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In-vitro and in-vivo antileishmanial activity of inexpensive Amphotericin B formulations: Heated Amphotericin B and Amphotericin B-loaded microemulsion. Exp Parasitol 2018; 192:85-92. [DOI: 10.1016/j.exppara.2018.07.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 06/18/2018] [Accepted: 07/30/2018] [Indexed: 12/20/2022]
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Tripathi P, Jaiswal AK, Dube A, Mishra PR. Hexadecylphosphocholine (Miltefosine) stabilized chitosan modified Ampholipospheres as prototype co-delivery vehicle for enhanced killing of L. donovani. Int J Biol Macromol 2017; 105:625-637. [PMID: 28716750 DOI: 10.1016/j.ijbiomac.2017.07.076] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/25/2017] [Accepted: 07/12/2017] [Indexed: 12/18/2022]
Abstract
Lipid nanoparticles are stable, biodegradable and biocompatible carriers offering excellent therapeutic efficacy. Here, a novel effort has been made to develop Miltefosine (HePC- hexadecylphosphocholine) stabilized chitosan anchored nanostructured lipid carriers (NLC) of Amphotericin B (AmB) as co-delivery vehicle to enhance killing of L. donovani. The entrapment efficiency of AmB was achieved upto 85.3% for HePC-AmB-CNLCs with mean particle size of 150.8±8.4nm, and zeta potential value of +28.2±1.1mV, respectively. The cumulative amount of AmB released at even after the 24h was less than 65% from HePC-AmB-CNLCs and Tween-80-AmB-CNLCs. Intravenous administration of HePC-AmB-CNLCs revealed the significantly increased localization of AmB in both liver and spleen when estimated. FACS study represented enhanced uptake of FITC-HePC-CNLCs over FITC-HePC-NLCs in J774A.1 cell lines. Highly significant in vitro and in vivo anti-leishmanial activity (p<0.05 compared with Tween 80-AmB-CNLCs) was observed with HePC-AmB-CNLCs when tested against VL in Leishmania donovani-infected hamsters. The haemolysis and cytotoxicity studies showed the safety of HePC-AmB-CNLCs and Tween 80-AmB-CNLCs. The findings suggested that it would be preferable to deliver AmB through HePC stabilized chitosan anchored nanostructured lipid carriers for rapid and effective treatment with decreased adverse effects.
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Affiliation(s)
- Priyanka Tripathi
- Pharmaceutics Division, CSIR-Central Drug Research Institute, Lucknow 226031, India; Academy of Scientific and Innovative Research (AcSIR), New Delhi 110001, India
| | - Anil Kumar Jaiswal
- Parasitology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Anuradha Dube
- Parasitology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Prabhat Ranjan Mishra
- Pharmaceutics Division, CSIR-Central Drug Research Institute, Lucknow 226031, India; Academy of Scientific and Innovative Research (AcSIR), New Delhi 110001, India.
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Jesus JA, Fragoso TN, Yamamoto ES, Laurenti MD, Silva MS, Ferreira AF, Lago JHG, Santos-Gomes G, Passero LFD. Therapeutic effect of ursolic acid in experimental visceral leishmaniasis. Int J Parasitol Drugs Drug Resist 2017; 7:1-11. [PMID: 27984757 PMCID: PMC5156607 DOI: 10.1016/j.ijpddr.2016.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 12/01/2016] [Indexed: 12/14/2022]
Abstract
Leishmaniasis is an important neglected tropical disease, affecting more than 12 million people worldwide. The available treatments are not well tolerated and present diverse side effects in patients, justifying the search for new therapeutic compounds. In the present study, the therapeutic potential and toxicity of ursolic acid (UA), isolated from the leaves of Baccharis uncinella C. DC. (Asteraceae), were evaluated in experimental visceral leishmaniasis. To evaluate the therapeutic potential of UA, hamsters infected with L. (L.) infantum were treated daily during 15 days with 1.0 or 2.0 mg UA/kg body weight, or with 5.0 mg amphotericin B/kg body weight by intraperitoneal route. Fifteen days after the last dose, the parasitism of the spleen and liver was stimated and the main histopathological alterations were recorded. The proliferation of splenic mononuclear cells was evaluated and IFN-γ, IL-4, and IL-10 gene expressions were analyzed in spleen fragments. The toxicity of UA and amphotericin B were evaluated in healthy golden hamsters by histological analysis and biochemical parameters. Animals treated with UA had less parasites in the spleen and liver when compared with the infected control group, and they also showed preservation of white and red pulps, which correlate with a high rate of proliferation of splenic mononuclear cells, IFN-γ mRNA and iNOS production. Moreover, animals treated with UA did not present alterations in the levels of AST, ALT, creatinine and urea. Taken together, these findings indicate that UA is an interesting natural compound that should be considered for the development of prototype drugs against visceral leishmaniasis.
