Abstract

Miltefosine (Milt) is the only oral treatment for visceral leishmaniasis (VL) but its use is associated with adverse effects, e.g., teratogenicity, vomiting, diarrhoea. Understanding how its chemical structure induces cytotoxicity, whilst not compromising its anti-parasitic efficacy, could identify more effective compounds. Therefore, we systemically modified the compound’s head, tail and linker tested the in vitro activity of three alkylphosphocholines (APC) series against Leishmania donovani strains with different sensitivities to antimony. The analogue, APC12, with an alkyl carbon chain of 12 atoms, was also tested for anti-leishmanial in vivo activity in a murine VL model. All APCs produced had anti-leishmanial activity in the micromolar range (IC50 and IC90, 0.46– > 82.21 µM and 4.14–739.89 µM; 0.01– > 8.02 µM and 0.09–72.18 µM, respectively, against promastigotes and intracellular amastigotes). The analogue, APC12 was the most active, was 4–10 fold more effective than the parent Milt molecule (APC16), irrespective of the strain’s sensitivity to antimony. Intravenous administration of 40 mg/kg APC12 to L. donovani infected BALB/c mice reduced liver and spleen parasite burdens by 60 ± 11% and 60 ± 19%, respectively, while oral administration reduced parasite load in the bone marrow by 54 ± 34%. These studies confirm that it is possible to alter the Milt structure and produce more active anti-leishmanial compounds.

Highlights

  • Visceral leishmaniasis (VL) is a devastating disease for millions of people, primarily in East Africa, South Asia, South America, and Mediterranean Region

  • In this study we have shown that the activity of APCs against L. donovani promastigotes was dependent on its alkyl carbon chain length, with a 12-alkyl carbon analogue that is zwitterionic or cationic (DA) charge on the head being most effective

  • The significant activity of APC12 against Sb- and Milt- resistant parasites, suggests that it can be used for treatment of leishmaniasis caused by these parasites in clinics

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Summary

Introduction

Visceral leishmaniasis (VL) is a devastating disease for millions of people, primarily in East Africa, South Asia, South America, and Mediterranean Region. VL monotherapy with Milt was associated with a 20% relapse rate in Nepal at 12 months post-treatment [8]. Despite this drawback, Milt may have a role in combating the emergence of drug resistance as part of a combination treatment. Milt may have a role in combating the emergence of drug resistance as part of a combination treatment It has recently been used in combination with paromomycin (PMM) or amphotericin B (AMB) to determine which regimen was most effective in curing VL and preventing relapse [9]. Our results confirmed that the anti-leishmanial activity of APCs was dependent on their structure and that synergism was exhibited by some combinations

Methods and Reagents
Animals and Parasites
Statistical Analysis
Result
The Effect of Charge on Tailed Molecules against Leishmania donovani
Findings
Discussion
Full Text
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