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甘草酸与抗利什曼原虫药物葡萄糖酸锑钠(SAG)联合用药可治愈 SAG 耐药性内脏利什曼病。

Co-administration of glycyrrhizic acid with the antileishmanial drug sodium antimony gluconate (SAG) cures SAG-resistant visceral leishmaniasis.

机构信息

Division of Molecular Medicine, Bose Institute, P-1/12, CIT Scheme VII M, Kolkata, India.

Department of In vitro Carcinogenesis and Cellular Chemotherapy, Chittaranjan National Cancer Institute, Kolkata, India.

出版信息

Int J Antimicrob Agents. 2015 Mar;45(3):268-77. doi: 10.1016/j.ijantimicag.2014.10.023. Epub 2014 Dec 8.


DOI:10.1016/j.ijantimicag.2014.10.023
PMID:25600891
Abstract

Since there are very few affordable antileishmanial drugs available, antimonial resistance has crippled antileishmanial therapy, thereby emphasising the need for development of novel therapeutic strategies. This study aimed to evaluate the antileishmanial role of combined therapy with sodium antimony gluconate (SAG) and the triterpenoid glycyrrhizic acid (GA) against infection with SAG-resistant Leishmania (GE1F8R). Combination therapy with GA and SAG successfully limited infection with SAG-resistant Leishmania in a synergistic manner (fractional inhibitory concentration index <1.0). At the same time, mice infected with SAG-resistant Leishmania and co-treated with GA and SAG exhibited a significant reduction in hepatic and splenic parasite burden. In probing the mechanism, it was observed that GA treatment suppressed the expression and efflux activity of P-glycoprotein (P-gp) and multidrug resistance-associated protein 1 (MRP1), two host ABC transporters responsible for antimony efflux from host cells infected with SAG-resistant parasites. This suppression correlated with greater intracellular antimony retention during SAG therapy both in vitro and in vivo, which was reflected in the reduced parasite load. Furthermore, co-administration of GA and SAG induced a shift in the cytokine balance towards a Th1 phenotype by augmenting pro-inflammatory cytokines (such as IL-12, IFNγ and TNFα) and inducing nitric oxide generation in GE1F8R-infected macrophages as well as GE1F8R-infected mice. This study aims to provide an affordable leishmanicidal alternative to expensive antileishmanial drugs such as miltefosine and amphotericin B. Furthermore, this report explores the role of GA as a resistance modulator in MRP1- and P-gp-overexpressing conditions.

摘要

由于目前可用的负担得起的抗利什曼药物很少,因此锑耐药性削弱了抗利什曼病的治疗效果,从而强调了开发新的治疗策略的必要性。本研究旨在评估葡萄糖酸锑钠(SAG)和三萜甘草酸(GA)联合治疗对 SAG 耐药利什曼原虫(GE1F8R)感染的抗利什曼作用。GA 和 SAG 的联合治疗成功地以协同方式限制了 SAG 耐药利什曼原虫的感染(部分抑制浓度指数<1.0)。同时,感染 SAG 耐药利什曼原虫并接受 GA 和 SAG 联合治疗的小鼠肝脾寄生虫负荷显著降低。在探讨机制时,观察到 GA 处理抑制了 P-糖蛋白(P-gp)和多药耐药相关蛋白 1(MRP1)的表达和外排活性,这两种宿主 ABC 转运蛋白负责将 SAG 耐药寄生虫感染的宿主细胞中的锑排出。这种抑制作用与体内外 SAG 治疗期间细胞内锑的保留增加有关,这反映在寄生虫负荷的减少上。此外,GA 和 SAG 的联合给药通过增强促炎细胞因子(如 IL-12、IFNγ和 TNFα)和诱导 GE1F8R 感染的巨噬细胞以及 GE1F8R 感染的小鼠中一氧化氮的产生,诱导细胞因子平衡向 Th1 表型转变。本研究旨在为 miltefosine 和两性霉素 B 等昂贵的抗利什曼药物提供一种负担得起的杀利什曼药物替代方案。此外,本报告探讨了 GA 作为 MRP1 和 P-gp 过表达情况下的耐药调节剂的作用。

相似文献

[1]
Co-administration of glycyrrhizic acid with the antileishmanial drug sodium antimony gluconate (SAG) cures SAG-resistant visceral leishmaniasis.

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[2]
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Exp Parasitol. 2009-6

[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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Antimicrob Agents Chemother. 2004-9

[9]
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Antimicrob Agents Chemother. 2008-3

[10]
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Indian J Med Res. 2004-9

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[6]
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[7]
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[8]
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