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Affiliation(s)
- Jéssica A Jesus
- Laboratory of Pathology of Infectious Diseases (LIM50), Department of Pathology, Medical School of São Paulo University, Av. Dr. Arnaldo, 455. Cerqueira César, São Paulo, 01246-903, SP, Brazil; Center of Natural Sciences and Humanities, Federal University of ABC, Santo Andre, São Paulo, 09210-180, Brazil
| | - Thais N Fragoso
- Laboratory of Pathology of Infectious Diseases (LIM50), Department of Pathology, Medical School of São Paulo University, Av. Dr. Arnaldo, 455. Cerqueira César, São Paulo, 01246-903, SP, Brazil
| | - Eduardo S Yamamoto
- Laboratory of Pathology of Infectious Diseases (LIM50), Department of Pathology, Medical School of São Paulo University, Av. Dr. Arnaldo, 455. Cerqueira César, São Paulo, 01246-903, SP, Brazil
| | - Márcia D Laurenti
- Laboratory of Pathology of Infectious Diseases (LIM50), Department of Pathology, Medical School of São Paulo University, Av. Dr. Arnaldo, 455. Cerqueira César, São Paulo, 01246-903, SP, Brazil
| | - Marcelo S Silva
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Rua da Junqueira 100, 1349-008 Lisboa, Portugal; Departamento de Análises Clínicas e Toxicológicas, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Rua General Gustavo Cordeiro de Farias, 384, 59012-570 Natal, Brazil
| | - Aurea F Ferreira
- Laboratory of Pathology of Infectious Diseases (LIM50), Department of Pathology, Medical School of São Paulo University, Av. Dr. Arnaldo, 455. Cerqueira César, São Paulo, 01246-903, SP, Brazil
| | - João Henrique G Lago
- Center of Natural Sciences and Humanities, Federal University of ABC, Santo Andre, São Paulo, 09210-180, Brazil
| | - Gabriela Santos-Gomes
- Departamento de Análises Clínicas e Toxicológicas, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Rua General Gustavo Cordeiro de Farias, 384, 59012-570 Natal, Brazil
| | - Luiz Felipe D Passero
- São Paulo State University (Unesp), Institute of Biosciences, São Vicente, Praça Infante Dom Henrique, s/n, 11330-900 São Vicente, SP, Brazil.
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Arruda GJB, Rossanezi G, Scarpa MV, Egito ESTD, Oliveira AGD. ESTRATÉGIAS TECNOLÓGICAS PARA FORMULAÇÕES DE ANFOTERICINA B EM SISTEMAS LIPÍDICOS DISPONÍVEIS NO MERCADO FARMACÊUTICO E OUTROS PROMISSORES SISTEMAS DE ADMINISTRAÇÃO. ACTA ACUST UNITED AC 2016. [DOI: 10.14450/2318-9312.v28.e2.a2016.pp59-67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A anfotericina B (AmB) é um fármaco antifúngico utilizado no tratamento de micoses sistêmicas desde sua descoberta nos anos de 1950. O objetivo deste trabalho foi estabelecer o estado da arte das estratégias tecnológicas envolvidas nas formas de administração da AmB, nas intervenções diretas nos aspectos de melhoria de solubilidade do fármaco, que possibilitem sua administração por via intravenosa (iv) e minimizem sua toxicidade. Devido à limitada utilidade clínica do sal de desoxicolato (Fungizon®) em razão de sua alta toxicidade, sistemas de liberação mais eficientes foram desenvolvidos. Neste trabalho, são apresentadas as principais formulações disponíveis no mercado farmacêutico e outras formulações lipídicas promissoras, as quais se mostraram mais eficazes como veículos de solubilização e menos tóxicas quando comparadas com a AmB esoxicolato, mas ainda não fazem parte da rotina hospitalar para o tratamento de micoses profundas.
