Recebido em 24/5/04; aceito em 14/9/04; publicado na web em 17/2/05 LIPOSOMES: PHYSICOCHEMICAL AND PHARMACOLOGICAL PROPERTIES, APPLICATIONS IN ANTIMONY-BASED CHEMOTHERAPY. The use of organoantimonial complexes in the therapeutic of leishmaniasis and schistosomiasis has been limited mainly by the need for daily parenteral administration, their adverse side-effects and the appearance of drug resistance. Liposome encapsulation has been so far the most effective means to improve the efficacy of pentavalent antimonials against visceral leishmaniasis. Pharmacologically-and pharmaceutically-acceptable liposomal compositions are still being investigated through manipulation of preparation method, lipid composition and vesicle size. Recently, the encapsulation of a trivalent antimonial within "stealth" liposomes was found to reduce its acute toxicity and effectively deliver this compound to the parasite in experimental schistosomiasis.Keywords: liposomes; antimony; chemotherapy. INTRODUÇÃONo início do século passado, Gaspar Vianna, pesquisador pioneiro em doença de Chagas e leishmaniose, relatou a eficácia do complexo de antimônio trivalente (Sb(III)), tártaro emético, no tratamento da leishmaniose muco-cutânea 1 . Da mesma forma, o tártaro emético foi o primeiro medicamento empregado com êxito no tratamento da esquistossomose 2,3 . Entretanto, o uso clínico deste composto foi interrompido, por causa de seus severos efeitos colaterais e da descoberta de novos fármacos menos tóxicos.A partir da década de 1940, complexos de antimônio pentavalente (Sb(V)) começaram a ser utilizados na terapêutica das leishmanioses 4 . Os principais antimoniais atualmente em uso são complexos de Sb(V) com o N-metil-glucamina (antimoniato de meglumina) e com o gluconato de sódio (estibogluconato de sódio). Até hoje, nem a estrutura desses compostos, nem seu mecanismo de ação foram completamente elucidados. Foi sugerido que o Sb(V) seria uma pró-droga, sendo reduzido no organismo hospedeiro a Sb(III) que seria a forma ativa e tóxica 5 . Recentemente, foi mostrado que os tióis podem estar envolvidos nesse processo de redução 6 . Embora os antimoniais pentavalentes continuem sendo os medicamentos de primeira escolha no tratamento de todas as formas de leishmanioses, o seu uso clínico apresenta várias limitações. Esses compostos devem ser administrados por via parenteral (injeção intravenosa ou intramuscular), diariamente, num período de 20-40 dias. Nesse contexto, efeitos colaterais são freqüentes Essencialmente duas estratégias diferentes estão atualmente disponíveis para o desenvolvimento de novos medicamentos. Uma estratégia envolve o planejamento/síntese de novas substâncias ativas ou de fármacos já conhecidos com modificações químicas; a outra envolve a associação reversível de fármacos já em uso a um sistema transportador, visando direcionar o fármaco para a célula alvo e evitar os locais indesejáveis onde o fármaco exerce toxicidade. Esta última estratégia, além de prolongar a validade de proteção por patente no uso do fármaco, oferece um...

No abstract

Canine visceral leishmaniasis (CVL) is a severe and fatal systemic chronic inflammatory disease. We investigated the alterations in, and potential associations among, antioxidant enzymes, trace elements and histopathology in CVL. Blood and tissue levels of Cu-Zn superoxide dismutase, catalase and glutathione peroxidase were measured in mixed-breed dogs naturally infected with Leishmania infantum chagasi, symptomatic (n = 19) and asymptomatic (n = 11). Serum levels of copper, iron, zinc, selenium and nitric oxide, and plasma lipid peroxidation were measured. Histological and morphometric analyses were conducted of lesions in liver, spleen and lymph nodes. We found lower blood catalase and glutathione peroxidase activity to be correlated with lower iron and selenium respectively. However, higher activity of Cu-Zn superoxide dismutase was not correlated with the increase in copper and decreased in zinc observed in infected animals compared to controls. Organ tissue was characterized by lower enzyme activity in infected dogs than in controls, but this was not correlated with trace elements. Lipid peroxidation was higher in symptomatic than in asymptomatic and control dogs and was associated with lesions such as chronic inflammatory reaction, congestion, haemosiderin and fibrosis. Systemic iron deposition was observed primarily in the symptomatic dogs showing a higher tissue parasite load. Dogs with symptomatic CVL displayed enhanced LPO and Fe tissue deposition associated with decreased levels of antioxidant enzymes. These results showed new points in the pathology of CVL and might open new treatment perspectives associated with antioxidants and the role of iron in the pathogenesis of CVL.

The orally active composition comprising meglumine antimoniate (MA) and beta-cyclodextrin (beta-CD) differs markedly from conventional drug-CD complexes, since it combines a water-soluble drug and a hydrophilic CD. In order to obtain insights into the mechanism(s) responsible for the improved oral delivery of the drug, physicochemical and pharmacokinetic studies were carried out. The composition investigated here was prepared at a 7:1 antimony(Sb)/beta-CD molar ratio, a condition that improves its solubility in water and allows the oral administration of a high dose of Sb in large animals. It was characterized by circular dichroism, (1)H-NMR, ESI-MS and photon correlation spectroscopy. Pharmacokinetic data were obtained in Beagle dogs after oral administration of the composition at 100 mg Sb/kg. (1)H-NMR and ESI-MS data supported the formation of non-inclusion complexes between MA and beta-CD. Sub-micron assemblies were also evidenced that slowly dissociate and presumably release the MA drug, upon reconstitution of the composition in water. Pharmacokinetic studies of MA and MA/beta-CD in dogs showed a prolongation of the serum mean residence time of Sb from 4.1 to 6.8 h, upon complexation of MA with beta-CD. Evidence was also obtained that Sb remains essentially under the form of pentavalent Sb-meglumine complex, following gastro-intestinal absorption from the MA/beta-CD composition. In conclusion, the present data support the model that the sustained drug release property of 7:1 MA/beta-CD composition resulted in the prolongation of MA absorption by the oral route and, consequently, in the increase of the drug mean residence time in serum.

The aim of the present study was to evaluate the impact of a multiple dose regimen of a liposomal formulation of meglumine antimoniate (LMA) on the pharmacokinetics of antimony in the bone marrow of dogs with visceral leishmaniasis and on the ability of LMA to eliminate parasites from this tissue. Dogs naturally infected with Leishmania chagasi received 4 intravenous doses of either LMA (6.5 mg antimony/kg body weight, N = 9), or empty liposomes (at the same lipid dose as LMA, N = 9) at 4-day intervals. A third group of animals was untreated (N = 8). Before each administration and at different times after treatment, bone marrow was obtained and analyzed for antimony level (LMA group) by electrothermal atomic absorption spectrometry, and for the presence of Leishmania parasites (all groups). There was a significant increase of antimony concentration from 0.76 µg/kg wet organ (4 days after the first dose) to 2.07 µg/kg (4 days after the fourth dose) and a half-life of 4 days for antimony elimination from the bone marrow. Treatment with LMA significantly reduced the number of dogs positive for parasites (with at least one amastigote per 1000 host cells) compared to controls (positive dogs 30 days after treatment: 0 of 9 in the LMA group, 3 of 9 in the group treated with empty liposomes and 3 of 8 in the untreated group). However, complete elimination of parasites was not achieved. In conclusion, the present study showed that multiple dose treatment with LMA was effective in improving antimony levels in the bone marrow of dogs with visceral leishmaniasis and in reducing the number of positive animals, even though it was not sufficient to achieve complete elimination of parasites.