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Olías-Molero AI, de la Fuente C, Cuquerella M, Torrado JJ, Alunda JM. Antileishmanial Drug Discovery and Development: Time to Reset the Model? Microorganisms 2021; 9:2500. [PMID: 34946102 PMCID: PMC8703564 DOI: 10.3390/microorganisms9122500] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 11/26/2021] [Accepted: 12/01/2021] [Indexed: 01/27/2023] Open
Abstract
Leishmaniasis is a vector-borne parasitic disease caused by Leishmania species. The disease affects humans and animals, particularly dogs, provoking cutaneous, mucocutaneous, or visceral processes depending on the Leishmania sp. and the host immune response. No vaccine for humans is available, and the control relies mainly on chemotherapy. However, currently used drugs are old, some are toxic, and the safer presentations are largely unaffordable by the most severely affected human populations. Moreover, its efficacy has shortcomings, and it has been challenged by the growing reports of resistance and therapeutic failure. This manuscript presents an overview of the currently used drugs, the prevailing model to develop new antileishmanial drugs and its low efficiency, and the impact of deconstruction of the drug pipeline on the high failure rate of potential drugs. To improve the predictive value of preclinical research in the chemotherapy of leishmaniasis, several proposals are presented to circumvent critical hurdles-namely, lack of common goals of collaborative research, particularly in public-private partnership; fragmented efforts; use of inadequate surrogate models, especially for in vivo trials; shortcomings of target product profile (TPP) guides.
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Affiliation(s)
- Ana Isabel Olías-Molero
- Department of Animal Health, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.I.O.-M.); (C.d.l.F.); (M.C.)
| | - Concepción de la Fuente
- Department of Animal Health, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.I.O.-M.); (C.d.l.F.); (M.C.)
| | - Montserrat Cuquerella
- Department of Animal Health, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.I.O.-M.); (C.d.l.F.); (M.C.)
| | - Juan J. Torrado
- Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - José M. Alunda
- Department of Animal Health, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.I.O.-M.); (C.d.l.F.); (M.C.)
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de Lana M, Giunchetti RC. Dogs as a Model for Chemotherapy of Chagas Disease and Leishmaniasis. Curr Pharm Des 2021; 27:1741-1756. [PMID: 33371843 DOI: 10.2174/1381612826666201228142703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 10/22/2020] [Accepted: 11/02/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Dogs are natural reservoir of Chagas disease (CD) and leishmaniasis and have been used for studies of these infections as they develop different clinical forms of these diseases similar to humans. OBJECTIVE This article describes publications on the dog model relative to CD and leishmaniasis chemotherapy. METHODS The search of articles was based on PubMed, Scopus and MESH using the keywords: dog, Trypanosoma cruzi, treatment (T. cruzi chemotherapy analysis), Leishmania chagasi, Leishmania infantum, canine visceral leishmaniasis, treatment (Leishmania chemotherapy evaluation). RESULTS Benznidazole and nifurtimox were used as a reference in the treatment of CD and in combination with other compounds. Eleven out of the fifteen studies have authors from the same team, using similar protocols and post-treatment evaluations, which assured more reproducibility and credibility. Twenty leishmaniasis studies, especially on visceral leishmaniasis, presenting at least one parasitological analysis tested in distinct monochemotherapy and polychemotherapy approaches were accessed. Data demonstrated that polychemotherapy was more effective in improving the clinical signs and parasitism control. CONCLUSION The benefits of treatment in terms of reducing or eliminating lesions and/or cardiac dysfunctions were demonstrated at acute and/or chronic phases relative to parasite load and/or the T. cruzi strain resistance to treatment. BZ presented better therapeutic results than the two EBI compounds evaluated. Although treatment of the canine visceral leishmaniasis was not able to induce complete parasite clearance, it can improve clinical recovery. Thus, the dog is a good model for CD and leishmaniasis studies of chemotherapy and may be indicated for pre-clinical trials of new treatments.