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Gupta PK, Jaiswal AK, Kumar V, Verma A, Dwivedi P, Dube A, Mishra PR. Covalent Functionalized Self-Assembled Lipo-Polymerosome Bearing Amphotericin B for Better Management of Leishmaniasis and Its Toxicity Evaluation. Mol Pharm 2014; 11:951-63. [DOI: 10.1021/mp400603t] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Pramod K. Gupta
- Pharmaceutics Division and ‡Parasitology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector
10, Jankipuram Extension, Sitapur Road, Lucknow, India 226031
| | - Anil K. Jaiswal
- Pharmaceutics Division and ‡Parasitology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector
10, Jankipuram Extension, Sitapur Road, Lucknow, India 226031
| | - Vivek Kumar
- Pharmaceutics Division and ‡Parasitology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector
10, Jankipuram Extension, Sitapur Road, Lucknow, India 226031
| | - Ashwni Verma
- Pharmaceutics Division and ‡Parasitology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector
10, Jankipuram Extension, Sitapur Road, Lucknow, India 226031
| | - Pankaj Dwivedi
- Pharmaceutics Division and ‡Parasitology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector
10, Jankipuram Extension, Sitapur Road, Lucknow, India 226031
| | - Anuradha Dube
- Pharmaceutics Division and ‡Parasitology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector
10, Jankipuram Extension, Sitapur Road, Lucknow, India 226031
| | - Prabhat R. Mishra
- Pharmaceutics Division and ‡Parasitology Division, Council of Scientific and Industrial Research-Central Drug Research Institute, B 10/1, Sector
10, Jankipuram Extension, Sitapur Road, Lucknow, India 226031
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Asthana S, Gupta PK, Chaurasia M, Dube A, Chourasia MK. Polymeric colloidal particulate systems: intelligent tools for intracellular targeting of antileishmanial cargos. Expert Opin Drug Deliv 2013; 10:1633-51. [PMID: 24147603 DOI: 10.1517/17425247.2013.838216] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Targeted cargo delivery systems can overcome drawbacks associated with antileishmanials delivery, by defeating challenges of physiological barriers. Various colloidal particulate systems have been developed in the past; few of them even achieved success in the market, but still are limited in some ways. AREAS COVERED This review is focused on the pathobiology of leishmaniasis, interactions of particulate systems with biological environment, targeting strategies along with current conventional and vaccine therapies with special emphasis on polymeric nanotechnology for effective antileishmanial cargo delivery. EXPERT OPINION The problems concerned with limited accessibility of chemotherapeutic cargos in conventional modes to Leishmania-harboring macrophages, their toxicity, and resistant parasitic strain development can be sorted out through target-specific delivery of cargos. Vaccination is another therapeutic approach employing antigen alone or adjuvant combinations delivered by means of a carrier, and can provide preventive measures against human leishmaniasis (HL). Therefore, there is an urgent need of designing site-specific antileishmanial cargo carriers for safe and effective management of HL. Among various colloidal carriers, polymeric particulate systems hold tremendous potential as an effective delivery tool by providing control over spatial and temporal distribution of cargos after systemic or localized administration along with enhancing their stability profile at a comparatively cost-effective price leading to improved chances of commercial applicability.
