Browsing by Author "Nascimento, Álvaro Fernando da Silva do"

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    Antitrypanosomal activity of fexinidazole metabolites, potential new drug candidates for Chagas disease.
    (2014) Bahia, Maria Terezinha; Nascimento, Álvaro Fernando da Silva do; Mazzeti, Ana Lia; Marques, Luiz F.; Gonçalves, Karolina Ribeiro; Mota, Ludmilla Walter Reis; Diniz, Lívia de Figueiredo; Caldas, Ivo Santana; Silva, André Talvani Pedrosa da; Shackleford, David M.; Koltun, Maria; Saunders, Jessica; White, Karen L.; Scandale, Ivan; Charman, Susan A.; Chatelain, Eric
    This study was designed to verify the in vivo efficacy of sulfoxide and sulfone fexinidazole metabolites following oral administration in a murine model of Chagas disease. Female Swiss mice infected with the Y strain of Trypanosoma cruzi were treated orally once per day with each metabolite at doses of 10 to 100 mg/kg of body weight for a period of 20 days. Parasitemia was monitored throughout, and cures were detected by parasitological and PCR assays. The results were compared with those achieved with benznidazole treatment at the same doses. Fexinidazole metabolites were effective in reducing the numbers of circulating parasites and protecting mice against death, compared with untreated mice, but without providing cures at daily doses of 10 and 25 mg/kg. Both metabolites were effective in curing mice at 50 mg/kg/day (30% to 40%) and 100 mg/kg/day (100%). In the benznidazole- treated group, parasitological cure was detected only in animals treated with the higher dose of 100 mg/kg/day (80%). Single-dose pharmacokinetic parameters for each metabolite were obtained from a parallel group of uninfected mice and were used to estimate the profiles following repeated doses. Pharmacokinetic data suggested that biological efficacy most likely resides with the sulfone metabolite (or subsequent reactive metabolites formed following reduction of the nitro group) following administration of either the sulfoxide or the sulfone and that prolonged plasma exposure over the 24-h dosing window is required to achieve high cure rates. Fexinidazole metabolites were effective in treating T. cruzi in a mouse model of acute infection, with cure rates superior to those achieved with either fexinidazole itself or benznidazole.
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    Benznidazole/Itraconazole combination treatment enhances anti-Trypanosoma cruzi activity in experimental Chagas disease.
    (2015) Martins, Tassiane Assíria Fontes; Diniz, Lívia de Figueiredo; Mazzeti, Ana Lia; Nascimento, Álvaro Fernando da Silva do; Caldas, Sérgio; Caldas, Ivo Santana; Andrade, Isabel Mayer de; Ribeiro, Isabela; Bahia, Maria Terezinha
    The nitroheterocyclic drugs nifurtimox and benznidazole are first-line drugs available to treat Chagas disease; however, they have limitations, including long treatment courses and toxicity. Strategies to overcome these limitations include the identification of new drugs with specific target profiles, re-dosing regimens for the current drugs, drug repositioning and combination therapy. In this work, we evaluated combination therapy as an approach for optimization of the current therapeutic regimen for Chagas disease. The curative action of benznidazole/itraconazole combinations was explored in an established infection of the mice model with the T. cruzi Y strain. The activities of the benznidazole/itraconazole combinations were compared with the results from those receiving the same dosage of each individual drug. The administration of benznidazole/itraconazole in combination eliminated parasites from the blood more efficiently than each drug alone. Here, there was a significant reduction of the number of treatment days (number of doses) necessary to induce parasitemia suppression with the benznidazole/itraconazole combination, as compared to each compound administered alone. These results clearly indicate the enhanced effects of these drugs in combination, particularly at the dose of 75 mg/kg, as the effects observed with the drug combinations were four times more effective than those of each drug used alone. Moreover, benznidazole/itraconazole treatment was shown to prevent or decrease the typical lesions associated with chronic experimental Chagas disease, as illustrated by similar levels of inflammatory cells and fibrosis in the cardiac muscle tissue of healthy and treated mice. These results emphasize the importance of exploring the potential of combination treatments with currently available compounds to specifically treat Chagas disease.
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    Fexinidazole : a potential new drug candidate for Chagas disease.
