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Dadashpour S, Ghobadi E, Emami S. Chemical and biological aspects of posaconazole as a classic antifungal agent with non-classical properties: highlighting a tetrahydrofuran-based drug toward generation of new drugs. Med Chem Res 2022. [DOI: 10.1007/s00044-022-02901-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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2
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Surwase SM, Mane YD, Patil SS, Sarnikar YP, Khade BC. Synthesis and Evaluation of a New Series of Antileishmanial Agents. Polycycl Aromat Compd 2021. [DOI: 10.1080/10406638.2021.2014532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Santosh M. Surwase
- Department of Chemistry, Shri Chhatrapati Shivaji College, Omerga, Maharashtra, India
| | - Yogesh D. Mane
- Department of Chemistry, BSS Arts, Science & Commerce College, Makni, Maharashtra, India
| | - Smita S. Patil
- Department of Chemistry, Modern Science College, Latur, Maharashtra, India
| | - Yuvaraj P. Sarnikar
- Department of Chemistry, Dayanand Science College, Latur, Maharashtra, India
| | - Bhimrao C. Khade
- Department of Chemistry, College of Arts, Commerce & Science, Parbhani, Maharashtra, India
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3
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Blanco Z, Mijares MR, Ramírez H, Fernandez-Moreira E, Oviedo HJ, Rodríguez NM, Charris JE. In vitro evaluation and in vivo efficacy of nitroimidazole-sulfanyl ethyl derivatives against Leishmania (V.) braziliensis and Leishmania (L.) mexicana. Parasitol Res 2021; 120:3307-3317. [PMID: 34370070 DOI: 10.1007/s00436-021-07266-w] [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: 04/12/2021] [Accepted: 07/21/2021] [Indexed: 11/24/2022]
Abstract
The aim of this study was to synthesize several small molecules of the type 5-nitroimidazole-sulfanyl and evaluate biological properties against the main Leishmania species that cause cutaneous leishmaniasis in Venezuela. Final compounds 4-7 were generated through simple nucleophilic substitution of 1-(2-chloroethyl)-2-methyl-5-nitroimidazole 3 with 2-mercaptoethanol, 1-methyl-2-mercaptoethanol, and 2-thyolacetic acid derivative. Compound 8 was synthesized via a coupling reaction between 7 and (S)-Methyl 2-amino-4-methylpentanoate hydrochloride. The inhibitory concentrations of (3, 4, 7, 8) against Leishmania (L.) mexicana and (V.) braziliensis in promastigotes and experimentally infected macrophages were determined by in vitro activity assays. Compounds 7 and 8 shown high activity against both species of Leishmania and were selected for the in vivo evaluation. Animals were infected with promastigotes of the two species and divided into four groups of ten (10) animals and a control group. Intralesional injection way was used for the treatment. The parasitological diagnostic after treatment was obtained by PCR using species specific oligonucleotides. The two Leishmania species were susceptible to compounds 7 and 8 in vivo assays. The results indicated that both compounds reduce significantly (96%) the size of the lesion and cure 63% of the mice infected with L (L) mexicana or L (V) braziliensis as was determined by PCR. The results are indicating that both compounds may represent an alternative treatment for these two Leishmania species.
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Affiliation(s)
- Zuleima Blanco
- Organic Synthesis Laboratory, Faculty of Pharmacy, Central University of Venezuela, Los Chaguaramos 1041-A, Caracas, 47206, Venezuela
| | - Michael R Mijares
- Biotechnology Unit, Faculty of Pharmacy, Central University of Venezuela, Los Chaguaramos 1041-A, Caracas, 47206, Venezuela
| | - Hegira Ramírez
- Organic Synthesis Laboratory, Faculty of Pharmacy, Central University of Venezuela, Los Chaguaramos 1041-A, Caracas, 47206, Venezuela.,Facultad de Medicina, Universidad de Las Américas, Quito, Ecuador
| | | | - Henry J Oviedo
- Institute of Biomedicine, Faculty of Medicine, Central University of Venezuela, 1010-A, 4043, Caracas, Venezuela
| | - Noris M Rodríguez
- Institute of Biomedicine, Faculty of Medicine, Central University of Venezuela, 1010-A, 4043, Caracas, Venezuela
| | - Jaime E Charris
- Organic Synthesis Laboratory, Faculty of Pharmacy, Central University of Venezuela, Los Chaguaramos 1041-A, Caracas, 47206, Venezuela.
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4
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Rodríguez M, Gutiérrez J, Domínguez J, Peixoto PA, Fernández A, Rodríguez N, Deffieux D, Rojas L, Quideau S, Pouységu L, Charris J. Synthesis and leishmanicidal evaluation of sulfanyl‐ and sulfonyl‐tethered functionalized benzoate derivatives featuring a nitroimidazole moiety. Arch Pharm (Weinheim) 2020; 353:e2000002. [DOI: 10.1002/ardp.202000002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Miguel Rodríguez
- Laboratorio de Síntesis Orgánica, Facultad de FarmaciaUniv. Central de Venezuela Caracas Venezuela
| | - Joyce Gutiérrez
- Laboratorio de Síntesis Orgánica, Facultad de FarmaciaUniv. Central de Venezuela Caracas Venezuela
| | - José Domínguez
- Laboratorio de Síntesis Orgánica, Facultad de FarmaciaUniv. Central de Venezuela Caracas Venezuela
| | | | - Alexis Fernández
- Instituto de Biomedicina, Facultad de MedicinaUniv. Central de Venezuela Caracas Venezuela
| | - Noris Rodríguez
- Instituto de Biomedicina, Facultad de MedicinaUniv. Central de Venezuela Caracas Venezuela
| | | | - Luis Rojas
- Laboratorio de Productos Naturales, Facultad de Farmacia y BioanálisisUniv. de Los Andes Mérida Venezuela
| | | | | | - Jaime Charris
- Laboratorio de Síntesis Orgánica, Facultad de FarmaciaUniv. Central de Venezuela Caracas Venezuela
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5
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Surwase SM, Mane YD, Surwase MM, Khade BC. Synthesis of diverse (E)‐2‐((1
H
‐imidazol‐1‐yl)methyl)‐2‐((benzyloxy)methyl)‐2,3‐dihydro‐1
H
‐inden‐1‐one O‐benzyl oxime derivatives as potent antileishmanial agents. J Heterocycl Chem 2020. [DOI: 10.1002/jhet.3812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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6
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Lepesheva GI, Friggeri L, Waterman MR. CYP51 as drug targets for fungi and protozoan parasites: past, present and future. Parasitology 2018; 145:1820-1836. [PMID: 29642960 PMCID: PMC6185833 DOI: 10.1017/s0031182018000562] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The efficiency of treatment of human infections with the unicellular eukaryotic pathogens such as fungi and protozoa remains deeply unsatisfactory. For example, the mortality rates from nosocomial fungemia in critically ill, immunosuppressed or post-cancer patients often exceed 50%. A set of six systemic clinical azoles [sterol 14α-demethylase (CYP51) inhibitors] represents the first-line antifungal treatment. All these drugs were discovered empirically, by monitoring their effects on fungal cell growth, though it had been proven that they kill fungal cells by blocking the biosynthesis of ergosterol in fungi at the stage of 14α-demethylation of the sterol nucleus. This review briefs the history of antifungal azoles, outlines the situation with the current clinical azole-based drugs, describes the attempts of their repurposing for treatment of human infections with the protozoan parasites that, similar to fungi, also produce endogenous sterols, and discusses the most recently acquired knowledge on the CYP51 structure/function and inhibition. It is our belief that this information should be helpful in shifting from the traditional phenotypic screening to the actual target-driven drug discovery paradigm, which will rationalize and substantially accelerate the development of new, more efficient and pathogen-oriented CYP51 inhibitors.