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Affiliation(s)
- Shalini Asthana
- CSIR-Central Drug Research Institute, CDRI communication No. 8523, Pharmaceutics Division , Lucknow-226031, UP , India +91 522 2612411 18 ; +91 522 2623405 ;
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Immunomodulation by chemotherapeutic agents against Leishmaniasis. Int Immunopharmacol 2011; 11:1668-79. [DOI: 10.1016/j.intimp.2011.08.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 08/03/2011] [Indexed: 01/24/2023]
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Pal A, Gupta S, Jaiswal A, Dube A, Vyas SP. Development and evaluation of tripalmitin emulsomes for the treatment of experimental visceral leishmaniasis. J Liposome Res 2011; 22:62-71. [PMID: 21740098 DOI: 10.3109/08982104.2011.592495] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The antifungal and antileishmanial agent amphotericin B (AmB) was formulated in tripalmitin based nanosize lipid partices (emulsomes) for macrophage targeting for the treatment of visceral leishmaniasis (VL). Emulsomes were modified by coating them with macrophage-specific ligand (O-palmitoyl mannan, OPM). The antileishmanial activity of AmB (0.5 and 1 mg/kg) was investigated in-vivo against VL by the inhibition of parasitic load in the spleen of L. donovani infected hamsters after intraperitoneal injections of AmB-Doc (Mycol), plain emulsomes (TPEs) and OPM coated emulsomes (TPEs-OPM). The formulations were found to be less effective at the dose of 0.5 mg/kg. At the dose of 1 mg/kg, formulation TPEs-OPM eliminated intracellular amastigotes of L. donovani within splenic macrophages more efficiently (62.76 ± 3.54 % parasite inhibition) than the formulation TPEs (42.68 ± 2.36 % parasite inhibition) (P < 0.01) or AmB-Doc (25.87 ± 3.87 % parasite inhibition) (P < 0.001). Our results suggest that these formulations (plain and ligand grafted emulsomes) are a promising substitute to the conventional AmB-Doc formulation for the treatment of VL.
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Affiliation(s)
- Ajay Pal
- Nanomedicine Research Center, Department Of Pharmaceutics, I.S.F. College Of Pharmacy , Moga 142 001 (PB) , INDIA
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Khan W, Kumar N. Drug targeting to macrophages using paromomycin-loaded albumin microspheres for treatment of visceral leishmaniasis: anin vitroevaluation. J Drug Target 2010; 19:239-50. [DOI: 10.3109/1061186x.2010.492524] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gupta S, Pal A, Vyas SP. Drug delivery strategies for therapy of visceral leishmaniasis. Expert Opin Drug Deliv 2010; 7:371-402. [PMID: 20201740 DOI: 10.1517/17425240903548232] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
IMPORTANCE OF THE FIELD Visceral leishmaniasis (VL) is the most overwhelming type of leishmaniasis associated with the poverty of developing countries and usually mortal if untreated. Most of the conventionally used dosage forms offer us the shortcomings of toxic side effects and emergence of drug resistance. Several efforts have been made to overcome the barriers involved in the treatment of VL. Colloidal carriers extensively represent the drug delivery systems (DDSs) for intracellular localization of antileishmanial compounds in macrophage-rich organs such as liver, spleen and bone marrow. These DDSs offer superior therapeutic efficacy over the conventional treatment in terms of site-specific drug delivery with reduced side effects. However, after 35 years of research in the field, AmBisome (Amphotericin B liposome for injection, Astellas Pharma US, Inc.) is the only DDS used against the VL. AREAS COVERED IN THIS REVIEW A literature search was performed (for drugs and DDSs against VL) on PubMed and through Google. WHAT THE READER WILL GAIN This review aims to describe the pathophysiology of VL and its current conventional treatment with special reference to DDSs designed against VL. TAKE HOME MESSAGE On reviewing the conventional drugs and DDSs developed against VL, it is concluded that advances in the field of targeted drug delivery can result in more efficient strategies for the therapy of VL.
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Affiliation(s)
- Swati Gupta
- Nanomedicine Research Center, Department of Pharmaceutics, ISF College of Pharmacy, Moga (PB), India.