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Affiliation(s)
- Marta de Lana
- Programa de Pos-Graduacao em Ciencias Farmaceuticas (CiPHARMA), Escola de Farmacia, Programa Pos-Graduacao em de Ciencias Biologicas, Nucleo de Pesquisas em Ciencias Biologicas (NUPEB), Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG, Brazil
| | - Rodolfo Cordeiro Giunchetti
- Departamento de Morfologia, Instituto de Ciencias Biologicas (ICB), Universidade Federal de Minas Gerais, MG, Brazil
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Daza González MA, Miró G, Fermín Rodríguez M, Rupérez Noguer C, Fragío Arnold C. Short term impacts of meglumine antimoniate treatment on kidney function in dogs with clinical leishmaniosis. Res Vet Sci 2019; 126:131-138. [PMID: 31491669 DOI: 10.1016/j.rvsc.2019.08.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/11/2019] [Accepted: 08/27/2019] [Indexed: 01/22/2023]
Abstract
This study examines correlations among serum proteins, clinical score, body weight and kidney function biomarkers after a standard treatment course (meglumine antimoniate plus allopurinol) in twelve Canine leishmaniosis (CanL) patients at the three times points pre treatment, after treatment and after the end of treatment. The laboratory variables measured were those used for the follow-up of sick dogs along with biomarkers of kidney function: glomerular filtration rate (GFR), creatinine (Cr), urea, calcium, inorganic phosphorus, urine specific gravity (USG) and urine protein to creatinine ratio (UPC). Arterial blood pressure (systolic blood pressure, SBP), clinical score (CS) and weight were also monitored over the study period. At Tp0, GFR was within the normal range in most dogs. Hyperfiltration was detected in three patients and hypofiltration in one. In dogs showing hyperfiltration, this factor remained in the non-azotemic range over the whole study period. After treatment normal filtration values were recovered. Meglumine antimoniate did not modify GFR or USG. A significant reduction in UPC was recorded. In all dogs, clinical scores improved. Negative correlation was found between GFR and Cr, UPC and albumin (Alb) and CS and Alb, while positive correlation was detected between UPC and total globulins (GlobT), CS and GlobT, UPC and total solids (TS), SBP and CS and SBP and UPC. Our findings indicate no impacts on kidney function of the treatment of CanL with meglumine antimoniate, as no effects were produced on GFR or USG. Treatment was effective and found to reduce UPC which could suggest improved glomerular injury.
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Affiliation(s)
- M A Daza González
- Small Animal Emergency and ICU Service, Hospital Clínico Veterinario Complutense, Veterinary Faculty, Universidad Complutense de Madrid, Avda Puerta Hierro sn., Madrid 28040, Spain.
| | - G Miró
- Department of Animal Health, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, Avda Puerta hierro sn., Madrid 28040, Spain
| | - M Fermín Rodríguez
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, Avda Puerta hierro sn., Madrid 28040, Spain
| | - C Rupérez Noguer
- Department of Animal Health, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, Avda Puerta hierro sn., Madrid 28040, Spain
| | - C Fragío Arnold
- Small Animal Emergency and ICU Service, Hospital Clínico Veterinario Complutense, Veterinary Faculty, Universidad Complutense de Madrid, Avda Puerta Hierro sn., Madrid 28040, Spain; Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, Avda Puerta hierro sn., Madrid 28040, Spain
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Coelho DR, Miranda ES, Saint'Pierre TD, Paumgartten FJR. Tissue distribution of residual antimony in rats treated with multiple doses of meglumine antimoniate. Mem Inst Oswaldo Cruz 2015; 109:420-7. [PMID: 25075781 PMCID: PMC4155842 DOI: 10.1590/0074-0276140030] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 06/04/2014] [Indexed: 12/03/2022] Open
Abstract
Meglumine antimoniate (MA) and sodium stibogluconate are pentavalent antimony
(SbV) drugs used since the mid-1940s. Notwithstanding the fact that
they are first-choice drugs for the treatment of leishmaniases, there are gaps in our
knowledge of their toxicological profile, mode of action and kinetics. Little is
known about the distribution of antimony in tissues after SbV
administration. In this study, we evaluated the Sb content of tissues from male rats
24 h and three weeks after a 21-day course of treatment with MA (300 mg
SbV/kg body wt/d, subcutaneous). Sb concentrations in the blood and
organs were determined by inductively coupled plasma-mass spectrometry. In rats, as
with in humans, the Sb blood levels after MA dosing can be described by a
two-compartment model with a fast (t1/2 = 0.6 h) and a slow (t1/2 >> 24 h)
elimination phase. The spleen was the organ that accumulated the highest amount of
Sb, while bone and thyroid ranked second in descending order of tissues according to
Sb levels (spleen >> bone, thyroid, kidneys > liver, epididymis, lungs,
adrenals > prostate > thymus, pancreas, heart, small intestines > skeletal
muscle, testes, stomach > brain). The pathophysiological consequences of Sb
accumulation in the thyroid and Sb speciation in the liver, thyroid, spleen and bone
warrant further studies.