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Affiliation(s)
- Galina I. Lepesheva
- Department of Biochemistry, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA
| | - Laura Friggeri
- Department of Biochemistry, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA
| | - Michael R. Waterman
- Department of Biochemistry, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA
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Teixeira de Macedo Silva S, Visbal G, Lima Prado Godinho J, Urbina JA, de Souza W, Cola Fernandes Rodrigues J. In vitro antileishmanial activity of ravuconazole, a triazole antifungal drug, as a potential treatment for leishmaniasis. J Antimicrob Chemother 2018; 73:2360-2373. [DOI: 10.1093/jac/dky229] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 05/21/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Sara Teixeira de Macedo Silva
- Laboratório de Ultraestrutura Celular Hertha Meyer, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Ciência e Tecnologia de Biologia Estrutural e Bioimagem, Rio de Janeiro, Brazil
| | - Gonzalo Visbal
- Instituto Nacional de Metrologia, Qualidade e Tecnologia, Rio de Janeiro, Brazil
| | - Joseane Lima Prado Godinho
- Laboratório de Ultraestrutura Celular Hertha Meyer, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Ciência e Tecnologia de Biologia Estrutural e Bioimagem, Rio de Janeiro, Brazil
| | - Julio A Urbina
- Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela
| | - Wanderley de Souza
- Laboratório de Ultraestrutura Celular Hertha Meyer, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Ciência e Tecnologia de Biologia Estrutural e Bioimagem, Rio de Janeiro, Brazil
| | - Juliany Cola Fernandes Rodrigues
- Laboratório de Ultraestrutura Celular Hertha Meyer, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Ciência e Tecnologia de Biologia Estrutural e Bioimagem, Rio de Janeiro, Brazil
- Núcleo Multidisciplinar de Pesquisa UFRJ-Xerém, Divisão Biologia, Universidade Federal do Rio de Janeiro, Campus Duque de Caxias, Rio de Janeiro, Brazil
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8
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Antileishmanial Efficacy and Pharmacokinetics of DB766-Azole Combinations. Antimicrob Agents Chemother 2017; 62:AAC.01129-17. [PMID: 29061761 DOI: 10.1128/aac.01129-17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/18/2017] [Indexed: 01/04/2023] Open
Abstract
Given the limitations of current antileishmanial drugs and the utility of oral combination therapy for other infections, developing an oral combination against visceral leishmaniasis should be a high priority. In vitro combination studies with DB766 and antifungal azoles against intracellular Leishmania donovani showed that posaconazole and ketoconazole, but not fluconazole, enhanced DB766 potency. Pharmacokinetic analysis of DB766-azole combinations in uninfected Swiss Webster mice revealed that DB766 exposure was increased by higher posaconazole and ketoconazole doses, while DB766 decreased ketoconazole exposure. In L. donovani-infected BALB/c mice, DB766-posaconazole combinations given orally for 5 days were more effective than DB766 or posaconazole alone. For example, 81% ± 1% (means ± standard errors) inhibition of liver parasite burden was observed for 37.5 mg/kg of body weight DB766 plus 15 mg/kg posaconazole, while 37.5 mg/kg DB766 and 15 mg/kg posaconazole administered as monotherapy gave 40% ± 5% and 21% ± 3% inhibition, respectively. Combination index (CI) analysis indicated that synergy or moderate synergy was observed in six of nine combined dose groups, while the other three were nearly additive. Liver concentrations of DB766 and posaconazole increased in almost all combination groups compared to monotherapy groups, although many increases were not statistically significant. For DB766-ketoconazole combinations evaluated in this model, two were antagonistic, one displayed synergy, and one was nearly additive. These data indicate that the efficacy of DB766-posaconazole and DB766-ketoconazole combinations in vivo is influenced in part by the pharmacokinetics of the combination, and that the former combination deserves further consideration in developing new treatment strategies against visceral leishmaniasis.
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Emami S, Tavangar P, Keighobadi M. An overview of azoles targeting sterol 14α-demethylase for antileishmanial therapy. Eur J Med Chem 2017; 135:241-259. [PMID: 28456033 DOI: 10.1016/j.ejmech.2017.04.044] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/11/2017] [Accepted: 04/18/2017] [Indexed: 02/07/2023]
Abstract
The azole antifungal drugs are an important class of chemotherapeutic agents with broad-spectrum of activity against yeasts and filamentous fungi, act in the ergosterol biosynthetic pathway through inhibition of the cytochrome P450-dependent enzyme sterol 14α-demethylase. Azole antifungals have also been repurposed for treatment of tropical protozoan infections including human leishmaniasis. Recent advances in molecular biology and computational chemistry areas have increased our knowledge about sterol biochemical pathway in Leishmania parasites. Based on the importance of sterol biosynthetic pathway in Leishmania parasites, we reviewed all studies reported on azoles for potential antileishmanial therapy along their structural and biological aspects. This review may help medicinal chemists for design of new azole-derived antileishmanial drugs.
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Affiliation(s)
- Saeed Emami
- Department of Medicinal Chemistry and Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Pegah Tavangar
- Department of Medicinal Chemistry and Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Keighobadi
- Student Research Committee, Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
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Dauchy FA, Bonhivers M, Landrein N, Dacheux D, Courtois P, Lauruol F, Daulouède S, Vincendeau P, Robinson DR. Trypanosoma brucei CYP51: Essentiality and Targeting Therapy in an Experimental Model. PLoS Negl Trop Dis 2016; 10:e0005125. [PMID: 27855164 PMCID: PMC5113867 DOI: 10.1371/journal.pntd.0005125] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 10/24/2016] [Indexed: 01/03/2023] Open
Abstract
Trypanosoma brucei gambiense is the main causative agent of Human African Trypanosomiasis (HAT), also known as sleeping sickness. Because of limited alternatives and treatment toxicities, new therapeutic options are urgently needed for patients with HAT. Sterol 14alpha-demethylase (CYP51) is a potential drug target but its essentiality has not been determined in T. brucei. We used a tetracycline-inducible RNAi system to assess the essentiality of CYP51 in T. brucei bloodstream form (BSF) cells and we evaluated the effect of posaconazole, a well-tolerated triazole drug, within a panel of virulent strains in vitro and in a murine model. Expression of CYP51 in several T. brucei cell lines was demonstrated by western blot and its essentiality was demonstrated by RNA interference (CYP51RNAi) in vitro. Following reduction of TbCYP51 expression by RNAi, cell growth was reduced and eventually stopped compared to WT or non-induced cells, showing the requirement of CYP51 in T. brucei. These phenotypes were rescued by addition of ergosterol. Additionally, CYP51RNAi induction caused morphological defects with multiflagellated cells (p<0.05), suggesting cytokinesis dysfunction. The survival of CYP51RNAi Doxycycline-treated mice (p = 0.053) and of CYP51RNAi 5-day pre-induced Doxycycline-treated mice (p = 0.008) were improved compared to WT showing a CYP51 RNAi effect on trypanosomal virulence in mice. The posaconazole concentrations that inhibited parasite growth by 50% (IC50) were 8.5, 2.7, 1.6 and 0.12 μM for T. b. brucei 427 90-13, T. b. brucei Antat 1.1, T. b. gambiense Feo (Feo/ITMAP/1893) and T. b. gambiense Biyamina (MHOM/SD/82), respectively. During infection with these last three virulent strains, posaconazole-eflornithine and nifurtimox-eflornithine combinations showed similar improvement in mice survival (p≤0.001). Our results provide support for a CYP51 targeting based treatment in HAT. Thus posaconazole used in combination may represent a therapeutic alternative for trypanosomiasis.
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Affiliation(s)
- Frédéric-Antoine Dauchy
- University of Bordeaux, laboratoire de parasitologie, France
- IRD-CIRAD-University of Bordeaux, France
- University Hospital of Bordeaux, Department of infectious and tropical diseases, Hôpital Pellegrin, France
- * E-mail:
| | - Mélanie Bonhivers
- University of Bordeaux, Microbiologie Fondamentale et Pathogénicité, France
- CNRS, Microbiologie Fondamentale et Pathogénicité, France
| | - Nicolas Landrein
- University of Bordeaux, Microbiologie Fondamentale et Pathogénicité, France
- CNRS, Microbiologie Fondamentale et Pathogénicité, France
| | - Denis Dacheux
- University of Bordeaux, Microbiologie Fondamentale et Pathogénicité, France
- CNRS, Microbiologie Fondamentale et Pathogénicité, France
- Bordeaux INP, ENSTBB, Microbiologie Fondamentale et Pathogénicité, France
| | - Pierrette Courtois
- University of Bordeaux, laboratoire de parasitologie, France
- IRD-CIRAD-University of Bordeaux, France
| | - Florian Lauruol
- University of Bordeaux, laboratoire de parasitologie, France
- IRD-CIRAD-University of Bordeaux, France
| | - Sylvie Daulouède
- University of Bordeaux, laboratoire de parasitologie, France
- IRD-CIRAD-University of Bordeaux, France
| | - Philippe Vincendeau
- University of Bordeaux, laboratoire de parasitologie, France
- IRD-CIRAD-University of Bordeaux, France
- University Hospital of Bordeaux, laboratoire de parasitologie, Hôpital Pellegrin, France
| | - Derrick R. Robinson
- University of Bordeaux, Microbiologie Fondamentale et Pathogénicité, France
- CNRS, Microbiologie Fondamentale et Pathogénicité, France
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11
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Prates FVDO, Dourado MEF, Silva SC, Schriefer A, Guimarães LH, Brito MDGO, Almeida J, Carvalho EM, Machado PRL. Fluconazole in the Treatment of Cutaneous Leishmaniasis Caused by Leishmania braziliensis: A Randomized Controlled Trial. Clin Infect Dis 2016; 64:67-71. [PMID: 27803094 DOI: 10.1093/cid/ciw662] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 09/16/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The treatment of cutaneous leishmaniasis (CL) caused by Leishmania braziliensis in Brazil with pentavalent antimony (Sbv) is associated with a high rate of failure, up to 45% of cases. In addition, Sbv can only administered parenterally and has important toxic effect. An effective, safe, and oral treatment for CL is required. METHODS A randomized controlled clinical trial was conducted to compare the efficacy and safety of high-dosage oral fluconazole (6.5-8.0 mg/kg/d for 28 days) versus a standard Sbv protocol (20 mg/kg/d for 20 days) for the treatment of CL in Bahia, Brazil. RESULTS A total of 53 subjects were included in the trial; 26 were treated with Sbv, and 27 with fluconazole. Intention-to-treat analysis showed initial cure rates (2 months after treatment) of 22.2% (6 of 27) in the fluconazole and 53.8% (14 of 26) in the Sbv group (P = .04). Six months after treatment, the final cure rate remained the same in both groups, without any relapses. The frequencies of adverse effects in the Sbv and fluconazole groups were similar, 34.6% versus 37% respectively. One patient treated with fluconazole discontinued treatment owing to malaise, headache, and moderate dizziness (Common Terminology Criteria for Adverse Events grade 2). CONCLUSIONS Oral fluconazole at a dosage of 6.5-8 mg/kg/d for 28 days should not be considered an effective treatment for CL caused by L. braziliensisClinical Trials Registration. NCT01953744.
