Glibenclamide reduced the rate of lesion growth in BALB/c mice infected with Leishmania (Leishmania) mexicana, the effect was dose dependent, and the highest dose proved more effective than glucantime. Crossresistance to glucantime was found in animals infected with a glibenclamide-resistant line, but combined therapy reduced lesion progression even in the glibenclamide-resistant strain.

Leishmaniasis is parasitic disease that is an important problem of public health worldwide. Intramuscularly administered glucantime and pentostam are the most common drugs used for treatment of this disease, but they have significant limitations due to toxicity and increasing resistance. A recent breakthrough has been the introduction of orally administered miltefosine for the treatment of visceral, cutaneous, and mucocutaneous leishmaniasis, but the relative high cost and concerns about teratogenicity have limited the use of this drug. Searching for alternative drugs, we previously demonstrated that the antiarrhythmic drug amiodarone is active against Leishmania mexicana promastigotes and intracellular amastigotes, acting via disruption of intracellular Ca 2؉ homeostasis (specifically at the mitochondrion and the acidocalcisomes of these parasites) and through inhibition of the parasite's de novo sterol biosynthesis (X. Serrano-Martín, Y. García-Marchan, A. Fernandez, N. Rodriguez, H. Rojas, G. Visbal, and G. Benaim, Antimicrob. Agents Chemother. 53:1403-1410, 2009). In the present work, we found that miltefosine also disrupts the parasite's intracellular Ca 2؉ homeostasis, in this case by inducing a large increase in intracellular Ca 2؉ levels, probably through the activation of a plasma membrane Ca 2؉ channel. We also investigated the in vitro and in vivo activities of amiodarone and miltefosine, used alone or in combination, on L. mexicana. It was found that the drug combination had synergistic effects on the proliferation of intracellular amastigotes growing inside macrophages and led 90% of parasitological cures in a murine model of leishmaniasis, as revealed by a PCR assay using a novel DNA sequence specific for L. mexicana.

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A polymerase chain reaction (PCR) method that amplifies genus- and species-specific sequences present within the small subunit of ribosomal ribonucleic acid (ssRNA) genes of the human malaria parasites was used for the diagnosis of malaria in south-eastern Venezuela. One hundred blood samples were submitted to deoxyribonucleic acid extraction, PCR amplification and electrophoretic analysis of the PCR products, and the results were compared to those of routine microscopical diagnosis. The sensitivity of PCR for detection of Plasmodium vivax and P. falciparum malaria was 99% and 100%, respectively. However, 6 patients (6%) harboured parasites undetected by microscopy. The PCR assay detected a high proportion of mixed infections: 29% (17/59) of the infections microscopically diagnosed as P. vivax were shown to be mixed infections of P. vivax and P. falciparum. Forty per cent (7/17) of the individuals with a missed P. falciparum infection had received chloroquine in the previous 30 d. These results suggest that, in places where transmission of both P. vivax and P. falciparum occurs, PCR detection of malaria parasites can be a very useful complement to microscopical diagnosis in order to ascertain the true incidence of each species and for the follow-up of patients after specific treatment.

The seroprevalence of trypanosomiasis and the prevalence of current trypanosome infection in water buffaloes from the most important livestock areas of Venezuela were evaluated by IFAT and the microhaematocrit centrifugation technique, respectively. The usefulness of a PCR-based assay for identifying the trypanosome species in the buffaloes was also evaluated. Of the 644 animals investigated, 40 (6.2%) were found infected with trypanosomes by blood centrifugation, and 196 (30.4%) were found positive for anti-trypanosome antibodies, by IFAT. The results of the PCR-based assay indicated that 92.5% of the animals with current infections were infected with Trypanosoma vivax and the rest with T. theileri (the first molecular confirmation of T. theileri in Venezuelan water buffaloes). The national programme to treat and prevent trypanosome infections in the buffaloes does not appear to be meeting with great success, even though it is focused on T. vivax. Although the level of parasitaemia was categorized as low for 28 (70%) of the infections detected (and packed-cell volumes appeared to be unassociated with IFAT result, and uncorrelated, in the infected animals, with level of parasitaemia), the 40 infected buffaloes had a significantly lower mean packed-cell volume than the uninfected animals (P<0.05). Farmers should therefore be made aware of the probability of trypanosome-attributable losses in buffalo productivity.