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Affiliation(s)
- Deise Riba Coelho
- Laboratório de Toxicologia Ambiental, Departamento de Ciências Biológicas, Escola Nacional de Saúde Pública-Fiocruz, Rio de Janeiro, RJ, Brasil
| | - Elaine Silva Miranda
- Laboratório de Toxicologia Ambiental, Departamento de Ciências Biológicas, Escola Nacional de Saúde Pública-Fiocruz, Rio de Janeiro, RJ, Brasil
| | | | - Francisco José Roma Paumgartten
- Laboratório de Toxicologia Ambiental, Departamento de Ciências Biológicas, Escola Nacional de Saúde Pública-Fiocruz, Rio de Janeiro, RJ, Brasil
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Coelho DR, De-carvalho RR, Rocha RC, Saint’pierre TD, Paumgartten FJ. Effects of in utero and lactational exposure to SbV on rat neurobehavioral development and fertility. Reprod Toxicol 2014; 50:98-107. [DOI: 10.1016/j.reprotox.2014.10.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/25/2014] [Accepted: 10/14/2014] [Indexed: 11/20/2022]
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Borborema SET, Osso JA, Andrade HFD, Nascimento ND. Biodistribution of meglumine antimoniate in healthy and Leishmania (Leishmania) infantum chagasi-infected BALB/c mice. Mem Inst Oswaldo Cruz 2014; 108:623-30. [PMID: 23903979 PMCID: PMC3970594 DOI: 10.1590/0074-0276108052013014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 05/28/2013] [Indexed: 11/29/2022] Open
Abstract
Pentavalent antimonials such as meglumine antimoniate (MA) are the
primary treatments for leishmaniasis, a complex disease caused by protozoan
parasites of the genus Leishmania . Despite over 70 years of
clinical use, their mechanisms of action, toxicity and pharmacokinetics have not
been fully elucidated. Radiotracer studies performed on animals have the
potential to play a major role in pharmaceutical development. The aims of this
study were to prepare an antimony radiotracer by neutron irradiation of MA and
to determine the biodistribution of MA in healthy and Leishmania
(Leishmania) infantum chagasi-infected mice. MA
(Glucantime(r)) was neutron irradiated inside the IEA-R1 nuclear
reactor, producing two radioisotopes, 122Sb and 124Sb, with high radionuclidic
purity and good specific activity. This irradiated compound presented
anti-leishmanial activity similar to that of non-irradiated MA in both in vitro
and in vivo evaluations. In the biodistribution studies, healthy mice showed
higher uptake of antimony in the liver than infected mice and elimination
occurred primarily through biliary excretion, with a small proportion of the
drug excreted by the kidneys. The serum kinetic curve was bi-exponential, with
two compartments: the central compartment and another compartment associated
with drug excretion. Radiotracers, which can be easily produced by neutron
irradiation, were demonstrated to be an interesting tool for answering several
questions regarding antimonial pharmacokinetics and chemotherapy.
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Affiliation(s)
- Samanta Etel Treiger Borborema
- Centro de Biotecnologia, Instituto de Pesquisas Energéticas e Nucleares, Comissão Nacional de Energia Nuclear, São Paulo, SP, Brasil.