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Jain JP, Kumar N. Development of amphotericin B loaded polymersomes based on (PEG)(3)-PLA co-polymers: Factors affecting size and in vitro evaluation. Eur J Pharm Sci 2010; 40:456-65. [PMID: 20580669 DOI: 10.1016/j.ejps.2010.05.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Revised: 04/18/2010] [Accepted: 05/09/2010] [Indexed: 12/16/2022]
Abstract
Amphotericin B (AmB) is a broad spectrum antifungal and antileishmenial agent and its clinical use is limited due to substantial dose limiting toxicities such as nephrotoxicity. In this work, amphotericin B is formulated in polymersomes of branched (PEG)(3)-PLA co-polymer. Polymersomes were prepared by solvent injection method and the effects of various formulation and process parameters on size and size distribution were studied. The results showed that viscosity of biphasic solution during formulation has significant influence on the size and size distribution of the polymersomes. Further, drug-loaded polymersomes with size of 199.6+/-14.1nm, PDI of 0.258+/-0.18, zeta potential (zeta) of -18.07+/-4.91mV and loading of 16.26+/-2.50% were obtained. Drug was found to be intercalated in the wall of polymersomes as observed using FITC tagged drug and CLSM study. An in vitro release media containing sodium deoxycholate was developed and a significant amount of drug release was observed up to 24h there after a very slow release was obtained. Free drug was not found in the formulation and different molecular forms of the drug (AmB) were observed by UV-visible spectroscopy and circular dichroism. This was further supported by hemolysis experiments, where negligible hemolysis in the test formulation was observed as compared to 100% hemolysis in a marketed formulation (Fungizone).
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Affiliation(s)
- Jay Prakash Jain
- Department of Pharmaceutics, National Institute of Pharmaceutical Education & Research, S.A.S. Nagar, India
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Romero EL, Morilla MJ. Drug delivery systems against leishmaniasis? Still an open question. Expert Opin Drug Deliv 2008; 5:805-23. [DOI: 10.1517/17425247.5.7.805] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Gupta S, Dube A, Vyas SP. Antileishmanial efficacy of amphotericin B bearing emulsomes against experimental visceral leishmaniasis. J Drug Target 2007; 15:437-44. [PMID: 17613662 DOI: 10.1080/10611860701453836] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Amphotericin B (AmB) was formulated in trilaurin-based emulsomes (nanosize lipid particles) stabilized by soya phosphatidylcholine (PC), as a new delivery system for macrophage targeting for the treatment of visceral leishmaniasis (VL). Emulsomes were modified by coating them with macrophage-specific ligand (O-palmitoyl mannan, OPM). The antileishmanial activity of AmB-deoxycholate (AmB-Doc) and emulsome entrapped AmB was tested in vitro in Leishmania donovani infected macrophage-amastigote system (J774A.1 cells), which showed higher efficacy of OPM grafted AmB emulsomes (TLEs-OPM) over plain AmB emulsomes (TLEs) and AmB-Doc. The in vivo antileishmanial activity of the AmB (0.5 mg/kg) was tested in AmB-Doc, TLEs and TLEs-OPM forms against VL in L. donovani infected hamsters. Formulation TLEs-OPM eliminated intracellular amastigotes of L. donovani within splenic macrophages more efficiently (73.7 +/- 6.7% parasite inhibition) than the formulation TLEs (51.7 +/- 5.4% parasite inhibition) (P < 0.01) or AmB-Doc (30.4 +/- 4.8% parasite inhibition) (P < 0.001). Our results suggest that these newer formulations (plain and ligand appended emulsomes) are a promising alternative to the conventional AmB-Doc formulation for the treatment of VL.