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Affiliation(s)
- Fernanda V de O Prates
- Serviço de Imunologia, Hospital Universitário Prof Edgard Santos, Universidade Federal da Bahia
| | - Mayra E F Dourado
- Serviço de Imunologia, Hospital Universitário Prof Edgard Santos, Universidade Federal da Bahia
| | - Silvana C Silva
- Serviço de Imunologia, Hospital Universitário Prof Edgard Santos, Universidade Federal da Bahia
| | - Albert Schriefer
- Serviço de Imunologia, Hospital Universitário Prof Edgard Santos, Universidade Federal da Bahia.,Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais
| | - Luiz H Guimarães
- Serviço de Imunologia, Hospital Universitário Prof Edgard Santos, Universidade Federal da Bahia.,Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais
| | | | - Juliana Almeida
- Serviço de Imunologia, Hospital Universitário Prof Edgard Santos, Universidade Federal da Bahia
| | - Edgar M Carvalho
- Serviço de Imunologia, Hospital Universitário Prof Edgard Santos, Universidade Federal da Bahia.,Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais.,Centro de Pesquisa Gonçalo Moniz, Fiocruz, Salvador, Bahia, Brazil
| | - Paulo R L Machado
- Serviço de Imunologia, Hospital Universitário Prof Edgard Santos, Universidade Federal da Bahia.,Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais
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Shafi S, Afrin F, Islamuddin M, Chouhan G, Ali I, Naaz F, Sharma K, Zaman MS. β-Nitrostyrenes as Potential Anti-leishmanial Agents. Front Microbiol 2016; 7:1379. [PMID: 27635124 PMCID: PMC5007854 DOI: 10.3389/fmicb.2016.01379] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 08/19/2016] [Indexed: 12/20/2022] Open
Abstract
Development of new therapeutic approach to treat leishmaniasis has become a priority. In the present study, the antileishmanial effect of β-nitrostyrenes was investigated against in vitro promastigotes and amastigotes. A series of β-nitrostyrenes have been synthesized by using Henry reaction and were evaluated for their antimicrobial activities by broth microdilution assay and in vitro antileishmanial activities against Leishmania donovani promastigotes by following standard guidelines. The most active compounds were futher evaluated for their in vitro antileishmanial activities against intracellular amastigotes. Among the tested β-nitrostyrenes, compounds 7, 8, 9, 12, and 17 exhibited potential activities (MICs range, 0.25–8 μg/mL) against clinically significant human pathogenic fungi. However, the microbactericidal concentrations (MBCs) and the microfungicidal concentrations (MFCs) were found to be either similar or only two-fold greater than the MICs. Anti-leishmanial results demonstrated that compounds 9, 12, 14, and 18 were found to be most active among the tested samples and exhibited 50% inhibitory concentration (IC50) by 23.40 ± 0.71, 37.83 ± 3.74, 40.50 ± 1.47, 55.66 ± 2.84 nM against L. donovani promastigotes and 30.5 ± 3.42, 21.46 ± 0.96, 26.43 ± 2.71, and 61.63 ± 8.02 nM respectively against intracellular L. donovani promastigotes amastigotes respectively which are comparable with standard AmB (19.60 ± 1.71 nM against promastigotes and 27.83 ± 3.26 nM against amastigotes). Compounds 9, 12, 14, and 18 were found to have potent in vitro leishmanicidal activity against L. donovani and found to be non-toxic against mammalian macrophages even at a concentration of 25 μM. Nitric oxide (NO) estimation studies reveals that these compounds are moderately inducing NO levels.
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Affiliation(s)
- Syed Shafi
- Medicinal Chemistry Lab, Department of Chemistry, Faculty of Science, Hamdard University New Delhi, India
| | - Farhat Afrin
- Department of Medical Laboratories Technology, Faculty of Applied Medical Sciences, Taibah UniversityMedina, Saudi Arabia; Parasite Immunology Lab, Department of Biotechnology, Faculty of Science, Hamdard UniversityNew Delhi, India
| | - Mohammad Islamuddin
- Parasite Immunology Lab, Department of Biotechnology, Faculty of Science, Hamdard UniversityNew Delhi, India; Molecular Virology and Vaccinology Lab, Department of Biotechnology, Faculty of Science, Hamdard UniversityNew Delhi, India
| | - Garima Chouhan
- Parasite Immunology Lab, Department of Biotechnology, Faculty of Science, Hamdard University New Delhi, India
| | - Intzar Ali
- Membrane Biology Laboratory, School of Life Sciences, Jawaharlal Nehru University New Delhi, India
| | - Faatima Naaz
- Medicinal Chemistry Lab, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Jamia Hamdard New Delhi, India
| | - Kalicharan Sharma
- Medicinal Chemistry Lab, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Jamia Hamdard New Delhi, India
| | - Mohammad S Zaman
- Medicinal Chemistry Lab, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Jamia Hamdard New Delhi, India
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13
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Potent In Vitro Antiproliferative Synergism of Combinations of Ergosterol Biosynthesis Inhibitors against Leishmania amazonensis. Antimicrob Agents Chemother 2015; 59:6402-18. [PMID: 26239973 DOI: 10.1128/aac.01150-15] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 07/21/2015] [Indexed: 12/23/2022] Open
Abstract
Leishmaniases comprise a spectrum of diseases caused by protozoan parasites of the Leishmania genus. Treatments available have limited safety and efficacy, high costs, and difficult administration. Thus, there is an urgent need for safer and more-effective therapies. Most trypanosomatids have an essential requirement for ergosterol and other 24-alkyl sterols, which are absent in mammalian cells. In previous studies, we showed that Leishmania amazonensis is highly susceptible to aryl-quinuclidines, such as E5700, which inhibit squalene synthase, and to the azoles itraconazole (ITZ) and posaconazole (POSA), which inhibit C-14α-demethylase. Herein, we investigated the antiproliferative, ultrastructural, and biochemical effects of combinations of E5700 with ITZ and POSA against L. amazonensis. Potent synergistic antiproliferative effects were observed against promastigotes, with fractional inhibitory concentration (FIC) ratios of 0.0525 and 0.0162 for combinations of E5700 plus ITZ and of E5700 plus POSA, respectively. Against intracellular amastigotes, FIC values were 0.175 and 0.1125 for combinations of E5700 plus ITZ and E5700 plus POSA, respectively. Marked alterations of the ultrastructure of promastigotes treated with the combinations were observed, in particular mitochondrial swelling, which was consistent with a reduction of the mitochondrial transmembrane potential, and an increase in the production of reactive oxygen species. We also observed the presence of vacuoles similar to autophagosomes in close association with mitochondria and an increase in the number of lipid bodies. Both growth arrest and ultrastructural/biochemical alterations were strictly associated with the depletion of the 14-desmethyl endogenous sterol pool. These results suggest the possibility of a novel combination therapy for the treatment of leishmaniasis.
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14
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Sifontes-Rodríguez S, Monzote-Fidalgo L, Castañedo-Cancio N, Montalvo-Álvarez AM, López-Hernández Y, Diogo NM, Infante-Bourzac JF, Pérez-Martín O, Meneses-Marcel A, García-Trevijano JAE, Cabrera-Pérez MÁ. The efficacy of 2-nitrovinylfuran derivatives against Leishmania in vitro and in vivo. Mem Inst Oswaldo Cruz 2015; 110:166-73. [PMID: 25946239 PMCID: PMC4489446 DOI: 10.1590/0074-02760140324] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/26/2015] [Indexed: 11/22/2022] Open
Abstract
Despite recent advances in the treatment of some forms of leishmaniasis, the
available drugs are still far from ideal due to inefficacy, parasite resistance,
toxicity and cost. The wide-spectrum antimicrobial activity of 2-nitrovinylfuran
compounds has been described, as has their activity against Trichomonas vaginalis and
other protozoa. Thus, the aim of this study was to test the antileishmanial
activities of six 2-nitrovinylfurans in vitro and in a murine model of leishmaniasis.
Minimum parasiticide concentration (MPC) and 50% inhibitory concentration
(IC50) values for these compounds against the promastigotes of
Leishmania amazonensis, Leishmania infantum and Leishmania braziliensis were
determined, as were the efficacies of two selected compounds in an experimental model
of cutaneous leishmaniasis (CL) caused by L. amazonensis in BALB/c mice. All of the
compounds were active against the promastigotes of the three Leishmania species
tested. IC50 and MPC values were in the ranges of 0.8-4.7 µM and 1.7-32
µM, respectively. The compounds 2-bromo-5-(2-bromo-2-nitrovinyl)-furan (furvina) and
2-bromo-5-(2-methyl-2-nitrovinyl)-furan (UC245) also reduced lesion growth in vivo at
a magnitude comparable to or higher than that achieved by amphotericin B treatment.
