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关于针对……的实验性治疗策略的综述

Review on Experimental Treatment Strategies Against .

作者信息

Mazzeti Ana Lia, Capelari-Oliveira Patricia, Bahia Maria Terezinha, Mosqueira Vanessa Carla Furtado

机构信息

Laboratório de Desenvolvimento Galênico e Nanotecnologia, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, 35400-000, Brazil.

Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, 21040-360, Brazil.

出版信息

J Exp Pharmacol. 2021 Mar 31;13:409-432. doi: 10.2147/JEP.S267378. eCollection 2021.

Abstract

Chagas disease is a neglected tropical disease caused by the protozoan . Currently, only nitroheterocyclic nifurtimox (NFX) and benznidazole (BNZ) are available for the treatment of Chagas disease, with limitations such as variable efficacy, long treatment regimens and toxicity. Different strategies have been used to discover new active molecules for the treatment of Chagas disease. Target-based and phenotypic screening led to thousands of compounds with anti- activity, notably the nitroheterocyclic compounds, fexinidazole and its metabolites. In addition, drug repurposing, drug combinations, re-dosing regimens and the development of new formulations have been evaluated. The CYP51 antifungal azoles, as posaconazole, ravuconazole and its prodrug fosravuconazole presented promising results in experimental Chagas disease. Drug combinations of nitroheterocyclic and azoles were able to induce cure in murine infection. New treatment schemes using BNZ showed efficacy in the experimental chronic stage, including against dormant forms of . And finally, sesquiterpene lactone formulated in nanocarriers displayed outstanding efficacy against different strains of , susceptible or resistant to BNZ, the reference drug. These pre-clinical results are encouraging and provide interesting evidence to improve the treatment of patients with Chagas disease.

摘要

恰加斯病是一种由原生动物引起的被忽视的热带病。目前,仅有硝基杂环类药物硝呋替莫(NFX)和苯硝唑(BNZ)可用于治疗恰加斯病,但存在疗效不一、治疗方案长和毒性等局限性。人们已采用不同策略来发现治疗恰加斯病的新活性分子。基于靶点和表型的筛选产生了数千种具有抗活性的化合物,尤其是硝基杂环化合物、非昔硝唑及其代谢产物。此外,还评估了药物重新利用、药物组合、重新给药方案以及新制剂的开发。CYP51抗真菌唑类药物,如泊沙康唑、雷夫康唑及其前药伏立康唑在实验性恰加斯病中显示出有前景的结果。硝基杂环类药物与唑类药物的组合能够使小鼠感染治愈。使用苯硝唑的新治疗方案在实验性慢性期显示出疗效,包括对[病原体名称]休眠形式的疗效。最后,纳米载体中配制的倍半萜内酯对苯硝唑(参考药物)敏感或耐药的不同[病原体名称]菌株显示出卓越疗效。这些临床前结果令人鼓舞,并为改善恰加斯病患者的治疗提供了有趣的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea26/8020333/81a93e39b088/JEP-13-409-g0001.jpg

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