho) model membrane (small unilamellar vesicles, SUV) bilayers was shown to be dependent on the molecular packing of the lipids and on the presence of Zn2+ or Mg2+. The CD properties of mithramycin have been used to follow its complexation to Zn2+ and to Mg2+. In the absence of SUV, Mg2+ and Zn2+ are each able to form with mithramycin two types of complexes of different chirality: at low molar ratios of M2+ to mithramycin, a complex in the left-handed conformation is obtained whereas at high molar ratios the complex formed has the right-handed conformation. In the presence of Zn2+ or Mg2+, mithramycin binds to SUV in the gel-phase state as a dimer in the left-handed conformation. No binding is observed when SUV are in liquid-crystal state.

Mithramycin: a very strong metal chelating agent

The interaction of mithramycin (MTR) with Ca2+, Cd2+, Tb3+, Gd3+, Li+, Na+ and K+ ions has been studied by circular dichroism and absorption spectroscopy. Mithramycin binds strongly to Ca2+, Cd2+, Tb3+ and Gd3+ forming a 1:4 Ca2+: MTR entities with a left-handed screw conformation. The concentration of Ca2+ present in water currently used being about 10 microM, this leads to the conclusion that, in most of the experiments reported in the literature, about 40 microM mithramycin were actually bound to Ca2+. Mithramycin also binds to Na+, forming entities with left-handed screw conformation, but not to K+ and Li+. None of these cations were able to promote the mithramycin-DNA interaction.

Interaction of mithramycin with DNA. Evidence that mithramycin binds to DNA as a dimer in a right-handed screw conformation

The CD and fluorescence properties of mithramycin have been used to follow its complexation to cations such as Mg2+ and Zn2+ and the binding of these complexes to DNA. At low concentration (less than 2 microM) in aqueous solution, mithramycin is always in the dimeric state, the conformation of the dimer being either a right-handed screw when the dimer is neutral, or a left-handed screw when the dimer is negatively charged. In the deprotonated state the dimer can bind one cation forming a complex [M2+(Mit-)2] which has a right-handed screw conformation. The stability constants of the complex at 37 degrees C in 0.1 M KCl are 4 x 10(5) and 1 x 10(6) for Mg2+ and Zn2+, respectively. The complex in the right-handed screw conformation binds DNA. In this case the stability constants of the complex [M2+ (Mit-)2] increase and are 3.6 x 10(6) and 1.2 x 10(7) for Mg2+ and Zn2+, respectively.

Mithramycin cannot bind to left-handed poly(dG-m5dC) in the presence of Mg2+ ion

Mithramycin (MTR) is an antitumor compound that inhibits RNA and DNA polymerase action by forming a non covalent complex with double strand DNA, in the presence of divalent cations. We have shown that in the presence of Mg2+, MTR binds to right-handed poly(dG-m5dC) as a dimer in the right-handed screwness conformation but cannot bind to left-handed poly(dG-m5dC).