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      Antileishmanial activity of some Brazilian plants, with particular reference to Casearia sylvestris

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          Abstract

          Leishmaniasis is a complex of diseases caused by Leishmania protozoa which treatment is restricted to a limited number of drugs that exhibit high toxicity, collateral effects and are often costly. There are a variety of tropical plants distributed in Brazil, and for many poor people the therapy for several diseases is based mainly on the use of traditional herbal remedies. In this work, the cytotoxic activity of 17 plant methanol extracts was evaluated on several Leishmania species and murine macrophages. Among them, the extract of Casearia sylvestris, Piptocarpha macropoda, Trembleya parviflora, Samanea tubulosa and Plectranthus neochilusshowed a promissing leishmanicidal activity, exhibiting IC50 values below of 20 µg/mL against at least one species of Leishmania. Casearia sylvestris showed the most expressive activity against all promastigote forms of Leishmania species (IC50 values of 5.4 µg/mL, 5.0 µg/mL, 8.5 µg/mL and 7.7 µg/mL for L. amazonensis, L. braziliensis, L. chagasi and L. major, respectively), being more effective than the reference drug miltefosine. In spite of the cytotoxic effect on macrophages (CC50 value of 5.2 µg/mL), C. sylvestris exhibited a strong inhibition against intracellular amastigotes of L. braziliensis (IC50 value of 1.3 µg/mL). Further studies, including bio-guided fractionation will be conducted to identify the active compounds.

          Translated abstract

          As leishmanioses são um complexo de doenças causadas por protozoários Leishmania, cujo tratamento é restrito a um número limitado de fármacos que apresentam toxicidade elevada, efeitos colaterais e geralmente custos elevados. Existe uma enorme variedade de plantas tropicais distribuídas no Brasil e para muitas pessoas pobres a terapia para várias doenças baseia-se principalmente no uso de remédios tradicionais obtidos de plantas. Neste trabalho, a atividade citotóxica de 17 extratos metanólicos de plantas foi avaliada em várias espécies de Leishmania e em macrófagos murinos. Dentre eles, os extratos de Casearia sylvestris, Piptocarpha macropoda, Trembleya parviflora, Samanea Tubulosa e Plectranthus neochilus mostraram atividade leishmanicida promissora, exibindo valores de CI50 abaixo de 20 µg/mL em pelo menos uma das espécies de Leishmania. Casearia sylvestris apresentou a atividade mais expressiva em todas as formas promastigotas de espécies de Leishmania (valores de CI50de 5,4 µg/mL, 5,0 µg/mL, 8,5 µg/mL and 7,7 µg/mL em L. amazonensis, L. braziliensis, L. chagasi e L. major, respectivamente), sendo mais eficaz que o fármaco de referência miltefosina. Apesar do efeito citotóxico em macrófagos (valor de CC50 de 5,2 µg/mL), C. sylvestris exibiu uma forte inibição em formas amastigotas de L. braziliensis (valor de CI50 de 1,3 µg/mL). Mais estudos, incluindo fracionamento bio-guiado, serão realizados para identificar os compostos ativos.

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          Dicionário das plantas úteis do Brasil e das exóticas cultivada

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            Miltefosine: a review of its pharmacology and therapeutic efficacy in the treatment of leishmaniasis.

            Miltefosine is an alkylphosphocholine drug with demonstrated activity against various parasite species and cancer cells as well as some pathogenic bacteria and fungi. For 10 years it has been licensed in India for the treatment of visceral leishmaniasis (VL), a fatal neglected parasitic disease. It is the first and still the only oral drug that can be used to treat VL and cutaneous leishmaniasis (CL). The standard 28 day miltefosine monotherapy regimen is well tolerated, except for mild gastrointestinal side effects, although its teratogenic potential severely hampers its general use in the clinic and roll-out in national elimination programmes. The pharmacokinetics of miltefosine are mainly characterized by its long residence time in the body, resulting in extensive drug accumulation during treatment and long elimination half-lives. At the moment, different combination therapy strategies encompassing miltefosine are being tested in multiple controlled clinical trials in various geographical areas of endemicity, both in South Asia and East Africa. We here review the most salient pre-clinical and clinical pharmacological aspects of miltefosine, its mechanism of action against Leishmania parasites and other pathogens, and provide a systematic overview of the efficacy and safety data from all clinical trials of miltefosine, either alone or in combination, in the treatment of VL and CL.
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              Oral miltefosine for Indian visceral leishmaniasis.

              There are 500,000 cases per year of visceral leishmaniasis, which occurs primarily in the Indian subcontinent. Almost all untreated patients die, and all the effective agents have been parenteral. Miltefosine is an oral agent that has been shown in small numbers of patients to have a favorable therapeutic index for Indian visceral leishmaniasis. We performed a clinical trial in India comparing miltefosine with the most effective standard treatment, amphotericin B. The study was a randomized, open-label comparison, in which 299 patients 12 years of age or older received orally administered miltefosine (50 or 100 mg [approximately 2.5 mg per kilogram of body weight] daily for 28 days) and 99 patients received intravenously administered amphotericin B (1 mg per kilogram every other day for a total of 15 injections). The groups were well matched in terms of age, weight, proportion with previous failure of treatment for leishmaniasis, parasitologic grade of splenic aspirate, and splenomegaly. At the end of treatment, splenic aspirates were obtained from 293 patients in the miltefosine group and 98 patients in the amphotericin B group. No parasites were identified, for an initial cure rate of 100 percent. By six months after the completion of treatment, 282 of the 299 patients in the miltefosine group (94 percent [95 percent confidence interval, 91 to 97]) and 96 of the 99 patients in the amphotericin B group (97 percent) had not had a relapse; these patients were classified as cured. Vomiting and diarrhea, generally lasting one to two days, occurred in 38 percent and 20 percent of the patients in the miltefosine group, respectively. Oral miltefosine is an effective and safe treatment for Indian visceral leishmaniasis. Miltefosine may be particularly advantageous because it can be administered orally. It may also be helpful in regions where parasites are resistant to current agents. Copyright 2002 Massachusetts Medical Society
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                aabc
                Anais da Academia Brasileira de Ciências
                An. Acad. Bras. Ciênc.
                Academia Brasileira de Ciências (Rio de Janeiro )
                1678-2690
                June 2015
                : 87
                : 2
                : 733-742
                Affiliations
                [1 ] Universidade Federal de Juiz de Fora Brazil
                [2 ] Universidade Federal de Juiz de Fora Brazil
                Article
                S0001-37652015000200733
                10.1590/0001-3765201520140288
                69fbd73e-a6b0-49fc-a0df-7fa7be1273b3

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0001-3765&lng=en
                Categories
                MULTIDISCIPLINARY SCIENCES

                Brazil,Casearia sylvestris,leishmanicidal activity,medicinal plants,natural products,Brasil,atividade leishmanicida,plantas medicinais,produtos naturais

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