The results demonstrate the potential of this class of compounds as antileishmanial
agents and support the clinical testing of Dermofural(r) (a
furvina-containing antifungal ointment) for the treatment of CL.
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Affiliation(s)
- Sergio Sifontes-Rodríguez
- Centro de Bioactivos Químicos, Universidad Central Martha Abreu de Las Villas, Santa Clara, Villa Clara, Cuba
| | | | - Nilo Castañedo-Cancio
- Centro de Bioactivos Químicos, Universidad Central Martha Abreu de Las Villas, Santa Clara, Villa Clara, Cuba
| | | | - Yamilé López-Hernández
- Centro de Biociencias, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
| | - Niurka Mollineda Diogo
- Centro de Bioactivos Químicos, Universidad Central Martha Abreu de Las Villas, Santa Clara, Villa Clara, Cuba
| | | | | | - Alfredo Meneses-Marcel
- Centro de Bioactivos Químicos, Universidad Central Martha Abreu de Las Villas, Santa Clara, Villa Clara, Cuba
| | | | - Miguel Ángel Cabrera-Pérez
- Centro de Bioactivos Químicos, Universidad Central Martha Abreu de Las Villas, Santa Clara, Villa Clara, Cuba
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15
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Targeting Ergosterol biosynthesis in Leishmania donovani: essentiality of sterol 14 alpha-demethylase. PLoS Negl Trop Dis 2015; 9:e0003588. [PMID: 25768284 PMCID: PMC4359151 DOI: 10.1371/journal.pntd.0003588] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 02/03/2015] [Indexed: 01/14/2023] Open
Abstract
Leishmania protozoan parasites (Trypanosomatidae family) are the causative agents of cutaneous, mucocutaneous and visceral leishmaniasis worldwide. While these diseases are associated with significant morbidity and mortality, there are few adequate treatments available. Sterol 14alpha-demethylase (CYP51) in the parasite sterol biosynthesis pathway has been the focus of considerable interest as a novel drug target in Leishmania. However, its essentiality in Leishmania donovani has yet to be determined. Here, we use a dual biological and pharmacological approach to demonstrate that CYP51 is indispensable in L. donovani. We show via a facilitated knockout approach that chromosomal CYP51 genes can only be knocked out in the presence of episomal complementation and that this episome cannot be lost from the parasite even under negative selection. In addition, we treated wild-type L. donovani and CYP51-deficient strains with 4-aminopyridyl-based inhibitors designed specifically for Trypanosoma cruzi CYP51. While potency was lower than in T. cruzi, these inhibitors had increased efficacy in parasites lacking a CYP51 allele compared to complemented parasites, indicating inhibition of parasite growth via a CYP51-specific mechanism and confirming essentiality of CYP51 in L. donovani. Overall, these results provide support for further development of CYP51 inhibitors for the treatment of visceral leishmaniasis. Visceral leishmaniasis is the second most lethal parasitic infection after malaria. Other forms of leishmaniasis also cause significant morbidity. However, there are few treatments available, and many cause severe side effects or are associated with the development of resistance. A key difference between mammalian cells and Leishmania parasites is the type of sterol in their membranes: while mammalian cell membranes contain cholesterol, Leishmania parasites use ergosterol. There has therefore been considerable interest in developing inhibitors of sterol biosynthesis pathways to target Leishmania parasites. Sterol 14alpha-demethylase (CYP51) is one of the enzymes in the sterol biosynthesis pathway, and the target of significant drug development research in Leishmania. Here we use a double approach to determine whether this gene is essential in Leishmania donovani, the causative agent of visceral leishmaniasis. We demonstrate via gene knockout and drug targeting approaches that loss or inhibition of CYP51 inhibits L. donovani growth. These results validate CYP51 as a drug target in L. donovani and support further work to develop CYP51-directed therapies for visceral leishmaniasis.
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16
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Choi JY, Podust LM, Roush WR. Drug strategies targeting CYP51 in neglected tropical diseases. Chem Rev 2014; 114:11242-71. [PMID: 25337991 PMCID: PMC4254036 DOI: 10.1021/cr5003134] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Indexed: 01/04/2023]
Affiliation(s)
- Jun Yong Choi
- Department
of Chemistry, Scripps Florida, 130 Scripps Way, Jupiter, Florida 33458, United States
| | - Larissa M. Podust
- Center for Discovery and Innovation in Parasitic Diseases, and Department of
Pathology, University of California—San
Francisco, San Francisco, California 94158, United States
| | - William R. Roush
- Department
of Chemistry, Scripps Florida, 130 Scripps Way, Jupiter, Florida 33458, United States
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17
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Smirlis D, Soares MBP. Selection of molecular targets for drug development against trypanosomatids. Subcell Biochem 2014; 74:43-76. [PMID: 24264240 DOI: 10.1007/978-94-007-7305-9_2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Trypanosomatid parasites are a group of flagellated protozoa that includes the genera Leishmania and Trypanosoma, which are the causative agents of diseases (leishmaniases, sleeping sickness and Chagas disease) that cause considerable morbidity and mortality, affecting more than 27 million people worldwide. Today no effective vaccines for the prevention of these diseases exist, whereas current chemotherapy is ineffective, mainly due to toxic side effects of current drugs and to the emergence of drug resistance and lack of cost effectiveness. For these reasons, rational drug design and the search of good candidate drug targets is of prime importance. The search for drug targets requires a multidisciplinary approach. To this end, the completion of the genome project of many trypanosomatid species gives a vast amount of new information that can be exploited for the identification of good drug candidates with a prediction of "druggability" and divergence from mammalian host proteins. In addition, an important aspect in the search for good drug targets is the "target identification" and evaluation in a biological pathway, as well as the essentiality of the gene in the mammalian stage of the parasite, which is provided by basic research and genetic and proteomic approaches. In this chapter we will discuss how these bioinformatic tools and experimental evaluations can be integrated for the selection of candidate drug targets, and give examples of metabolic and signaling pathways in the parasitic protozoa that can be exploited for rational drug design.
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18
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de Macedo-Silva ST, Urbina JA, de Souza W, Rodrigues JCF. In vitro activity of the antifungal azoles itraconazole and posaconazole against Leishmania amazonensis. PLoS One 2013; 8:e83247. [PMID: 24376670 PMCID: PMC3871555 DOI: 10.1371/journal.pone.0083247] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 10/31/2013] [Indexed: 01/13/2023] Open
Abstract
Leishmaniasis, caused by protozoan parasites of the Leishmania genus, is one of the most prevalent neglected tropical diseases. It is endemic in 98 countries, causing considerable morbidity and mortality. Pentavalent antimonials are the first line of treatment for leishmaniasis except in India. In resistant cases, miltefosine, amphotericin B and pentamidine are used. These treatments are unsatisfactory due to toxicity, limited efficacy, high cost and difficult administration. Thus, there is an urgent need to develop drugs that are efficacious, safe, and more accessible to patients. Trypanosomatids, including Leishmania spp. and Trypanosoma cruzi, have an essential requirement for ergosterol and other 24-alkyl sterols, which are absent in mammalian cells. Inhibition of ergosterol biosynthesis is increasingly recognized as a promising target for the development of new chemotherapeutic agents. The aim of this work was to investigate the antiproliferative, physiological and ultrastructural effects against Leishmania amazonensis of itraconazole (ITZ) and posaconazole (POSA), two azole antifungal agents that inhibit sterol C14α-demethylase (CYP51). Antiproliferative studies demonstrated potent activity of POSA and ITZ: for promastigotes, the IC50 values were 2.74 µM and 0.44 µM for POSA and ITZ, respectively, and for intracellular amastigotes, the corresponding values were 1.63 µM and 0.08 µM, for both stages after 72 h of treatment. Physiological studies revealed that both inhibitors induced a collapse of the mitochondrial membrane potential (ΔΨm), which was consistent with ultrastructural alterations in the mitochondrion. Intense mitochondrial swelling, disorganization and rupture of mitochondrial membranes were observed by transmission electron microscopy. In addition, accumulation of lipid bodies, appearance of autophagosome-like structures and alterations in the kinetoplast were also observed. In conclusion, our results indicate that ITZ and POSA are potent inhibitors of L. amazonensis and suggest that these drugs could represent novel therapies for the treatment of leishmaniasis, either alone or in combination with other agents.
