Abstract

Paul Ehrlich's dream of a 'magic bullet' that would specifically destroy invading microbes is now a major aspect of clinical medicine. However, a century later, the implementation of this medical holy grail continues being a challenge in three main fronts: identifying the right molecular or cellular targets for a particular disease, having a drug that is effective against it, and finding a strategy for the efficient delivery of sufficient amounts of the drug in an active state exclusively to the selected targets. In a previous work, we engineered an immunoliposomal nanovector for the targeted delivery of its contents exclusively to Plasmodium falciparum-infected red blood cells [pRBCs]. In preliminary assays, the antimalarial drug chloroquine showed improved efficacy when delivered inside immunoliposomes targeted with the pRBC-specific monoclonal antibody BM1234. Because difficulties in determining the exact concentration of the drug due to its low amounts prevented an accurate estimation of the nanovector performance, here, we have developed an HPLC-based method for the precise determination of the concentrations in the liposomal preparations of chloroquine and of a second antimalarial drug, fosmidomycin. The results obtained indicate that immunoliposome encapsulation of chloroquine and fosmidomycin improves by tenfold the efficacy of antimalarial drugs. The targeting antibody used binds preferentially to pRBCs containing late maturation stages of the parasite. In accordance with this observation, the best performing immunoliposomes are those added to Plasmodium cultures having a larger number of late form-containing pRBCs. An average of five antibody molecules per liposome significantly improves in cell cultures the performance of immunoliposomes over non-functionalized liposomes as drug delivery vessels. Increasing the number of antibodies on the liposome surface correspondingly increases performance, with a reduction of 50% parasitemia achieved with immunoliposomes encapsulating 4 nM chloroquine and bearing an estimated 250 BM1234 units. The nanovector prototype described here can be a valuable platform amenable to modification and improvement with the objective of designing a nanostructure adequate to enter the preclinical pipeline as a new antimalarial therapy.

Highlights

  • Malaria is an acute and/or chronic infection caused by protozoans of the genus Plasmodium

  • We present a quantitative study of the efficacy of this nanovector in ameliorating the activity of the antimalarial drugs chloroquine and fosmidomycin, and discuss its characteristics and room for improvement regarding future animal assays that might place this prototype on the threshold of clinical trials

  • The dry lipids were hydrated at 37°C in phosphate-buffered saline [PBS] containing the antimalarial drug to obtain a concentration of 10 mM lipid

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Summary

Introduction

Malaria is an acute and/or chronic infection caused by protozoans of the genus Plasmodium. Chills, prostration, and anemia, whereas severe disease can include metabolic acidosis, cerebral malaria, and multiorgan system failure, and coma and death may ensue. More than 40% of the world’s (for a review, see Tuteja [6]), the female Anopheles mosquito inoculates, during a bite, Plasmodium sporozoites that bind to and infect hepatocytes and proliferate into thousands of merozoites in the liver. Merozoites rupture from the hepatocytes and invade red blood cells [RBCs], where they develop first into rings and into the late forms, trophozoites and schizonts (Figure 1). Schizont-infected RBCs burst and release more merozoites, which start the blood cycle again. Because the bloodstage infection is responsible for all symptoms and pathologies of malaria, Plasmodium-infected RBCs [pRBCs] are a main chemotherapeutic target [7]

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