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Affiliation(s)
- Swati Gupta
- Drug Delivery Research Laboratory, Department of Pharmaceutical Sciences, Dr Hari Singh Gour Vishwavidyalaya, Sagar, MP, India
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Rama Iñiguez S, Dea-Ayuela MA, Sanchez-Brunete JA, Torrado JJ, Alunda JM, Bolas-Fernández F. Real-time reverse transcription-PCR quantification of cytokine mRNA expression in golden Syrian hamster infected with Leishmania infantum and treated with a new amphotericin B formulation. Antimicrob Agents Chemother 2006; 50:1195-201. [PMID: 16569829 PMCID: PMC1426985 DOI: 10.1128/aac.50.4.1195-1201.2006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A real-time quantitative reverse transcription-PCR assay was developed for the quantification of cytokine mRNA expression in the golden Syrian hamster Mesocricetus auratus infected with Leishmania infantum and treated with amphotericin B (AMB) formulated in microspheres made of human serum albumin (HSA). Treatment was administered intravenously on days 69, 71, and 73 postinfection (p.i.) with 10(7) metacyclic promastigotes, at doses of 2 and 40 mg/kg of AMB. High infection levels were recorded for untreated animals by day 76 p.i., with parasite loads always about 2 log10 per gram higher in the liver than in the spleen. Treatment was highly effective with both doses, but at 40 mg/kg, almost complete parasite elimination was achieved. mRNA expression of gamma interferon (IFN-gamma) and, to a lesser extent, tumor necrosis factor alpha (TNF-alpha) and transforming growth factor beta (TGF-beta) in spleen cells was up-regulated in most animals of the untreated group. The mRNA expression of interleukin-4 was strongly down-regulated in untreated as well as treated infected animals. Treatment with the lower dose of AMB-HSA down-regulated the mRNA expression of IFN-gamma and TNF-alpha, with no effect on the deactivating cytokine TGF-beta. In contrast, treatment with the higher dose (40 mg/kg) of the formulation caused moderate up-regulation of IFN-gamma and TNF-alpha and strong suppression of TGF-beta. Treatment of noninfected animals did not alter the cytokine expression pattern with regard to untreated controls. Our results suggest that treatment of L. infantum-infected Syrian hamsters with highly effective nontoxic doses of AMB-HSA causes deactivation of the anti-inflammatory cytokine TGF-beta, which in turn results in up-regulation of the Th1 cytokines IFN-gamma and TNF-alpha.
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Affiliation(s)
- S Rama Iñiguez
- Departamento de Parasitología, Facultad de Farmacia, Universidad Complutense, Plaza de Ramón y Cajal s/n, Ciudad Universitaria, 28040 Madrid, Spain
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Barratt G, Legrand P. Comparison of the efficacy and pharmacology of formulations of amphotericin B used in treatment of leishmaniasis. Curr Opin Infect Dis 2006; 18:527-30. [PMID: 16258327 DOI: 10.1097/01.qco.0000191508.48481.f4] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Several lipid-based formulations of the antifungal and antiparasitic drug amphotericin B are now available on the market. The purpose of this review is to assess their efficacy against leishmaniasis in both experimental and clinical settings, and to point out new developments in the formulation of this antibiotic. RECENT FINDINGS The development of resistance to pentavalent antimony compounds has shifted the emphasis to amphotericin B for the treatment of visceral leishmaniasis in India. Lipid formulations show good efficacy but are expensive. The treatment period with lipid formulations is shorter, however, which reduces hospitalization costs. As a result, in developed countries where these costs are an important proportion of the treatment, lipid formulations are preferred, whereas they remain largely inaccessible in developing countries. Lipid-associated amphotericin B has been found to be effective for secondary prophylaxis in HIV-positive patients, in studies carried out in European countries bordering the Mediterranean. SUMMARY The reduced toxicity of lipid-based formulations of amphotericin B is no longer in doubt. In India, their efficacy against visceral leishmaniasis and shorter treatment periods compared with the conventional formulation with deoxycholate has to be counter-balanced against the very high cost. By contrast, in developed countries around the Mediterranean, where leishmaniasis occurs mainly in immunocompromised individuals, lipid formulations have become the treatment of choice for visceral disease. The efficacy against cutaneous lesions is variable, however, and in some reports oral miltefosine was active after failure of treatment with amphotericin B.
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Affiliation(s)
- Gillian Barratt
- Centre of Pharmaceutical Studies, Université Paris XI, 5 rue J.B. Clément, 92296 Chatenay-Malabry Cedex, France.
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