González-Herrera Fabiola, Cramer Allysson, Pimentel Pollyana, Castillo Christian, Liempi Ana, Kemmerling Ulrike, Machado Fabiana S, Maya Juan D
Programa de Farmacología Molecular y Clínica-ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Program in Health Sciences: Infectious Diseases and Tropical Medicine, Medical School, and Departments of Biochemistry and Immunology, Microbiology, and Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Antimicrob Agents Chemother. 2017 Feb 23;61(3). doi: 10.1128/AAC.02137-16. Print 2017 Mar.
Current treatments for chronic Chagas cardiomyopathy, a disease with high mortality rates and caused by the protozoan , are unsatisfactory. Myocardial inflammation, including endothelial activation, is responsible for the structural and functional damage seen in the chronic phase. The clinical efficacy of benznidazole could be improved by decreasing chronic inflammation. Statins, which have anti-inflammatory properties, may improve the action of benznidazole. Here, the action of simvastatin in a murine model of chronic Chagas cardiomyopathy and the link with the production of the proresolving eicosanoid 15-epi-lipoxin A4, produced by 5-lipoxygenase, are evaluated. Simvastatin decreased the expression of the adhesion molecules E-selectin, intracellular adhesion molecule type 1 (ICAM-1), and vascular cell adhesion molecule type 1 (VCAM-1) in -infected mice. However, when this drug was administered to 5-lipoxygenase-deficient mice, the anti-inflammatory effect was not observed unless exogenous 15-epi-lipoxin A4 was administered. Thus, in chronic Chagas disease, 5-epi-lipoxin A4 induced by simvastatin treatment could improve the pathophysiological condition of patients by increasing the trypanocidal action of benznidazole.
由原生动物引起的慢性恰加斯心肌病死亡率很高,目前针对该病的治疗并不理想。心肌炎症,包括内皮细胞活化,是导致慢性期出现结构和功能损伤的原因。通过减轻慢性炎症,可提高苯硝唑的临床疗效。具有抗炎特性的他汀类药物可能会增强苯硝唑的作用。在此,对辛伐他汀在慢性恰加斯心肌病小鼠模型中的作用以及与5-脂氧合酶产生的促消退类二十烷酸15-表-脂氧素A4的产生之间的联系进行了评估。辛伐他汀降低了感染小鼠中黏附分子E-选择素、细胞间黏附分子1(ICAM-1)和血管细胞黏附分子1(VCAM-1)的表达。然而,当将这种药物给予5-脂氧合酶缺陷小鼠时,除非给予外源性15-表-脂氧素A4,否则未观察到抗炎作用。因此,在慢性恰加斯病中,辛伐他汀治疗诱导产生的5-表-脂氧素A4可通过增强苯硝唑的杀锥虫作用来改善患者的病理生理状况。