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Paradies P, Sasanelli M, Amato ME, Greco B, De Palo P, Lubas G. Monitoring the reverse to normal of clinico-pathological findings and the disease free interval time using four different treatment protocols for canine leishmaniosis in an endemic area. Res Vet Sci 2012; 93:843-7. [PMID: 22296941 DOI: 10.1016/j.rvsc.2012.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 12/23/2011] [Accepted: 01/06/2012] [Indexed: 11/15/2022]
Abstract
Twenty-four dogs naturally infected by Leishmania spp. were treated with four different protocols using meglumine antimoniate (aNm) and allopurinol in combination or in monotherapy. Aiming to compare the efficacy of the different treatments the reverse to normal of clinico-pathological findings and the disease free interval time (DFIT) were evaluated. Treated dogs were monitored for 1 year and, in absence of relapses, the DFIT was postponed to the last available follow-up. Seven dogs treated with aNm alone showed relapses during the year of observation. In the group of dogs treated with the combination of aNm (50 mg/kg/SC 12 hourly up to clinico-pathological recovery) and allopurinol (15 mg/kg/PO 12 hourly administered for 6months) no relapses were registered in the year of monitoring and the DFIT reached up to 65 months. Our results showed that this combination represents the best choice to treat canine leishmaniosis compared to other protocols.
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Affiliation(s)
- Paola Paradies
- Department of Public Health and Animal Sciences, Faculty of Veterinary Medicine, University of Bari, Italy.
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8
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Oliva G, Roura X, Crotti A, Maroli M, Castagnaro M, Gradoni L, Lubas G, Paltrinieri S, Zatelli A, Zini E. Guidelines for treatment of leishmaniasis in dogs. J Am Vet Med Assoc 2010; 236:1192-8. [PMID: 20513197 DOI: 10.2460/javma.236.11.1192] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Gaetano Oliva
- Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, University of Naples, 80137 Naples, Italy
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9
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Bianciardi P, Brovida C, Valente M, Aresu L, Cavicchioli L, Vischer C, Giroud L, Castagnaro M. Administration of Miltefosine and Meglumine Antimoniate in Healthy Dogs: Clinicopathological Evaluation of the Impact on the Kidneys. Toxicol Pathol 2009; 37:770-5. [DOI: 10.1177/0192623309344088] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In canine leishmaniosis (CanL), kidneys are affected in virtually all dogs. Treatment of CanL is limited in Europe to meglumine antimoniate and miltefosine. This study evaluated the pharmacological, toxicological, and pathological effects of both drugs in healthy beagle dogs. Four male and four female dogs were divided into two groups. The animals in Group 1 were administered an oral solution of 2% of miltefosine at 2 mg/kg b.w. once a day, for twenty-eight days. The animals in Group 2 were administered a preparation of meglumine antimoniate at 100 mg/kg b.w. subcutaneously once a day for twenty-eight days. After treatment, all dogs were followed-up for a further twenty-eight days. Dogs were observed daily and clinically examined ten times throughout the study. On days -1 and 55 a renal biopsy was performed on all dogs and analyzed by light microscopy, immunofluorescence, and electron microscopy. All the examinations failed to demonstrate any lesions in the miltefosine-treated dogs. Conversely, all the meglumine antimoniate–treated dogs demonstrated severe tubular damage, characterized by tubular cell necrosis and apoptosis. In conclusion, although no clinical signs of renal disease were evident, the use of meglumine antimoniate in the pharmacological treatment approach of CanL-affected dogs should be carefully considered.