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Affiliation(s)
- Sara Teixeira de Macedo-Silva
- Laboratório de Ultraestrutura Celular Hertha Meyer, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Ciência e Tecnologia de Biologia Estrutural e Bioimagem, Rio de Janeiro, Brazil
| | - Julio A. Urbina
- Instituto Venezolano de Investigaciones Científicas, Centro de Bioquímica y Biofísica, Caracas, Venezuela
| | - Wanderley de Souza
- Laboratório de Ultraestrutura Celular Hertha Meyer, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Ciência e Tecnologia de Biologia Estrutural e Bioimagem, Rio de Janeiro, Brazil
- Instituto Nacional de Metrologia, Qualidade e Tecnologia, Inmetro, Rio de Janeiro, Brazil
| | - Juliany Cola Fernandes Rodrigues
- Laboratório de Ultraestrutura Celular Hertha Meyer, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Ciência e Tecnologia de Biologia Estrutural e Bioimagem, Rio de Janeiro, Brazil
- Instituto Nacional de Metrologia, Qualidade e Tecnologia, Inmetro, Rio de Janeiro, Brazil
- Núcleo Multidisciplinar de Pesquisa em Biologia (NUMPEX-BIO), Polo Avançado de Xerém, Universidade Federal do Rio de Janeiro, Duque de Caxias, Brazil
- * E-mail:
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19
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Hussain H, Al-Harrasi A, Abbas G, Rehman NU, Mabood F, Ahmed I, Saleem M, van Ree T, Green IR, Anwar S, Badshah A, Shah A, Ali I. The GenusPluchea:Phytochemistry, Traditional Uses, and Biological Activities. Chem Biodivers 2013; 10:1944-71. [DOI: 10.1002/cbdv.201200140] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Indexed: 11/11/2022]
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20
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Drug resistance in leishmaniasis: current drug-delivery systems and future perspectives. Future Med Chem 2013; 5:1877-88. [DOI: 10.4155/fmc.13.143] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Leishmaniasis is a complex of diseases with numerous clinical manifestations for instance harshness from skin lesions to severe disfigurement and chronic systemic infection in the liver and spleen. So far, the most classical leishmaniasis therapy, despite its documented toxicities, remains pentavalent antimonial compounds. The arvailable therapeutic modalities for leishmaniasis are overwhelmed with resistance to leishmaniasis therapy. Mechanisms of classical drug resistance are often related with the lower drug uptake, increased efflux, the faster drug metabolism, drug target modifications and over-expression of drug transporters. The high prevalence of leishmaniasis and the appearance of resistance to classical drugs reveal the demand to develop and explore novel, less toxic, low cost and more promising therapeutic modalities. The review describes the mechanisms of classical drug resistance and potential drug targets in Leishmania infection. Moreover, current drug-delivery systems and future perspectives towards Leishmaniasis treatment are also covered.
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21
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Monzote L, García M, Scull R, Cuellar A, Setzer WN. Antileishmanial activity of the essential oil from Bixa orellana. Phytother Res 2013; 28:753-8. [PMID: 23983115 DOI: 10.1002/ptr.5055] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 07/13/2013] [Accepted: 07/16/2013] [Indexed: 12/31/2022]
Abstract
Leishmaniasis is a neglected tropical disease caused by Leishmania protozoa. There is currently no vaccine against leishmaniasis, and chemotherapy remains the only effective control. However, conventional drugs are toxic, expensive, and require long periods of treatment, and resistance to clinical chemotherapeutic agents is emerging. Recent research on plants has shown a successful approach to obtain new antileishmanial alternatives. Herein, the in vitro and in vivo effects of the essential oil from Bixa orellana seeds against Leishmania amazonensis were evaluated. A total of 73 compounds were detected by gas chromatography-mass spectrometry analysis, of which ishwarane (18.6%) and geranylgeraniol (9.1%) were the major components. The oil showed activity against intracellular amastigote form (IC50 = 8.5 µg/mL), while the cytotoxic concentration was sevenfold higher for the host cells. The ability of Bixa oil to control disease progression of established cutaneous leishmaniasis in BALB/c mice was demonstrated, after a treatment with 30 mg/kg by intraperitoneal administration over 14 days. The present study reports for the first time the antileishmanial potentialities of the essential oil from B. orellana.
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Affiliation(s)
- Lianet Monzote
- Parasitology Department, Institute of Tropical Medicine 'Pedro Kouri', Havana, Cuba
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22
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Strategies for the design of orally bioavailable antileishmanial treatments. Int J Pharm 2013; 454:539-52. [PMID: 23871737 DOI: 10.1016/j.ijpharm.2013.07.035] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 07/08/2013] [Accepted: 07/10/2013] [Indexed: 12/21/2022]
Abstract
Leishmaniasis is one of the six major tropical diseases targeted by the World Health Organization. The most serious, life-threatening form is visceral leishmaniasis (VL). No vaccine is yet available for human use and chemotherapy is the main mean of dealing with this disease. This review focuses on the development of drug delivery systems (DDS) for treatment of leishmaniasis. After an overview of the significance of leishmaniasis in 2013, current chemotherapy and its limitations are considered, leading to possible strategies to improve the treatment of VL: new drugs, combinations of existing drugs and DDS, particularly for oral administration. Nanostructured biomaterials such as lipid-based or polymeric nanoparticles have unique physicochemical properties, ultra-small and controllable size, large surface area to mass ratio and the possibility of surface modification which can be used to advantage for the oral administration of antileishmanial drugs. They can improve the rate of dissolution of poorly water-soluble drugs, increase intestinal residence time by bioadhesion and, especially when lipid additives are used, influence the route and efficiency of absorption. These recent advances in this very active field should lead to better management of this serious disease.
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23
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Chemotherapy of leishmaniasis. Part XII: Design, synthesis and bioevaluation of novel triazole integrated phenyl heteroterpenoids as antileishmanial agents. Bioorg Med Chem Lett 2013; 23:2925-8. [DOI: 10.1016/j.bmcl.2013.03.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Revised: 03/04/2013] [Accepted: 03/15/2013] [Indexed: 11/20/2022]
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24
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Reimão JQ, Trinconi CT, Yokoyama-Yasunaka JK, Miguel DC, Kalil SP, Uliana SRB. Parasite burden in Leishmania (Leishmania) amazonensis-infected mice: validation of luciferase as a quantitative tool. J Microbiol Methods 2013; 93:95-101. [PMID: 23466934 DOI: 10.1016/j.mimet.2013.02.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 02/22/2013] [Accepted: 02/23/2013] [Indexed: 10/27/2022]
Abstract
Given the lack of effective and safe alternatives to the drugs already in use, considerable efforts are being applied to the search of new therapeutic options to treat leishmaniasis. A necessary step in the discovery of antileishmanial drugs is the validation of drug candidates in mouse models. The standard methods to quantify the parasite burden in animal models, mainly culture-based, are time consuming and expensive. In recent years, in vivo imaging systems have been proposed as a tool to overcome these problems, allowing parasite detection in living organisms. Here we compared different treatment efficacy evaluation approaches. Recombinant Leishmania (L.) amazonensis lines expressing the luciferase gene (La-LUC) were obtained and characterized for biological properties as compared with the wild type (WT) parental line. Bioluminescence generated by La-LUC was shown to correlate with the number of promastigotes in vitro. La-LUC promastigotes and intracellular amastigotes were equally sensitive to amphotericin B (AmB) as the WT parasites. The clinical pattern of lesion development upon infection with the transgenic lines was similar to lesions observed after infection with the WT strain. The half maximal effective dose (ED50) of AmB was determined in La-LUC infected mice through quantification of bioluminescence in vivo and ex vivo, by limiting dilution and using clinical parameters. There was agreement in the ED50 determined by all methods. Quantification of bioluminescence in vivo and/or ex vivo was elected as the best tool for determining parasite burden to assess drug efficacy in infected mice. Furthermore, the detailed analysis of AmB effectiveness in this model generated useful data to be used in drug combination experiments.
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Affiliation(s)
- Juliana Q Reimão
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, Av. Prof. Lineu Prestes 1374, 05508-000 São Paulo, Brazil.
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25
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Kulkarni MM, Reddy N, Gude T, McGwire BS. Voriconazole suppresses the growth of Leishmania species in vitro. Parasitol Res 2013; 112:2095-9. [PMID: 23392902 DOI: 10.1007/s00436-013-3274-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 01/06/2013] [Indexed: 11/29/2022]
Abstract
The digenetic protozoan Leishmania is dependent on ergosterol synthesis for growth and viability. We compared the in vitro activity of ergosterol synthesis inhibitor voriconazole with fluconazole and ketoconazole against cutaneous and visceral Leishmania species. We found the IC50 of voriconazole was comparable to ketoconazole and both were superior to fluconazole. Both ketoconazole and voriconazole were active against insect and mammalian stage parasites. This is the first report of the in vitro activity of voriconazole against leishmanial species.
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Affiliation(s)
- Manjusha M Kulkarni
- Division of Infectious Diseases and Center for Microbial Interface Biology, The Ohio State University, Columbus, OH 43210, USA
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26
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García M, Perera WH, Scull R, Monzote L. Antileishmanial assessment of leaf extracts from Pluchea carolinensis, Pluchea odorata and Pluchea rosea. ASIAN PAC J TROP MED 2012; 4:836-40. [PMID: 22014743 DOI: 10.1016/s1995-7645(11)60204-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 07/15/2011] [Accepted: 08/15/2011] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate the antileishmanial activity of different extracts from three Cuban Pluchea species. METHODS In in vitro assays the IC(50) was calculated in the promastigotes and amastigotes forms as cytotoxicity in murine macrophages. In leishmaniasis cutanea experiment, mortality, weight loss, lesion size and burden parasite were measured. RESULTS Extracts evaluated showed inhibitive effect on growing of promastigote form; however, active extracts caused a high toxicity. Ethanol and n-hexane extracts demonstrated specific antileishmanial activity. Ethanol and n-hexane extracts from Pluchea carolinensis (P. carolinensis) caused similar inhibition against amastigote form. The intraperitoneal administration of the ethanol extract of P. carolinensis at 100 mg/kg prevented lesion development compared with control groups. CONCLUSIONS The antileishmanial experiment suggests that ethanol extracts from P. carolinensis is the most promising. Further studies are still needed to evaluate the potential of this plant as a source of new antileishmanial agents.