    (2012) Bahia, Maria Terezinha; Andrade, Isabel Mayer de; Martins, Tassiane Assíria Fontes; Nascimento, Álvaro Fernando da Silva do; Diniz, Lívia de Figueiredo; Caldas, Ivo Santana; Silva, André Talvani Pedrosa da; Trunz, Bernadette Bourdin; Torreele, Els; Ribeiro, Isabela
    Background: New safe and effective treatments for Chagas disease (CD) are urgently needed. Current chemotherapy options for CD have significant limitations, including failure to uniformly achieve parasitological cure or prevent the chronic phase of CD, and safety and tolerability concerns. Fexinidazole, a 2-subsituted 5-nitroimidazole drug candidate rediscovered following extensive compound mining by the Drugs for Neglected Diseases initiative and currently in Phase I clinical study for the treatment of human African trypanosomiasis, was evaluated in experimental models of acute and chronic CD caused by different strains of Trypanosoma cruzi. Methods and Findings: We investigated the in vivo activity of fexinidazole against T. cruzi, using mice as hosts. The T. cruzi strains used in the study were previously characterized in murine models as susceptible (CL strain), partially resistant (Y strain), and resistant (Colombian and VL-10 strains) to the drugs currently in clinical use, benznidazole and nifurtimox. Our results demonstrated that fexinidazole was effective in suppressing parasitemia and preventing death in infected animals for all strains tested. In addition, assessment of definitive parasite clearance (cure) through parasitological, PCR, and serological methods showed cure rates of 80.0% against CL and Y strains, 88.9% against VL-10 strain, and 77.8% against Colombian strain among animals treated during acute phase, and 70% (VL-10 strain) in those treated in chronic phase. Benznidazole had a similar effect against susceptible and partially resistant T. cruzi strains. Fexinidazole treatment was also shown to reduce myocarditis in all animals infected with VL-10 or Colombian resistant T. cruzi strains, although parasite eradication was not achieved in all treated animals at the tested doses. Conclusions: Fexinidazole is an effective oral treatment of acute and chronic experimental CD caused by benznidazolesusceptible, partially resistant, and resistant T. cruzi. These findings illustrate the potential of fexinidazole as a drug candidate for the treatment of human CD.
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    Myocarditis in different experimental models infected by Trypanosoma cruzi is correlated with the production of IgG1 isotype.
    (2017) Caldas, Ivo Santana; Diniz, Lívia de Figueiredo; Guedes, Paulo Marcos da Matta; Nascimento, Álvaro Fernando da Silva do; Galvão, Lúcia Maria da Cunha; Lima, Wanderson Geraldo de; Caldas, Sérgio; Bahia, Maria Terezinha
    This study was designed to verify the relationship between IgG antibodies isotypes and myocarditis inTrypanosoma cruzi infection using mice and dogs infected with different T. cruzi strains. The animals wereinfected with benznidazole-susceptible Berenice-78 and benznidazole-resistant AAS and VL-10 strains.The IgG subtypes were measured in serum samples from dogs (IgG, IgG1, and IgG2) and mice (IgG, IgG1,IgG2a, and IgG2b). The infection of dogs with VL-10 strain induced the highest levels of heart inflammationwhile intermediate and lower levels were detected with Berenice-78 and AAS strains, respectively. Similarresults were found in mice infected with VL-10, but not in those infected with AAS or Berenice-78 strains.The AAS strain induced higher levels of heart inflammation in mice, while Berenice-78 strain was notable to induce it. Correlation analysis between myocarditis and antibody reactivity index revealed veryinteresting results, mainly for IgG and IgG1, the latter being the most exciting. High IgG1 showed asignificant correlation with myocarditis in both experimental models, being more significant in dogs(r = 0.94, p < 0.0001) than in mice (r = 0.58, p = 0.047). Overall, our data suggest that IgG1 could be a goodmarker to demonstrate myocarditis intensity in Chagas disease.©
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    Time and dose-dependence evaluation of nitroheterocyclic drugs for improving efficacy following Trypanosoma cruzi infection : a pre-clinical study.
    (2018) Mazzeti, Ana Lia; Diniz, Lívia de Figueiredo; Gonçalves, Karolina Ribeiro; Nascimento, Álvaro Fernando da Silva do; Spósito, Pollyanna Álvaro; Mosqueira, Vanessa Carla Furtado; Coelho, George Luiz Lins Machado; Ribeiro, Isabela; Bahia, Maria Terezinha
    Benznidazole and nifurtimox-treatments regimens currently used in human are supported by very limited experimental data. This study was designed to evaluate the time and dose dependence for efficacy of the most important nitroheterocyclic drugs in use for Chagas disease. In order to evaluate time dependence, Y strain-infected mice received benznidazole for a total of 1, 3, 7, 10, 20, and 40 days. Treatment courses of 3–10-day were effective in clearing parasitaemia and suppressing mortality, but parasitological cure was not achieved. Extending the treatments to 20 or 40 days clearly improved benznidazole efficacy. The 20-day treatment induced cure in 57.1% of Y strain infections (partially drug resistant) but failed to cure Colombian strain infections (full drug resistant), while the 40-day treatment resulted in cure of 100% of Y and 50% of Colombian strain infected mice. The increased cure rates in T. cruzi infected animals that received nifurtimox for 40 days confirm the relationship between the length of treatment and efficacy. An improvement in efficacy was observed with increasing benznidazole doses; cure was verified in 28.6% (75 mg/kg), 57.1% (100 mg/kg) and 80% (300 mg/kg). Overall, these nonclinical study data provide evidence that the efficacy of benznidazole is dose and time dependent. These findings may be relevant for optimizing treatment of human Chagas disease.