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Affiliation(s)
| | - Claudio Brovida
- ANUBI Ospedale per Animali da Compagnia, 10024 Moncalieri, Torino, Italy
| | - Marialuisa Valente
- Department of Medical-Diagnostic Sciences and Special Therapies, University of Padua, Medical School, 35121 Padova, Italy
| | - Luca Aresu
- Dipartimento di Sanità Pubblica Patologia Comparata e Igiene Veterinaria, Facoltà di Medicina Veterinaria, Università degli Studi di Padova, 35020 Legnaro, Padova, Italy
| | - Laura Cavicchioli
- Dipartimento di Sanità Pubblica Patologia Comparata e Igiene Veterinaria, Facoltà di Medicina Veterinaria, Università degli Studi di Padova, 35020 Legnaro, Padova, Italy
| | | | | | - Massimo Castagnaro
- Dipartimento di Sanità Pubblica Patologia Comparata e Igiene Veterinaria, Facoltà di Medicina Veterinaria, Università degli Studi di Padova, 35020 Legnaro, Padova, Italy
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Chu DF, Fu XQ, Liu WH, Liu K, Li YX. Pharmacokinetics and in vitro and in vivo correlation of huperzine A loaded poly(lactic-co-glycolic acid) microspheres in dogs. Int J Pharm 2006; 325:116-23. [PMID: 16876971 DOI: 10.1016/j.ijpharm.2006.06.032] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2006] [Revised: 05/09/2006] [Accepted: 06/22/2006] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to investigate the pharmacokinetics and in vitro/in vivo correlation (IVIVC) of huperzine A loaded poly(lactic-co-glycolic acid) (PLGA) microspheres in dogs. Several huperzine A loaded PLGA microspheres were prepared by an O/W method and three of them (single dose) were injected intramuscularly (i.m.) or subcutaneously (s.c.) to five beagle dogs, respectively. With the increase of the molecular weight of PLGA and the particle size of microspheres, the in vitro and in vivo release periods of huperzine A were prolonged. After s.c. injection, the release of huperzine A from microspheres was faster than that after i.m. injection. The IVIVC models of huperzine A loaded PLGA microspheres were established successfully and after i.m. administration the linear relationship between the in vitro and the in vivo releases was better than that after s.c. administration. It was also found when the particle size of the microspheres was smaller; the values of correlation coefficient were higher.
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Affiliation(s)
- Da-Feng Chu
- School of Pharmacy, Yantai University, No. 32 Qingquan Road, 264005 Yantai, Shandong Province, PR China
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Affiliation(s)
- Ki‐Woong Kim
- Industrial Health Research Institute, Korea Industrial Safety Corporation
| | | | - Seong‐Kyu Kang
- Industrial Health Research Institute, Korea Industrial Safety Corporation
| | | | - Sang Shin Park
- Industrial Health Research Institute, Korea Industrial Safety Corporation
| | - Young‐Sook Cho
- Industrial Health Research Institute, Korea Industrial Safety Corporation
| | - Moon‐Gi Song
- Industrial Health Research Institute, Korea Industrial Safety Corporation
| | - Young‐Hahn Moon
- Industrial Health Research Institute, Korea Industrial Safety Corporation
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Abstract
Canine leishmaniasis is caused by Leishmania infantum (syn. L. chagasi, in America) and is transmitted by the bite of phlebotomine sand flies. Infected dogs constitute the main domestic reservoir of the parasite and play a key role in transmission to humans, in which the parasite produces visceral leishmaniasis. The increasing awareness that control of the human disease depends on effective control of canine leishmaniasis has promoted, in the last few years, research into leishmanial infection in dogs. Newly available specific reagents and molecular tools have been applied to the detailed investigation of canine leishmaniasis and important advances have been made in elucidating the epidemiology and pathology of the disease. These new findings have led to better understanding of the disease, and have also helped in the development of new diagnostic methods and control measures against the infection, such as insecticide-impregnated collars for dogs, new drugs and treatment protocols, and second generation vaccines, with the hope of not only reducing the heavy burden of the disease among dogs but also reducing the incidence of human visceral leishmaniasis.
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Affiliation(s)
- Jorge Alvar
- WHO Collaborating Centre for Leishmaniasis, Servicio de Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28220-Majadahonda, Madrid, Spain.
