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      Diamidines versus Monoamidines as Anti- Pneumocystis Agents: An in vivo Study

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          Abstract

          Some compounds articulated around a piperazine or an ethylenediamine linker have been evaluated in vitro to determine their activity in the presence of a 3T6 fibroblast cell line and an axenic culture of Pneumocystis carinii, respectively. The most efficient antifungal derivatives, namely N, N′-bis(benzamidine-4-yl)ethane-1,2-diamine (compound 6, a diamidine) and N-(benzamidine-4-yl)- N′-phenylethane-1,2-diamine (compound 7, a monoamidine), exhibited no cytotoxicity and were evaluated in vivo in a rat model. Only the diamidine 6 emerged as a promising hit for further studies.

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          Most cited references37

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          Pneumocystis jirovecii Pneumonia.

          Pneumocystis jirovecii has gained attention during the last decade in the context of the AIDS epidemic and the increasing use of cytotoxic and immunosuppressive therapies. This article summarizes current knowledge on biology, pathophysiology, epidemiology, diagnosis, prevention, and treatment of pulmonary P jirovecii infection, with a particular focus on the evolving pathophysiology and epidemiology. Pneumocystis pneumonia still remains a severe opportunistic infection, associated with a high mortality rate. Copyright 2010 Elsevier Inc. All rights reserved.
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            Update on the diagnosis and treatment of Pneumocystis pneumonia.

            Pneumocystis is an opportunistic fungal pathogen that causes an often-lethal pneumonia in immunocompromised hosts. Although the organism was discovered in the early 1900s, the first cases of Pneumocystis pneumonia in humans were initially recognized in Central Europe after the Second World War in premature and malnourished infants. This unusual lung infection was known as plasma cellular interstitial pneumonitis of the newborn, and was characterized by severe respiratory distress and cyanosis with little or no fever and no pathognomic physical signs. At that time, only anecdotal cases were reported in adults and usually these patients had a baseline malignancy that led to a malnourished state. In the 1960-1970s additional cases were described in adults and children with hematological malignancies, but Pneumocystis pneumonia was still considered a rare disease. However, in the 1980s, with the onset of the HIV epidemic, Pneumocystis prevalence increased dramatically and became widely recognized as an opportunistic infection that caused potentially life-treating pneumonia in patients with impaired immunity. During this time period, prophylaxis against this organism was more generally instituted in high-risk patients. In the 1990s, with widespread use of prophylaxis and the initiation of highly active antiretroviral therapy (HAART) in the treatment of HIV-infected patients, the number of cases in this specific population decreased. However, Pneumocystis pneumonia still remains an important cause of severe pneumonia in patients with HIV infection and is still considered a principal AIDS-defining illness. Despite the decreased number of cases among HIV-infected patients over the past decade, Pneumocystis pneumonia continues to be a serious problem in immunodeficient patients with other immunosuppressive conditions. This is mostly due to increased use of immunosuppressive medications to treat patients with autoimmune diseases, following bone marrow and solid organ transplantation, and in patients with hematological and solid malignancies. Patients with hematologic disorders and solid organ and hematopoietic stem cell transplantation are currently the most vulnerable groups at risk for developing this infection. However, any patient with an impaired immunity, such as those receiving moderate doses of oral steroids for greater than 4 weeks or those receiving other immunosuppressive medications are at also at significant risk.
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              Pneumocystis infection in humans: diagnosis and treatment.

              Pneumocystis jirovecii is an atypical fungus exhibiting pulmonary tropism and a highly defined host specificity. It is generally regarded as an opportunistic microorganism causing serious pneumonia in AIDS patients. However, with the currently rising number of patients receiving immunosuppressive therapies for malignancies, allogeneic organ transplantations and autoimmune diseases, Pneumocystis pneumonia is becoming more and more recognized in non-HIV immunosuppressed individuals. The clinical presentation in HIV-infected patients may differ from that in other immunocompromised patients and its diagnosis continues to be challenging as there are no specific symptoms or signs. Cotrimoxazole is the drug of choice for prophylaxis and therapy of any form or severity of Pneumocystis pneumonia, but there are only a few options for other alternative treatments. The management of this pneumonia remains a major challenge for all physicians caring for immunosuppressed patients.
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                Author and article information

                Journal
                Pharmaceuticals (Basel)
                Pharmaceuticals (Basel)
                pharmaceuticals
                Pharmaceuticals
                MDPI
                1424-8247
                01 July 2013
                July 2013
                : 6
                : 7
                : 837-850
                Affiliations
                [1 ]Laboratory of Organic Chemistry, University of Mons-UMONS, B-7000 Mons, Belgium; E-Mails: dimitri.stanicki@ 123456umons.ac.be (D.S.); delphine.forge@ 123456umons.ac.be (D.F.)
                [2 ]Biology & Diversity of Emerging Eukaryotic Pathogens (BDEEP), Center for Infection and Immunity of Lille (CIIL), INSERM U1019, CNRS UMR 8204, EA-4547, Univ Lille Nord de France, UDSL, Institut Pasteur de Lille, F-59000 Lille, France; E-Mails: muriel.pottier@ 123456univ-lille2.fr (M.P.); nausicaa.gantois@ 123456pasteur-lille.fr (N.G.); mtz.anna@ 123456gmail.com (A.M.); eduardo.deicas@ 123456gmail.com (E.D.-C.); elmoukhtar.aliouat-3@ 123456univ-lille2.fr (E-.M.A.)
                [3 ]EA2694, Department of Biostatistics, Université de Lille Nord de France, F-59000 Lille, France; E-Mail: claire.pincon@ 123456univ-lille2.fr
                [4 ]Department of General, Organic, and Biomedical Chemistry, NMR and Molecular Imaging Laboratory, University of Mons-UMONS, B-7000 Mons, Belgium; E-Mails: isabelle.mahieu@ 123456umons.ac.be (I.M.); sebastien.boutry@ 123456umons.ac.be (S.B.)
                [5 ]CHU Lille, Biology & Pathology Center, Parasitology-Mycology, F-59000 Lille, France
                Author notes
                [* ] Author to whom correspondence should be addressed; E-Mail: jean-jacques.vandeneynde@ 123456umons.ac.be ; Tel.: +32-65-373337.
                Article
                pharmaceuticals-06-00837
                10.3390/ph6070837
                3816707
                6a1bad87-1a7b-4db3-b5ef-6e5653e8bb41
                © 2013 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                : 22 April 2013
                : 14 May 2013
                : 17 June 2013
                Categories
                Article

                pneumocystis,pentamidine,diamidine
                pneumocystis, pentamidine, diamidine

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