RESUMO

Schistosomiasis, a widespread parasitic disease caused by the blood fluke of the genus Schistosoma, affects over 230 million people, primarily in developing countries. Praziquantel, the sole drug currently approved for schistosomiasis treatment, demonstrates effectiveness against patent infections. A recent study highlighted the antiparasitic properties of amiodarone, an anti-arrhythmic drug, exhibiting higher efficacy than praziquantel against prepatent infections. This study assessed the efficacy of amiodarone and praziquantel, both individually and in combination, against Schistosoma mansoni through comprehensive in vitro and in vivo experiments. In vitro experiments demonstrated synergistic activity (fractional inhibitory concentration index ≤0.5) for combinations of amiodarone with praziquantel. In a murine model of schistosomiasis featuring prepatent infections, treatments involving amiodarone (200 or 400 mg/kg) followed by praziquantel (200 or 400 mg/kg) yielded a substantial reduction in worm burden (60%-70%). Given the low efficacy of praziquantel in prepatent infections, combinations of amiodarone with praziquantel may offer clinical utility in the treatment of schistosomiasis.

Assuntos

RESUMO

La ivermectina demostró importantes acciones antivirales ante varios virus con genoma de ARN, inclusive contra el SARS-CoV-2. Este fármaco inhibe la actividad del heterodímero importina α/ß1, sin embargo, se desconoce los blancos específicos de interacción de la molécula. Objetivos: analizar in silico los blancos de interacción de la ivermectina en interacción con la estructura de la importina α humana, utilizando la estrategia del acoplamiento molecular. Métodos: se realizaron simulaciones del acoplamiento utilizando un modelo semiflexible y el algoritmo Broyden-Fletcher-Goldfarb-Shanno entre las estructuras de ivermectina y la importina α. Resultados: los datos obtenidos revelan una mayor afinidad de interacción de la ivermectina a la región mayor de unión (armadillo ARM2-ARM4) de las importinas α humanas, con energías de unión favorables de -9,5 a -8,0 kcal.mol-1. Los aminoácidos activos de importancia en las uniones fueron el Triptófano, Asparagina y Arginina, los cuales también son fundamentales para el reconocimiento de secuencias NLS (secuencias de localización nuclear) de las proteínas virales. También se registró afinidades por los dominios H1-ARM5, H2-ARM6 y H2-ARM7, con energía de unión de -7,5 kcal.mol-1. Conclusiones: los hallazgos demuestran que la ivermectina presenta afinidades de unión favorables a la región mayor de unión (ARM2-ARM4) de las importinas a el cual es un sitio importante de unión a proteínas virales.

Ivermectin has demonstrated significant antiviral actions against several RNA-genome viruses, including SARS-CoV-2. This drug inhibits the activity of the α/ß1 importin heterodimer; however, the specific interaction targets of the molecule are unknown yet. Objectives: to analyze in silico the interaction targets of ivermectin interacting with the human α-importin structure using the molecular docking strategy. Methods: simulations of the molecular docking were carried out using a semi-flexible model and the Broyden-Fletcher-Goldfarb- Shanno algorithm between the structures of ivermectin and importin α. Results: data obtained reveal a higher interaction affinity of ivermectin to the major binding region (armadillo ARM2-ARM4) of human importins α, with favorable binding energies of -9,5 to -8,0 kcal.mol-1. The active amino acids of importance in the bindings were Tryptophan, Asparagine and Arginine, which are also critical for the recognition of NLS sequences (nuclear location sequences) of viral proteins. Affinities for H1-ARM5, H2-ARM6 and H2-ARM7 domains were also recorded, with binding energy of -7,5 kcal.mol-1. Conclusions: the findings demonstrate that ivermectin exhibits favorable binding affinities to the major binding region (ARM2-ARM4) of importins a which is an important viral protein binding site.

RESUMO

Intestinal parasites continue to be a public health problem in low- and middle-income countries. Broad use of anthelmintics during deworming programs is still necessary in many regions. However, description of the usage of these medications in general medical practice has been limited. The objective of this study was to determine the use of anthelmintic drugs and their indications in a group of Colombian patients. This was a descriptive study from a drug-dispensing database, identifying patients with prescriptions for anthelmintic drugs. A total of 381 cases were randomly selected, and their medical records were reviewed, analyzing sociodemographic, clinical, and pharmacological variables (indication of use). The lack of diagnosis registration or clinical manifestations of parasites was determined as a prescription without indication. In total, 50.9% (n = 194) of patients were female, and 67.4% of all patients were under 18 yr of age. The diagnosis of helminthiases was clearly stated in 114 (29.9%) patients, and only 4.2% (n = 16) of these had microbiological confirmation. The most commonly used anthelmintic drug was albendazole (70.4% of all prescriptions). The use of anthelmintics was not indicated in 266 cases (69.8%). Nutritional supplements or vitamin prescriptions were associated with using anthelmintics without indication (odds ratio: 2.25; 95% confidence interval: 1.26-4.03). A high proportion of patients lacked symptoms or diagnoses in their clinical records that supported the use of anthelmintic drugs.