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Affiliation(s)
- Marley García
- Parasitology Department, Institute of Medicine Tropical Pedro Kourí, Havana City, Cuba
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27
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Croft SL, Olliaro P. Leishmaniasis chemotherapy--challenges and opportunities. Clin Microbiol Infect 2012; 17:1478-83. [PMID: 21933306 DOI: 10.1111/j.1469-0691.2011.03630.x] [Citation(s) in RCA: 291] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although there have been significant advances in the treatment of visceral leishmaniasis (VL), there remain challenges to ensure that treatments effective in India are also effective in other regions of the world and to identify treatment for post kala-azar dermal leishmaniasis as well as the opportunity to develop a safe oral short-course treatment. At the same time, there have been few advances for the treatment of simple or complex forms of cutaneous leishmaniasis (CL), other than topical paromomycin formulations. The main challenge for CL is to ensure that this disease is on the research and development agenda, so that new drugs are evaluated or compounds are screened in appropriate models, and that the standardization of quality of clinical trials is guaranteed. Problems also remain in the treatment of HIV/leishmaniasis co-infected patients. We are some way from having the ideal treatments for VL and CL and drug research and development for these diseases must remain focused.
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Affiliation(s)
- S L Croft
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
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28
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Boechat N, Pinheiro LCS, Santos-Filho OA, Silva IC. Design and synthesis of new N-(5-trifluoromethyl)-1H-1,2,4-triazol-3-yl benzenesulfonamides as possible antimalarial prototypes. Molecules 2011; 16:8083-97. [PMID: 21934646 PMCID: PMC6264137 DOI: 10.3390/molecules16098083] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 09/09/2011] [Accepted: 09/16/2011] [Indexed: 12/05/2022] Open
Abstract
A rational approach was used to synthesize a new set of 15 1H-1,2,4-triazol-3-yl benzenesulfonamide derivatives with the aim of developing new antimalarial lead compounds. These derivatives were prepared in yields between 50% and 62%, and their structures were elucidated using IR, ¹H-, ¹³C-, ¹⁹F-NMR, MS and elemental analysis. A docking study based on sulfonamides previously used against malaria identified trifluoromethyl-substituted derivatives to be the best lead compounds for new antimalarial drug development.
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Affiliation(s)
- Nubia Boechat
- Departamento de Sintese Organica, Instituto de Tecnologia em Farmacos, Fundacao Oswaldo Cruz, Manguinhos, CEP 21041-250, Rio de Janeiro, RJ, Brazil.
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29
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Blanco O, Lugones Y, Díaz E, Monzote L. In vitro activity of the clinical pulmonary surfactant Surfacen® against Leishmania amazonensis. Rev Inst Med Trop Sao Paulo 2011; 53:235-8. [DOI: 10.1590/s0036-46652011000400012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Accepted: 06/01/2011] [Indexed: 11/21/2022] Open
Abstract
Surfacen® is an exogenous natural lung surfactant, composed by phospholipids and hydrophobic proteins, which is applied successfully in Newborn Respiratory Distress Syndrome. In this paper, in vitro activity of Surfacen® against Leishmania amazonensis is described. The product showed activity against the amastigote form found in peritoneal macrophages from BALB/c mice, with an IC50 value of 17.9 ± 3.0 µg/mL; while no toxic effect on host cell was observed up to 200 µg/mL. This is the first report about the antileishmanial activity of Surfacen®.
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Affiliation(s)
| | | | - Elaine Díaz
- Centro Nacional de Sanidad Agropecuaria, Cuba
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30
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Antiprotozoal compounds: state of the art and new developments. Int J Antimicrob Agents 2011; 38:118-24. [DOI: 10.1016/j.ijantimicag.2011.03.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2011] [Accepted: 03/08/2011] [Indexed: 11/20/2022]
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31
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Shakya N, Bajpai P, Gupta S. Therapeutic switching in leishmania chemotherapy: a distinct approach towards unsatisfied treatment needs. J Parasit Dis 2011; 35:104-12. [PMID: 23024489 DOI: 10.1007/s12639-011-0040-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 05/06/2011] [Indexed: 11/26/2022] Open
Abstract
Current drugs for the treatment of visceral leishmaniasis are inadequate. No novel compound is in the pipeline. Since economic returns on developing a new drug for neglected disease, leishmaniasis is so low that therapeutic switching represents the only realistic strategy. It refers to "alternative drug use" discoveries which differ from the original intent of the drug. Amphotericin B, paromomycin, miltefosine and many other drugs are very successful examples of "new drugs from old". This article reviews the discovery, growth and current status of these drugs and concluded that the potential of this approach (therapeutic switching) may use in the development of new antileishmanials in future also.
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Affiliation(s)
- Nishi Shakya
- Division of Parasitology, Central Drug Research Institute, Chattar Manzil Palace, M.G. Road, Lucknow, 226001 UP India
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da Cunha-Junior EF, Pacienza-Lima W, Ribeiro GA, Netto CD, Canto-Cavalheiro MMD, da Silva AJM, Costa PRR, Rossi-Bergmann B, Torres-Santos EC. Effectiveness of the local or oral delivery of the novel naphthopterocarpanquinone LQB-118 against cutaneous leishmaniasis. J Antimicrob Chemother 2011; 66:1555-9. [DOI: 10.1093/jac/dkr158] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Design and synthesis of novel tetrahydronaphthyl azoles and related cyclohexyl azoles as antileishmanial agents. Bioorg Med Chem Lett 2011; 21:1407-10. [DOI: 10.1016/j.bmcl.2011.01.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 01/05/2011] [Accepted: 01/07/2011] [Indexed: 11/19/2022]
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Verma A, Srivastava S, Sane SA, Marrapu VK, Srinivas N, Yadav M, Bhandari K, Gupta S. Antileishmanial activity of benzocycloalkyl azole oximino ethers: the conformationally constraint analogues of oxiconazole. Acta Trop 2011; 117:157-60. [PMID: 21078278 DOI: 10.1016/j.actatropica.2010.10.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 10/25/2010] [Accepted: 10/27/2010] [Indexed: 11/29/2022]
Abstract
Antileishmanial activities of 16 synthetic oximino benzocycloalkyl azoles against Leishmania donovani were evaluated in vitro against extracellular promastigotes and intracellular amastigotes. Based on SI (Selectivity Index), five compounds were tested further in vivo in hamster model. Out of these, three compounds have shown medium activity (53-58%) and one has shown significant inhibition of parasite multiplication (70%). Despite the fact that these compounds were better than the existing antileishmanials in respect to IC(50) and SI values, they were less active than miltefosine in vivo. The present study has helped us in identifying a new lead that could be exploited as a potential antileishmanial agent.
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Affiliation(s)
- Aditya Verma
- Division of Parasitology, Central Drug Research Institute (CSIR), Chattar Manzil Palace, Lucknow 226001 (UP), India
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35
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Successful treatment of Old World cutaneous leishmaniasis caused by Leishmania infantum with posaconazole. Antimicrob Agents Chemother 2011; 55:1774-6. [PMID: 21282455 DOI: 10.1128/aac.01498-10] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Old World cutaneous leishmaniasis is a widespread and potentially disfiguring protozoal infection that is endemic in the Mediterranean basin, Africa, and parts of Asia. Human infection is caused by several species of Leishmania parasites, such as Leishmania infantum. Available systemic and topical treatments vary in efficacy and are often unjustified due to their toxicity. We report on a case that was treated with posaconazole, a drug typically considered an antifungal agent but which also targets specific metabolic pathways of the parasite.
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García M, Monzote L, Montalvo AM, Scull R. Effect of Bixa orellana against Leishmania amazonensis. ACTA ACUST UNITED AC 2011; 18:351-3. [DOI: 10.1159/000335280] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Salerno C, Carlucci AM, Bregni C. Study of in vitro drug release and percutaneous absorption of fluconazole from topical dosage forms. AAPS PharmSciTech 2010; 11:986-93. [PMID: 20521179 DOI: 10.1208/s12249-010-9457-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Accepted: 05/13/2010] [Indexed: 11/30/2022] Open
Abstract
The present study aimed to evaluate different dosage forms, emulsions, emulgels, lipogels, and thickened microemulsion-based hydrogel, as fluconazole topical delivery systems with the purpose of determining a formulation with the capacity to deliver the whole active compound and maintain it within the skin so as to be considered a useful formulation either for topical mycosis treatment or as adjuvant in a combined therapy for Cutaneous Leishmaniasis. Propylene glycol and diethyleneglycol monoethyl ether were used for each dosage form as solvent for the drug and also as penetration enhancers. In vitro drug release after application of a clinically relevant dose of each formulation was evaluated and then microemulsions and lipogels were selected for the in vitro penetration and permeation study. Membranes of mixed cellulose esters and full-thickness pig ear skin were used for the in vitro studies. Candida albicans was used to test antifungal activity. A microemulsion containing diethyleneglycol monoethyl ether was found to be the optimum formulation as it was able to deliver the whole contained dose and enhance its skin penetration. Also this microemulsion showed the best performance in the antifungal activity test compared with the one containing propylene glycol. These results are according to previous reports of the advantages of microemulsions for topical administration and they are very promising for further clinical evaluation.
