Miltefosine and nifuratel combination: a promising therapy for the treatment of leishmania donovani visceral leishmaniasis

[EN] Visceral leishmaniasis is a neglected vector-borne tropical disease caused by Leishmania donovani and Leishmania infantum that is endemic not only in East African countries, but also in Asia, regions of South America and the Mediterranean Basin. For the pharmacological control of this disease,...

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Detalles Bibliográficos
Autores: Melcón Fernández, Estela, Galli, Giulio, García Estrada, Carlos, Balaña Fouce, Rafael, Reguera Torres, Rosa María, Pérez Pertejo, Maria Yolanda
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Universidad Rey Juan Carlos
Repositorio:BULERIA. Repositorio Institucional de la Universidad de León
OAI Identifier:oai:buleria.unileon.es:10612/17821
Acceso en línea:https://www.mdpi.com/1422-0067/24/2/1635
https://hdl.handle.net/10612/17821
Access Level:acceso abierto
Palabra clave:Farmacología
Medicina. Salud
Leishmania
Drug combinations
Nifuratel
Miltefosine
Drug repurposing
32 Ciencias Médicas
3214 Toxicología
3109 Ciencias Veterinarias
Descripción
Sumario:[EN] Visceral leishmaniasis is a neglected vector-borne tropical disease caused by Leishmania donovani and Leishmania infantum that is endemic not only in East African countries, but also in Asia, regions of South America and the Mediterranean Basin. For the pharmacological control of this disease, there is a limited number of old and, in general, poorly adherent drugs, with a multitude of adverse effects and low oral bioavailability, which favor the emergence of resistant pathogens. Pentavalent antimonials are the first-line drugs, but due to their misuse, resistant Leishmania strains have emerged worldwide. Although these drugs have saved many lives, it is recommended to reduce their use as much as possible and replace them with novel and more friendly drugs. From a commercial collection of anti-infective drugs, we have recently identified nifuratel-a nitrofurantoin used against vaginal infections-as a promising repurposing drug against a mouse model of visceral leishmaniasis. In the present work, we have tested combinations of miltefosine-the only oral drug currently used against leishmaniasis-with nifuratel in different proportions, both in axenic amastigotes from bone marrow and in intracellular amastigotes from infected Balb/c mouse spleen macrophages, finding a potent synergy in both cases. In vivo evaluation of oral miltefosine/nifuratel combinations using a bioimaging platform has revealed the potential of these combinations for the treatment of this disease.