Assuntos

RESUMO

Ivermectin has emerged as a therapeutic option for various parasitic diseases, including strongyloidiasis, scabies, lice infestations, gnathostomiasis, and myiasis. This study comprehensively reviews the evidence-based indications for ivermectin in treating parasitic diseases, considering the unique context and challenges in Peru. Fourteen studies were selected from a systematic search of scientific evidence on ivermectin in PubMed, from 2010 to July 2022. The optimal dosage of ivermectin for treating onchocerciasis, strongyloidiasis, and enterobiasis ranges from 150 to 200 µg/kg, while lymphatic filariasis requires a higher dose of 400 µg/kg (Brown et al., 2000). However, increased dosages have been associated with a higher incidence of ocular adverse events. Scientific evidence shows that ivermectin can be safely and effectively administered to children weighing less than 15 kg. Systematic reviews and meta-analyses provide strong support for the efficacy and safety of ivermectin in combating parasitic infections. Ivermectin has proven to be an effective treatment for various parasitic diseases, including intestinal parasites, ectoparasites, filariasis, and onchocerciasis. Dosages ranging from 200 µg/kg to 400 µg/kg are generally safe, with adjustments made according to the specific pathology, patient age, and weight/height. Given Peru's prevailing social and environmental conditions, the high burden of intestinal parasites and ectoparasites in the country underscores the importance of ivermectin in addressing these health challenges.

RESUMO

Infections caused by parasitic helminths have enormous health, social, and economic impacts worldwide. The treatment and control of these diseases have been dependent on a limited set of drugs, many of which have become less effective, necessitating the search for novel anthelmintic agents. In this study, a simplified compound, N-(4-methoxyphenyl)pentanamide (N4MP), based on the structure of the most widely used anthelmintic (albendazole), was chemically prepared using 4-anisidine and pentanoic acid. N-(4-Methoxyphenyl)pentanamide was evaluated in vitro against the nematode Toxocara canis, an ascarid roundworm of animals that can infect humans. Similar to albendazole, bioassays showed that N-(4-methoxyphenyl)pentanamide affected the viability of parasites in a time- and concentration-dependent manner. Interestingly, N-(4-methoxyphenyl)pentanamide showed a profile of lower cytotoxicity to human and animal cell lines than albendazole. Pharmacokinetic, drug-likeness, and medicinal chemistry friendliness studies demonstrated an excellent drug-likeness profile for N-(4-methoxyphenyl)pentanamide as well as an adherence to major pharmaceutical companies' filters. Collectively, the results of this study demonstrate that the molecular simplification of albendazole to give N-(4-methoxyphenyl)pentanamide may be an important pipeline in the discovery of novel anthelmintic agents. IMPORTANCE Infections caused by parasitic helminths have enormous health, social, and economic impacts worldwide. The treatment and control of these diseases have been dependent on a limited set of drugs, many of which have become less effective, necessitating the search for novel anthelmintic agents. Considering this scenario, the present study reports the preparation of N-(4-methoxyphenyl)pentanamide (N4MP), a simplified molecule based on the structure of the most widely used anthelmintic (albendazole). N4MP was evaluated in vitro against the nematode Toxocara canis, a common ascarid roundworm of domestic animals that can infect humans. Similar to albendazole, bioassays showed that N4MP affected the viability of parasites in a time- and concentration-dependent manner but displayed a profile of lower cytotoxicity to human and animal cell lines than albendazole. Therefore, this study demonstrates that the molecular simplification of albendazole to give N4MP may be an important pipeline in the discovery of novel anthelmintic agents.

Assuntos

RESUMO

Human African Trypanosomiasis (HAT), Chagas disease or American Trypanosomiasis (CD), and leishmaniases are protozoan infections produced by trypanosomatid parasites belonging to the kinetoplastid order and they constitute an urgent global health problem. In fact, there is an urgent need of more efficient and less toxic chemotherapy for these diseases. Medicinal inorganic chemistry currently offers an attractive option for the rational design of new drugs and, in particular, antiparasitic ones. In this sense, one of the main strategies for the design of metal-based antiparasitic compounds has been the coordination of an organic ligand with known or potential biological activity, to a metal centre or an organometallic core. Classical metal coordination complexes or organometallic compounds could be designed as multifunctional agents joining, in a single molecule, different chemical species that could affect different parasitic targets. This review is focused on the rational design of palladium(II) and platinum(II) compounds with bioactive ligands as prospective drugs against trypanosomatid parasites that has been conducted by our group during the last 20 years.