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Parra MG, Fidalgo LM, Martinez JM, Alvarez AMM, Iglesias OV. Leishmanicidal activity of Echinaster (Othilia) echinophorus crude extract. Rev Inst Med Trop Sao Paulo 2010; 52:89-93. [DOI: 10.1590/s0036-46652010000200005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2008] [Accepted: 01/12/2009] [Indexed: 11/21/2022] Open
Abstract
In this study, a methanolic extract from Echinaster (Othilia) echinophorus was evaluated for activity against Leishmania amazonensis. The extract showed activity against the promastigote and amastigote forms with IC50 values of 62.9 and 37.5 μg.mL-1 respectively. This extract showed a moderate toxicity on macrophages from BALB/c mice. A dose of 100 mg/kg/day was effective when administered during 15 days by intraperitoneal route to BALB/c mice infected experimentally.
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39
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Sterol Biosynthesis Pathway as Target for Anti-trypanosomatid Drugs. Interdiscip Perspect Infect Dis 2009; 2009:642502. [PMID: 19680554 PMCID: PMC2721973 DOI: 10.1155/2009/642502] [Citation(s) in RCA: 131] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Accepted: 04/27/2009] [Indexed: 12/03/2022] Open
Abstract
Sterols are constituents of the cellular membranes that are essential for their normal structure and function. In mammalian cells, cholesterol is the main sterol found in the various membranes. However, other sterols predominate in eukaryotic microorganisms such as fungi and protozoa. It is now well established that an important metabolic pathway in fungi and in members of the Trypanosomatidae family is one that produces a special class of sterols, including ergosterol, and other 24-methyl sterols, which are required for parasitic growth and viability, but are absent from mammalian host cells. Currently, there are several drugs that interfere with sterol biosynthesis (SB) that are in use to treat diseases such as high cholesterol in humans and fungal infections. In this review, we analyze the effects of drugs such as (a) statins, which act on the mevalonate pathway by inhibiting HMG-CoA reductase, (b) bisphosphonates, which interfere with the isoprenoid pathway in the step catalyzed by farnesyl diphosphate synthase, (c) zaragozic acids and quinuclidines, inhibitors of squalene synthase (SQS), which catalyzes the first committed step in sterol biosynthesis, (d) allylamines, inhibitors of squalene epoxidase, (e) azoles, which inhibit C14α-demethylase, and (f) azasterols, which inhibit Δ24(25)-sterol methyltransferase (SMT). Inhibition of this last step appears to have high selectivity for fungi and trypanosomatids, since this enzyme is not found in mammalian cells. We review here the IC50 values of these various inhibitors, their effects on the growth of trypanosomatids (both in axenic cultures and in cell cultures), and their effects on protozoan structural organization (as evaluted by light and electron microscopy) and lipid composition. The results show that the mitochondrial membrane as well as the membrane lining the protozoan cell body and flagellum are the main targets. Probably as a consequence of these primary effects, other important changes take place in the organization of the kinetoplast DNA network and on the protozoan cell cycle. In addition, apoptosis-like and autophagic processes induced by several of the inhibitors tested led to parasite death.
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Aryloxy cyclohexyl imidazoles: A novel class of antileishmanial agents. Bioorg Med Chem Lett 2009; 19:324-7. [DOI: 10.1016/j.bmcl.2008.11.094] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Revised: 11/19/2008] [Accepted: 11/24/2008] [Indexed: 11/18/2022]
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41
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Le Pape P. Development of new antileishmanial drugs – current knowledge and future prospects. J Enzyme Inhib Med Chem 2008; 23:708-18. [DOI: 10.1080/14756360802208137] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Patrice Le Pape
- Département de Parasitologie et de Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, IICiMed UPRES EA 1155, UFR de Sciences Pharmaceutiques, 1 rue Gaston VeilNantes cedex 01F-44035, France
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Pagniez F, Abdala-Valencia H, Marchand P, Le Borgne M, Le Baut G, Robert-Piessard S, Le Pape P. Antileishmanial activities and mechanisms of action of indole-based azoles. J Enzyme Inhib Med Chem 2008; 21:277-83. [PMID: 16918075 DOI: 10.1080/14756360600700517] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Two 3-(alpha-azolylbenzyl)indoles were evaluated against Leishmania amastigotes. Both compounds proved to be very active against intracellular and axenic amastigotes. The IC50 values of the imidazole derivative, PM17, and the triazole analogue, PM19, against L. mexicana axenic amastigotes, were 4.4 +/- 0.1 and 6.4 +/- 0.1 microM, respectively. Against intracellular amastigotes, PM17 produced a 66% decrease of leishmanial burden at 1 microM and PM19 had an IC50 of 1.3 microM. In a Balb/c mice model of L. major leishmaniasis, administration of PM17 led to a clear-cut parasite burden reduction: 98.9% in the spleen, 79.0% in the liver and 49.9% in the popliteal node draining the cutaneous lesion. As anticipated, it was brought to the fore that PM17 decreases ergosterol biosynthesis leading to membrane fungal cell alterations. Moreover it was proved that this imidazole antifungal agent induces a parasite burden-correlated decrease in interleukine-4 production both in the splenocyte and the popliteal node of the mouse.
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Affiliation(s)
- Fabrice Pagniez
- Department of Parasitology and Medical Mycology, BioCiT UPRES EA 1155, Faculty of Pharmacy, Nantes University, 1 rue Gaston Veil, 44035 Nantes cedex 01, France
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Amato VS, Tuon FF, Bacha HA, Neto VA, Nicodemo AC. Mucosal leishmaniasis . Current scenario and prospects for treatment. Acta Trop 2008; 105:1-9. [PMID: 17884002 DOI: 10.1016/j.actatropica.2007.08.003] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Revised: 08/14/2007] [Accepted: 08/14/2007] [Indexed: 11/27/2022]
Abstract
Leishmaniasis causes significant morbidity and mortality and thus constitutes a serious public health problem. Even though it has long been endemic in developing countries, in recent years the economic globalization and the increased volume of international travel have extended its prevalence in developed countries. In addition, native populations may be exposed to the infection through blood transfusion and the use of blood products produced from infected asymptomatic individuals. Mucosal leishmaniasis (ML) is a chronic form of this infection, which attacks the mucosa. In most cases this form of leishmaniasis results from the metastatic spread of Leishmania (Viannia) braziliensis from cutaneous lesions. It is a healthcare issue because of its wide demographic distribution, its association with significant morbidity levels, and because of the pressing concern that tourists who travel to endemic areas might present the disease even years later. The treatment currently available for ML is based on drugs such as pentavalent antimony-containing compounds, amphotericin B deoxycholate and pentamidine and often guarantees a satisfactory clinical response. Nevertheless, it also frequently provokes serious side effects. This review offers a critical analysis of the drugs now available for the treatment of ML as also of the future prospects for the treatment of the disease.
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Affiliation(s)
- Valdir Sabbaga Amato
- Infectious and Parasitic Diseases Clinic, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, 05403-010, São Paulo, Brazil.
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44
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Farowski F, Vehreschild JJ, Cornely OA. Posaconazole: a next-generation triazole antifungal. Future Microbiol 2007; 2:231-43. [PMID: 17661696 DOI: 10.2217/17460913.2.3.231] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Posaconazole is a new drug in the triazole class that has recently been investigated in pivotal Phase III clinical trials. Its antifungal activity is based on the inhibition of the fungal ergosterol synthesis. As demonstrated in vitro, posaconazole exhibits fungicidal activity against Aspergillus spp., Candida spp. and zygomycetes. Currently, posaconazole is only available as an oral suspension. Food consumption affects the bioavailability of posaconazole, while the exposure to posaconazole increases in a dose-proportional manner with a saturation of absorption occurring with a daily dose over 800 mg. Posaconazole is well tolerated without an increase in risk of any treatment-related adverse events during prolonged treatment for 6 or more months (n = 108). Posaconazole has been recently approved by the US FDA and other regulatory bodies for the treatment of oropharyngeal candidiasis, and the prophylaxis of invasive Aspergillus and Candida infections in severely immunocompromised patients. As demonstrated in two pivotal Phase III trials, posaconazole prophylaxis of invasive fungal infection in patients severely immunocompromised by graft-versus-host disease (n = 600) or neutropenia (n = 602) is superior to fluconazole and/or itraconazole prophylaxis. Significantly more patients who received posaconazole, instead of fluconazole, as treatment for oropharyngeal candidiasis sustained clinical success after the treatment was stopped. Preliminary data from a subgroup analysis (n = 24) of two salvage therapy trials for invasive fungal infections, as well as single case reports and series and in vitro studies, suggest that posaconazole might be an attractive oral treatment alternative for zygomycosis.