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13
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Nieto J, Alvar J, Mullen AB, Carter KC, Rodríguez C, San Andrés MI, San Andrés MD, Baillie AJ, González F. Pharmacokinetics, toxicities, and efficacies of sodium stibogluconate formulations after intravenous administration in animals. Antimicrob Agents Chemother 2003; 47:2781-7. [PMID: 12936974 PMCID: PMC182616 DOI: 10.1128/aac.47.9.2781-2787.2003] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2002] [Revised: 07/27/2002] [Accepted: 06/03/2003] [Indexed: 11/20/2022] Open
Abstract
The pharmacokinetics and toxicities of free sodium stibogluconate (SSG) and two vesicular formulations of this drug (a nonionic surfactant vesicular formulation of SSG [SSG-NIV] and SSG-NIV-dextran) were determined after treatment with a single intravenous dose in healthy dogs and were related to their antileishmanial efficacies in mice. Analysis of the curves of the concentrations in plasma after intravenous administration of SSG and SSG-NIV in dogs showed that both formulations produced similar antimony (Sb) pharmacokinetics. In contrast, treatment with SSG-NIV-dextran significantly modified the pharmacokinetics of the drug. The elimination half-life was four times longer (280 min) than that observed after administration of SSG (71 min) (P = 0.01), and the volume of distribution at steady state (V(SS)) was also increased (V(SS) for SSG, 0.21 liters/kg; V(SS) for SSG-NIV-dextran, 0.34 liters/kg [P = 0.02]), thus indicating that drug encapsulation favors the distribution of Sb into organs and increases its residence time in tissues. This would explain the superior antileishmanial efficacy of this formulation compared to those of the free drug in mice. No signs of toxicity were found in dogs after SSG and SSG-NIV administration. However, SSG-NIV-dextran treatment was associated with short-term toxicity, demonstrated by the development of chills and diarrhea, which cleared by 24 h postdosing, and hepatic dysfunction at 24 h postdosing (P < 0.05). The levels of all the biochemical parameters had returned to normal at 1 month postdosing. No signs of toxicity were observed in mice treated with all three formulations.
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Affiliation(s)
- J Nieto
- WHO Collaborating Center for Leishmaniasis Servicio de Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.
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Abstract
Visceral leishmaniosis is a widespread and potentially fatal disease of dogs and humans common in the Mediterranean region, the Middle East, and South America. Canine leishmaniosis is most frequently treated with the drugs meglumine antimoniate, allopurinol, amphotericin B, or a combination of meglumine antimoniate and allopurinol. Therapy with the currently used drugs often achieves temporary clinical improvement and changes in immunologic parameters with restoration of the ability to mount parasite-specific cell mediated responses and decrease in anti-leishmanial antibody titers. However, treatment usually does not prevent relapse of disease or eliminate parasite carriage. Due to the current lack of an ultimate and effective therapy for canine leishmaniosis, new drugs, delivery systems and treatment strategies are necessary to achieve a consistent parasitological cure in infected dogs.
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Affiliation(s)
- Gad Baneth
- School of Veterinary Medicine, Hebrew University, P.O. Box 12, 76100, Rehovot, Israel.
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Valladares JE, Riera C, González-Ensenyat P, Díez-Cascón A, Ramos G, Solano-Gallego L, Gállego M, Portús M, Arboix M, Alberola J. Long term improvement in the treatment of canine leishmaniosis using an antimony liposomal formulation. Vet Parasitol 2001; 97:15-21. [PMID: 11337123 DOI: 10.1016/s0304-4017(01)00389-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Pharmacokinetic and clinical effectiveness of liposome-encapsulated N-methylglucamine antimoniate (LMA) was performed in dogs suffering from experimental leishmaniosis. LMA was compared with N-methylglucamine antimoniate (MGA), the same drug in its free form. Sb plasma concentrations for LMA were always higher than those for MGA. Mean residence time (MRT), half-life time (t(1/2)) and clearance (Cl) showed that Sb was eliminated slower after liposome administration. The high volume of distribution (Vd) obtained with LMA suggests that Sb could achieve therapeutic concentrations in parasite-infected tissues. Average plasma concentration at steady state (Css(ave)) shows that Sb body concentrations after LMA treatment (9.8 mg/kg Sb, each 24h) would be effective in Leishmania infantum canine infection. Comparing LMA with MGA in a 1-year follow-up we observed no relapses for LMA and total protein and gammaglobulin concentrations were within normal range, while for MGA both began to rise 3 months after treatment. Use of antimonial liposomal formulations may restore effectiveness to an existing drug and reduce toxicity.