RESUMO

CONTEXTO: A COVID-19 é uma pandemia de risco muito alto a nível global pela OMS. Até o momento não existem terapias específicas, embora diferentes tratamentos estejam em investigação. Mais recentemente, tem havido crescente interesse no uso da nitazoxanida no tratamento de COVID-19, dada sua atividade antiviral de amplo espectro. OBJETIVOS: Identificar, avaliar sistematicamente e sumarizar as melhores evidências científicas disponíveis sobre a eficácia e a segurança da nitazoxanida para COVID-19. MÉTODOS: Revisão sistemática rápida (rapid review methodology). RESULTADOS: Após o processo de seleção, foram avaliados cinco estudos clínicos em andamento. CONCLUSÃO: Cinco estudos com o objetivo de avaliar a eficácia e segurança da nitazoxanida no tratamento de COVID-19 estão em andamento. Devido à ausência de evidência sobre o uso deste medicamento para o tratamento de infecções por coronavírus que causem infecções respiratórias, não é possível recomendar seu uso como terapia para COVID-19.(AU)

Assuntos

RESUMO

Chagas disease (CD) is a human infection caused by Trypanosoma cruzi CD was traditionally endemic to the Americas; however, due to migration it has spread to countries where it is not endemic. The current chemotherapy to treat CD induces several side effects, and its effectiveness in the chronic phase of the disease is controversial. In this contribution, substituted phenylbenzothiazole derivatives were synthesized and biologically evaluated as trypanocidal agents against Trypanosoma cruzi The trypanocidal activities of the most promising compounds were determined through systematic in vitro screening, and their modes of action were determined as well. The physicochemical-structural characteristics responsible for the trypanocidal effects were identified, and their possible therapeutic application in Chagas disease is discussed. Our results show that the fluorinated compound 2-methoxy-4-[5-(trifluoromethyl)-1,3-benzothiazol-2-yl] phenol (BT10) has the ability to inhibit the proliferation of epimastigotes [IC50(Epi) = 23.1 ± 1.75 µM] and intracellular forms of trypomastigotes [IC50(Tryp) = 8.5 ± 2.9 µM] and diminishes the infection index by more than 80%. In addition, BT10 has the ability to selectively fragment 68% of the kinetoplastid DNA compared with 5% of nucleus DNA. The mode of action for BT10 on T. cruzi suggests that the development of fluorinated phenylbenzothiazole with electron-withdrawing substituent is a promising strategy for the design of trypanocidal drugs.

Assuntos

RESUMO

Chagas disease (CD) is a human infection caused by Trypanosoma cruzi. CD was traditionally endemic to the Americas; however, due to migration it has spread to countries where it is not endemic. The current chemotherapy to treat CD induces several side effects, and its effectiveness in the chronic phase of the disease is controversial. In this contribution, substituted phenylbenzothiazole derivatives were synthesized and biologically evaluated as trypanocidal agents against Trypanosoma cruzi. The trypanocidal activities of the most promising compounds were determined through systematic in vitro screening, and their modes of action were determined as well. The physicochemical-structural characteristics responsible for the trypanocidal effects were identified, and their possible therapeutic application in Chagas disease is discussed. Our results show that the fluorinated compound 2-methoxy-4-[5-(trifluoromethyl)-1,3-benzothiazol-2-yl] phenol (BT10) has the ability to inhibit the proliferation of epimastigotes [IC50(Epi) = 23.1 ± 1.75 µM] and intracellular forms of trypomastigotes [IC50(Tryp) = 8.5 ± 2.9 µM] and diminishes the infection index by more than 80%. In addition, BT10 has the ability to selectively fragment 68% of the kinetoplastid DNA compared with 5% of nucleus DNA. The mode of action for BT10 on T. cruzi suggests that the development of fluorinated phenylbenzothiazole with electron-withdrawing substituent is a promising strategy for the design of trypanocidal drugs.

RESUMO

Chagas disease is a serious public health problem in Latin America and, due to migration, in other non-endemic regions. Benznidazole (BNZ) is first choice drug in pediatric therapeutics. However, little is known regarding its metabolism in humans. The aim of the study was to isolate and identify products of human BZN metabolism in urine samples obtained from a pediatric Chagas patient and a healthy adult volunteer both treated with BZN. Urine samples were collected after dose of BNZ. Urine was treated with β-glucuronidase followed by an extraction procedure under two different pH conditions and a HPLC/UV and MS/MS identification of BZN and its metabolites. BZN (m/z 260.09847) was identified in all urine extracts. Peaks from each extracted chromatograms were selected for MS and MS/MS identification. Three compounds structurally related to BZN were identified: BZN-Na+ (m/z 283.08009), N-amine-BZN (m/z 230.12307) and N-hydroxi-amine-BZN (m/z 246.11702). BNZ-Na+ was identified in all extracts, but N-amine-BZN and N-hydroxi-amine-BZN were only observed in those extracts treated with β-glucuronidase. This is the first experimental report showing elimination of BZN N-reduced metabolites in urine. As they were released after treatment with β-glucuronidase it can be suggested that glucuronization plays a role in BNZ metabolism and renal elimination.