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Affiliation(s)
- Fedja Farowski
- Klinikum der Universität zu Köln, Klinik I für Innere Medizin, Klinisches Studienzentrum-Schwerpunkt Infektiologie II, Köln, Germany.
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45
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Ferreira SB, Costa MS, Boechat N, Bezerra RJS, Genestra MS, Canto-Cavalheiro MM, Kover WB, Ferreira VF. Synthesis and evaluation of new difluoromethyl azoles as antileishmanial agents. Eur J Med Chem 2007; 42:1388-95. [PMID: 17445951 DOI: 10.1016/j.ejmech.2007.02.020] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2006] [Revised: 01/30/2007] [Accepted: 02/26/2007] [Indexed: 11/21/2022]
Abstract
Several compounds of great pharmacological interest contain the triazole and imidazole rings. In order to find new drugs with antileishmanial activity we have synthesized and evaluated new imidazole and triazole compounds carrying either the carbaldehyde or the difluoromethylene functionalities against promastigote forms of Leishmania amazonensis. Among the compounds tested difluoromethylene azoles 4b and 8f have inhibited the parasite growth significantly. Our results show that the introduction of the difluoromethylene moieties has turned the inactive carbaldehydes into active antileishmanial compounds.
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Affiliation(s)
- Sabrina B Ferreira
- Universidade Federal do Rio de Janeiro Departamento de Química Orgânica, Instituto de Química, Cidade Universitária, 21949-900 Rio de Janeiro, RJ, Brazil
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46
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Ameen M. Cutaneous leishmaniasis: therapeutic strategies and future directions. Expert Opin Pharmacother 2007; 8:2689-99. [DOI: 10.1517/14656566.8.16.2689] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Mahreen Ameen
- Consultant Dermatologist, Royal Free Hospital, Department of Dermatology, London NW3 2QG, UK ;
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47
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Groll AH, Walsh TJ. Antifungal efficacy and pharmacodynamics of posaconazole in experimental models of invasive fungal infections. Mycoses 2007; 49 Suppl 1:7-16. [PMID: 16961576 DOI: 10.1111/j.1439-0507.2006.01296.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Posaconazole is a novel lipophilic antifungal triazole with potent and broad-spectrum activity against opportunistic, endemic and dermatophytic fungi. This activity extends to organisms that are often refractory to existing triazoles, amphotericin B or echinocandins such as Candida glabrata, Candida krusei, Aspergillus terreus, Fusarium spp. and the Zygomycetes. A large number of experimental animal models of invasive fungal infections has demonstrated the potent and broad-spectrum efficacy of posaconazole in vivo, both in normal and in immunocompromised animals. Consistent with these preclinical data, posaconazole showed strong a antifungal efficacy in phase II and phase III clinical trials in immunocompromised patients with oropharyngeal and oesophageal candidiasis and as salvage therapy in patients with invasive fungal infections, and was effective as antifungal prophylaxis in high-risk patients. This paper reviews the preclinical disposition, antifungal efficacy and pharmacodynamics of posaconazole in and its implications for treatment and prevention of invasive fungal infections.
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Affiliation(s)
- Andreas H Groll
- Infectious Disease Research Program, Department of Pediatric Hematology/Oncology, Children's University Hospital, Münster, Germany.
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48
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Monzote L, Montalvo AM, Scull R, Miranda M, Abreu J. Activity, toxicity and analysis of resistance of essential oil from Chenopodium ambrosioides after intraperitoneal, oral and intralesional administration in BALB/c mice infected with Leishmania amazonensis: A preliminary study. Biomed Pharmacother 2007; 61:148-53. [PMID: 17254746 DOI: 10.1016/j.biopha.2006.12.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2006] [Revised: 08/30/2006] [Accepted: 12/04/2006] [Indexed: 09/30/2022] Open
Abstract
The World Health Organization has classified the leishmaniasis as a major tropical disease. Current therapy is toxic, expensive and cause several adverse effects. The majority of people in endemic areas of leishmaniasis depend of natural and traditional medicine. This study was developed to examine the activity of the essential oil from Chenopodium ambrosioides in BALB/c mice infected with Leishmania amazonensis. The infected animals received two cycle of treatment by different routes (intraperitoneal, oral or intralesional route). The intraperitoneal administration of the essential oil at dose of 30 mg/Kg prevented lesion development and decrease the parasite burden. Oral administration retarded the infection in the experimental model compared with untreated mice, although it was less effective that the intraperitoneal route. The administration by intralesional route did not show activity. Intraperitoneal and oral treatment at 30 mg/Kg with the essential oil had better antileishmanial effect that treatment with the reference drug, amphotericin B at 1 mg/Kg. Preliminarily, we examined the toxicity and the resistance after treatment. Signs of toxicity were evident only in the animals treated by intraperitoneal route. No resistance was detected in L. amazonensis isolates obtained from treated mice. These data clearly demonstrated that this natural product could be an alternative for the development of a new drug against cutaneous leishmaniasis based in the ethnomedical information.
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Affiliation(s)
- Lianet Monzote
- Parasitology Department, Institute of Medicine Tropical "Pedro Kourí", Apartado Postal No. 601, Marianao 13, Havana City, Cuba.
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Abstract
Posaconazole is a lipophilic triazole antifungal agent that is structurally similar to itraconazole but has an expended spectrum of activity including yeast, molds, and dimorphic fungi. Posaconazole was licensed by the European Commission for the treatment of invasive aspergillosis, fusariosis, mycetoma, chromoblastomycosis, and coccidioidomycosis in adults who are refractory, or intolerant to other antifungal agents. Posaconazole was recently indicated for prophylaxis of invasive fungal infections in the following patients: patients receiving remission-induction chemotherapy for acute myelogenous leukemia (AML) or myelodysplastic syndromes (MDS) expected to result in prolonged neutropenia and hematopoietic stem cell transplant (HSCT) recipients who are undergoing high-dose immunosuppressive therapy for versus host disease. The spectacular activity of posaconazole against refractory infections due to zygomycetes is encouraging and suggests using posaconazole in this case. Posaconazole is only available in oral suspension formulation. Posaconazole was well tolerated in clinical trials and has lower drug interaction profile compared to other available azoles.
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Affiliation(s)
- A Paugam
- Laboratoire de Parasitologie-Mycologie, hopital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
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50
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Groll AH, Walsh TJ. Posaconazole: clinical pharmacology and potential for management of fungal infections. Expert Rev Anti Infect Ther 2007; 3:467-87. [PMID: 16107193 DOI: 10.1586/14787210.3.4.467] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Posaconazole is a novel lipophilic antifungal triazole that inhibits cytochrome P450-dependent 14-alpha demethylase in the biosynthetic pathway of ergosterol. Inhibition of this enzyme leads to an accumulation of toxic 14-alpha methylsterols and a depletion of ergosterol, resulting in a perturbation of the function of the fungal cell membrane and blockage of cell growth and division. In vitro, posaconazole has potent and broad-spectrum activity against opportunistic, endemic and dermatophytic fungi. This activity extends to organisms that are often refractory to existing triazoles, amphotericin B or echinocandins, such as Candida glabrata, Candida krusei, Aspergillus terreus, Fusarium spp. and the Zygomycetes. A large variety of animal models of invasive fungal infections have provided consistent evidence of efficacy against these organisms in vivo, both in normal and immunocompromised animals. Posaconazole is available as an oral suspension and optimal exposure is achieved when the drug is administered in two to four divided doses along with food or a nutritional supplement. The compound has a large volume of distribution, in the order of 5 l/kg, and a half-life of approximately 20 h. Posaconazole is not metabolized to a significant extent through the cytochrome P450 enzyme system and is primarily excreted in an unchanged form in the feces. Although it is inhibitory, cytochrome P3A4 has no effect on 1A2, 2C8, 2C9, 2D6 and 2E1 isoenzymes, and therefore, a limited spectrum of drug-drug interactions can be expected. Pharmacokinetic studies in special populations revealed no necessity for dosage adjustment based on differences in age, gender, race, renal or hepatic function. Posaconazole has demonstrated strong antifungal efficacy in Phase II and III clinical trials in immunocompromised patients with oropharyngeal and esophageal candidiasis. Posaconazole also showed promising efficacy as salvage therapy in a large Phase II study including 330 patients with invasive fungal infections intolerant to or refractory to standard therapies. Posaconazole appears to be well tolerated in a manner comparable with that of fluconazole and it is currently under regulatory review in the USA and Europe for the treatment of refractory invasive fungal infections. This drug profile reviews the preclinical and clinical pharmacology of posaconazole and its potential role for prevention and treatment of invasive fungal infections.
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Affiliation(s)
- Andreas H Groll
- Children's University Hospital, Dept. of Hematology/Oncology, Center for Bone Marrow Transplantation, Albert-Schweitzer-Strasse 33, 48149 Münster, Germany.
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