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Affiliation(s)
- J E Valladares
- Departament de Farmacologia i Terapèutica, Facultat de Veterinària, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Barcelona, Spain
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Valladares JE, Riera C, Alberola J, Gállego M, Portús M, Cristòfol C, Franquelo C, Arboix M. Pharmacokinetics of meglumine antimoniate after administration of a multiple dose in dogs experimentally infected with Leishmania infantum. Vet Parasitol 1998; 75:33-40. [PMID: 9566092 DOI: 10.1016/s0304-4017(97)00193-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pharmacokinetics of meglumine antimoniate in dogs with experimentally induced leishmaniosis has been investigated. After infection, dogs received a dose of 75 mg kg-1 of meglumine antimoniate twice daily by subcutaneous injection for 10 days. Blood samples were collected throughout the treatment. No statistical differences were found in the kinetic behaviour of the drug administered as a single dose to healthy dogs and that administered as a multiple dose to infected animals. However, peak plasma concentrations (Cmax) of 30.8 +/- 12.8 micrograms ml-1 found after this dosage regimen were higher than those observed after the single dose administration of 100 mg kg-1 24 h-1. Furthermore, sustained antimony concentrations of 1.14 +/- 0.52 micrograms Sb ml-1 were detected throughout the treatment. No signs of toxicity were found in the animals treated indicating that this regimen would be very appropriate to treat canine leishmaniosis.
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Affiliation(s)
- J E Valladares
- Departament de Farmacologia i Terapèutica, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain.
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Abstract
A study was carried out in dogs to define the pharmacokinetic profile of antimony and to define a better therapeutic protocol for the treatment of canine leishmaniasis. Six healthy beagle dogs received 100 mg/kg of N-methylglucamine antimoniate containing 27.2 per cent of antimony intravenously, intramuscularly and subcutaneously. After intravenous administration the plasma concentration of antimony decreased rapidly and after 240 minutes it was lower than the ED50 values suggested for Leishmania donovani. The pharmacokinetic parameters and bioavailability of antimony were calculated after each route of administration in each dog. The curves of plasma concentrations vs time were best described by a triexponential open model with a mean (sd) half life t1/2 alpha of 9.4 (4.4) min, a t1/2 beta of 45.3 (4.5) min and a t1/2 gamma of 618.0 (93.5) min. The mean volume of distribution at steady state was 0.25 (0.03) litres/kg and the total body clearance was 0.25 (0.04) litres/h/kg. The peak plasma concentration (Cmax) after intramuscular administration was 27.2 (3.1) micrograms/ml, and after subcutaneous administration it was 25.5 (4.5) micrograms/ml; they were reached after 73.6 (11.9) min and 85.6 (11.3) min, respectively. The bioavailabilities after intramuscular and subcutaneous administration were 91.7 (7.1) and 92.2 (7.1) per cent, respectively. More than 80 per cent of the antimony was excreted in the urine in the first nine hours.
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Affiliation(s)
- J E Valladares
- Divisió de Farmacologia, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Belloli C, Ceci L, Carli S, Tassi P, Montesissa C, De Natale G, Marcotrigiano G, Ormas P. Disposition of antimony and aminosidine in dogs after administration separately and together: implications for therapy of leishmaniasis. Res Vet Sci 1995; 58:123-7. [PMID: 7761689 DOI: 10.1016/0034-5288(95)90064-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The pharmacokinetic behaviour of aminosidine (15 mg kg-1) and antimony (25.65 mg kg-1 as N-methylglucamine antimoniate), administered subcutaneously either separately or together was studied on four dogs. The results demonstrated that antimony (Sb) did not significantly modify the kinetics of aminosidine (AM) but that the kinetic behaviour of the metal was markedly influenced by the antibiotic, as shown by the differences in mean residence time (MRT), elimination rate constant (Kel) and area under the curve (AUC) with and without the antibiotic (MRT[Sb] = 243.8 +/- 29.5 minutes, MRT[Sb+AM] = 1067.9 +/- 199.2 minutes; Kel[Sb] = 0.008 +/- 0.001 min-1, Kel[Sb+AM] = 0.0015 +/- 0.0003 min-1; AUC[Sb] = 21,024.6 +/- 4448.5 micrograms min ml-1, AUC[Sb+AM] = 130,478.5 +/- 30,481.7 micrograms min ml-1). The persistence of high serum concentrations of antimony when it was administered with aminosidine suggests that the therapeutic doses commonly used should be reduced and that the interval between administration should be increased to avoid the metal reaching toxic concentrations.
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Affiliation(s)
- C Belloli
- Institute of Veterinary Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Milan, Italy
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